Primary isolated bone marrow disease as presenting feature of non-Hodgkin's lymphoma (NHL) is very rare. We describe an elderly patient who presented with pancytopenia and was initially diagnosed as acute leukemia on the basis of morphology on peripheral blood. Flow cytometry (FCM) showed light chain restriction. Later on bone marrow biopsy along with immunohistochemistry (IHC) revealed results in concordance to FCM. Correlation of morphological findings with FCM, IHC and other ancillary techniques serves an adjunctive role in the diagnosis and classification of NHL. Immunophenotyping by flow cytometry as an auxiliary method and in correlation with morphological findings can make the diagnosis of B-cell lymphomas faster and more specific.

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