title: Histology and immunohistology of bone marrow biopsy in multiple myeloma.
abstract: B5-fixed/paraffin-embedded Jamshidi needle biopsies from 125 multiple myeloma patients were reviewed according to both morphological and immunohistological criteria. At microscopic examination, the following parameters were evaluated: i) grade of malignancy (low = 56; intermediate = 50; high = 19); ii) growth pattern (interstitial +/- sheets/nodules = 90; nodular = 13; packed marrow = 18; sarcomatous = 4); III) histological stage (I = 64; II = 35; III = 26). Comparison of the findings in trephine biopsies and aspirates showed that in 30% of the cases the latter led to an underestimation of the tumor burden. Immunohistochemical determination of Ig easily allowed: i) differential diagnosis from exuberant reactive plasmacytosis; ii) recognition and counting of neoplastic plasma cells; iii) detection of minimal residual disease after treatment. Immunohistochemistry also confirmed phenotypic aberration of neoplastic plasma cells, showing positivity for CD45, EMA, and cytokeratins in 14%, 59%, and 25% of the cases, respectively. Furthermore, it displayed expression of the P-glycoprotein in 4/8 resistant cases. These findings underline that routinely processed Jamshidi needle biopsies can be of great value in the study of patients with multiple myeloma.
authors.forename: S
authors.initials: S
authors.lastname: Pileri
authors.forename: S
authors.initials: S
authors.lastname: Poggi
authors.forename: P
authors.initials: P
authors.lastname: Baglioni
authors.forename: M
authors.initials: M
authors.lastname: Montanari
authors.forename: E
authors.initials: E
authors.lastname: Sabattini
authors.forename: P
authors.initials: P
authors.lastname: Galieni
authors.forename: P L
authors.initials: PL
authors.lastname: Tazzari
authors.forename: M
authors.initials: M
authors.lastname: Gobbi
authors.forename: M
authors.initials: M
authors.lastname: Cavo
authors.forename: B
authors.initials: B
authors.lastname: Falini
mesh_terms: D000208:Acute Disease; D000951:Antigens, Neoplasm / Q000032:analysis; D001707:Biopsy, Needle; D001853:Bone Marrow / Q000276:immunology / Q000473:pathology*; D001856:Bone Marrow Examination / Q000379:methods*; D006689:Hodgkin Disease / Q000175:diagnosis; D006801:Humans; D007150:Immunohistochemistry; D007938:Leukemia / Q000175:diagnosis; D009101:Multiple Myeloma / Q000175:diagnosis / Q000276:immunology / Q000473:pathology*; D009363:Neoplasm Proteins / Q000032:analysis; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis
chemical_list: D000951:Antigens, Neoplasm; D009363:Neoplasm Proteins