Non-Hodgkin lymphoma diagnostic study of choice
|
Non-Hodgkin lymphoma Microchapters |
|
Differentiating Non-Hodgkin's Lymphoma |
|---|
|
Treatment |
|
Case Studies |
|
Non-Hodgkin lymphoma diagnostic study of choice On the Web |
|
American Roentgen Ray Society Images of Non-Hodgkin lymphoma diagnostic study of choice |
|
Risk calculators and risk factors for Non-Hodgkin lymphoma diagnostic study of choice |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]; Associate Editor(s)-in-Chief: Preeti Singh, M.B.B.S.[3]
Overview
The diagnostic study of choice for non-Hodgkin lymphoma is excisional lymph node biopsy. A bone marrow biopsy is an alternative to a lymph node biopsy.
Diagnostic study of choice
- The diagnostic study of choice for non-Hodgkin's lymphoma is excisional lymph node biopsy.[1]
- An excisional biopsy is needed because it preserves the architecture of the lymph node and allows for precise determination of the type of lymphoma.
- Fine needle aspiration biopsy is usually insufficient.[2]
- In addition to light microscopy evaluation of the excisional biopsy samples, the immunophenotypic analysis with immunohistochemistry helps to determine non-Hodgkin's lymphoma subtypes and distinguish non-Hodgkin's lymphoma from T cell rich large B cell lymphoma and anaplastic large cell lymphoma.[2]
- The presence of CD20 positive clonal B cells defines non-Hodgkin lymphoma.[3]
- In about 40% of adult patients with Non Hodgkin Lymphoma, the extranodal sites are the primary presenting sites with the most common site being the Gastrointestinal tract.[3]
- A bone marrow (BM) biopsy can also be done to diagnose non-Hodgkin lymphoma if there is sufficient evidence of marrow involvement such as presence of cytopenias.[3]
- Non-Hodgkin lymphoma cells originate in the bone marrow, which is the site of B cell production and maturation.
- Bilateral BM biopsy has been recommended with trephine biopsy being preferred to marrow aspiration for detecting marrow infiltration.[4][5]
- BM biopsies, performed under local anesthesia, were obtained using the conventional technique with a Jamshidi needle from the posterior superior iliac spines, fixed in 10% formalin solution and decalcified using 10% formal - formic acid for 4 - 6 h followed by routine processing and paraffin embedding.[6]
References
- ↑ Jiang M, Bennani NN, Feldman AL (2017). "Lymphoma classification update: B-cell non-Hodgkin lymphomas". Expert Rev Hematol. 10 (5): 405–415. doi:10.1080/17474086.2017.1318053. PMID 28395545.
- ↑ 2.0 2.1 Intragumtornchai T, Bunworasate U, Wudhikarn K, Lekhakula A, Julamanee J, Chansung K; et al. (2018). "Non-Hodgkin lymphoma in South East Asia: An analysis of the histopathology, clinical features, and survival from Thailand". Hematol Oncol. 36 (1): 28–36. doi:10.1002/hon.2392. PMID 28332735.
- ↑ 3.0 3.1 3.2 Casulo C, Burack WR, Friedberg JW (2015). "Transformed follicular non-Hodgkin lymphoma". Blood. 125 (1): 40–7. doi:10.1182/blood-2014-04-516815. PMID 25499449.
- ↑ Bartl R, Frisch B, Burkhardt R, Jδger K, Pappenberger R, Hoffmann-Fezer G. Lymphoproliferations in bone marrow: i0 dentification and evaluation, classification and staging. J Clin Pathol 1984;37:233-54.
- ↑ Bain BJ, Clark DM, Lampert IA, Wilkins BS, editors. Bone marrow pathology. 3 rd ed. UK: Blackwell Science Ltd; 2001.
- ↑ Culling CF, Allison RT, Barr WT. Connective tissue. In: Cellular Pathology Techniques. 4 th ed. London: Butterworth and Co. ltd; 1985. p. 172-3.