Detection of neuroblastoma in the bone marrow: biopsy versus aspiration.
OBJECTIVE
Multiple studies have emphasized the higher yield of detection of metastatic neuroblastoma (MNb) by bone marrow biopsy (BMB) than by bone marrow aspiration (BMA). Because the need for BMA has been questioned, the yield of both procedures was investigated at diagnosis and during the course of disease.


METHODS
For morphologic and immunohistochemical detection of MNb, 289 specimens obtained by BMA and BMB from 57 children with neuroblastoma were reviewed.


RESULTS
In 34% of cases, MNb was present in both the aspirate and biopsy specimen. MNb was present in only the biopsy specimen in 8% and in only the aspirate in 6%. In 52%, neither BMA nor BMB detected MNb. In 15 of 18 cases in which MNb was present in the aspirate only, protein gene product 9.5 (PGP) stain was performed on the biopsy specimen. In one case, this helped to identify MNb that was not evident by routine hematoxylin and eosin stain. Of the 24 cases in which only the BMB was positive, 3 were identified only by means of PGP stain.


CONCLUSIONS
Even with the additional use of immunohistochemistry, both BMA and BMB should be performed to have the highest yield of detection of MNb in bone marrow.
University of Pittsburgh Medical Center, Pennsylvania 15213, USA.
P A
PA
Aronica
V T
VT
Pirrotta
E J
EJ
Yunis
L
L
Penchansky
D001399:Azure Stains; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D001707:Biopsy, Needle; D001853:Bone Marrow / Q000737:chemistry / Q000473:pathology*; D001856:Bone Marrow Examination; D002675:Child, Preschool; D004273:DNA, Neoplasm / Q000032:analysis; D004801:Eosine Yellowish-(YS); D005069:Evaluation Studies as Topic; D005188:False Negative Reactions; D005260:Female; D006416:Hematoxylin; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D008297:Male; D009363:Neoplasm Proteins / Q000032:analysis; D014411:Neoplastic Stem Cells / Q000737:chemistry / Q000473:pathology; D009447:Neuroblastoma / Q000737:chemistry / Q000473:pathology*; D016133:Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D013194:Staining and Labeling / Q000379:methods; D013869:Thiolester Hydrolases / Q000032:analysis; D043222:Ubiquitin Thiolesterase
D001399:Azure Stains; D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm; D009363:Neoplasm Proteins; D013869:Thiolester Hydrolases; D043222:Ubiquitin Thiolesterase; D004801:Eosine Yellowish-(YS); D006416:Hematoxylin