Common pitfalls in bone marrow biopsy based diagnostic approach

1. Bone marrow biopsy is the gold standard for diagnosing many hematological diseases but can have pitfalls in interpretation if not done or interpreted properly. 2. Key factors that can limit interpretation include inadequate clinical information, small or distorted specimen, limited staining, and insufficient experience. 3. Specialized ancillary tests like cytogenetics, immunophenotyping, and immunohistochemistry are often needed to make an accurate diagnosis when morphology is inconclusive or to differentiate between possible conditions. 4. A systematic approach incorporating clinical findings and additional test results is important to avoid common pitfalls like misdiagnosing infiltration, fibrosis, or focal lesions.