Differentiating Benign From Malignant Bone Marrow B-Cell Lymphoid Aggregates: A Statistical Analysis of Distinguishing Features

Abstract

When taken collectively, the presence of more than 2 of these characteristic features was strongly predictive of malignancy.

The cut-offs for kappa/lambda ratio in bone marrow immunohistochemistry for the diagnosis of multiple myeloma

“…B cell morphology and lymphoid infiltrate were evaluated based on CD20. Additional specimen exclusions if plasma cell count <100 cell/histologic section, PC% <10, weak or high background staining of kappa or lambda, and histologically suspicious of B-cell neoplasm (large cell size or lymphoid aggregate was having an infiltrative edge or predominantly B cells or central cores of B cells or size greater than 600 microns) [12].…”

The prognostic significance of monoclonal immunoglobulin gene rearrangement in conjunction with histologic B‐cell aggregates in the bone marrow of patients with diffuse large B‐cell lymphoma

“…In addition, the possible limitations of microscopic examination might have been reduced, as structural changes may have been relatively less affected by artifacts such as tissue processes. Although small (<600 μ m) nonparatrabecular, well‐circumscribed aggregates of small‐ to medium‐sized mature B cells within bone marrow have been considered to be benign lymphoid aggregates in previous studies , the clonal status of such B‐cell aggregates was not robustly investigated in those studies. In fact, this study noted that the growth pattern of histologic B‐cell aggregates itself was closely related to poor prognostic factors such as high IPI scores and significantly associated with an inferior OS rate.…”

“…S1A and B). Proliferations of small‐ to medium‐sized mature B cells that occupied large proportions of marrow surfaces and showed characteristic growth patterns indicative of malignant lymphoid aggregates such as paratrabecular location, infiltrative edges, inclusion of fat cells or location surrounding large sinuses were defined as small cell B‐cell lymphoma aggregates (Fig. S1C and D).…”

“…S1C and D). Sparse collections of nonparatrabecular, interstitial aggregates of small‐ to medium‐sized mature B cells were defined as B‐cell aggregates of unknown biological potential because lymphoid aggregates of this category could not fulfill the criteria of lymphoma due to low cellularity and/or lack of histologic characteristics indicative of malignant lymphoid aggregates (Fig.S1E–H).…”

Morphology and Immunoprofiling of Benign Lymphoid Aggregates in Bone Marrow Biopsies of Lymphoma Patients

“…BLA in bone marrow have been reported to be frequently associated with certain conditions including aging, autoimmune diseases, inflammatory conditions, and infectious disorders. 1 They have also been reported to be commonly identified in patients with myeloproliferative neoplasms, especially primary myelofibrosis. Moreover, an increased incidence of BLA in patients with lymphoma who have been treated with rituximab has been reported.…”