Q. The reports of bone marrow aspiration and biopsy differ. How?

Answered by
Dr. Parth R Goswami
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Apr 15, 2017 and last reviewed on: Oct 09, 2018

Hi doctor,

Bone marrow aspiration twice showed hypercellular bone marrow with overgrowth of WBC and megakaryocytes with all stages of maturing including micromegakaryocytes. But at the same time, the second BMA during bone marrow biopsy showed normocellular bone marrow. Is something like that possible? Can it be due to any mistake during the reading of BMB sample? The doctor who made BMA and BMB told that the patient has no fat in the bone marrow. The health position of the patient is worsening, the bone pain, fatigue, abdominal pain is more and more intensive. Can you give an explanation for this?



Welcome to

  • You have not mentioned the age of the patient, peripheral smear, and CBC (complete blood count) findings.
  • You have mentioned that bone marrow was showing overgrowth of the WBC (white blood cells) and micromegakaryocytes. So, it is a myeloproliferative condition.
  • Here, clinical correlation is necessary. If it is in an infective condition, then also more WBC series cells will be produced.
  • Bone pain, fatigue history, and micromegakaryocytes present along with hypercellular bone marrow. Hence, myeloproliferative neoplasm or myelodysplasia needs to be ruled out.
  • For that, CBC, peripheral smear examination and ESR (erythrocyte sedimentation rate) should be done first along with liver, spleen and lymph node palpation as primary work up.
  • The two consecutive bone marrow aspiration findings can be different if done with a long time interval in between.
  • If bone marrow biopsy is done and sent for histopathology examination, then it is more confirmative.
  • You can provide bone marrow report and CBC report as an attachment along with other clinical histories for more comment. Take care.

Revert with the reports to a hematologist online -->

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