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11 - Lymphoma

from Part 2 - Hematological malignancies

Published online by Cambridge University Press:  06 December 2010

By
Jennifer Herrick  and
Ahmet Dogan
Edited by
Wendy N. Erber
Wendy N. Erber
Affiliation:
University of Western Australia, Perth
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Summary

Introduction

The cornerstone of the diagnosis of lymphoma is the architectural pattern and cytology of the lesion in the affected tissue and this is supplemented by immunophenotypic, molecular and cytogenetic characteristics. These features together define our modern classification scheme of lymphoma. These same investigations are utilized in the assessment of bone marrow involvement by lymphoma, but with some variations and limitations. The role of bone marrow examination varies according to the subtype of lymphoma. This chapter will provide the general principles and practical guidelines of the most useful diagnostic techniques for the detection of bone marrow involvement by malignant lymphomas. It will detail the typical features and roles of morphology, immunohistochemistry, flow cytometric immunophenotyping, cytogenetic and molecular testing in different types of lymphoma. The existence of significant variations from the classical description will be identified by “caveats.” Disease monitoring and pre-transplant assessment will be discussed where applicable. Acronyms used for the various entities are listed in Table 11.1.

General principles of bone marrow evaluation in lymphoma

Bone marrow examination is routinely performed for lymphoma staging. A bone marrow may also be performed as an ad hoc diagnostic procedure in patients suspected of having a neoplasm lymphoma but who are not deemed suitable for a surgical biopsy of the implicated tissue lesion (e.g. thrombocytopenia, anticoagulation, unsuitable for general anesthesia). In many specimens malignancy (hematopoietic or non-hematopoietic) and cell lineage can be established. However, accurate sub-typing may require correlation with a tissue biopsy.

Type
Chapter
Information
Diagnostic Techniques in Hematological Malignancies , pp. 206 - 243
Publisher: Cambridge University Press
Print publication year: 2010

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References

Zhang, QY, Foucar, K. Bone marrow involvement by Hodgkin and non-Hodgkin lymphomas. Hematol Oncol Clin N Am 2009;23(4):873–902.CrossRefGoogle ScholarPubMed
Wang, J, Weiss, LM, Chang, KLet al. Diagnostic utility of bilateral bone marrow examination: significance of morphologic and ancillary technique study in malignancy. Cancer 2002;94(5):1522–31.CrossRefGoogle ScholarPubMed
Evans, PA, Pott, Ch, Groenen, PJet al. PCR-based clonality testing in B-cell malignancies by use of multiple immunoglobulin gene targets. Report of the BIOMED-2 Concerted Action BHM4-CT98–3936. Leukemia 2007;21(2):207–14.CrossRefGoogle ScholarPubMed
Aksentijevich, I, Flinn, IW. Monoclonal antibody therapy with autologous peripheral blood stem cell transplantation for non-Hodgkin's lymphoma. Cancer Control 2002;9(2):99–105.CrossRefGoogle ScholarPubMed
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(12):1549–57.CrossRefGoogle ScholarPubMed
Iancu, D, Hao, S, Lin, Pet al. Follicular lymphoma in staging bone marrow specimens: correlation of histologic findings with the results of flow cytometry immunophenotypic analysis. Arch Pathol Lab Med 2007;131(2):282–7.Google ScholarPubMed
Schmidt, B, Kremer, M, Götze, Ket al. Bone marrow involvement in follicular lymphoma: comparison of histology and flow cytometry as staging procedures. Leuk Lymphoma 2006;47(9):1857–62.CrossRefGoogle ScholarPubMed
Gu, K, Chan, WC, Hawley, RC. Practical detection of t(14;18)(IgH/BCL2) in follicular lymphoma. Arch Pathol Lab Med 2008;132(8):1355–61.Google Scholar
Campbell, LJ. Cytogenetics of lymphomas. Pathology 2005;37(6):493–507.CrossRefGoogle ScholarPubMed
Belaud-Rotureau, MA, Parrens, M, Carrere, Net al. Interphase fluorescence in situ hybridization is more sensitive than BIOMED-2 polymerase chain reaction protocol in detecting IGH-BCL2 rearrangement in both fixed and frozen lymph node with follicular lymphoma. Hum Pathol 2007;38(2):365–72.CrossRefGoogle ScholarPubMed
Mandigers, CM, Meijerink, JP, 't Veer, MBet al. Dynamics of circulating t(14;18)-positive cells during first-line and subsequent lines of treatment in follicular lymphoma. Ann Hematol 2003;82(12):743–9.CrossRefGoogle Scholar
Hirt, C, Schüler, F, Kiefer, T, Schwenke, Cet al. Rapid and sustained clearance of circulating lymphoma cells after chemotherapy plus rituximab: clinical significance of quantitative t(14;18) PCR monitoring in advanced stage follicular lymphoma patients. Br J Haematol 2008;141(5):631–40.CrossRefGoogle Scholar
Arcaini, L, Montanari, F, Alessandrino, EPet al. Immunochemotherapy with in vivo purging and autotransplant induces long clinical and molecular remission in advanced relapsed and refractory follicular lymphoma. Ann Oncol 2008;19(7):1331–5.CrossRefGoogle ScholarPubMed
Swerdlow, SH, Campo, E, Harris, NLet al. (eds.). WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues, 4th edn. Lyon: IARC Press; 2008.
Thomas, PW, Avet-Loiseau, H, Oscier, D. A subset of t(11;14) lymphoma with mantle cell features displays mutated IgVH genes and includes patients with good prognosis, non-nodal disease. Blood 2003;101(12):4975–81.Google Scholar
Boer, CJ, Kluin-Nelemans, JC, Dreef, Eet al. Involvement of the CCND1 gene in hairy cell leukemia. Ann Oncol 1996;7(3):251–6.CrossRefGoogle ScholarPubMed
Fu, K, Weisenburger, DD, Greiner, TCet al. Lymphoma/Leukemia Molecular Profiling Project. Cyclin D1-negative mantle cell lymphoma: a clinicopathologic study based on gene expression profiling. Blood. 2005;106(13):4315–21.CrossRefGoogle ScholarPubMed
Brizova, H, Kalinova, M, Krskova, L, Mrhalova, M, Kodet, R. Quantitative monitoring of cyclin D1 expression: a molecular marker for minimal residual disease monitoring and a predictor of the disease outcome in patients with mantle cell lymphoma. Int J Cancer 2008;123(12):2865–70.CrossRefGoogle Scholar
Inamdar, KV, Medeiros, LJ, Jorgensen, JLet al. Bone marrow involvement by marginal zone B-cell lymphomas of different types. Am J Clin Pathol 2008;129(5):714–22.CrossRefGoogle ScholarPubMed
Orchard, J, Garand, R, Davis, Zet al. Bone marrow histology in marginal zone B-cell lymphomas: correlation with clinical parameters and flow cytometry in 120 patients. Ann Oncol 2009;20(1):129–36.Google Scholar
Dong, HY, Weisberger, J, Liu, Z, Tugulea, S. Immunophenotypic analysis of CD103+ B-lymphoproliferative disorders: hairy cell leukemia and its mimics. Am J Clin Pathol 2009;131(4):586–95.CrossRefGoogle ScholarPubMed
Remstein, ED, Dogan, A, Einerson, RRet al. The incidence and anatomic site specificity of chromosomal translocations in primary extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) in North America. Am J Surg Pathol 2006;30(12):1546–53.CrossRefGoogle Scholar
Baiyee, D, Warnke, R, Natkunam, Y. Lack of utility of CD20 immunohistochemistry in staging bone marrow biopsies for diffuse large B-cell lymphoma. Appl Immunohistochem Mol Morphol 2009;17(2):93–5.CrossRefGoogle ScholarPubMed
Duggan, PR, Easton, D, Luider, J, Auer, IA. Bone marrow staging of patients with non-Hodgkin lymphoma by flow cytometry: correlation with morphology. Cancer 2000;88(4):894–9.3.0.CO;2-O>CrossRefGoogle ScholarPubMed
Talaulikar, D, Dahlstrom, JE. Staging bone marrow in diffuse large B-cell lymphoma: the role of ancillary investigations. Pathology 2009;41(3):214–22.CrossRefGoogle ScholarPubMed
Skinnider, BF, Horsman, , Dupuis, B, Gascoyne, RD. Bcl-6 and Bcl-2 protein expression in diffuse large B-cell lymphoma and follicular lymphoma: correlation with 3q27 and 18q21 chromosomal abnormalities. Hum Pathol 1999;30(7):803–8.CrossRefGoogle ScholarPubMed
Bellan, C, Stefano, L, Giulia, F, Rogena, EA, Lorenzo, L. Burkitt lymphoma versus diffuse large B-cell lymphoma: a practical approach. Hematol Oncol 2009;27(4):182–5.CrossRefGoogle ScholarPubMed
Busch, K, Borkhardt, A, Wössmann, W, Reiter, A, Harbott, J. Combined polymerase chain reaction methods to detect c-myc/IgH rearrangement in childhood Burkitt's lymphoma for minimal residual disease analysis. Haematologica 2004;89(7):818–25.Google ScholarPubMed
Hebeda, KM, Altena, MC, Rombout, P, Krieken, JH, Groenen, PJ. PCR clonality detection in Hodgkin lymphoma. J Hematop 2009;2(1):34–41.CrossRefGoogle ScholarPubMed
Savage, KJ, Harris, NL, Vose, JMet al. International Peripheral T-Cell Lymphoma Project. ALK− anaplastic large-cell lymphoma is clinically and immunophenotypically different from both ALK+ ALCL and peripheral T-cell lymphoma, not otherwise specified: report from the International Peripheral T-Cell Lymphoma Project. Blood 2008;111(12):5496–504.CrossRefGoogle Scholar
Benner, MF, Willemze, R. Bone marrow examination has limited value in the staging of patients with an anaplastic large cell lymphoma first presenting in the skin. Retrospective analysis of 107 patients. Br J Dermatol 2008;159(5):1148–51.Google ScholarPubMed
Weinberg, OK, Seo, K, Arber, DA. Prevalence of bone marrow involvement in systemic anaplastic large cell lymphoma: are immunohistochemical studies necessary?Hum Pathol 2008;39(9):1331–40.CrossRefGoogle ScholarPubMed
Bovio, IM, Allan, RW. The expression of myeloid antigens CD13 and/or CD33 is a marker of ALK+ anaplastic large cell lymphomas. Am J Clin Pathol 2008;130(4):628–34.CrossRefGoogle ScholarPubMed
Muzzafar, T, Wei, EX, Lin, Pet al. Flow cytometric immunophenotyping of anaplastic large cell lymphoma. Arch Pathol Lab Med 2009;133(1):49–56.Google ScholarPubMed
Kalinova, M, Krskova, L, Brizova, Het al. Quantitative PCR detection of NPM/ALK fusion gene and CD30 gene expression in patients with anaplastic large cell lymphoma – residual disease monitoring and a correlation with the disease status. Leuk Res 2008;32(1):25–32.CrossRefGoogle Scholar
Grogg, KL, Morice, WG, Macon, WR. Spectrum of bone marrow findings in patients with angioimmunoblastic T-cell lymphoma. Br J Haematol 2007;137(5):416–22.CrossRefGoogle ScholarPubMed
Khokhar, FA, Payne, WD, Talwalkar, SSet al. Angioimmunoblastic T-cell lymphoma in bone marrow: a morphologic and immunophenotypic study. Hum Pathol 2010;41(1):79–87.CrossRefGoogle ScholarPubMed
Bellan, C, Stefano, L, Giulia, F, Rogena, EA, Lorenzo, L. Burkitt lymphoma versus diffuse large B-cell lymphoma: a practical approach. Hematol Oncol 2010;28(2):53–6.Google ScholarPubMed

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