title: Dealing with bone marrow biopsies in the staging of classical Hodgkin lymphoma: an old issue revisited in the (18)F-fluorodeoxyglucose-positron emission tomography era.
abstract: Bone marrow biopsy is recommended for staging of classical Hodgkin lymphoma. The aim of this study was to compare bone marrow evaluation by histology with that obtained by (18)F-fluorodeoxyglucose-positron emission tomography (FDG-PET). One hundred and three cases of Classical Hodgkin Lymphoma were reviewed. All patients were submitted to FDG-PET evaluation. Bone marrow biopsy results were compared with clinical data and FDG-PET results. Ninety-one cases had available bone marrow biopsies. Overall, there were 16 positive and one suspect case. In five cases, the FDG-PET scan was positive and biopsy was negative: 1/5 was found to correspond to a bone fracture, 3/5 showed marked reactive bone marrow changes and in 1/5 no explanation for the discrepancy was found. FDG-PET showed high sensitivity, supporting the idea that when it is negative, biopsy could be avoided. Care should be taken in patients with a positive FDG-PET, where confirmation by bone marrow biopsy should be recommended.
authors.affiliation: a Pathology, Clinics Hospital, University of Sao Paulo Medical School , Sao Paulo , Brazil.
authors.forename: Marianne de Castro
authors.initials: Mde C
authors.lastname: Gonçalves
authors.affiliation: b Pathology, University of Goias Medical School , Goiania , Brazil.
authors.forename: Henrique Moura
authors.initials: HM
authors.lastname: de Paula
authors.affiliation: c Hematology, Clinics Hospital, University of Sao Paulo Medical School , Sao Paulo , Brazil.
authors.forename: Camila da Cruz Gouveia
authors.initials: Cda C
authors.lastname: Linardi
authors.affiliation: d Division of PET/CT, Quanta - Diagnóstico Nuclear , Curitiba , Brazil.
authors.forename: Juliano J
authors.initials: JJ
authors.lastname: Cerci
authors.affiliation: e Pathology, University of São Paulo , São Paulo , Brazil.
authors.forename: Vera Lucia
authors.initials: VL
authors.lastname: Aldred
authors.affiliation: a Pathology, Clinics Hospital, University of Sao Paulo Medical School , Sao Paulo , Brazil.
authors.forename: Sheila Aparecida Coelho
authors.initials: SA
authors.lastname: Siqueira
authors.affiliation: c Hematology, Clinics Hospital, University of Sao Paulo Medical School , Sao Paulo , Brazil.
authors.forename: Valeria
authors.initials: V
authors.lastname: Buccheri
authors.affiliation: a Pathology, Clinics Hospital, University of Sao Paulo Medical School , Sao Paulo , Brazil.
authors.forename: Maria Claudia Nogueira
authors.initials: MC
authors.lastname: Zerbini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods; D001853:Bone Marrow / Q000473:pathology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: Lymphoma and Hodgkin disease; morphology; prognostication