Kalra Supreet Kaur, Sancheti Sankalp, Somal Puneet Kaur, Sali Akash Pramod, Sharma Aishwarya, Goel Alok, Jain Shivani, Dora Tapas Kumar, Gulia Ashish, Divetia Jigeeshu V
Department of Pathology, Homi Bhabha Cancer Hospital and Research Centre (a unit of Tata Memorial Centre), Sangrur, Punjab, India.
Department of Medical Oncology, Homi Bhabha Cancer Hospital and Research Centre (a unit of Tata Memorial Centre), Sangrur, Punjab, India.
J Lab Physicians. 2022 Aug 17;15(1):69-77. doi: 10.1055/s-0042-1751318. eCollection 2023 Mar.
The evaluation of bone marrow (BM) status is an integral part of the initial workup of patients diagnosed with lymphoma as it plays an important role in staging and predicting prognosis in these patients. This article determines the incidence and pattern of BM involvement in lymphoma cases and distinguishes benign from malignant lymphoid aggregates in BM biopsies. The study group included 121 cases of Hodgkin and non-Hodgkin lymphomas for which BM biopsies were performed, fixed in acetic acid-zinc formalin solution, decalcified using 10% formic acid, and subjected to hematoxylin and eosin and immunohistochemistry. The overall incidence of BM biopsy involvement in our study was 31.4% (37/118), including 34.7% (35/101) in cases of B cell lymphomas, 25% (2/8) in cases of T cell lymphomas, and no involvement in Hodgkin lymphoma. The predominant histological pattern of BM involvement was diffused (14/37; 37.8%), followed by interstitial (10/37; 27.1%). Five cases revealed benign nonparatrabecular lymphoid aggregates which could be confused with lymphomatous involvement, especially in low grade lymphomas. A careful examination of the BM biopsies along with clinical history, peripheral blood examination, flow cytometry, and immunohistochemistry will help in arriving at the correct diagnosis.
评估骨髓（BM）状态是淋巴瘤确诊患者初始检查的一个重要组成部分，因为它在这些患者的分期和预后预测中起着重要作用。本文确定了淋巴瘤病例中骨髓受累的发生率和模式，并在骨髓活检中区分良性与恶性淋巴样聚集物。
研究组包括121例进行了骨髓活检的霍奇金淋巴瘤和非霍奇金淋巴瘤病例，活检组织用乙酸 - 锌福尔马林溶液固定，用10%甲酸脱钙，然后进行苏木精 - 伊红染色和免疫组织化学检查。
在我们的研究中，骨髓活检受累的总体发生率为31.4%（37/118），其中B细胞淋巴瘤病例的发生率为34.7%（35/101），T细胞淋巴瘤病例的发生率为25%（2/8），霍奇金淋巴瘤未出现骨髓受累情况。骨髓受累的主要组织学模式为弥漫性（14/37；37.8%），其次为间质型（10/37；27.1%）。5例显示良性非小梁旁淋巴样聚集物，可能会与淋巴瘤浸润相混淆，尤其是在低级别淋巴瘤中。
仔细检查骨髓活检组织并结合临床病史、外周血检查、流式细胞术和免疫组织化学将有助于做出正确诊断。
