Naghmana Mazher, Seema Mazher, Naumaan Aslam, Zafar Iqbal.
Frequency of bone marrow infiltration in NHL patients; unilateral versus bilateral bone marrow examination.
Ann Pak Inst Med Sci Jan ;7(2):72-4.

Objective: To investigate the yield of bone marrow involvement in NHL patients on performing bilateral bone marrow aspiration and trephine biopsy. Study Type: Descriptive Cross Sectional Study Introduction: Lymphomas represent clonal malignancies of lymphoreticular system in which the majority of the cells are frozen at a single stage of normal differentiation. Diagnosis in lymphomas, especially with regard to their histologic subclassification, is best made on histopathology. The cytologic evaluation of marrow smears and imprints, however, may provide a chance for reasonably accurate diagnosis of these disorders. Cytologically, NHL infiltration in the marrow shows morphologic features similar to those observed in lymph nodes from the same patients. Materials and Methods: The present study was conducted on 143 subjects irrespective of age and sex divided into two groups; group A consisted of patients of NHL without bone marrow infiltration (n=113) and group B comprised of NHL patients with bone marrow infiltration (n=30). Newly diagnosed cases of NHL by lymph node biopsy prior to the institution of chemotherapy of both sexes and all age groups were selected for this study. Bilateral bone marrow aspiration, touch imprint, bone marrow clot and bone marrow trephine biopsy were done to assess the patterns of bone marrow infiltration. Results: Bone marrow examination consisted of bone marrow aspirate, touch imprint, clot section preparation, and trephine section preparation. On bone marrow aspirate, infiltration was noted in 1(3%) patient unilaterally and in 3(10%) patients bilaterally. On clot section examination the yield was increased; 2(7%) cases unilaterally and 5(16%) cases bilaterally. Bone marrow touch imprint revealed infiltration in 10 (33%) patients unilaterally and 14(46%) patients bilaterally. In 13 (43%) patients trephine biopsy section was positive for infiltration unilaterally while in 17 (57%) patients infiltration was detected on bilateral biopsy. Conclusion: We conclude that bilateral bone marrow examination increases the yield of infiltration in cases of NHL.

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