Three-Dimensional Reconstruction of Non-Hodgkin's Lymphoma in Bone Marrow Trephines

BACKGROUND Up to the current time, diagnosis of bone marrow (BM) involvement in non‐Hodgkin lymphoma (NHL) has been based on morphologic findings. Polymerase chain reaction (PCR) for antigen receptor gene rearrangements has the potential to increase the detection sensitivity of minimal degrees of BM involvement. The authors therefore assessed PCR‐based clonalities of BM concurrently with morphology from 170 cases with NHL and evaluated the usefulness of comparative analysis of clonalities between bilateral BMs and the lymph node and the clinical significance of PCR based clonalities of BM. METHODS Bilateral BM clot sections of 170 cases and 47 lymph nodes were tested for immunoglobulin heavy chain gene rearrangement or T‐cell receptor gamma gene rearrangement according to the B‐ or T‐lineage of the lymph node. RESULTS When compared with morphology, the results of PCR showed an unexpectedly low positive concordance rate of 61.0% for B‐cell NHL and 57.1% for T‐cell NHL. When the clonality of BM was compared with that of lymph nodes in B‐cell NHL, bilateral clonalities of BM showed high concordance with the clonality of the lymph nodes. PCR‐based clonality did not show significant impact on survival. CONCLUSIONS Morphology remains the gold standard in the evaluation of BM involvement by NHL. Although the comparative analysis of BM clonality and that of the lymph nodes is considered a valuable tool that increases the reliability of clonality, PCR‐based clonality of BM does not significantly add to the sensitivity of diagnosing BM involvement by NHL. Cancer 2002;94:3073–82. © 2002 American Cancer Society. DOI 10.1002/cncr.10584

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Polymerase chain reaction‐based diagnosis of bone marrow involvement in 170 cases of non‐Hodgkin lymphoma

Kang

Park

Seo

et al. 2002

Cancer

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Immunohistochemistry in bone marrow pathology: a useful adjunct for morphologic diagnosis

Kremer

Quintanilla-Martı́nez

Nährig

et al. 2005

Virchows Arch

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Pathomorphological examination of trephine biopsies of the bone marrow (BM) represents a standard method for the diagnosis and staging of hematologic neoplasms and other disorders involving the BM. The increasing knowledge about the genetic basis and biology of hematologic neoplasms, as well as the recently proposed WHO classification system, provide the framework for an accurate diagnosis. Although conventional morphology remains the gold standard for paraffin-embedded BM trephines, immunohistochemical stainings have become an integral part of the diagnostic workup. Antibodies suitable for paraffin sections are generally applicable to BM trephines, but modifications of staining protocols may be necessary due to the alternative fixatives and decalcification procedures used for BM biopsies. The indications for immunostainings range from confirmation and classification of lymphoma involvement, subclassification of acute leukemias, and estimating blast counts in myelodysplastic and myeloproliferative syndromes to characterization of BM involvement in nonhematologic neoplasms. Although subtyping of NHL in the BM is more difficult from the point of morphology, classification of the entities that frequently involve the BM, especially the small B-cell lymphomas, can easily be achieved with the help of immunohistochemistry. In this review, we try to summarize the current state of the art in BM immunohistochemistry for the diagnosis of hematologic disorders. Moreover, diagnostic algorithms and useful antibody panels are proposed for a rational and cost-effective approach.

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The pre-lymphatic pathway, the rooths of the lymphatic system in breast tissue: a 3D study

et al. 2008

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Three-dimensional (3D) visualisation of microscopic structures provides useful information about their configuration and the spatial (hence functional) relationship between different components in tissues. This paper describes 3D dynamic reconstructions of the pre-lymphatic labyrinth in two cases of "normal" breast core biopsies and one case of pseudoangiomatous stromal hyperplasia. Direct anastomoses between pre-lymphatic channels and true lymphatics of the breast were demonstrated. It is concluded that pre-lymphatics are a way of communication between breast epithelial/stromal structures and the main lymphatic system. The present findings suggest that the existence of pre-lymphatics has to be taken in consideration in the intramammary spread of malignant tumours.

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Three-Dimensional Reconstruction of Non-Hodgkin's Lymphoma in Bone Marrow Trephines

Cited by 8 publications

References 11 publications

Polymerase chain reaction‐based diagnosis of bone marrow involvement in 170 cases of non‐Hodgkin lymphoma

Polymerase chain reaction‐based diagnosis of bone marrow involvement in 170 cases of non‐Hodgkin lymphoma

Immunohistochemistry in bone marrow pathology: a useful adjunct for morphologic diagnosis

The pre-lymphatic pathway, the rooths of the lymphatic system in breast tissue: a 3D study

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