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Related Experiment Videos

Bone marrow lymphoid aggregates in malignant lymphomas.

Mara Dominis1, Anita Pesut, Ana Borovecki

  • 1Mara Dominis, Department of Clinical Pathology and Cytology, Merkur University Hospital, Zajceva 19, 10000 Zagreb, Croatia. mara.dominis@zg.htnet.hr

Croatian Medical Journal
|April 30, 2005
PubMed
Summary

Molecular analysis of immunoglobulin heavy chain (IgH) gene rearrangement helps differentiate lymphoid aggregates (LA) and nodular lymphoid hyperplasia (NLH) from malignant lymphoma infiltrates in bone marrow biopsies. Aggressive B-cell non-Hodgkin lymphoma (B-NHL) cases showed higher incidence of LA/NLH.

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Area of Science:

  • Hematopathology
  • Molecular diagnostics
  • Oncology

Background:

  • Bone marrow biopsies are crucial for staging malignant lymphomas.
  • Lymphoid aggregates (LA) and nodular lymphoid hyperplasia (NLH) can mimic lymphoma infiltrates.
  • Distinguishing benign lymphoid proliferations from malignant ones is essential for accurate diagnosis and treatment.

Purpose of the Study:

  • To evaluate the utility of IgH gene rearrangement analysis for assessing clonality in bone marrow biopsies with LA/NLH.
  • To differentiate LA/NLH from malignant lymphoma infiltrates in bone marrow.
  • To investigate the association of LA/NLH with different lymphoma subtypes.

Main Methods:

  • Analysis of 529 bone marrow biopsies from lymphoma patients.
  • Polymerase chain reaction (PCR) analysis of the IgH-CDR3 region for B-cell clonality in 43 samples with LA/NLH.

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  • Histocytomorphological and topographic assessment of LA/NLH.

    • Main Results:

    • Bone marrow lymphoma infiltrates were found in 33.8% of cases.
    • LA/NLH occurred in 8.1% of bone marrow samples.
    • IgH PCR revealed monoclonal patterns in 1 Hodgkin lymphoma and 1 control case, oligoclonal in 2 extranodal B-NHL, and polyclonal in others.
    • LA/NLH were more frequent in extranodal disease and aggressive B-NHL.

    Conclusions:

    • Topographic pattern and histocytomorphology can differentiate LA/NLH from malignant lymphoma infiltrates.
    • Aggressive B-NHL patients, both nodal and extranodal, exhibited a higher incidence of bone marrow LA/NLH compared to indolent B-NHL.
    • Molecular analysis of IgH gene rearrangement is a valuable tool in assessing clonality within bone marrow lymphoid aggregates.