Guidelines for subtyping small B-cell lymphomas in bone marrow biopsies.

Area of Science:

• Hematology
• Oncology
• Pathology

Background:

• Bone marrow involvement is a key factor in staging and prognosis of small B-cell lymphomas.
• Histopathological examination of bone marrow biopsies is crucial for accurate diagnosis.

Purpose of the Study:

• To review and summarize the characteristic bone marrow involvement patterns for various small B-cell lymphoma subtypes.
• To correlate specific histopathological features with distinct lymphoma classifications.

Main Methods:

• Review of literature and personal experience on bone marrow biopsies from patients with small B-cell lymphomas.
• Analysis of growth patterns (paratrabecular, intertrabecular, diffuse, interstitial) and cytological composition.

Main Results:

• Follicle centre cell lymphoma: paratrabecular infiltrate of centrocytes.
• Mantle cell lymphoma: intertrabecular nodules of monotonous small to intermediate lymphoid cells.
• Marginal zone cell lymphoma: loose, polymorphic intertrabecular infiltrates with monocytoid features.
• Lymphoplasmacytoid lymphoma/immunocytoma: diffuse infiltrates with plasma cells (Dutcher bodies) and mast cells.
• Chronic lymphocytic leukaemia/small lymphocytic lymphoma: interstitial infiltrate of small lymphoid cells.
• Hairy cell leukaemia: interstitial pattern with clear cytoplasm, erythrocyte extravasation, and hematopoietic abnormalities.

Conclusions:

• Distinct histopathological patterns in bone marrow aid in differentiating small B-cell lymphoma subtypes.
• Accurate identification of these patterns is essential for precise diagnosis and patient management.