A review of histology of bone marrow trephine in malignant lymphomas.

BACKGROUND

To investigate the prevalence and pattern of bone marrow involvement and its effects on the peripheral blood counts of malignant lymphoma patients.

METHODS

A prospective study of patients with histologically confirmed malignant lymphomas that presented from January 1994 to December, 1999 at the Department of Haematology, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife. Patients underwent routine investigations such as packed cell volume (PCV); white blood cell counts (total and differentials), and platelet counts. Bone marrow aspirates and trephine biopsies were carried out on admission. Histological classification was based on the working formulation, while clinical staging was based on the Ann Arbor classification. The data collected was analysed using simple statistical methods and Epi info 6. (World Health Organisation), Geneva, Center for disease control (CDC), Atlanta, USA (1994) statistical software was used for all statistical analysis.

RESULTS

Out of the thirty cases (19 males and 11 females) of lymphoma that were studied, twenty-four (80%) were Non Hodgkins lymphoma (NHL) and 6 (20%) were Hodgkins disease (HD). In the NHLs, age range was 18-75 years with a median of 50 years with sixteen males and eight females, male:female ratio 2:1. Twelve of the patients had marrow involvement and were low-grade indolent disease. The most common pattern of marrow involvement in NHL was diffuse type. In HD, the age range was 18-65 years with a median of 45.5 years. There were three females and three males with M:F of 1:1. The most common pattern of marrow involvement was mixed cellularity in four patients, while one patient had lymphocyte predominant and the other lymphocyte depleted. In all cases with marrow involvement there were varying degrees of marrow suppression as reflected by anaemia and thrombocytopaenia, and in one pancytopaenia.

CONCLUSION

Bone marrow examination is an important aspect in the diagnosis of patients with malignant lymphoma and there is superiority of trephine biopsy over the aspiration biopsy.