Dealing with bone marrow biopsies in the staging of classical Hodgkin lymphoma: an old issue revisited in the<sup>18</sup>F-fluorodeoxyglucose-positron emission tomography era

Gonçalves, Marianne de Castro; Paula, Henrique Moura de; Linardi, Camila da Cruz Gouveia; Cerci, Juliano Júlio; Aldred, Vera Lucia; Siqueira, Sheila Aparecida Coelho; Buccheri, Valéria; Zerbini, Maria Cláudia Nogueira

doi:10.3109/10428194.2015.1016928

Cited by 3 publications

(2 citation statements)

References 21 publications

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“…in spite of the advances like positron emission tomography, BM biopsy is still essential to confirm BM involvement in Hl (11). although BM involvement has been reported to be less common in Hl when compared to non-Hodgkin lymphomas (4), it is still essential to do BM staging in Hl as it has prognostic significance (5).…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological features of bone marrow infiltration in hodgkin lymphoma. should bone marrow staging be done only in high risk patients?

Sudalaimuthu

Basu²

2017

TJPATH

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Objective: the frequency of bone marrow infiltration by Hodgkin lymphoma is low and varies from 3 to 18%. Hence there exists a dilemma whether bone marrow staging should be done only in the high risk cases. this study aims to study the clinicopathological features and the histomorphology of bone marrow infiltration by Hodgkin lymphoma. Material and Method:Bone marrow aspirates and biopsies from cases of Hodgkin lymphoma diagnosed between 2007 and 2015 were studied. immunohistochemistry with CD15 and CD30 were done in necessary cases. Bone marrow infiltration was correlated with various clinicopathological parameters.Results: ten of the 81 cases (12.3%) studied showed infiltration by Hodgkin lymphoma in the bone marrow biopsy sections. all the aspirates were negative. Bone marrow in the involved cases showed Reed-Sternberg cells and/or mononuclear Hodgkin cells positive for CD30 in a polymorphous inflammatory background. Cases of lymphocyte depleted subtype (66%) and those with leucopenia/ thrombocytopenia (100%) were frequently associated with bone marrow infiltration. B-symptoms, anemia and mixed cellularity were the other risk factors. However none of these risk factors were noted in two out of the ten cases with bone marrow infiltration.Conclusion: as the role of bone marrow aspirate is minimal in the staging of Hodgkin lymphoma, bone marrow biopsy should be the method of choice. immunohistochemistry helps in the doubtful cases. Bone marrow involvement was frequent but not confined to the high risk groups. Our findings suggest that bone marrow staging should not be restricted to the high risk cases alone.

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Section: Discussionmentioning

confidence: 99%

Clinicopathological features of bone marrow infiltration in hodgkin lymphoma. should bone marrow staging be done only in high risk patients?

Sudalaimuthu

Basu²

2017

TJPATH

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“…BM studies are usually done as a part of the staging workup for HL because its involvement is considered as stage IV disease with poorer prognosis and reduced survival. 1,5,6,8 When compared with non-Hodgkin lymphomas, HL involving marrow is relatively rare with an incidence of 3 to 18%. 1,[9][10][11] HL invariably arises in the lymph nodes, and primary extranodal HL is very rare.…”

Section: Discussionmentioning

confidence: 99%

Clinically Undetected Hodgkin Lymphoma Diagnosed Initially on Bone Marrow Biopsy: A Large Retrospective Observational Study from a Tertiary Care Center

Vangala

Paul

Uppin

et al. 2021

Indian J Med Paediatr Oncol

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Introduction Hodgkin lymphoma (HL) involving the bone marrow (BM) is relatively rare with an incidence ranging from 4% to 18%. The incidence of primary HL of marrow is 0.25%. To the best of our knowledge, the present study is the largest study on HL diagnosed initially on marrow biopsy. Objective To establish diagnostic criteria based on clinicopathological and histological features in HL diagnosed first on the marrow. Materials and Methods This was a retrospective study done from January 2012 to December 2020 that included 36 cases of HL diagnosed initially on BM. Based on the presence of large mononuclear or binucleate Reed–Sternberg (RS)-like cells in a polymorphous inflammatory background, HL was suspected and immunohistochemistry (IHC) with CD15 and CD30 was done. Correlation with subsequent lymph node biopsies was done, wherever possible. Results Fever (94.4%) was the most common symptom, followed by loss of weight (66.7%). Twenty-one cases (58.4%) had uni/bicytopenia and 15 cases (41.6%) had pancytopenia. Only one case showed suspicious mononuclear RS cells on aspirates and the rest of the cases were diagnosed on trephine biopsy alone. Trephine imprints showed variable cellularity in 13 (36%) cases. Diffuse involvement was seen in 24 cases (66.7%), and focal nodular aggregates were seen in 12 cases (33.3%). Out of 36 cases, 26 cases (19 cases on marrow and 7 cases on lymph node) were confirmed as HL with IHC. Immunophenotype of the RS cells on the marrow was CD30+/CD15+ in (6/29) (20.7%) cases, CD30+/CD15− in (7/29) (24.1%) cases and CD30−/CD15+ in (6/29) (20.7%) cases. Seven cases (26.9%) were diagnosed on subsequent lymph node biopsy as mixed cellularity HL with IHC confirmation. Marrow fibrosis was seen in 16 cases (44.4%), and granulomas were seen in 8 cases (22.2%). Conclusion In cases presenting with long-standing fever and cytopenias, HL must always be suspected, even if there are no palpable lymph nodes. Bone marrow biopsy is preferable over aspiration in such cases and IHC plays a major role in diagnosing the cases.

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Whole body MRI with qualitative and quantitative analysis of DWI for assessment of bone marrow involvement in lymphoma

Balbo-Mussetto¹,

Saviolo²,

Fornari³

et al. 2017

Radiol med

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Dealing with bone marrow biopsies in the staging of classical Hodgkin lymphoma: an old issue revisited in the¹⁸F-fluorodeoxyglucose-positron emission tomography era

Cited by 3 publications

References 21 publications

Clinicopathological features of bone marrow infiltration in hodgkin lymphoma. should bone marrow staging be done only in high risk patients?

Clinicopathological features of bone marrow infiltration in hodgkin lymphoma. should bone marrow staging be done only in high risk patients?

Clinically Undetected Hodgkin Lymphoma Diagnosed Initially on Bone Marrow Biopsy: A Large Retrospective Observational Study from a Tertiary Care Center

Whole body MRI with qualitative and quantitative analysis of DWI for assessment of bone marrow involvement in lymphoma

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Dealing with bone marrow biopsies in the staging of classical Hodgkin lymphoma: an old issue revisited in the18F-fluorodeoxyglucose-positron emission tomography era

Cited by 3 publications

References 21 publications

Clinicopathological features of bone marrow infiltration in hodgkin lymphoma. should bone marrow staging be done only in high risk patients?

Clinicopathological features of bone marrow infiltration in hodgkin lymphoma. should bone marrow staging be done only in high risk patients?

Clinically Undetected Hodgkin Lymphoma Diagnosed Initially on Bone Marrow Biopsy: A Large Retrospective Observational Study from a Tertiary Care Center

Whole body MRI with qualitative and quantitative analysis of DWI for assessment of bone marrow involvement in lymphoma

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Dealing with bone marrow biopsies in the staging of classical Hodgkin lymphoma: an old issue revisited in the¹⁸F-fluorodeoxyglucose-positron emission tomography era