Subramanian Rajiv, Basu Debdatta, Badhe Bhawana, Dutta Tarun K
Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry.
Indian J Pathol Microbiol. 2007 Jul;50(3):640-3.
Bone marrow involvement in Hodgkin's disease alters the stage and hence the prognosis and treatment modality. Seventy-six patients of biopsy proven Hodgkin's disease in whom a bone marrow aspiration and biopsy were done simultaneously at the time of diagnosis were included in the study. Bone marrow involvement was seen in 14 (18%) cases. All 14 cases were diagnosed on biopsy. Only one aspirate was suspicious of involvement. Rest was either diluted (28%) or was normal (64%). Eleven patients were upstaged from stage I, II and III to stage IV. All patients had cytopenia of one or more cell line. Increased fibrosis, necrosis and a polymorphic cellular infiltrate were associated findings in the marrow. We wish to highlight the importance of bone marrow trephine biopsy over aspirate in staging even clinically early stage Hodgkin's disease.
霍奇金淋巴瘤的骨髓受累会改变分期，进而影响预后和治疗方式。本研究纳入了76例经活检证实为霍奇金淋巴瘤的患者，这些患者在诊断时同时进行了骨髓穿刺和活检。14例（18%）患者出现骨髓受累。所有14例均经活检确诊。仅1例穿刺结果怀疑有受累。其余要么稀释（28%）要么正常（64%）。11例患者从Ⅰ期、Ⅱ期和Ⅲ期上调至Ⅳ期。所有患者均有一个或多个细胞系的血细胞减少。骨髓中可见纤维化、坏死增加以及多形性细胞浸润等相关表现。我们希望强调骨髓环钻活检在霍奇金淋巴瘤分期中的重要性，即使是临床早期病例，其重要性也高于骨髓穿刺。
