BONE-MARROW EXAMINATION IN STAGING OF LYMPHOMA - REVISITED

Objective: The aim of this study was to establish the prevalence of bo ne marrow involvement in non-Hodgkin's Lymphoma (NHL) and Hodgkin's di sease, to assess the agreement in bone marrow involvement between vari ous modalities such as bone mat-row aspiration, unilateral and bilater al trephine biopsies and bone marrow clot section, and to determine th e association between the length of trephine biopsy and disease predic tion. Methods: The bone marrow specimens of 374 patients with establis hed diagnosis of lymphoma based on morphologic lymph node examination and immunophenotyping by immunohistochemistry were reviewed retrospect ively. Results: The most frequently encountered lymphoma by working fo rmulation classification regardless of age and site is diffuse large c ell lymphoma (50%) with a minimal involvement of the bone marrow (14.3 %). However, lymphoblastic lymphoma is the most common type in childre n with a bone marrow involvement reaching 38.7% excluding acute lympho blastic leukemia cases. Conclusion: In this group of patients, an addi tional bone marrow sampling showed no statistically significant increa se in the detection rate of bone marrow involvement. High detection ra te of involvement in bone marrow was noticed at a length of 2.0-2.5 cm . However, a lengthy biopsy of 2.5 cm does not significantly increase the yield of detection.