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

Fend F. · Kremer M.

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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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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


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Article / Publication Details

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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)

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