Bone marrow histopathology in peripheral T‐cell lymphomas

Abstract

Peripheral T-cell lymphomas (PTCL) account for 10-15% of all lymphoproliferative disorders in the western hemisphere. In PTCL, bone marrow biopsy is performed to establish the diagnosis, rule out other pathology, assess the extent of disease and monitor treatment response. The frequency and histology of bone marrow involvement varies greatly between different clinicopathological entities recognized by the World Health Organisation (WHO) classification, reflecting the differences in the underlying biology. Some lymphomas, such as angioimmunoblastic T-cell lymphoma, show nodular and/or interstitial pattern of infiltration with accompanying reactive changes. Others, including hepatosplenic T-cell lymphoma and large granular lymphocyte leukaemia, are characterized by intrasinusoidal infiltration. In many instances the pathological features are subtle and immunohistochemical and molecular studies are required for the diagnosis. Histological appearances may overlap with a variety of reactive T-cell proliferations and other malignancies. Furthermore PTCL frequently induce secondary changes in the marrow that may obscure the neoplastic infiltrate. The diagnosis often requires critical integration of the information obtained from clinical features, peripheral blood, bone marrow aspirate and biopsy findings. In this article we review the histopathology of bone marrow biopsy in PTCL within the context of the new WHO classification.

Spectrum of bone marrow findings in patients with angioimmunoblastic T‐cell lymphoma

“…AITL is unique among peripheral T-cell lymphomas in that numerous B cells can be present in involved lymph nodes (Dogan et al, 2003;Dogan & Morice, 2004). These B cells are present in some cases within hyperplastic or regressed Without an established diagnosis of AITL, these findings can lead to misinterpretation of BM AITL infiltrates as benign lymphoid aggregates or T-cell rich large B-cell lymphoma respectively.…”

T and B lymphocyte abnormalities in bone marrow biopsies of common variable immunodeficiency

“…Alternatively, the nodular T-cell infiltrates may represent autoreactive T-cell clones impeding the early B-cell differentiation in analogy to the well-known T lymphoproliferative disorders leading to autoimmune cytopenia, pure red cell aplasia, or neutropenia. 46,47 We favor the hypothesis of activated T cells playing a decisive pathogenic role in our 9 CVID patients presenting with a partial differentiation block at the pre-B-I stage, although the association with nodular T-cell infiltrates did not reach statistical significance (P ϭ .1). We think that this is mainly because of the limited number of cases rather than to the inclusion of patients with B-cell activating factor receptor (patients 1 and 19) or transmembrane activator and modulator and cyclophilin ligand interactor polymorphisms (patients 18 and 22) and ICOS deficiency (patient 13); at least recalculation without the ICOS-deficient patient did not change the statistics.…”

Diagnosis and Classification of Malignant Lymphoma and Related Entities in the Bone Marrow Trephine Biopsy

“…10% of all NHL in Western countries. The frequency of BM infiltration is strongly dependent on the lymphoma subtype [72][73][74] . Leukemic and generalized T-NHL including T-cell large granular lymphocyte leukemia (T-LGL), T-cell prolymphocytic leukemia (T-PLL) and hepatosplenic T-cell lymphoma involve the BM in virtually all cases, but the infiltrate is frequently subtle and difficult to recognize by morphology.…”

“…BM infiltration is relatively common and usually characterized by irregular, nodular infiltrates with a high content of reactive cells, making immunophenotypical characterization of the infiltrate difficult ( fig. 1 H, I) [72][73][74] . Angioimmunoblastic T-NHL (AITL) infiltrates the BM in the majority of cases and shows similar diagnostic features as in lymph node biopsies.…”