Waldenström's macroglobulinemia bone marrow aspiration and biopsy: Difference between revisions

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{{Waldenström's macroglobulinemia}}
{{Waldenström's macroglobulinemia}}
{{CMG}}; {{AE}} {{RAK}}
{{CMG}}; {{AE}} {{S.M.}} {{RAK}}; {{GRR}} {{Nat}}


==Overview==
==Overview==
A [[bone marrow aspiration]] may be helpful in the diagnosis of Waldenström macroglobulinemia. A [[bone marrow biopsy]] can be diagnostic of Waldenström macroglobulinemia.
A [[bone marrow aspiration]] and [[biopsy]] is essential in the [[diagnosis]] of [[Waldenström macroglobulinemia]] and shows hypercellular [[bone marrow]], Dutcher bodies, and three [[Pattern|patterns]] of [[bone marrow]] [[Infiltration (medical)|infiltration]] including lymphoplasmacytoid [[Cells (biology)|cells]], lymphoplasmacytic [[Cells (biology)|cells]] in an [[interstitial]]/[[nodular]] [[pattern]], and a polymorphous [[Infiltration (medical)|infiltrate]].  


==Bone Marrow Aspirate==
==Bone Marrow Aspirate==
A [[Bone marrow aspiration|bone marrow aspirate]] may be helpful in the diagnosis of Waldenström macroglobulinemia.  
A [[Bone marrow aspiration|bone marrow aspirate]] is essential in the [[diagnosis]] of [[Waldenström macroglobulinemia]].  


Findings suggestive of Waldenström macroglobulinemia include:
Findings [[Suggestion|suggestive]] of [[Waldenström macroglobulinemia]] include:<ref name="pmid18555588">{{cite journal| author=Leleu X, Roccaro AM, Moreau AS, Dupire S, Robu D, Gay J et al.| title=Waldenstrom macroglobulinemia. | journal=Cancer Lett | year= 2008 | volume= 270 | issue= 1 | pages= 95-107 | pmid=18555588 | doi=10.1016/j.canlet.2008.04.040 | pmc=3133633 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18555588  }} </ref>
* A hypocellular bone marrow aspirate
* A hypercellular [[bone marrow]] [[aspirate]]
* Lymphoplasmacytic [[Infiltration (medical)|infiltrate]] with [[Characteristic function (probability theory)|characteristic]] [[immunophenotype]]
 
{|
|
[[File:Wm bm aspirate.png|thumb|250px|none| Bone marrow aspirate. Lymphocytes with lymphoplasmacytoid appearance (arrows).[https://openi.nlm.nih.gov/detailedresult.php?img=PMC3894394_br-48-300-g001&query=waldenstrom+macroglobulinaemia&it=xg&req=4&npos=91 Source: D'Angelo G. et al, Laboratorio di Chimica-Clinica, Ematologia e Microbiologia (Ematologia/Coagulazione), Azienda Ospedaliera "S. Antonio Abate" di Gallarate, Varese, Italy.]]]
|}


== Bone Marrow Biopsy ==
== Bone Marrow Biopsy ==
A [[bone marrow biopsy]] may be helpful in the diagnosis of Waldenström macroglobulinemia.


Findings on the biopsy suggestive of Waldenström macroglobulinemia include:
* A [[bone marrow biopsy]] may be helpful in the [[diagnosis]] of [[Waldenström macroglobulinemia]]. <ref name="pmid18555588">{{cite journal| author=Leleu X, Roccaro AM, Moreau AS, Dupire S, Robu D, Gay J et al.| title=Waldenstrom macroglobulinemia. | journal=Cancer Lett | year= 2008 | volume= 270 | issue= 1 | pages= 95-107 | pmid=18555588 | doi=10.1016/j.canlet.2008.04.040 | pmc=3133633 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18555588  }} </ref>
* Hypercellular and [[Infiltration (medical)|infiltrated]] with [[lymphoid]] and [[Plasmacytoid|plasmacytoid cells]].
 
* Findings on the [[biopsy]] [[Suggestion|suggestive]] of [[Waldenström macroglobulinemia]] include:<ref name="pmid18555588">{{cite journal| author=Leleu X, Roccaro AM, Moreau AS, Dupire S, Robu D, Gay J et al.| title=Waldenstrom macroglobulinemia. | journal=Cancer Lett | year= 2008 | volume= 270 | issue= 1 | pages= 95-107 | pmid=18555588 | doi=10.1016/j.canlet.2008.04.040 | pmc=3133633 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18555588  }} </ref>
** Hypercellular and [[Infiltration (medical)|infiltrated]] with [[lymphoid]] and [[Plasmacytoid|plasmacytoid cells]]
 
** Dutcher [[Body|bodies]] ([[PAS stain|PAS]] positive intra-[[nuclear]] [[vacuoles]] containing [[IgM]] [[Monoclonal antibody|monoclonal]] [[protein]])
***[[Characteristic function (probability theory)|Characteristic]] [[Features (pattern recognition)|feature]] of [[Waldenström macroglobulinemia]]
 
* Three [[Pattern|patterns]] of [[Bone marrow|marrow]] involvement are described, as follows:


* Dutcher bodies (PAS positive Intranuclear vacuoles containing IgM monoclonal protein)  
** Lymphoplasmacytoid [[Cells (biology)|cells]] ([[Lymphoplasmacytic lymphoma|lymphoplasmacytic]] and small [[lymphocytes]]) in a [[nodular]] [[pattern]]
** Characteristic feature of Waldenström macroglobulinemia.
** Lymphoplasmacytic [[Cells (biology)|cells]] (small [[lymphocytes]], mature [[plasma cells]], [[mast cells]]) in an [[interstitial]]/[[nodular]] [[pattern]]
Three patterns of marrow involvement are described, as follows:
** A polymorphous [[Infiltration (medical)|infiltrate]] (small [[lymphocytes]], [[plasma cells]], [[plasmacytoid]] [[Cells (biology)|cells]], [[Immunoblast|immunoblasts]] with [[mitotic]] figures)
* Lymphoplasmacytoid cells (lymphoplasmacytic and small lymphocytes) in a nodular pattern
* Lymphoplasmacytic cells (small lymphocytes, mature plasma cells, mast cells) in an interstitial/nodular pattern
* A polymorphous infiltrate (small lymphocytes, plasma cells, plasmacytoid cells, immunoblasts with mitotic figures)


==References==
==References==

Latest revision as of 18:44, 15 August 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mohsin, M.D.[2] Roukoz A. Karam, M.D.[3]; Grammar Reviewer: Natalie Harpenau, B.S.[4]

Overview

A bone marrow aspiration and biopsy is essential in the diagnosis of Waldenström macroglobulinemia and shows hypercellular bone marrow, Dutcher bodies, and three patterns of bone marrow infiltration including lymphoplasmacytoid cells, lymphoplasmacytic cells in an interstitial/nodular pattern, and a polymorphous infiltrate.

Bone Marrow Aspirate

A bone marrow aspirate is essential in the diagnosis of Waldenström macroglobulinemia.

Findings suggestive of Waldenström macroglobulinemia include:[1]

Bone marrow aspirate. Lymphocytes with lymphoplasmacytoid appearance (arrows).Source: D'Angelo G. et al, Laboratorio di Chimica-Clinica, Ematologia e Microbiologia (Ematologia/Coagulazione), Azienda Ospedaliera "S. Antonio Abate" di Gallarate, Varese, Italy.

Bone Marrow Biopsy

References

  1. 1.0 1.1 1.2 Leleu X, Roccaro AM, Moreau AS, Dupire S, Robu D, Gay J; et al. (2008). "Waldenstrom macroglobulinemia". Cancer Lett. 270 (1): 95–107. doi:10.1016/j.canlet.2008.04.040. PMC 3133633. PMID 18555588.

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