Bone marrow histopathology in peripheral T-cell lymphomas

Area of Science:

• Hematology
• Oncology
• Pathology

Background:

• Peripheral T-cell lymphomas (PTCL) represent 10-15% of lymphoproliferative disorders in the West.
• Bone marrow biopsy is essential for PTCL diagnosis, staging, and treatment monitoring.
• PTCL bone marrow involvement patterns differ significantly based on World Health Organization (WHO) classification subtypes.

Purpose of the Study:

• To review the histopathology of bone marrow biopsies in PTCL.
• To correlate bone marrow findings with the latest WHO classification of PTCL.
• To highlight diagnostic challenges and the importance of integrating various clinical and pathological data.

Main Methods:

• Review of histopathological features of bone marrow biopsies in various PTCL entities.
• Correlation of findings with the current WHO classification.
• Discussion of immunohistochemical and molecular techniques aiding diagnosis.

Main Results:

• Bone marrow infiltration patterns in PTCL vary, including nodular, interstitial, and intrasinusoidal.
• Angioimmunoblastic T-cell lymphoma shows nodular/interstitial patterns; hepatosplenic T-cell lymphoma and LGL leukemia exhibit intrasinusoidal infiltration.
• Subtle pathological features and reactive changes can complicate diagnosis, necessitating ancillary studies.

Conclusions:

• Bone marrow biopsy is integral to PTCL management, with diverse histopathological presentations.
• Accurate PTCL diagnosis relies on integrating clinical, aspirate, biopsy findings, and advanced molecular/immunohistochemical studies.
• Understanding subtype-specific bone marrow involvement is key for effective PTCL diagnosis and patient care.