[The morphological assessment of bone marrow infiltration in neuroblastoma].
Bone marrow biopsy is very important in diagnosis and follow-up of children affected by neuroblastoma (NB). Between June 1995 and May 1997 we studied 55 patients with NB stage 4. Specimens were obtained at the diagnosis (in 8 patients) and after chemotherapy (in 55 patients) in order to evaluate the effects of treatment on bone marrow disease. 88% of 343 biopsies were representative versus 99% of 639 aspirates. Of 8 stage 4 patients evaluated at diagnosis, 15/16 biopsies versus 9/15 aspirates were positive. Following chemotherapy, out of 298 evaluable sites examined, 111 biopsies versus 30 aspirates (37 versus 10%) were positive. Of 111 positive biopsies 53 showed a focal pattern (35 differentiated, 18 undifferentiated), while 51 showed a diffuse pattern (18 differentiated, 40 undifferentiated). Our results confirm previous literature data indicating a better efficacy of histology versus morphology in detecting residual bone marrow disease (especially in case of focal differentiated pattern). The recent introduction of a specific monoclonal antibody, called anti-GD2, has improved our capacity to detect minimal residual disease in patients' bone marrow. The inclusion of anti-GD2 immunohistochemistry in our evaluation will possibly increase our overall sensitivity to detect minimal residual disease and may provide information capable to direct the physician's decision into a more rational patient's treatment.
Brisigotti
M
M
1o Servizio di Anatomia Patologica, Spedali Civili di Brescia, Italia.
Medicina
D
D
Bercich
L
L
Bonetti
M F
MF
Fabbretti
G
G
Gambini
C
C
Lo Piccolo
M S
MS
Milanaccio
C
C
Rosanda
C
C
Garaventa
A
A
De Bernardi
B
B
Callea
F
F
D000293:Adolescent; D001707:Biopsy, Needle; D001853:Bone Marrow / Q000378:metabolism / Q000473:pathology; D019046:Bone Marrow Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000556:secondary*; D001842:Bone and Bones / Q000378:metabolism / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006652:Histological Techniques; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D018365:Neoplasm, Residual; D009423:Nervous System Neoplasms / Q000378:metabolism / Q000473:pathology*; D009447:Neuroblastoma / Q000378:metabolism / Q000473:pathology* / Q000556:secondary*