title: Multiple lymphoid nodules in bone marrow have the same clonality as underlying myelodysplastic syndrome recognized with fluorescent in situ hybridization technique.
abstract: Benign nodular lymphoid lesions are not rare in the bone marrow of patients with myelodysplastic syndrome (MDS). Herein, we report a case of MDS with clonal lymphoid aggregates in the bone marrow but without evidence of systemic lymphoma. The case of a 71-year-old man was evaluated for cytopenia. His bone marrow was initially hypocellular, with 10% blasts and a few small lymphoid aggregates. The diagnosis of refractory anemia with excess blasts was made. The disease progressed gradually, and he received erythropoietin and granulocyte colony-stimulating factor for a short time. Forty-two months later, acute leukemia (M1) developed, with 60% to 70% blasts in the bone marrow. The bone marrow also showed large aggregates of lymphocytes. Immunohistochemical study of these cells in the nodular lesions showed 50% CD3+ and 50% CD20+. Cytogenetic and molecular genetic studies revealed monosomy 7 and T- and B-cell clonal gene rearrangement. Fluorescent in situ hybridization study with centromere-specific probes of a bone marrow specimen showed monosomy 7 in both nodular lymphoid lesions and surrounding bone marrow cells, indicating that both processes originated from the same abnormal pluripotential progenitor.
authors.affiliation: Division of Hematopathology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
authors.forename: W
authors.initials: W
authors.lastname: Mongkonsritragoon
authors.forename: L
authors.initials: L
authors.lastname: Letendre
authors.forename: C Y
authors.initials: CY
authors.lastname: Li
mesh_terms: D000368:Aged; D015139:Blotting, Southern; D001854:Bone Marrow Cells / Q000473:pathology*; D002503:Centromere; D002999:Clone Cells / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D008221:Lymphoid Tissue / Q000473:pathology*; D008297:Male; D009190:Myelodysplastic Syndromes / Q000235:genetics / Q000473:pathology*