[Histopathologic aspects of bone marrow in angioimmunoblastic lymphadenopathy]

42 bone marrow biopsies (BMB) were done in 34 patients with angio-immunoblastic lymphadenopathy (AIL), 3 of them associated with Gougerot-Sjögren syndrome. Involvement of bone marrow was discovered in 36 BMB (85%) and in 27 patients (79%). The lesions appeared as nodules destroying the hematopoietic tissue. Each nodule was constituted by a variable amount of lymphocytes, plasma cells, immunoblasts and histiocytes. Epithelioid cells were associated in 14 BMB and in 11 patients. Collagenous myelofibrosis was seen in and around nodules. The bone marrow lesions were uninodular in 5 BMB (11.9%), multinodular in 17 patients and 20 BMB (47.6%) or massive in 10 patients and 11 BMB (26.1%). Vascular lesions were disclosed in only 17 BMB with multinodular or massive involvement. The hematopoietic bone marrow outside the nodular lesions showed hyperplasia in 12 BMB and was normal in all other cases. In the 7 BMB without AIL localization the hematopoiesis was 6 times normal and hyperplasic in one case. No case of malignant lymphoma was disclosed. AIL bone marrow involvement should not be confused with non Hodgkin's ML or Hodgkin's disease. Correlation with median survival and bone marrow involvement was shown: 12 months in cases with massive involvement, 16 months in uni or multinodular lesions, 56 months in bone marrow free of disease. So BMB is useful for the diagnosis of AIL and the presence or absence of bone marrow involvement is of prognostic value.