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Liu E.-B.,Hospital of Blood Diseases CAMS and PUMC | Zhang P.-H.,Hospital of Blood Diseases CAMS and PUMC | Li Z.-Q.,Hospital of Blood Diseases CAMS and PUMC | Sun Q.,Hospital of Blood Diseases CAMS and PUMC | And 3 more authors.
Journal of Leukemia and Lymphoma | Year: 2010

Objective: To explore the bone marrow pathology ,diagnosis and differential diagnosis of Waldenström macroglobulinemia(WM). Methods: 19 WM patients was examined by bone marrow aspiration (BMA) and bone marrow biopsy (BMB) for morphology. Flow cytometry (FCM) and immunohistochemistry (IHC) for immunophenotyping. Results: Plasmacytoid lymphocytes were identified in 11 BMA. All of 19 BMB were involved by lymphoma cells. 17 cases showed a predominance of small lymphocytes and 2 of plasmacytoid lymphocytes. Typically plasmacytoid lymphocytes were not seen in 4 cases. Patterns of bone marrow involvement were as follow: diffuse (12 cases), nodular (4 cases), interstitial (3 cases). Immunophenotypically, FCM showed all cases were CD19 +, CD20 +, CD22 +, CD5 - and CD10 -. IHC revealed small lymphocytes and plasmacytoid lymphocytes were Pax5+ CD20 + and plasma cells were CD38 +CD138 +, CD20 - Pax5-. Conclusion: Small lymphocytes proliferation with plasmacytic differentiation is the typical bone marrow pathologic features of WM. IHC is benefit for identifying lymphocytes and plasma cells components. The Combination of morphology, FCM and IHC is contributive to the diagnosis and differentiation of WM.


Liu E.-B.,Hospital of Blood Diseases CAMS and PUMC
Journal of Leukemia and Lymphoma | Year: 2010

Objective: To explore the bone marrow pathology ,diagnosis and differential diagnosis of diffuse large B cell lymphoma (DLBCL) bone marrow involvemem(BMI). Methods: Morphologic observation was performed on bone marrow biopsies (BMB) stained with Hematoxylin-eosin(HE) from 24 patients with DLBCL BMI. Immunohistochemistry (IHC) for immunophenotyping was conducted on 20 patients. The morphology of lymphoma cells in the medullary and extramedullary was compared for 10 cases with primary lymphoma. Results: Patterns of DLBCL BMI were presented by: diffuse(14 cases), interstitial(6 cases), mixed (2 case), nodular (1 case) and intrasinusoidal (1 case) types. The extent of BMI included severe(15 cases), moderate(4 cases) and mild (5 cases). The common morphological variants was centroblastic (21 cases) and the remainder was immunoblastic (3 cases). IHC showed the lymphoma cells expressing one or more B cell markers, including CD20, CD45RA and Pax5. They were negative for CD 3, CD45RO, CD5, CD10, TdT, Cyclin D1, CD38, CD68 and MPO.The morphology of lymphoma cells in the medullary was concordant with extramedullary of 10 cases with primary lymphoma. Conclusion: For most patients, bone marrow pathology of DLBCL BMI is distinctive. In the minority, IHC is contributive to the differentiation of the mild and interstitial pattern of BMI and merged with more small lymphocytes. Bone marrow biopsy is significantly important in the diagnosis of DLBCL BMI.

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