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Review

Diagnosis and Classification of Malignant Lymphoma and Related Entities in the Bone Marrow Trephine Biopsy

Fend F. · Kremer M.

Author affiliations

Institute of Pathology, Technical University Munich, Munich, Germany

Corresponding Author

Falko Fend, MD

Institute of Pathology, Technical University Munich

Ismaningerstrasse 22

DE–81675 Munich (Germany)

Tel. +49 89 4140 4162, Fax +49 89 4140 4865, E-Mail fend@lrz.tum.de

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Pathobiology 2007;74:133–143

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Abstract

The trephine bone marrow (BM) biopsy is an important diagnostic tool in patients with malignant lymphoma. BM examination can serve to establish or confirm a primary diagnosis of lymphoma or to determine the extent of disease dissemination for staging purposes. BM histology renders information which cannot be gained equally from aspirate material, such as spacial distribution and extent of infiltrates, BM cellularity and fibrosis. Furthermore, cytology including flow cytometric immunophenotyping can give false-negative results in BM involvement by lymphoma due to intralesional fibrosis. In addition to morphological examination, the availability of a broad panel of antibodies suitable for paraffin-embedded tissues, in conjunction with less damaging decalcification procedures, nowadays enables us to perform complete immunophenotyping on BM trephines and allows for classification of lymphoma infiltrates according to established algorithms. Molecular determination of clonality and interphase fluorescent in situ hybridization can be employed selectively to resolve difficult cases. This review describes important diagnostic features of malignant lymphoma in the BM, relevant differential diagnoses, and the proper use of ancillary techniques.

© 2007 S. Karger AG, Basel


References

  1. Brunning R, McKenna R: Bone marrow lymphomas; in Brunning R, McKenna RW (eds): Tumors of the Bone Marrow, Atlas of Tumor Pathology, Third Series. Washington, Armed Forces Institute of Pathology, 1994, pp 369–408.
  2. Bain BJ: Bone marrow trephine biopsy. J Clin Pathol 2001;54:737–742.
  3. Foucar K: Bone Marrow Pathology. Chicago, ASCP Press, 2001.
  4. Schmid C, Isaacson PG: Bone marrow trephine biopsy in lymphoproliferative disease. J Clin Pathol 1992;45:745–750.
  5. Crotty PL, Smith BR, Tallini G: Morphologic, immunophenotypic, and molecular evaluation of bone marrow involvement in non-Hodgkin’s lymphoma. Diagn Mol Pathol 1998;7:90–95.
  6. Henrique R, Achten R, Maes B, Verhoef G, De Wolf-Peeters C: Guidelines for subtyping small B-cell lymphomas in bone marrow biopsies. Virchows Arch 1999;435:549–558.
  7. Kremer M, Quintanilla-Martinez L, Nahrig J, von Schilling C, Fend F: Immunohistochemistry in bone marrow pathology: a useful adjunct for morphologic diagnosis. Virchows Arch 2005;447:920–937.
  8. Hanson CA, Kurtin PJ, Katzmann JA, Hoyer JD, Li CY, Hodnefield JM, Meyers CH, Habermann TM, Witzig TE: Immunophenotypic analysis of peripheral blood and bone marrow in the staging of B-cell malignant lymphoma. Blood 1999;94:3889–3896.
  9. Perea G, Altes A, Bellido M, Aventin A, Bordes R, Ayats R, Remacha AF, Espinosa I, Briones J, Sierra J, Nomdedeu JF: Clinical utility of bone marrow flow cytometry in B-cell non-Hodgkin lymphomas. Histopathology 2004;45:268–274.
  10. Schmidt B, Kremer M, Gotze K, John K, Peschel C, Hofler H, Fend F: Bone marrow involvement in follicular lymphoma: comparison of histology and flow cytometry as staging procedures. Leuk Lymphoma 2006;47:1857–1862.
  11. Campbell JK, Matthews JP, Seymour JF, Wolf MM, Juneja SK: Optimum trephine length in the assessment of bone marrow involvement in patients with diffuse large cell lymphoma. Ann Oncol 2003;14:273–276.
  12. Cheson BD, Horning SJ, Coiffier B, Shipp MA, Fisher RI, Connors JM, Lister TA, Vose J, Grillo-Lopez A, Hagenbeek A, Cabanillas F, Klippensten D, Hiddemann W, Castellino R, Harris NL, Armitage JO, Carter W, Hoppe R, Canellos GP: Report of an international workshop to standardize response criteria for non-Hodgkin’s lymphomas. NCI Sponsored International Working Group. J Clin Oncol 1999;17:1244.
  13. Buhr T, Laenger F, Schlué J, von Wasielewski R, Lehmann U, Braumann D, Kreipe H: Reliability of lymphoma classification in bone marrow trephines. Br J Haematol 2002;118:470–476.
  14. Howell SJ, Grey M, Chang J, Morgenstern GR, Cowan RA, Deakin DP, Radford JA: The value of bone marrow examination in the staging of Hodgkin’s lymphoma: a review of 955 cases seen in a regional cancer centre. Br J Haematol 2002;119:408–411.
  15. Munker R, Hasenclever D, Brosteanu O, Hiller E, Diehl V: Bone marrow involvement in Hodgkin’s disease: an analysis of 135 consecutive cases. German Hodgkin’s lymphoma study group. J Clin Oncol 1995;13:403–409.
  16. Pangalis GA, Roussou PA, Kittas C, Kokkinou S, Fessas P: B-chronic lymphocytic leukemia. Prognostic implication of bone marrow histology in 120 patients experience from a single hematology unit. Cancer 1987;59:767–771.
  17. Rozman C, Montserrat E, Rodriguez-Fernandez JM, Ayats R, Vallespi T, Parody R, Rios A, Prados D, Morey M, Gomis F, et al: Bone marrow histologic pattern – the best single prognostic parameter in chronic lymphocytic leukemia: a multivariate survival analysis of 329 cases. Blood 1984;64:642–648.
  18. Mauro FR, De Rossi G, Burgio VL, Caruso R, Giannarelli D, Monarca B, Romani C, Baroni CD, Mandelli F: Prognostic value of bone marrow histology in chronic lymphocytic leukemia. A study of 335 untreated cases from a single institution. Haematologica 1994;79:334–341.
  19. Franco V, Florena AM, Campesi G: Intrasinusoidal bone marrow infiltration: a possible hallmark of splenic lymphoma. Histopathology 1996;29:571–575.
  20. Franco V, Florena AM, Iannitto E: Splenic marginal zone lymphoma. Blood 2003;101:2464–2472.
  21. Labouyrie E, Marit G, Vial JP, Lacombe F, Fialon P, Bernard P, de Mascarel A, Merlio JP: Intrasinusoidal bone marrow involvement by splenic lymphoma with villous lymphocytes: a helpful immunohistologic feature. Mod Pathol 1997;10:1015–1020.
  22. Levine AM: HIV-associated Hodgkin’s disease. Biologic and clinical aspects. Hematol Oncol Clin North Am 1996;10:1135–1148.
  23. Levy R, Colonna P, Tourani JM, Gastaut JA, Brice P, Raphael M, Taillan B, Andrieu JM: Human immunodeficiency virus associated Hodgkin’s disease: report of 45 cases from the French Registry of HIV-Associated Tumors. Leuk Lymphoma 1995;16:451–456.
  24. Karcher DS: Clinically unsuspected Hodgkin disease presenting initially in the bone marrow of patients infected with the human immunodeficiency virus. Cancer 1993;71:1235–1238.
  25. Schade U, Bock O, Vornhusen S, Jager A, Busche G, Lehmann U, Kreipe H: Bone marrow infiltration pattern in B-cell chronic lymphocytic leukemia is related to immunoglobulin heavy-chain variable region mutation status and expression of 70-kDa zeta- associated protein (ZAP-70). Hum Pathol 2006;37:1153–1161.
  26. Kumar S, Green GA, Teruya-Feldstein J, Raffeld M, Jaffe ES: Use of CD23 (BU38) on paraffin sections in the diagnosis of small lymphocytic lymphoma and mantle cell lymphoma. Mod Pathol 1996;9:925–929.
  27. Vasef MA, Medeiros LJ, Koo C, McCourty A, Brynes RK: Cyclin D1 immunohistochemical staining is useful in distinguishing mantle cell lymphoma from other low-grade B-cell neoplasms in bone marrow. Am J Clin Pathol 1997;108:302–307.
  28. Perz J, Topaly J, Fruehauf S, Hensel M, Ho AD: Level of CD 20-expression and efficacy of rituximab treatment in patients with resistant or relapsing B-cell prolymphocytic leukemia and B-cell chronic lymphocytic leukemia. Leuk Lymphoma 2002;43:149–151.
  29. Crespo M, Bosch F, Villamor N, Bellosillo B, Colomer D, Rozman M, Marce S, Lopez-Guillermo A, Campo E, Montserrat E: ZAP-70 expression as a surrogate for immunoglobulin-variable-region mutations in chronic lymphocytic leukemia. N Engl J Med 2003;348:1764–1775.
  30. Wiestner A, Rosenwald A, Barry TS, Wright G, Davis RE, Henrickson SE, Zhao H, Ibbotson RE, Orchard JA, Davis Z, Stetler-Stevenson M, Raffeld M, Arthur DC, Marti GE, Wilson WH, Hamblin TJ, Oscier DG, Staudt LM: ZAP-70 expression identifies a chronic lymphocytic leukemia subtype with unmutated immunoglobulin genes, inferior clinical outcome, and distinct gene expression profile. Blood 2003;101:4944–4951.
  31. Carreras J, Villamor N, Colomo L, Moreno C, Ramon y Cajal S, Crespo M, Tort F, Bosch F, Lopez-Guillermo A, Colomer D, Montserrat E, Campo E: Immunohistochemical analysis of ZAP-70 expression in B-cell lymphoid neoplasms. J Pathol 2005;205:507–513.
  32. Sup SJ, Domiati-Saad R, Kelley TW, Steinle R, Zhao X, Hsi ED: ZAP-70 expression in B-cell hematologic malignancy is not limited to CLL/SLL. Am J Clin Pathol 2004;122:582–587.
  33. Admirand JH, Rassidakis GZ, Abruzzo LV, Valbuena JR, Jones D, Medeiros LJ: Immunohistochemical detection of ZAP-70 in 341 cases of non-Hodgkin and Hodgkin lymphoma. Mod Pathol 2004;17:954–961.
  34. Ruchlemer R, Parry-Jones N, Brito-Babapulle V, Attolico I, Wotherspoon AC, Matutes E, Catovsky D: B-prolymphocytic leukaemia with t(11;14) revisited: a splenomegalic form of mantle cell lymphoma evolving with leukaemia. Br J Haematol 2004;125:330–336.
  35. Kremer M, Dirnhofer S, Nickl A, Hoefler H, Quintanilla-Martinez L, Fend F: p27(Kip1) immunostaining for the differential diagnosis of small B-cell neoplasms in trephine bone marrow biopsies. Mod Pathol 2001;14:1022–1029.
  36. Torlakovic E, Torlakovic G, Brunning RD: Follicular pattern of bone marrow involvement by follicular lymphoma. Am J Clin Pathol 2002;118:780–786.
  37. West RB, Warnke RA, Natkunam Y: The usefulness of immunohistochemistry in the diagnosis of follicular lymphoma in bone marrow biopsy specimens. Am J Clin Pathol 2002;117:636–643.
  38. Hodges GF, Lenhardt TM, Cotelingam JD: Bone marrow involvement in large-cell lymphoma. Prognostic implications of discordant disease. Am J Clin Pathol 1994;101:305–311.
  39. Kremer M, Spitzer M, Mandl-Weber S, Stecker K, Schmidt B, Hofler H, Quintanilla-Martinez L, Fend F: Discordant bone marrow involvement in diffuse large B-cell lymphoma: comparative molecular analysis reveals a heterogeneous group of disorders. Lab Invest 2003;83:107–114.
  40. Robertson LE, Redman JR, Butler JJ, Osborne BM, Velasquez WS, McLaughlin P, Swan F, Rodriguez MA, Hagemeister FB, Fuller LM, et al: Discordant bone marrow involvement in diffuse large-cell lymphoma: a distinct clinical-pathologic entity associated with a continuous risk of relapse. J Clin Oncol 1991;9:236–242.
  41. Lin P, Bueso-Ramos C, Wilson CS, Mansoor A, Medeiros LJ: Waldenström macroglobulinemia involving extramedullary sites: morphologic and immunophenotypic findings in 44 patients. Am J Surg Pathol 2003;27:1104–1113.
  42. Feiner HD, Rizk CC, Finfer MD, Bannan M, Gottesman SR, Chuba JV, Amorosi E: IgM monoclonal gammopathy/Waldenström’s macroglobulinemia: a morphological and immunophenotypic study of the bone marrow. Mod Pathol 1990;3:348–356.
  43. Kent SA, Variakojis D, Peterson LC: Comparative study of marginal zone lymphoma involving bone marrow. Am J Clin Pathol 2002;117:698–708.
  44. Raderer M, Vorbeck F, Formanek M, Osterreicher C, Valencak J, Penz M, Kornek G, Hamilton G, Dragosics B, Chott A: Importance of extensive staging in patients with mucosa-associated lymphoid tissue-type lymphoma. Br J Cancer 2000;83:454–457.
  45. Thieblemont C, Berger F, Dumontet C, Moullet I, Bouafia F, Felman P, Salles G, Coiffier B: Mucosa-associated lymphoid tissue lymphoma is a disseminated disease in one third of 158 patients analyzed. Blood 2000;95:802–806.
  46. Berger F, Felman P, Thieblemont C, Pradier T, Baseggio L, Bryon PA, Salles G, Callet-Bauchu E, Coiffier B: Non-MALT marginal zone B-cell lymphomas: a description of clinical presentation and outcome in 124 patients. Blood 2000;95:1950–1956.
  47. Ferry JA, Yang WI, Zukerberg LR, Wotherspoon AC, Arnold A, Harris NL: CD5+ extranodal marginal zone B-cell (MALT) lymphoma. A low-grade neoplasm with a propensity for bone marrow involvement and relapse. Am J Clin Pathol 1996;105:31–37.
  48. Mollejo M, Menarguez J, Lloret E, Sanchez A, Campo E, Algara P, Cristobal E, Sanchez E, Piris MA: Splenic marginal zone lymphoma: a distinctive type of low-grade B-cell lymphoma. A clinicopathological study of 13 cases. Am J Surg Pathol 1995;19:1146–1157.
  49. Troussard X, Valensi F, Duchayne E, Garand R, Felman P, Tulliez M, Henry-Amar M, Bryon PA, Flandrin G: Splenic lymphoma with villous lymphocytes: clinical presentation, biology and prognostic factors in a series of 100 patients. Groupe Français d’Hématologie Cellulaire (GFHC). Br J Haematol 1996;93:731–736.
  50. Schmid C, Kirkham N, Diss T, Isaacson PG: Splenic marginal zone cell lymphoma. Am J Surg Pathol 1992;16:455–466.
  51. Audouin J, Le Tourneau A, Molina T, Camilleri-Broet S, Adida C, Comperat E, Benattar L, Delmer A, Devidas A, Rio B, Diebold J: Patterns of bone marrow involvement in 58 patients presenting primary splenic marginal zone lymphoma with or without circulating villous lymphocytes. Br J Haematol 2003;122:404–412.
  52. Feugier P, De March AK, Lesesve JF, Monhoven N, Dorvaux V, Braun F, Gregoire MJ, Jonveaux P, Lederlin P, Bene MC, Labouyrie E: Intravascular bone marrow accumulation in persistent polyclonal lymphocytosis: a misleading feature for B-cell neoplasm. Mod Pathol 2004;17:1087–1096.
  53. Hoyer JD, Li CY, Yam LT, Hanson CA, Kurtin PJ: Immunohistochemical demonstration of acid phosphatase isoenzyme 5 (tartrate-resistant) in paraffin sections of hairy cell leukemia and other hematologic disorders. Am J Clin Pathol 1997;108:308–315.
  54. Salomon-Nguyen F, Valensi F, Troussard X, Flandrin G: The value of the monoclonal antibody, DBA.44, in the diagnosis of B-lymphoid disorders. Leuk Res 1996;20:909–913.
  55. Went PT, Zimpfer A, Pehrs AC, Sabattini E, Pileri SA, Maurer R, Terracciano L, Tzankov A, Sauter G, Dirnhofer S: High specificity of combined TRAP and DBA.44 expression for hairy cell leukemia. Am J Surg Pathol 2005;29:474–478.
  56. Falini B, Tiacci E, Liso A, Basso K, Sabattini E, Pacini R, Foa R, Pulsoni A, Dalla Favera R, Pileri S: Simple diagnostic assay for hairy cell leukaemia by immunocytochemical detection of annexin A1 (ANXA1). Lancet 2004;363:1869–1870.
  57. Conlan MG, Bast M, Armitage JO, Weisenburger DD: Bone marrow involvement by non-Hodgkin’s lymphoma: the clinical significance of morphologic discordance between the lymph node and bone marrow. Nebraska Lymphoma Study Group. J Clin Oncol 1990;8:1163–1172.
  58. Rudiger T, Ott G, Ott MM, Muller-Deubert SM, Muller-Hermelink HK: Differential diagnosis between classic Hodgkin’s lymphoma, T-cell-rich B-cell lymphoma, and paragranuloma by paraffin immunohistochemistry. Am J Surg Pathol 1998;22:1184–1191.
  59. Skinnider BF, Connors JM, Gascoyne RD: Bone marrow involvement in T-cell-rich B-cell lymphoma. Am J Clin Pathol 1997;108:570–578.
  60. Grogan TM: Plasma cell myeloma marrow diagnosis including morphologic and phenotypic features. Semin Diagn Pathol 2003;20:211–225.
  61. Bartl R, Frisch B, Fateh-Moghadam A, Kettner G, Jaeger K, Sommerfeld W: Histologic classification and staging of multiple myeloma: a retrospective and prospective study of 674 cases. Am J Clin Pathol 1987;87:342–355.
  62. Ely SA, Knowles DM: Expression of CD56/neural cell adhesion molecule correlates with the presence of lytic bone lesions in multiple myeloma and distinguishes myeloma from monoclonal gammopathy of undetermined significance and lymphomas with plasmocytoid differentiation. Am J Pathol 2002;160:1293–1299.
  63. Wei A, Juneja S: Bone marrow immunohistology of plasma cell neoplasms. J Clin Pathol 2003;56:406–411.
  64. Turley H, Jones M, Erber W, Mayne K, de Waele M, Gatter K: VS38: a new monoclonal antibody for detecting plasma cell differentiation in routine sections. J Clin Pathol 1994;47:418–422.
  65. Specht K, Haralambieva E, Bink K, Kremer M, Mandl-Weber S, Koch I, Tomer R, Hofler H, Schuuring E, Kluin PM, Fend F, Quintanilla-Martinez L: Different mechanisms of cyclin D1 overexpression in multiple myeloma revealed by fluorescence in situ hybridization and quantitative analysis of mRNA levels. Blood 2004;15:1120–1126.
    External Resources
  66. Vasef MA, Medeiros LJ, Yospur LS, Sun NC, McCourty A, Brynes RK: Cyclin D1 protein in multiple myeloma and plasmacytoma: an immunohistochemical study using fixed, paraffin-embedded tissue sections. Mod Pathol 1997;10:927–932.
  67. Bergsagel PL, Kuehl WM: Critical roles for immunoglobulin translocations and cyclin D dysregulation in multiple myeloma. Immunol Rev 2003;194:96–104.
  68. Bergsagel PL, Kuehl WM: Molecular pathogenesis and a consequent classification of multiple myeloma. J Clin Oncol 2005;23:6333–6338.
  69. Fonseca R, Barlogie B, Bataille R, Bastard C, Bergsagel PL, Chesi M, Davies FE, Drach J, Greipp PR, Kirsch IR, Kuehl WM, Hernandez JM, Minvielle S, Pilarski LM, Shaughnessy JD Jr, Stewart AK, Avet-Loiseau H: Genetics and cytogenetics of multiple myeloma: a workshop report. Cancer Res 2004;64:1546–1558.
  70. Le Maitre CL, Byers RJ, Liu Yin JA, Hoyland JA, Freemont AJ: Dual colour FISH in paraffin wax-embedded bone trephines for identification of numerical and structural chromosomal abnormalities in acute myeloid leukaemia and myelodysplasia. J Clin Pathol 2001;54:730–733.
  71. Miranda RN, Mark HF, Medeiros LJ: Fluorescent in situ hybridization in routinely processed bone marrow aspirate clot and core biopsy sections. Am J Pathol 1994;145:1309–1314.
  72. Dogan A, Morice WG: Bone marrow histopathology in peripheral T-cell lymphomas. Br J Haematol 2004;127:140–154.
  73. Caulet S, Delmer A, Audouin J, Le Tourneau A, Bernadou A, Zittoun R, Diebold J: Histopathological study of bone marrow biopsies in 30 cases of T-cell lymphoma with clinical, biological and survival correlations. Hematol Oncol 1990;8:155–168.
  74. Gaulard P, Kanavaros P, Farcet JP, Rocha FD, Haioun C, Divine M, Reyes F, Zafrani ES: Bone marrow histologic and immunohistochemical findings in peripheral. T-cell lymphoma: A study of 38 cases. Hum Pathol 1991;22:331–338.
  75. Morice WG, Kurtin PJ, Tefferi A, Hanson CA: Distinct bone marrow findings in T-cell granular lymphocytic leukemia revealed by paraffin section immunoperoxidase stains for CD8, TIA-1, and granzyme B. Blood 2002;99:268–274.
  76. Vega F, Medeiros LJ, Bueso-Ramos C, Jones D, Lai R, Luthra R, Abruzzo LV: Hepatosplenic γ/δ T-cell lymphoma in bone marrow. A sinusoidal neoplasm with blastic cytologic features. Am J Clin Pathol 2001;116:410–409.
  77. Fraga M, Brousset P, Schlaifer D, Payen C, Robert A, Rubie H, Huguet-Rigal F, Delsol G: Bone marrow involvement in anaplastic large cell lymphoma. Immunohistochemical detection of minimal disease and its prognostic significance. Am J Clin Pathol 1995;103:82–89.
  78. Attygalle AD, Diss TC, Munson P, Isaacson PG, Du MQ, Dogan A: CD10 expression in extranodal dissemination of angioimmunoblastic T-cell lymphoma. Am J Surg Pathol 2004;28:54–61.
  79. Falini B, Pileri S, De Solas I, Martelli MF, Mason DY, Delsol G, Gatter KC, Fagioli M: Peripheral T-cell lymphoma associated with hemophagocytic syndrome. Blood 1990;75:434–444.
  80. Pileri SA, Ascani S, Milani M, Visani G, Piccioli M, Orcioni GF, Poggi S, Sabattini E, Santini D, Falini B: Acute leukaemia immunophenotyping in bone-marrow routine sections. Br J Haematol 1999;105:394–401.
  81. Arber DA, Jenkins KA, Slovak ML: CD79 alpha expression in acute myeloid leukemia. High frequency of expression in acute promyelocytic leukemia. Am J Pathol 1996;149:1105–1110.
  82. Tiacci E, Pileri S, Orleth A, Pacini R, Tabarrini A, Frenguelli F, Liso A, Diverio D, Lo-Coco F, Falini B: PAX5 expression in acute leukemias: higher B-lineage specificity than CD79a and selective association with t(8;21)-acute myelogenous leukemia. Cancer Res 2004;64:7399–7404.
  83. Zhang PJ, Barcos M, Stewart CC, Block AW, Sait S, Brooks JJ: Immunoreactivity of MIC2 (CD99) in acute myelogenous leukemia and related diseases. Mod Pathol 2000;13:452–458.
  84. Thiele J, Zirbes TK, Kvasnicka HM, Fischer R: Focal lymphoid aggregates (nodules) in bone marrow biopsies: differentiation between benign hyperplasia and malignant lymphoma – a practical guideline. J Clin Pathol 1999;52:294–300.
  85. Kremer M, Cabras AD, Fend F, Schulz S, Schwarz K, Hoefler H, Werner M: PCR analysis of IgH-gene rearrangements in small lymphoid infiltrates microdissected from sections of paraffin-embedded bone marrow biopsy specimens. Hum Pathol 2000;31:847–853.
  86. Hakimian D, Tallman MS, Kiley C, Peterson L: Detection of minimal residual disease by immunostaining of bone marrow biopsies after 2-chlorodeoxyadenosine for hairy cell leukemia. Blood 1993;82:1798–1802.
  87. Rimsza LM, Larson RS, Winter SS, Foucar K, Chong YY, Garner KW, Leith CP: Benign hematogone-rich lymphoid proliferations can be distinguished from B-lineage acute lymphoblastic leukemia by integration of morphology, immunophenotype, adhesion molecule expression, and architectural features. Am J Clin Pathol 2000;114:66–75.
  88. Rimsza LM, Viswanatha DS, Winter SS, Leith CP, Frost JD, Foucar K: The presence of CD34+ cell clusters predicts impending relapse in children with acute lymphoblastic leukemia receiving maintenance chemotherapy. Am J Clin Pathol 1998;110:313–320.
  89. Douglas VK, Gordon LI, Goolsby CL, White CA, Peterson LC: Lymphoid aggregates in bone marrow mimic residual lymphoma after rituximab therapy for non-Hodgkin lymphoma. Am J Clin Pathol 1999;112:844–853.
  90. Seliem RM, Freeman JK, Steingart RH, Hasserjian RP: Immunophenotypic changes and clinical outcome in B-cell lymphomas treated with rituximab. Appl Immunohistochem Mol Morphol 2006;14:18–23.
  91. Fend F, Bock O, Kremer M, Specht K, Quintanilla-Martinez L: Ancillary techniques in bone marrow pathology: molecular diagnostics on bone marrow trephine biopsies. Virchows Arch 2005;447:909–919.
  92. Braunschweig R, Baur AS, Delacretaz F, Bricod C, Benhattar J: Contribution of IgH-PCR to the evaluation of B-cell lymphoma involvement in paraffin-embedded bone marrow biopsy specimens. Am J Clin Pathol 2003;119:634–642.
  93. Brinckmann R, Kaufmann O, Reinartz B, Dietel M: Specificity of PCR-based clonality analysis of immunoglobulin heavy chain gene rearrangements for the detection of bone marrow involvement by low-grade B-cell lymphomas. J Pathol 2000;190:55–60.
  94. Pittaluga S, Tierens A, Dodoo YL, Delabie J, De Wolf-Peeters C: How reliable is histologic examination of bone marrow trephine biopsy specimens for the staging of non-Hodgkin lymphoma? A study of hairy cell leukemia and mantle cell lymphoma involvement of the bone marrow trephine specimen by histologic, immunohistochemical, and polymerase chain reaction techniques. Am J Clin Pathol 1999;111:179–184.
  95. Lehmann U, Bock O, Langer F, Kreipe H: Demonstration of light chain restricted clonal B-lymphoid infiltrates in archival bone marrow trephines by quantitative real-time polymerase chain reaction. Am J Pathol 2001;159:2023–2029.
  96. Specht K, Kremer M, Muller U, Dirnhofer S, Rosemann M, Hofler H, Quintanilla-Martinez L, Fend F: Identification of cyclin D1 mRNA overexpression in B-cell neoplasias by real-time reverse transcription-PCR of microdissected paraffin sections. Clin Cancer Res 2002;8:2902–2911.

Article / Publication Details

First-Page Preview
Abstract of Review

Received: November 24, 2006
Accepted: January 26, 2007
Published online: June 25, 2007
Issue release date: June 2007

Number of Print Pages: 11
Number of Figures: 1
Number of Tables: 1

ISSN: 1015-2008 (Print)
eISSN: 1423-0291 (Online)

For additional information: https://www.karger.com/PAT


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