BACKGROUND: The National Cancer Institute has recommended a bone marrow biopsy length of >/=20 mm for the staging and surveillance of patients with non-Hodgkin's lymphoma. However, there are few published data to support this recommendation, particularly the role of examining multiple levels. PATIENTS AND METHODS: Bone marrow biopsies from 172 patients with newly diagnosed diffuse large cell lymphoma (DLCL) entered in two consecutive trials of the Australasian Leukaemia and Lymphoma Group were analysed. The original haematoxylin and eosin-stained trephine biopsy and two or more deeper sections cut at 0.1-0.2 mm intervals were assessed with respect to the morphology, extent and pattern of lymphomatous involvement. The rate of positive diagnosis was correlated with the length of the biopsy specimen and the number of sections examined. RESULTS: Forty-seven biopsies (27%) demonstrated marrow involvement on examination of a mean of four trephine biopsy sections. The rate of positivity increased with the examination of multiple levels and correlated with increasing trephine length but was not dependent on the number of sites sampled. Twenty per cent of biopsies <20 mm in length were positive for lymphoma; this increased to 35% for biopsies >/=20 mm (P = 0.023). CONCLUSIONS: Morphological bone marrow involvement in DLCL is optimally demonstrated by a 20-mm long trephine biopsy from a single site which is examined at multiple levels (four or more). This obviates the need for bilateral sampling, thereby reducing patient morbidity from the procedure. This study provides evidence to support the National Cancer Institute recommendations regarding trephine biopsy in the staging of DLCL, providing multiple levels are examined.
BACKGROUND: The National Cancer Institute has recommended a bone marrow biopsy length of >/=20 mm for the staging and surveillance of patients with non-Hodgkin's lymphoma. However, there are few published data to support this recommendation, particularly the role of examining multiple levels. PATIENTS AND METHODS: Bone marrow biopsies from 172 patients with newly diagnosed diffuse large cell lymphoma (DLCL) entered in two consecutive trials of the Australasian Leukaemia and Lymphoma Group were analysed. The original haematoxylin and eosin-stained trephine biopsy and two or more deeper sections cut at 0.1-0.2 mm intervals were assessed with respect to the morphology, extent and pattern of lymphomatous involvement. The rate of positive diagnosis was correlated with the length of the biopsy specimen and the number of sections examined. RESULTS: Forty-seven biopsies (27%) demonstrated marrow involvement on examination of a mean of four trephine biopsy sections. The rate of positivity increased with the examination of multiple levels and correlated with increasing trephine length but was not dependent on the number of sites sampled. Twenty per cent of biopsies <20 mm in length were positive for lymphoma; this increased to 35% for biopsies >/=20 mm (P = 0.023). CONCLUSIONS: Morphological bone marrow involvement in DLCL is optimally demonstrated by a 20-mm long trephine biopsy from a single site which is examined at multiple levels (four or more). This obviates the need for bilateral sampling, thereby reducing patient morbidity from the procedure. This study provides evidence to support the National Cancer Institute recommendations regarding trephine biopsy in the staging of DLCL, providing multiple levels are examined.
Authors: Sweet Ping Ng; Richard Khor; Mathias Bressel; Michael MacManus; John F Seymour; Rodney J Hicks; Andrew Wirth Journal: Eur J Nucl Med Mol Imaging Date: 2018-08-07 Impact factor: 9.236
Authors: Z Yao; L Deng; Z Y Xu-Monette; G C Manyam; P Jain; A Tzankov; C Visco; G Bhagat; J Wang; K Dybkaer; W Tam; E D Hsi; J H van Krieken; M Ponzoni; A J M Ferreri; M B Møller; J N Winter; M A Piris; L Fayad; Y Liu; Y Song; R Z Orlowski; H Kantarjian; L J Medeiros; Y Li; J Cortes; K H Young Journal: Leukemia Date: 2017-07-12 Impact factor: 11.528
Authors: Ho Young Kim; Ju-Seok Kim; Dae Ro Choi; Hyeong Su Kim; Jung Hye Kwon; Geun-Doo Jang; Jung Han Kim; Joo Young Jung; Hun Ho Song; Young Kyung Lee; Soo Kee Min; Hee Sung Hwang; Hwa Jung Kim; Dae Young Zang; Hyo Jung Kim Journal: Cancer Res Treat Date: 2014-11-24 Impact factor: 4.679
Authors: Mihai Merzianu; Adrienne Groman; Alan Hutson; Claudiu Cotta; Russell K Brynes; Attilio Orazi; Vishnu Reddy; Julie Teruya-Feldstein; Ramila Amre; Manjula Balasubramanian; Guilherme Brandao; Sindhu Cherian; Elizabeth Courville; David Czuchlewski; Guang Fan; David Grier; Daniela Hoehn; Kedar V Inamdar; Ridas Juskevicius; Prabhjot Kaur; John Lazarchick; Michael R Lewis; Rodney R Miles; Jerome B Myers; Michel R Nasr; Hina N Qureishi; Horatiu Olteanu; Valentin G Robu; Gratian Salaru; Neerja Vajpayee; Jeffrey Vos; Ling Zhang; Shanxiang Zhang; Le Aye; Elisa Brega; James E Coad; John Grantham; Sinisa Ivelja; Robert McKenna; Kieran Sultan; Gregory Wilding; Robert Hutchison; LoAnn Peterson; Richard T Cheney Journal: Am J Clin Pathol Date: 2018-10-01 Impact factor: 2.493