Ben-Ezra J M, King B E, Harris A C, Todd W M, Kornstein M J
Department of Pathology, Medical College of Virginia, Richmond.
Mod Pathol. 1994 Jun;7(5):560-4.
Lymphoid nodules in a bone marrow biopsy may be either benign or malignant. Morphological clues may help to differentiate the benign from the malignant nodules. However, it is sometimes difficult, if not impossible, to make this distinction, especially in patients with a known low-grade lymphocytic malignancy. This study was undertaken to determine whether staining bone marrow biopsies with an antibody to the bcl-2 protein might aid in making this differentiation. Using a monoclonal antibody to bcl-2, we stained 26 bone marrows with benign lymphoid aggregates, 19 with a follicular lymphoma, 10 with small lymphocytic lymphoma/chronic lymphocytic leukemia, three with other non-Hodgkin's lymphomas, and three with other miscellaneous hematopoietic lesions. Only one of the 26 benign lymphoid aggregates had moderate to intense staining with this antibody; in contrast, 79% of the follicular lymphomas stained positively. Eight of the 10 small lymphocytic lymphoma/chronic lymphocytic leukemia cases stained with moderate to intense intensity; the other two cases had weak staining. No consistent pattern was seen with the other six lesions. Based on this data, we conclude that lack of staining of small lymphoid aggregates within the bone marrow with the antibody to the bcl-2 protein is suggestive of a benign aggregate, whereas moderate to strong staining intensity is most consistent with a malignant process.
骨髓活检中的淋巴小结可能是良性的，也可能是恶性的。形态学线索可能有助于区分良性和恶性小结。然而，有时即使不是不可能，也很难做出这种区分，尤其是在已知患有低度淋巴细胞恶性肿瘤的患者中。本研究旨在确定用抗bcl-2蛋白抗体对骨髓活检进行染色是否有助于做出这种区分。我们使用抗bcl-2单克隆抗体对26例有良性淋巴聚集的骨髓、19例滤泡性淋巴瘤、10例小淋巴细胞淋巴瘤/慢性淋巴细胞白血病、3例其他非霍奇金淋巴瘤以及3例其他造血系统病变进行染色。26例良性淋巴聚集中只有1例对该抗体有中度至强染色；相比之下，79%的滤泡性淋巴瘤呈阳性染色。10例小淋巴细胞淋巴瘤/慢性淋巴细胞白血病病例中有8例染色强度为中度至强；另外2例染色较弱。其他6种病变未观察到一致的模式。基于这些数据，我们得出结论，骨髓内小淋巴聚集对bcl-2蛋白抗体无染色提示为良性聚集，而中度至强染色强度最符合恶性过程。
