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The pattern of bone marrow infiltration in non-Hodgkin's lymphomas
K Hassan1, N Ikram, K P Bukhari
1Department of Pathology, Rawalpindi Medical College, Rawalpindi.
Insights
Bone marrow infiltration patterns in non-Hodgkin's lymphomas (NHLs) were studied. Diffuse infiltration was most common across all grades, particularly high-grade NHLs.
Area of Science:
- Hematology
- Oncology
- Pathology
Background:
- Non-Hodgkin's lymphomas (NHLs) are a diverse group of lymphoid malignancies.
- Bone marrow involvement is a significant prognostic factor in NHL.
- Understanding infiltration patterns is crucial for staging and treatment.
Purpose of the Study:
- To describe the patterns of bone marrow infiltration in patients with confirmed NHL.
- To correlate infiltration patterns with histological subtypes and grades of NHL.
Main Methods:
- Retrospective analysis of bone marrow biopsy specimens from 40 consecutive NHL cases with marrow involvement.
- Histological classification of NHLs based on the Working Formulation.
- Categorization of bone marrow infiltration patterns: diffuse, focal random, and focal paratrabecular.
Main Results:
- Low-grade NHLs constituted 50% of cases, followed by intermediate (32.5%) and high-grade (17.5%).
- Small lymphocytic type was the most frequent histological subtype (32.5%).
- Diffuse infiltration was the predominant pattern, seen in 70% of low-grade, 76.7% of intermediate-grade, and 100% of high-grade NHLs.
Conclusions:
- Bone marrow infiltration patterns vary with NHL grade and histology.
- Diffuse infiltration is the most common pattern, especially in higher-grade lymphomas.
- These findings aid in understanding NHL behavior and guiding clinical management.
Abstract:
The pattern of bone marrow infiltration in 40 consecutive cases of non-Hodgkin's lymphomas (NHLs) having marrow involvement is presented. For histological break-up, working formulation of NHLs was used. Low grade NHLs (50%) were the commonest, followed by intermediate (32.5%) and high grade NHLs (17.5%), respectively. Histologically, small lymphocytic type (32.5%) was the commonest, followed by diffuse small cleaved cell (15%) type; follicle small cleaved cell, diffuse mixed small and large cell as well as lymphoblastic types were equally frequent (12.5% each). Other histological types were less common. The pattern of infiltration of the bone marrow was diffuse in 76.7% of intermediate, 70% of low and 100% of high grade NHLs. It was focal random (non-paratrabecular) in 15% of low grade and 15.4% of intermediate grade NHLs. Focal paratrabecular pattern was evident in 15% of low grade and 7.7% of intermediate grade NHLs.