Combined utility of gene rearrangement analysis and flow cytometry in the diagnosis of lymphoproliferative disease in the bone marrow.
The diagnosis of lymphoma involving bone marrow is often complicated by the presence of nonspecific lymphoid aggregates. Morphologic criteria may not permit the distinction of benign from malignant lymphoid aggregates with certainty in all cases. We combined morphology with immunophenotypic and immunogenotypic analyses of aspirated marrow cells to develop more reliable criteria for the diagnosis of marrow involvement by lymphoma. The presence of morphologically recognizable lymphoma cells in the bone marrow aspirate was always confirmed by immunogenotypic analysis. The yield of either immunophenotypic or immunogenotypic analyses on morphologically negative marrows was very low. Focal paratrabecular involvement by lymphoma was not always confirmed by immunophenotypic or immunogenotypic analyses, probably due to sampling error and factors interfering with aspiration of the lymphoid aggregates. Thus, the immunologic and molecular studies supported, but did not substantially improve upon the morphologic criteria that are in common usage for distinguishing benign from malignant lymphoid aggregates in the bone marrow. Finally, evidence of B-lymphocyte clonality was obtained in four of five cases in which there were nonspecific lymphoid aggregates in the bone marrow in the absence of otherwise clinically definable malignancy.
Sandhaus
L M
LM
Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, Piscataway.
Voelkerding
K V
KV
Dougherty
J
J
Raska
K
K
D000368:Aged; D001707:Biopsy, Needle; D001855:Bone Marrow Diseases / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D005260:Female; D005434:Flow Cytometry; D015321:Gene Rearrangement / Q000235:genetics*; D005838:Genotype; D006801:Humans; D007124:Immunoenzyme Techniques; D016130:Immunophenotyping; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D008297:Male