title: CD34/QBEND10 immunostaining in the bone marrow trephine biopsy: a study of CD34-positive mononuclear cells and megakaryocytes.
abstract: BACKGROUND
  The immunohistochemical detection of CD34 protein using QBEND10 antibody in bone marrow trephine biopsies was shown recently to be a precise method for quantitation of blasts and a possibly useful approach in diagnosis and classification of myelodysplastic syndrome.
  
  
  OBJECTIVE
  To evaluate CD34+ cells in bone marrow biopsies with various diagnoses and to assess how counts obtained using this method correlate with blast counts obtained by traditional morphologic evaluation of bone marrow smears.
  
  
  METHODS
  Bone marrow trephine biopsies from 108 adult patients were evaluated by immunohistochemistry using anti-CD34 antibody (QBEND10). CD34+ mononuclear cells were counted and compared with the blast counts in the bone marrow aspirate smears or imprints. CD34+ mononuclear cell clusters and CD34+ megakaryocytes were also recorded. The type of positivity (membranous vs cytoplasmic) and the percentage of CD34+ megakaryocytes were evaluated because the presence of CD34+ megakaryocytes was recently suggested to be present in myelodysplastic syndrome, but not in myeloproliferative disease or nonneoplastic bone marrow.
  
  
  RESULTS
  Six of 24 biopsies with partial involvement by non-Hodgkin lymphoma and 5 of 60 biopsies with reactive changes had 5% to 10% CD34+ mononuclear cells and were associated with lymphocytosis and increased hematogones. The CD34+ mononuclear cell clusters were found only in myelodysplastic syndrome and myeloproliferative disease. The CD34+ megakaryocytes were present in all diagnostic groups.
  
  
  CONCLUSIONS
  The number of CD34+ mononuclear cells was often slightly higher than the number of myeloid blasts in the bone marrow smears, probably due to increased hematogones. The presence and the number of CD34+ megakaryocytes do not appear to have diagnostic value, but this finding should be further investigated in relation to clinical parameters.
authors.affiliation: Department of Pathology, The Norwegian Radium Hospital, Oslo, Norway.
authors.forename: Goran
authors.initials: G
authors.lastname: Torlakovic
authors.forename: Ruth
authors.initials: R
authors.lastname: Langholm
authors.forename: Emina
authors.initials: E
authors.lastname: Torlakovic
mesh_terms: D000911:Antibodies, Monoclonal / Q000276:immunology; D000918:Antibody Specificity; D018952:Antigens, CD34 / Q000276:immunology / Q000378:metabolism*; D001706:Biopsy; D001854:Bone Marrow Cells / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D007958:Leukocyte Count / Q000379:methods; D007963:Leukocytes, Mononuclear / Q000378:metabolism* / Q000473:pathology; D008533:Megakaryocytes / Q000378:metabolism* / Q000473:pathology; D009190:Myelodysplastic Syndromes / Q000378:metabolism / Q000473:pathology; D014207:Trephining
chemical_list: D000911:Antibodies, Monoclonal; D018952:Antigens, CD34