Significance of Bone Marrow Biopsy in Staging of Hodgkin’s Lymphoma

Abstract

Introduction:  Lymphomas are malignant neoplasms arising from the lymphoid tissue. They are divided into two groups,    Hodgkin's Lymphoma and Non- Hodgkin's Lymphoma. Staging of Hodgkin's lymphoma is important for the management and treatment of the patient. Bone marrow biopsy is one of the investigations carried out for staging of the disease along with other investigations.

Objective:  To determine the significance of bone marrow biopsy in clinical staging of patients diagnosed with Hodgkin's disease.

Study Design:  Descriptive case series study.

Settings:  Pathology Department King Edward Medical University Lahore, along with all the medical, surgical and oncology wards of Mayo hospital and affiliated hospitals.

Duration:  20^th March 2009 to 19^th September 2009.

Subjects:  50 patients diagnosed to have Hodgkin's lymphoma on lymph node biopsy.

Methods:  Clinical history was taken and relevant physical findings were recorded in the proforma.. CBC was done on Sysmex KX 21. Bone marrow aspirate and trephine biopsies were performed from posterior iliac crest. Bone marrow aspi-rates were stained with Wright- Giemsa stain and trephine biopsies were stained with Hematoxylin and Eosin. Aspirates and trephine biopsies were evaluated and assessed for cytological features, marrow architecture, haemopoietic tissue and any lymphoprolifrative infiltration.

Results:  Out of 50 patients bone marrow infiltration was seen in 15 (30%) cases. After bone marrow examination 5 patients in clinical stage II and 8 patients in stage III were placed in stage IV due to infiltration by Hodgkin's lymphoma.

Conclusions:  Bone marrow infiltration is more common in our setup as patients present at later stages. Bone marrow biopsy should be performed during initial staging of Hodgkin's lymphoma.

Key Words:  Hodgkin's lymphoma, Significance, Staging.