Value Of Different Bone Marrow Examinations In Diagnosing And Staging Lymphomas

Background Malignant lymphomas, which were categorized as Hodgkin lymphomas and non-Hodgkin lymphomas, were tumors originated from lymph nodes or extranodal lymph tissues. The morbidity and mortality of lymphomas were increased significantly in recent years. According to the latest WHO statistical data, lymphomas were ranked among the top10malignant tumors, most of which were non-Hodgkin lymphomas. Besides lymph nodes and extranodal lymph tissues, lymphomas could also infiltrate bone marrow and peripheral blood and cause lymphoma cell bone marrow infiltration and lymphoma cell leukemia. Different from Hodgkin lymphomas, non-Hodgkin lymphomas were more malignantly, they were more aggressive in extranodal infiltration and distant metastasis. It was easier for non-Hodgkin lymphomas to infiltrate bone marrow and peripheral blood. For patients newly diagnosed as lymphomas, whether bone marrow were infiltrated directly determined tumor staging and affecting clinical treatment strategies and evaluate their prognosis. For patients with fever of unknown origin, or hematological abnormalities but without enlarge lymph nodes nor hepatolienomegaly, or hepatolienomegaly but difficult to be biopsy, bone marrow examination could be helpful in diagnosis. The method of bone marrow examination had developed from single bone marrow smear to multiple technologies, such as bone marrow biopsy, flow cytometry, karyotype analysis and fusion gene. To determine whether bone marrow infiltrated by lymphoma cells, different examination technology had their own advantages and disadvantages.Objective The aim of this study is to investigate the value of different bone marrow examinations (bone marrow smear, bone marrow biopsy and flow cytometry) in diagnosing and staging lymphomas.Methods To evaluate the outcome, the impact on clinical staging and the risk of bone marrow infiltration in subtypes, we examined the bone marrow smear from74patients suffering from lymphomas in Shan Xi Tumor Hospital from Feb.2010to May.2011, and bone marrow biopsy and flow cytometry were performed simultaneously.Results1.The positive rate of lymphoma involved in bone marrow detected by bone marrow smear was16.2%(12/74),13.5%(10/74) by bone marrow biopsy and31.1%(23/74) by flow cytometry. The results showed that the positive rate by flow cytometry was much higher than those by bone marrow smear and biopsy(P<0.05).2. The clinical staging could be revised by examinations combining bone marrow smear, bone marrow biopsy and flow cytometry.3. Among all subtypes, the percentage of diffuse large B cell lymphoma involved in bone marrow was the highest.4. Bone marrow examinations played an important role on diagnosis for patients without lymphadenectasis or hepatosplenomegaly.Conclusions The study demonstrated that bone marrow smear, bone marrow biopsy and flow cytometry contributed the clinical significance in diagnosing and staging lymphoma, respectively, and each was complementary and could not be replaced by each other..