Concordance of Current Tests Used for the Diagnosis of Bone Marrow Involvement in B-Lineage Lymphoma with Respect to Various Lymphoma Grade
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Background: We evaluated the concordance of bone marrow (BM) aspirates, biopsy, immunohistochemical (IHC) staining, fluorescence in situ hybridization (FISH), and karyotyping used in diagnosing BM involvement in B-lineage lymphoma and assessed the concordance characteristics for lymphoma grade. Methods: Total 127 B-lineage lymphoma patients (92 high grade [HG], 35 low grade [LG]) diagnosed during recent 54 months and who underwent BM study were prospectively enrolled. BM aspiration/biopsy/CD3 and CD20 IHC staining/FISH/karyotyping were performed in each case, and results were compared. Results: Discrepancy rates (DR) between BM aspirates/biopsy and IHC staining were 14.2% and 6.3%, respectively, and IHC staining detected additional 13.4% and 6.5% BM-involved cases in BM aspirates-normal/biopsy-normal cases. DR between integrated BM involvement interpretation (IBMII, defined as abnormality in at least one morphologic evaluation) and karyotyping/FISH results was 34.6% and 22.0%, respectively, and FISH-abnormal/karyotyping-normal cases were more frequent than FISH-normal/karyotyping-abnormal cases. DR among IBMII, karyotyping, and FISH in LG lymphoma was significantly higher than in HG lymphoma (71.4% vs. 23.9%; P<0.001), and the proportion of cases with IBMII-involved but karyotyping/FISH-normal was significantly higher in LG lymphoma than HG lymphoma (45.7% vs. 8.7%; P<0.001). With FISH analysis, an additional 6.5% of HG and 25.7% of LG lymphoma cases showed abnormal results concordant with IBMII. Conclusions: IHC staining would be useful in the sensitive detection of BM involvement. FISH analysis can reduce DR and more sensitively detect BM involved cases compared to karyotyping. DR among IBMII, karyotyping, and FISH is higher in LG lymphoma than in HG lymphoma.
Abstract
Background: We evaluated the concordance of bone marrow (BM) aspirates, biopsy, immunohistochemical (IHC) staining, fluorescence in situ hybridization (FISH), and karyotyping used in diagnosing BM involvement in B-lineage lymphoma and assessed the concordance characteristics for lymphoma grade. Methods: Total 127 B-lineage lymphoma patients (92 high grade [HG], 35 low grade [LG]) diagnosed during recent 54 months and who underwent BM study were prospectively enrolled. BM aspiration/biopsy/CD3 and CD20 IHC staining/FISH/karyotyping were performed in each case, and results were compared. Results: Discrepancy rates (DR) between BM aspirates/biopsy and IHC staining were 14.2% and 6.3%, respectively, and IHC staining detected additional 13.4% and 6.5% BM-involved cases in BM aspirates-normal/biopsy-normal cases. DR between integrated BM involvement interpretation (IBMII, defined as abnormality in at least one morphologic evaluation) and karyotyping/FISH results was 34.6% and 22.0%, respectively, and FISH-abnormal/karyotyping-normal cases were more frequent than FISH-normal/karyotyping-abnormal cases. DR among IBMII, karyotyping, and FISH in LG lymphoma was significantly higher than in HG lymphoma (71.4% vs. 23.9%; P<0.001), and the proportion of cases with IBMII-involved but karyotyping/FISH-normal was significantly higher in LG lymphoma than HG lymphoma (45.7% vs. 8.7%; P<0.001). With FISH analysis, an additional 6.5% of HG and 25.7% of LG lymphoma cases showed abnormal results concordant with IBMII. Conclusions: IHC staining would be useful in the sensitive detection of BM involvement. FISH analysis can reduce DR and more sensitively detect BM involved cases compared to karyotyping. DR among IBMII, karyotyping, and FISH is higher in LG lymphoma than in HG lymphoma.
참고문헌 (22)
- Carbone PP, "Report of the committee on Hodgkin’s disease staging classification", Cancer Res, 31, pp.1860~1861 (1971)
- Lister TA, "Report of a committee convened to discuss the evaluation and staging of patients with Hodgkin’s disease : Cotswolds meeting", J Clin Oncol, 7, pp.1630~1636 (1989)
- Hoppe RT, "Hodgkin lymphoma", J Natl Compr Canc Netw, 9, pp.1020~1058 (2011)
- Zelenetz AD, "NCCN clinical practice guidelines in oncology : non-Hodgkin’s lymphomas", J Natl Compr Canc Netw, 8, pp.288~334 (2010)
- Zhang QY, "Bone marrow involvement by hodgkin and non-hodgkin lymphomas", Hematol Oncol Clin North Am, 23, pp.873~902 (2009)
- 박용, "Assessment of bone marrow involvement in patients with lymphoma: report on a consensus meeting of the Korean Society of Hematology Lymphoma Working Party", The Korean Journal of Internal Medicine, 31(6), pp.1030~1041 (2016), 대한내과학회[DOI]
- Foucar K, "Bone marrow pathology" (2010), American Society for Clinical Pathology Press
- Rozman C, "Chronic lymphocytic leukemia", N Engl J Med, 333, pp.1052~1057 (1995)
- Montserrat E, "Bone marrow assessment in B-cell chronic lymphocytic leukaemia: aspirate or biopsy? A comparative study in 258 patients", Br J Haematol, 93, pp.111~116 (1996)
- 전영우, "Chronic lymphocytic leukemia: a clinical review including Korean cohorts", The Korean Journal of Internal Medicine, 31(3), pp.433~443 (2016), 대한내과학회
- Fend F, "Diagnosis and classification of malignant lymphoma and related entities in the bone marrow trephine biopsy", Pathobiology, 74, pp.133~143 (2007)
- Hans CP, "Confirmation of the molecular classification of diffuse large B-cell lymphoma by immunohistochemistry using a tissue microarray", Blood, 103, pp.275~282 (2004)
- Kremer M, "Discordant bone marrow involvement in diffuse large B-cell lymphoma : comparative molecular analysis reveals a heterogeneous group of disorders", Lab Invest, 83, pp.107~114 (2003)
- 정소연, "세계보건기구 분류에 근거한 악성림프종의 골수침습 빈도 및 양상- 단일 기관 연구", Annals of Laboratory Medicine, 27(6), pp.383~387 (2007), 대한진단검사의학회
- 김지명, "한국인 비호지킨림프종의 백혈병성 골수침습에 대한 임상혈액학적 소견", Laboratory Medicine Online, 1(2), pp.81~87 (2011), 대한진단검사의학회
- Merli M, "Assessment of bone marrow involvement in non-Hodgkin’s lymphomas : comparison between histology and fiow cytometry", Eur J Haematol, 85, pp.405~415 (2010)
- Conlan MG, "Bone marrow involvement by non-Hodgkin’s lymphoma : the clinical significance of morphologic discordance between the lymph node and bone marrow. Nebraska Lymphoma Study Group", J Clin Oncol, 8, pp.1163~1172 (1990)
- Arsham MS, "The AGT cytogenetics laboratory manual" (2017), Wiley-Blackwell
- Pearson P, "The use of new staining techniques for human chromosome identification", J Med Genet, 9, pp.264~275 (1972)
- McGowan-Jordan J, "ISCN 2020: An International System for Human Cytogenomic Nomenclature (2020)" (2020), Karger
- Ishizawa K, "Detection of bone marrow infiltration of lymphoma cells by fiuorescence in situ hybridization", Clin Chim Acta, 344, pp.79~82 (2004)
- Huh HJ, "Investigation of bone marrow involvement in malignant lymphoma using fiuorescence in situ hybridization : possible utility in the detection of micrometastasis", Cancer Genet Cytogenet, 186, pp.1~5 (2008)