Comparison of the efficacies of closed trephine needle biopsy, aspirated paraffin-embedded clot section, and smear preparation in the diagnosis of bone-marrow involvement by lymphoma.

Bone marrow aspirates totaling 1,024 and trephine biopsies totaling 386 were obtained from 234 patients with various diagnoses of lymphoma. The study analyzed the morphologic patterns of bone-marrow involvement by each entity and compared the sensitivity of aspiration versus biopsy for detecting lymphomatous involvement of bone marrow. Lymphoma may appear in one of three forms: nodular, diffuse (packed bone marrow), and diffusely infiltrative. Trephine biopsy was superior to aspiration in most instances, especially for the nodular form. In some cases, however, examination of paraffin-embedded clot sections and smears was diagnostic of lymphoma whereas the biopsy section appeared negative.