title: Bone marrow diagnosis in lymphoproliferative disorders: comparison of results obtained from conventional histomorphology and immunohistology.
abstract: In this study we have investigated 313 bone marrow biopsies from 280 patients with lymphoproliferative disorders. Trephines were sectioned transversely to obtain one cylinder for cryostat sectioning and immunostaining and a second for histomorphological evaluation using a plastic-embedding technique. The results obtained by histomorphological and immunohistological evaluation were compared for their contribution to staging and classification. Using both techniques, bone marrow involvement was seen in 3/43 (7.0%) biopsies from patients with Hodgkin's disease and in 193/270 (71.5%) cases with non-Hodgkin's lymphoma, including multiple myeloma and acute lymphocytic leukaemia. Immunohistology proved superior in detecting minimal mainly interstitial bone marrow infiltration in 15 leukaemia/lymphoma cases. Biopsies showing infiltration with both methods (n = 157) were re-examined for classification of lymphomatous infiltrates. Whereas immunohistology did not provide additional information in cases with Hodgkin's disease and myeloma, this method was crucial for establishing the definitive diagnosis in a number of cases with acute lymphocytic leukaemia and non-Hodgkin's lymphoma. In all of six leukaemia cases, in which no or inadequate material was available for immunophenotyping of cell suspensions, immunohistology clearly defined the subtype. In the 140 cases of non-Hodgkin's lymphoma the majority of cases (76.4%) were identically classified. In some cases, with important prognostic and therapeutic implications, immunohistology alone provided the definitive diagnosis: T-cell lymphoma (n = 2), hairy cell leukaemia (n = 2) and centrocytic non-Hodgkin's lymphoma (n = 3). Bone marrow immunohistology is, therefore, an important supplement for classical lymphoma/leukaemia diagnosis. The differences observed between histomorphology and immunohistology emphasize the importance of lymph node biopsy in lymphoma classification.
authors.affiliation: Department of Internal Medicine, University Hospital, Innsbruck, Austria.
authors.forename: J
authors.initials: J
authors.lastname: Thaler
authors.forename: O
authors.initials: O
authors.lastname: Dietze
authors.forename: H
authors.initials: H
authors.lastname: Denz
authors.forename: R
authors.initials: R
authors.lastname: Demuth
authors.forename: D
authors.initials: D
authors.lastname: Nachbaur
authors.forename: R
authors.initials: R
authors.lastname: Stauder
authors.forename: H
authors.initials: H
authors.lastname: Huber
mesh_terms: D015415:Biomarkers; D001706:Biopsy / Q000379:methods; D001853:Bone Marrow / Q000473:pathology*; D006652:Histological Techniques; D006801:Humans; D007124:Immunoenzyme Techniques; D008232:Lymphoproliferative Disorders / Q000145:classification / Q000473:pathology*
chemical_list: D015415:Biomarkers