Prevalence of bone marrow involvement in systemic anaplastic large cell lymphoma: are immunohistochemical studies necessary?

Olga K. Weinberg, Katie Seo, Daniel A. Arber

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

The frequency of bone marrow involvement in anaplastic large cell lymphoma has been reported with great variation. A prior study found that anaplastic large cell lymphoma involvement of bone marrow was often not evident on routine stains and advocated using immunohistochemical studies. We evaluated 70 bone marrow biopsies from 41 patients with anaplastic large cell lymphoma and found 10 morphologically involved cases (14% of all biopsies, 22% of all patients). In most cases (9/10 biopsies), the involvement of the bone marrow by anaplastic large cell lymphoma was massive and, thus, was evident on the hematoxylin and eosin section. In only 1 biopsy (1% of all biopsies, 2% of all patients), the involvement was minimal and more difficult to detect. To determine if the hematoxylin and eosin evaluation missed bone marrow involvement, we used a panel of antibodies including CD30, ALK-1, epithelial membrane antigen, and granzyme. Only the 10 morphologically involved cases showed anaplastic large cell lymphoma cells with distinct CD30 expression. Other stains highlighted only a subset of the CD30-positive cases. Clinical follow-up was available for 30 patients and shows correlation of marrow involvement with lower overall survival (P = .033). Overall, marrow involvement in anaplastic large cell lymphoma was relatively uncommon, and when present, it was identified on hematoxylin and eosin sections.

Original languageEnglish (US)
Pages (from-to)1331-1340
Number of pages10
JournalHuman Pathology
Volume39
Issue number9
DOIs
StatePublished - Sep 2008
Externally publishedYes

Keywords

  • ALK
  • Anaplastic large cell lymphoma
  • Bone marrow biopsy
  • CD30
  • EMA
  • Granzyme

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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