Saleem Ahmed Khan, Mumtaz Ahmed, Saeed Afzal, Shehzad Saeed, Azhar Mubarik, Masood Anwar.
Fever of unknown origin (FUO) — role of bone marrow trephine biopsy examination
Pak J Pathol Jul - Sep 2004;15(3):100-4.
Armed Forces Institute of Pathology, Rawalpindi

A retrospective descriptive study was carried out from July 2001 to June 2004 at Pathology department of Army Medical College, Rawalpindi to see the usefulness of bone marrow trephine biopsy in the diagnosis of `FUO` in our setup. A total of 148 cases were investigated. Bone marrow biopsy was taken from posterior iliac spine of patients of all age groups and both sexes. Male to female ratio was 2.9: 1. Majority of the cases were seen between 2nd and 4th decades of life. Bone marrow aspirate was suggestive of abnormal lymphoid infiltrate and metastatic bone disease in 7(4.73%) cases only. Bone marrow trephine examination was diagnostic in 46(31.08%) cases whereas 102(68.91%) were undiagnosed. Out of diagnostic yield 20(13.50%) patients had granulomatous inflammation, 14(9.46%) cases were suggestive of Non-Hodgkin`s lymphoma and 2(1.34%) were diagnosed as Hodgkin`s lymphoma. Metastatic disease and myelofibrosis were seen in 3(2.08%) and 7(4.71%) cases respectively. To conclude,bon marrow trephine biopsy is an essential tool in the diagnosis of `FUO`. It is superior than bone marrow aspiration. Most common cause of `FUO` in this series was tuberculosis followed by non —Hodgkin lymphoma, Hodgkin`s disease and metastatic tumour.

Category: Internal Medicine
Keywords: Fever of Unknown Origin. Bone Marrow Biopsy.

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