Pattern of Bone Marrow Infiltration in Non-Hodgkin’s Lymphomas

Abstract

Background: Non-Hodgkin’s lymphomas have a
predilection for bone marrow involvement, and bone
marrow biopsy is performed in an attempt to evaluate
stage IV disease. This study was conducted to evaluate the
pattern of bone marrow infiltration and morphology of
atypical cells in freshly diagnosed patients of Non-
Hodgkin’s Lymphomas (NHL).
Methods: This prospective, descriptive study was
conducted in the Department of Pathology, Pakistan
Institute of Medical Sciences (PIMS) Islamabad from
January 2003 to December 2004. A total of 50 cases of non-
Hodgkin’s lymphoma diagnosed on tissue biopsy, and
found to have bone marrow infiltration were randomly
selected. The H & E stained trephine sections were
examined for evidence of infiltration and pattern of
infiltration, viz. focal random, focal para-trabecular,
diffuse interstitial and diffuse infiltration.
Results: In 52% patients, the infiltration was diffuse; of
these patients, 34% showed a complete replacement of
normal marrow cellular elements by lymphoma cells, and
18% manifested diffuse interstitial infiltration. An
additional 10% cases manifested diffuse as well as diffuse
interstitial infiltration. In 30% of patients diffuse or
diffuse interstitial infiltration was accompanied with focal
random or focal paratrabecular infiltration.
Conclusion: Diffuse bone marrow infiltration is much
more common in our set-up probably because of a
relatively late presentation by patients of non-Hodgkin’s
lymphoma