Bone biopsy in haematological disorders.

Abstract

SUMMARY Bone marrow biopsies are now widely used in the investigation and follow-up of many diseases. Semi-thin sections of 8216 undecalcified biopsies of patients with haematological disorders were studied. Observations were made on the cytopenias and the myelodysplastic syndromes, the acute leukaemias and the myeloproliferative disorders, Hodgkin's disease and the malignant lymphomas including multiple myeloma, hairy cell leukaemia and angioimmunoblastic lymphadenopathy. Bone marrow biopsies are essential for the differential diagnosis of most cytopenias and for the early recognition of fibrosis which most frequently occurred as a consequence of megakaryocytic proliferation in the myeloproliferative disorders. Different patterns of bone marrow involvement were found in the lymphoproliferative disorders and both their type and extent constituted factors of prognostic significance. A survey of the literature is given and the conclusion is drawn that bone marrow biopsies provide indispensible information for the diagnostic evaluation and the follow-up of patients with haematological disorders.

Lymphoid Nodules and Nodular Lymphoid Hyperplasia in Bone Marrow Biopsies

“…In acute leukemia it was easy to find LN even in children [where they are usually quite rare; Maeda et al, 1977]. We have confirmed the high LN incidence in myeloproliferative diseases [Brun ning, 1981;Burkhardt et al, 1982;Jäger et al, 1983], especially in idiopathic myelofibrosis [Hernandez Nieto et al, 1979] and in polycythemia vera [Navone et al, 1983].…”

“…An increased incidence of bone marrow LN has been seen in various diseases, e.g. hemolytic anemia [Duhamel, 1974;Burkhardt et al, 1982], myelofibrosis [Hernandez Nieto et al, 1979], polycythemia vera [Navone et al, 1983] and acute leu kemia [Ceffoet al, 1983]. NLH has been described in patients affected by rheumatoid arthritis, systemic lu- pus erythematosus, hemolytic anemia, and malignant lymphomas [Rywlin, 1976;Duhamel, 1978;Brunning.…”

“…In normal bone marrow the LN incidence is about 15% [Navone et al, 1982], LN have been the subject of few clinical studies performed on bone marrow aspirates or biopsies 'in vivo'. The incidence of LN is higher in sections of as pirated marrow [15-47%: Rywlin, 1976;Maeda et al, 1977] than in trephine biopsies [3-16%: Duhamel, 1974;Krause, 1981;Burkhardt et al, 1982], probably owing to the larger size of bone marrow sample ex amined in the former. An increased incidence of bone marrow LN has been seen in various diseases, e.g.…”

Bone marrow trephine biopsy in lymphoproliferative disease.

“…38 Although divergences between the histology of the lymph node and bone marrow have been described39"" subtyping of NHL in the bone marrow is, in most cases, clinically relevant.40 Not only the subtype but also the growth pattern is of important prognostic value.' 4243 Non-Hodgkin's lymphoma may manifest one, or a mixture, of the following growth patterns: nodular; interstitial; paratrabecular; patchy; and dense (packed marrow) ( fig 5).…”

Routine immunofluorescent and histochemical analysis of bone marrow involvement of lymphoma/leukaemia: The use of cryostat sections

“…More information can be obtained using cryostat sections of frozen samples; most membrane, cytoplasmic and nuclear antigens are detectable on this material, and an impressive array of markers (including those detected by conventional and monoclonal antibodies) is available for cell phenotyping (Stein et al, 1980;Gatter et al, 1982). This is also the case for bone marrow biopsies obtained for the diagnosis and staging of a number of neoplastic conditions, in particular Hodgkin's and non-Hodgkin's lymphomas (Byrnes et al, 1978;Burkhardt et al, 1982;Dick et al, 1974;Savage et al, 1978). In order to evaluate bone marrow involvement in non-Hodgkin's lymphoma by immunohistological methods we have recently developed a procedure for obtaining cryostat sections of unfixed non-decalcified trephine biopsies (Chilosi et al, 1982b;Pizzolo et al, 1982).…”