Reliability of lymphoma classification in bone marrow trephines

Area of Science:

• Hematology
• Oncology
• Pathology

Background:

• Accurate lymphoma classification is crucial for patient management.
• The World Health Organization (WHO) classification provides updated criteria for lymphoma diagnosis.
• Bone marrow trephine biopsies are essential for staging and diagnosing hematologic malignancies.

Purpose of the Study:

• To evaluate the accuracy and reliability of lymphoma classification using bone marrow trephine biopsies.
• To assess concordance with reference diagnoses based on the latest WHO classification.
• To determine the utility of bone marrow trephines for lymphoma subtyping.

Main Methods:

• Retrospective analysis of 124 bone marrow trephine biopsies.
• Comparison of initial diagnoses with reference center diagnoses from lymph node or extranodal biopsies.
• Evaluation based on morphology and immunophenotype according to the WHO classification.

Main Results:

• Overall concordance rates exceeded 85% and 91% after excluding discordant malignancy grades.
• Concordance for low-grade B-cell lymphomas was 93%; for high-grade B-cell lymphomas, it was 84%.
• Discordant diagnoses were mainly due to immunophenotypic variations in low-grade and grading discrepancies in high-grade lymphomas.

Conclusions:

• Bone marrow trephine biopsies are a reliable diagnostic tool for lymphoma.
• This method accurately establishes bone marrow infiltration and aids in lymphoma subtyping.
• The findings support the use of bone marrow trephines for lymphoma classification under the current WHO guidelines.