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Frequencies and patterns of bone marrow involvement in non‐hodgkin lymphomas: Observations on the value of bilateral biopsies
Author(s) -
Coller Barry S.,
Chabner Bruce A.,
Gralnick Harvey R.
Publication year - 1977
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.2830030201
Subject(s) - lymphoma , medicine , pathology , histiocyte , bone marrow , biopsy
Pretreatment bone marrow biopsies and aspirations from 85 consecutive patients with non‐Hodgkin lymphoma were reviewed. All patients had at least one adequate biopsy. Criteria for involvement with lymphoma were clearly defined. The frequencies and morphologic patterns of involvement correlated with the lymph node diagnoses assigned according to Rappaport's classification. Diffuse, well‐differentiated lymphocytic and diffuse mixed lymphocytic‐histiocytic lymphoma were most frequently involved (100%), followed by diffuse, poorly differentiated lymphocytic (56%), nodular, poorly differentiated lymphocytic (39%), diffuse undifferentiated (33%), diffuse histiocytic (25%), and nodular mixed lymphocytic‐histiocytic lymphoma (23%). Each of the histologic subtypes tended to have an identifiable pattern of bone marrow involvement. Most striking was a predominance of paratrabecular localization of lymphoma in patients with nodular, poorly differentiated lymphocytic lymphoma. Biopsies were superior to both clot sections and aspirate smears in making the diagnosis of lymphoma in all subtypes, but discrepancies were more common in the nodular than in the diffuse lymphomas. A total of 52 pretreatment bilateral bone marrow biopsies from patients with non‐Hodgkin lymphoma were reviewed for concordance of diagnoses. In five patients, one biopsy was positive for lymphoma while the other was negative. Four of the five patients had histiocytic lymphoma, and the other had nodular mixed lymphoma. In two of these patients the bone marrow examination obviated the need for more invasive procedures to establish stage IV disease. We concluded that bone marrow biopsies are necessary for staging non‐Hodgkin lymphomas and that bilateral biopsies are most useful in the histiocytic subclass.