Korean J Lab Med.  2007 Dec;27(6):383-387. 10.3343/kjlm.2007.27.6.383.

Incidence and Histologic Patterns of Bone Marrow Involvement of Malignant Lymphoma Based on the World Health Organization Classification: A Single Institution Study

• Jeong SY
• Chang YH
• Lee JK
• Hong YJ
• Hong SI
• Lee SS

• KMID: 1781540
• DOI: http://doi.org/10.3343/kjlm.2007.27.6.383

Abstract

BACKGROUND: Working Formulation and Revised European American Classification of Lymphoid Neoplasms (REAL) have mainly been used in the studies for bone marrow involvement of malignant lymphoma in Korea. We investigated the incidence and histologic patterns of malignant lymphoma according to the WHO classification. METHODS: This study included 507 cases of malignant lymphoma that were requested for bone marrow study for the staging during the period January 1999-December 2005 in Korea Cancer Center Hospital. Medical records, peripheral blood smears, bone marrow aspiration smears, biopsy sections, and histopathologic findings were analyzed retrospectively. RESULTS: Of the 507 cases of malignant lymphoma, 473 (93.3%) were non-Hodgkin lymphoma (NHL) and 34 (6.7%) were Hodgkin lymphoma (HL). The overall incidence of bone marrow involvement by NHL and HL was 12.5% (59/473) and 11.8% (4/34), respectively. Among NHL cases, the incidence of bone marrow involvement by B-cell and T-cell neoplasms was 11.4% (43/377) and 16.7% (16/96), respectively. Although the incidences of bone marrow involvement by several B-cell neoplasms were more than 30%, diffuse large B cell lymphoma showed a relatively low incidence of bone marrow involvement (4.6%). Of bone marrow involvement patterns, diffuse infiltration pattern was the most common (40.0%). Peripheral blood involvement by lymphoma was observed in 35.6% of cases with bone marrow involvement. CONCLUSIONS: We used WHO classification in the study for the bone marrow involvement of malignant lymphoma, and this single-institution study should give a useful, up-to-date histopathologic information.

Keyword

WHO classification; Malignant lymphoma; Bone marrow involvement

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Bone Marrow/*pathology
Child
Child, Preschool
Female
Hodgkin Disease/classification/epidemiology/*pathology
Humans
Incidence
Lymphoma, B-Cell/classification/epidemiology/*pathology
Lymphoma, T-Cell/classification/epidemiology/*pathology
Male
Middle Aged
Neoplasm Invasiveness
Retrospective Studies
World Health Organization

Reference

1.Chung ME., Cho NS., Hong SI., Lee DS. Bone marrow involvement by malignant lymphoma: a study on the incidence and histologic patterns. Korean J Hematol. 1995. 30:101–10. (정미은, 조남선, 홍석일, 이동순. 악성림프종의 골수침습 빈도 및 양상. 대한혈액학회지 1995;30;101-10.).

2.Yoon JH., Park HS., Kim CW., Cho HI. Bone marrow involvement of malignant lymphoma. Korean J Hematol. 1993. 28:373–87. (윤종현, 박효순, 김철우, 조한익. 악성림프종의 골수침습. 대한혈액학회지 1993;28: 373-87.).

3.Hahn JS., Park JW., Min YH., Ko YW., Yang WI., Choi IJ. A clinical study on bone marrow involvement in malignant lymphoma. Korean J Hematol. 1990. 25:369–79. (한지숙, 박중원, 민유홍, 고윤웅, 양우익, 최인준. 악성 임파종의 골수 침범에 관한 임상적 연구. 대한혈액학회지 1990;25: 369-79.).

4.Jaffe ES, Harris NL, editors. WHO classification of tumours. Pathology and genetics of tumours of haematopoietic and lymphoid tissues. Lyon, France: IARC Press;2001. p. 109–253.

5.Yang WI. Neoplastic disease of the hematopoietic and lymphoid tissues: New world health organization classification. Korean J Pathol. 2002. 36:137–45. (양우익. 조혈림프조직의종양성질환: 새로운세계보건기구분류법. 대한병리학회지 2002;36: 137-45.).

6.Seo EJ., Chi HS. Bone marrow involvement by non-Hodgkin's lymphoma: incidence, histopathology and diagnostic efficacies. Korean J Clin Pathol. 1994. 14:20–9. (서을주 및 지현숙. 비호즈킨 림프종의골수침범에관한연구. 대한임상병리학회지 1994;14: 20-9.).

7.Lee WI., Lee JH., Kim IS., Lee KN., Kim SH. Bone marrow involvement by non-Hodgkin's lymphoma. J Korean Med Sci. 1994. 9:402–8.

8.Kang YK., Kim BS., Kim TW., Ryu MH., Lee SS., Ryoo BY, et al. Clinicopathologic characteristics of Korean non-Hodgkin's lymphomas based on REAL classification. J Korean Cancer Assoc. 1999. 31:641–52. (강윤구, 김봉석, 김태원, 류민희, 이승숙, 류백렬등. REAL 분류에근거한 한국인 비호즈킨 림프종의 임상-병리학적 특성. 대한 암학회지 1999;31: 641-52.).

9.Ko YH., Kim CW., Park CS., Jang HK., Lee SS., Kim SH, et al. REAL classification of malignant lymphomas in the Republic of Korea: incidence of recently recognized entities and changes in clinicopathologic features. Hematolymphoreticular Study Group of the Korean Society of Pathologists. Revised European-American lymphoma. Cancer. 1998. 83:806–12.

10.Morra E., Lazzarino M., Castello A., Inverardi D., Coci A., Pagnucco G, et al. Bone marrow and blood involvement by non-Hodgkin's lymphoma: a study of clinicopathologic correlations and prognostic significance in relationship to the Working Formulation. Eur J Haematol. 1989. 42:445–53.

11.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. 29:1549–57.

12.Juneja SK., Wolf MM., Cooper IA. Value of bilateral bone marow biopsy specimens in non-Hodgkin's lymphoma. J Clin Pathol. 1990. 43:630–2.