title: Loss of utility of bone marrow biopsy as a staging evaluation for Hodgkin lymphoma in the positron emission tomography-computed tomography era: a West of Scotland study.
abstract: Abstract Positron emission tomography-computed tomography (PET-CT) scanning has been shown to be more sensitive than bone marrow biopsy (BMB) in detecting bone marrow involvement (BMI) in classical Hodgkin lymphoma (cHL). In this 5-year retrospective series, 93 (54%) of all new cases of cHL were staged using PET-CT and BMB. PET-CT identified focal bone marrow uptake in 17/93 (18.3%), whilst only five of these (29.4%) were confirmed by BMB. Abnormal pelvic uptake was seen on PET-CT in these five cases. The other 12 cases were missed, giving BMB a sensitivity of 29.4% and a specificity of 100%. PET-CT upstaged 9.7% of patients compared to CT alone. BMB upstaged only one patient; however, this patient was already stage IV on PET-CT. BMB did not alter clinical management in any case. Bone positivity on PET-CT appeared to correlate with anemia, raised lactate dehydrogenase (LDH) and B symptoms. BMB has little or nothing to offer staging cHL in the PET-CT era.
authors.affiliation: Department of Hematology.
authors.forename: Róisín
authors.initials: R
authors.lastname: Hamilton
authors.forename: Iain
authors.initials: I
authors.lastname: Andrews
authors.forename: Pamela
authors.initials: P
authors.lastname: McKay
authors.forename: Mike
authors.initials: M
authors.lastname: Leach
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000592:standards; D001853:Bone Marrow / Q000473:pathology*; D005260:Female; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000592:standards; D049268:Positron-Emission Tomography; D015203:Reproducibility of Results; D012606:Scotland; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D055815:Young Adult