FREQUENCY AND PATTERN OF BONE MARROW INVOLVEMENT AMONG PATIENTS WITH NON HODGKIN LYMPHOMA
AbstractBackground: Non-Hodgkin lymphoma (NHLs) are a heterogeneous group of lymphoid neoplasms, characterized by an irregular pattern of spread and may present with extranodal involvement This study was conducted to determine the frequency and pattern of Bone marrow involvement on trephine biopsy in cases of Non-Hodgkin lymphoma (NHL). Methods: This cross sectional study was conducted in Pathology department of Fauji Foundation Hospital (FFH)/Foundation University medical college (FUMC) Rawalpindi, from14th December 2010 to 14th December 2011. One hundred and six patients with histopathologically confirmed Non-Hodgkin lymphoma on lymph node (LN) biopsy, who had not received any chemotherapy were selected and Bone Marrow (BM) trephine biopsies for staging were performed on them. Results: Out of one hundred and six patients, forty five (42.5%) were diagnosed to have Bone Marrow involvement on staging. The most common pattern was diffuse, i.e., 44.44%, followed by the interstitial infiltrate in 28.89%, focal and mixed constituted 11.11% each, and paratrabecular pattern was found in 4.44%. Conclusion: This study highlights the high incidence of involvement and diffuse pattern in the Bone marrow biopsies of newly diagnosed Non-Hodgkin lymphoma, both of which indicate poor prognosis. Keywords: Non-Hodgkin lymphoma; bone marrow; prognosis; staging
Hingorjo MR, Syed S. Presentation, staging and diagnosis of lymphoma: a clinical perspective. J Ayub Med Coll Abbottabad 2008;20(4):100–3.
Hoffbrand AV, Moss PAH. Non-Hodgkin lymphoma. In: Hoffbrand AV, Moss PAH, editirs. Essential Hematology. 6th edn. Oxford, UK: Wiley- Blackwell publications; 2011.p.253–71.
Jemal A, Murray T, Samuels A, Ghafoor A, Ward E, Thun MJ. Cancer Stastistics, 2003. CA Cancer J Clin 2003;53:5–26.
Alexander DD, Mink PJ, Adami HO, Chang ET, Cole P, Mandel JS, et al. The non-Hodgkin lymphomas: a review of the epidemiologic literature. Int J Cancer 2007;120:1–39.
El Bolkainy TM, Abo Deif WS, Gouda HM, Mokhtar NM. Evaluation of bone marrow in 143 lymphomas: the relative frequency and pattern of involvement, secondary myelopathies, pitfalls and diagnostic validity. J Egypt Natl Canc Inst 2008;20(1):17–30.
Kumar S, Rau AR, Naik R, Kini H, Mathai AM, Pai MR, et al. Bone marrow biopsy in non-Hodgkin lymphoma: A morphological study. Indian J Pathol Microbiol 2009;52(3):332–8.
Hamid GA, Hanbala N. Comparison of bone marrow aspiration and bone marrow biopsy in neoplastic diseases. Gulf J Oncolog 2009;6:41–4.
Pervez S, Nasir MI, Moatter T, Ahsan A, Haq A, Siddiqui T. Characterization of genetic lesions in apoptosis-regulating and proliferation control genes in diffuse large B-cell non-Hodgkin's lymphoma. J Cancer Res Ther 2009;5:254–62.
Cancer Registry and Clinical Data Management (CRCDM) .Annual Cancer Registry Report 2008.[Internet]. Shaukat Khanum Memorial Cancer Hospital and Research Center (SKMCH & RC) [cited 2013 Jan 15]. Available from http://www.shaukatkhanum.org.pk/research/cancer-registry-and-clinical-data-management.html
Arber DA, George TI. Bone marrow biopsy involvement by non-Hodgkin’s lymphoma: frequency of lymphoma types, patterns, blood involvement, and discordance with other sites in 450 specimens. Am J Surg Pathol 2005;29(12):1549–57.
Jeong SY, Chang YH, Lee JK, Hong YJ, Hong SI, Lee SS. Incidence and histologic patterns of bone marrow involvement of malignant lymphoma based on the World Health Organization classification: a single institution study. Korean J Lab Med 2007;27(6):383–7.
Bishop PW, McNally K, Harris M. Audit of bone marrow trephines. J Clin Pathol 1992;45(12):1105–8.
Bain BJ, Clark DM, Wilkins BS, editors. Bone marrow pathology. 4th edn. Oxford, UK: Wiley Blackwell Publications; 2010.
Butt F, Akhtar R, Rahmani T, Waheed A, Aman S, Hamid S. Bone Marrow Involvement in Lymphomas: Incidence and Co-relation with age and sex. Biomedica 2002;18:53–7.
Zhang QY, Foucar K. Bone marrow involvement by hodgkin and non-hodgkin Lymphomas. Hematol Oncol Clin North Am 2009;23(4):873–902.
Lee WI, Lee JH, Kim IS, Lee KN, Kim SH. Bone marrow involvement by non- Hodgkin's lymphoma. J Korean Med Sci 1994;9(5):402–8.
Hoffbrand AV, Catovsky D, Tuddenham EGD, Green AR, editors. Postgraduate Hematology. 6th ed. Oxford, UK: Wiley-Blackwell publications; 2011.
Fisher RI, Mauch PM, Harris NL, Friedberg JW. Non-Hodgkin’s lymphoma. In: Devita VT, Hellman S, Rosenberg SA, editors. Principles & Practice of Oncology. 7th ed. Philadelphia, USA: Lippincott William’s and Wilkins; 2005. p. 1957–2075.
Zinzani PL. Lymphoma: diagnosis, staging, natural history, and treatment strategies. Semin Oncol 2005;32(1 Suppl 1):S4–10.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.