Juneja S K, Wolf M M, Cooper I A
Haematology Research Unit, Peter MacCallum Cancer Institute, Melbourne, Australia.
J Clin Pathol. 1990 Aug;43(8):630-2. doi: 10.1136/jcp.43.8.630.
A study of 260 patients with non-Hodgkin's lymphoma (NHL) who underwent bilateral bone marrow biopsy at initial diagnosis showed marrow disease in 99 (38%) cases. The highest incidence of disease (83%) was seen in small lymphocytic lymphoma (SLL) and the lowest (19%) in diffuse large cell lymphoma (DLCL). Among cases with positive marrows, disease was bilateral in all 15 cases of SLL but in only 10 of 20 (50%) of the DLCL cases. In 30 of 99 (30%) positive marrows disease was unilateral. Follicular lymphomas were strongly associated with a paratrabecular pattern, with 40 of 45 positive cases showing this. Discordant histology was seen in six of 20 positive cases of DLCL and two of 37 positive cases of follicular small cleaved cell lymphomas (FSCCL). A bone marrow aspirate was positive in only 56 of the 99 (57%) cases. Peripheral blood disease was present in 15% of the bone marrow positive cases and in 6% of the cases overall. The incidence of marrow disease varies with the histological subtype of lymphoma. The paratrabecular pattern is associated with follicular lymphoma, and bilateral biopsy specimens increase the positivity rate in most subtypes of NHL.
一项针对260例初诊时接受双侧骨髓活检的非霍奇金淋巴瘤（NHL）患者的研究显示，99例（38%）存在骨髓病变。病变发生率最高的是小淋巴细胞淋巴瘤（SLL，83%），最低的是弥漫大细胞淋巴瘤（DLCL，19%）。在骨髓阳性的病例中，15例SLL均为双侧病变，而20例DLCL病例中只有10例（50%）为双侧病变。99例阳性骨髓病例中有30例（30%）为单侧病变。滤泡性淋巴瘤与小梁旁模式密切相关，45例阳性病例中有40例呈现此模式。20例阳性DLCL病例中有6例以及37例阳性滤泡性小裂细胞淋巴瘤（FSCCL）病例中有2例出现组织学不一致情况。99例病例中只有56例（57%）骨髓穿刺呈阳性。外周血病变在骨髓阳性病例中占15%，在所有病例中占6%。骨髓病变的发生率因淋巴瘤的组织学亚型而异。小梁旁模式与滤泡性淋巴瘤相关，双侧活检标本可提高大多数NHL亚型的阳性率。
