title: Discordant bone marrow involvement in non-Hodgkin lymphoma.
abstract: A discordant lymphoma occurs where 2 distinct histologic subtypes coexist in at least 2 separate anatomic sites. Histologic discordance is most commonly observed between the bone marrow (BM) and lymph nodes (LNs), where typically aggressive lymphoma is found in a LN biopsy with indolent lymphoma in a BM biopsy. Although the diagnosis of discordance relied heavily on histopathology alone in the past, the availability of flow cytometry and molecular studies have aided the identification of this entity. The true prevalence and clinical ramifications of discordance remain controversial as available data are principally retrospective, and there is therefore little consensus to guide optimal management strategies. In this review, we examine the available literature on discordant lymphoma and its outcome, and discuss current therapeutic approaches. Future studies in discordant lymphoma should ideally focus on a large series of patients with adequate tissue samples and incorporate molecular analyses.
authors.affiliation: Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD;
authors.forename: Jennifer
authors.initials: J
authors.lastname: Brudno
authors.affiliation: Hematology Unit, Bnai Zion Medical Center and The Ruth and Bruce Rappaport Faculty of Medicine, Technion Haifa, Haifa, Israel;
authors.forename: Tamar
authors.initials: T
authors.lastname: Tadmor
authors.affiliation: Hematopathology Section, Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, Bethesda, MD; and.
authors.forename: Stefania
authors.initials: S
authors.lastname: Pittaluga
authors.affiliation: Hematopathology Section, Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, Bethesda, MD; and.
authors.forename: Alina
authors.initials: A
authors.lastname: Nicolae
authors.affiliation: Department of Hematology, Hadassah University, Hospital and Hebrew University Medical School, Jerusalem, Israel.
authors.forename: Aaron
authors.initials: A
authors.lastname: Polliack
authors.affiliation: Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD;
authors.forename: Kieron
authors.initials: K
authors.lastname: Dunleavy
mesh_terms: D001853:Bone Marrow / Q000473:pathology*; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008228:Lymphoma, Non-Hodgkin / Q000473:pathology*