The value of bone marrow examination in the staging of Hodgkin's lymphoma: a review of 955 cases seen in a regional cancer centre

Howell, Sacha J.; Grey, Mark; Chang, James; Morgenstern, G. R.; Cowan, Richard A; Deakin, DP; Radford, John

doi:10.1046/j.1365-2141.2002.03842.x

Cited by 82 publications

(63 citation statements)

References 20 publications

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“…Our findings correlated with those of Moid et al [7] where they reported 95% of diagnosis of Hodgkin's disease by BMB alone. Our findings is also in close agreement with that of Howell et al [12] whose study suggest that BMA does not have a significant role in detecting marrow involvement by Hodgkin's disease. Similar findings were reported by Sharma et al [13] where they diagnosed Hodgkin's disease in BMB alone.…”

Section: Discussionsupporting

confidence: 93%

Comparative Evaluation of Simultaneous Bone Marrow Aspiration and Bone Marrow Biopsy: An Institutional Experience

Toi

Varghese

Rai

2010

Indian J Hematol Blood Transfus

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Bone marrow aspirations and bone marrow biopsies are important diagnostic procedures. A comparative study of both the procedures done simultaneously was retrospectively reviewed in 160 cases where the clinical history is correlated with BMA and BMB results. The advantage of each method is analyzed. Correlation of our findings with that given in the literature is done to give a guideline for both techniques. We have found that 61.25% of the cases showed a positive correlation between bone marrow aspiration and bone marrow biopsy. However, we found that tuberculous granulomas and Hodgkin disease involvement of the marrow were detected better in bone marrow biopsies. The advantage of both the procedures done together provided more material and enabled us to study the cytomorphology of the cells, with the pattern of distribution of the cells depending on the cases. However, when both the procedures are done simultaneously, a proper technique is required so as to yield good diagnostic material.

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Section: Discussionsupporting

confidence: 93%

Comparative Evaluation of Simultaneous Bone Marrow Aspiration and Bone Marrow Biopsy: An Institutional Experience

Toi

Varghese

Rai

2010

Indian J Hematol Blood Transfus

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“…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). The incidence of BM involvement in Hl in our study is consistent with the literature, which indicates a range between 3-18 % in many studies (4)(5)(6)(7)(8).…”

Section: Discussionsupporting

confidence: 92%

“…Studies have shown that the frequency of BM involvement in Hl is low and varies from 4 to 18% (4)(5)(6)(7). Hence some authors have suggested that BM studies can be done in selected high risk cases alone (5,8,9).…”

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confidence: 99%

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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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“…Its incidence varies between 4% and 14% in the series reported during the past 20 years (1)(2)(3). According to the Ann Arbor staging criteria for HL, a bone marrow biopsy (BMB) is recommended for patients with any of the following: elevated serum alkaline phosphatase, stage III/IV disease, any unexplained cytopenia or radiographic/scintigraphic evidence of osseus involvement (4).…”

Section: Introductionmentioning

confidence: 99%

Extensive Bone Marrow Involvement in Hodgkin Lymphoma Patient / Ekstenzivno Zahvatanje Koštane Srži Kod Bolesnika Sa Hočkinovim Limfomom

Petković¹,

Krstić²,

Stojnev³

et al. 2014

Acta Facultatis Medicae Naissensis

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Summary Bone marrow involvement is rare in patients with Hodgkin lymphoma (HL). Its incidence varies with respect to risk factors from 4% to 14%. Low risk patients do not need trephine biopsy according to some research. In the era of positron emission tomography/computed tomography (PET/CT) staging prior to therapy, the role of trephine biopsy as a part of staging procedures becomes debatable. Many institutions worldwide created their own guidelines in the application of trephine biopsy in staging of the (HL) patients. Our institution prefers performing trephine biopsy in all risk group patients, except those who underwent PET/CT staging before therapy and if no active bone sites were found. Most of our patients are staged using multislice computed tomography (MSCT) and we perform PET/CT in the follow up after completing the induction protocol. That is why we propose the trephine biopsy to the most of our patients. A Greek group of authors have derived a clinical prediction rule for the possibility of the bone marrow involvement, which is named the Z score (Zs), and if it is ≥10, patients are at high risk for bone marrow involvement. We present a case of a neglected, advanced (HL) patient, with the defined high risk for bone marrow involvement (Zs=25). He was clinically suspected to have affected bone marrow, which was later histologically confirmed. Unilateral trephine biopsy was performed.

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The value of bone marrow examination in the staging of Hodgkin's lymphoma: a review of 955 cases seen in a regional cancer centre

Cited by 82 publications

References 20 publications

Comparative Evaluation of Simultaneous Bone Marrow Aspiration and Bone Marrow Biopsy: An Institutional Experience

Comparative Evaluation of Simultaneous Bone Marrow Aspiration and Bone Marrow Biopsy: An Institutional Experience

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

Extensive Bone Marrow Involvement in Hodgkin Lymphoma Patient / Ekstenzivno Zahvatanje Koštane Srži Kod Bolesnika Sa Hočkinovim Limfomom

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