Role of bone marrow trephine biopsy in the diagnosis of marrow involvement in Hodgkin's disease
Subramanian, R.; Basu, D.; Badhe, B.; Dutta, T.K.
Indian Journal of Pathology and Microbiology 50(3): 640-643
2007
ISSN/ISBN: 0377-4929 PMID: 17883170 Document Number: 605375
Bone marrow involvement in Hodgkin's disease alters the stage and hence the prognosis and treatment modality. Seventy-six patients of biopsy proven Hodgkin's disease in whom a bone marrow aspiration and biopsy were done simultaneously at the time of diagnosis were included in the study. Bone marrow involvement was seen in 14 (18%) cases. All 14 cases were diagnosed on biopsy. Only one aspirate was suspicious of involvement. Rest was either diluted (28%) or was normal (64%). Eleven patients were upstaged from stage I, II and III to stage IV. All patients had cytopenia of one or more cell line. Increased fibrosis, necrosis and a polymorphic cellular infiltrate were associated findings in the marrow. We wish to highlight the importance of bone marrow trephine biopsy over aspirate in staging even clinically early stage Hodgkin's disease.