Korean J Hematol 1990; 25(2):
Published online June 30, 1990
© The Korean Society of Hematology
악성 임파종의 골수 침범에 관한 임상적 연구
한지숙, 박중원, 민유홍, 이선주, 고윤웅, 양우익, 최인준
연세대학교 의과대학 내과학교실,
연세대학교 의과대학 병리학교실
A Clincal Study on Bone Marrow Involvement in Malignant Lymphoma
The bone marrow examination is avaluable procedure in the diagnosis and management of patients with malignant lymphoma. But there were no reports of systemic speculation on the bone marrow involvement in malignant lymphona in Korea to the best of our knowledge. Therefore, this study was conducted to evaluate the incidence, pattern, and extent of bone marrow involvement in 195 cases with malignant lymphoma (29 Hodgkin's disease, 166 non-Hodgkins's lymphoma) during 10 years. The population was between 15 to 81 years of age, and the average age was 47 years.
The following results were obtained.
1. The incidence of bone marrow involvement in all lymphoma was 16.4%. And among 29 cases with Hodgkin's disease, bone marrow involvement were observed in 2 cases (6.9%) : 1 for lymphocyte predominance and 1 for nodular sclerosis. In
non-Hodgkin's lymphoma which could be classified in relationship to Working Formulation, bone marrow involvement were found in 30 of 151 cases(20%) :27% (4/15)
for low grade, 19% (21/108) for intermediate grade, and 18% (5/28) for high grade malignant lymphoma.
2. The incidence of bone marrow involvement was much higher with bilateral biopsy(29%) than with unilateral biopsy(13%) (p<0.05).
3. Though bone marrow biopsy was the most sensitive tool for the diagnosis of bone marrow involvement in malignant lymphoma, 2 cases(6%) with bone marrow infiltration
was documented by bone marrow aspiration smear only.
4. Eight of nine cases of diffuse bone marrow involvement showed extensive disease with replacement of greater than 70% of trephine biopsy section and in all ten cases of
focal involvement, the degree of marrow involvement was less than 30%. Therefore we thought that there was a significant correlation between the pattern and extent of bene marrow involvement.
5. The factors most significantly correlated with bone marrow involvement were low platelet count(<10,000/mm3) and high serum alkaline phosphatase(≥25IU/L).
With the above results, it is stressed on bilateral bone marrow biopsy because of its being more sensitive tool than unilateral biopsy for the diagnosis of marrow involvement
in malignant lymphoma. Further study is needed for the evaluation of correlation in pattern and extent of bone marrow involvement by lymphoma and the survival.
Keywords Bone marrow involvement; Malignant lymphoma;
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Korean J Hematol 1990; 25(2): 369-379
Published online June 30, 1990
Copyright © The Korean Society of Hematology.
악성 임파종의 골수 침범에 관한 임상적 연구
한지숙, 박중원, 민유홍, 이선주, 고윤웅, 양우익, 최인준
연세대학교 의과대학 내과학교실,
연세대학교 의과대학 병리학교실
A Clincal Study on Bone Marrow Involvement in Malignant Lymphoma
Jee Sook Hahn, Jung Won Park, Yu Hong Min, Sun Ju Lee, Yun Woong Ko, Woo Ick Yang, In Joon Choi
Department of Internal Medicine, Pathology, Yonsei University College of Medicine, Seoul, Korea
Abstract
The bone marrow examination is avaluable procedure in the diagnosis and management of patients with malignant lymphoma. But there were no reports of systemic speculation on the bone marrow involvement in malignant lymphona in Korea to the best of our knowledge. Therefore, this study was conducted to evaluate the incidence, pattern, and extent of bone marrow involvement in 195 cases with malignant lymphoma (29 Hodgkin's disease, 166 non-Hodgkins's lymphoma) during 10 years. The population was between 15 to 81 years of age, and the average age was 47 years.
The following results were obtained.
1. The incidence of bone marrow involvement in all lymphoma was 16.4%. And among 29 cases with Hodgkin's disease, bone marrow involvement were observed in 2 cases (6.9%) : 1 for lymphocyte predominance and 1 for nodular sclerosis. In
non-Hodgkin's lymphoma which could be classified in relationship to Working Formulation, bone marrow involvement were found in 30 of 151 cases(20%) :27% (4/15)
for low grade, 19% (21/108) for intermediate grade, and 18% (5/28) for high grade malignant lymphoma.
2. The incidence of bone marrow involvement was much higher with bilateral biopsy(29%) than with unilateral biopsy(13%) (p<0.05).
3. Though bone marrow biopsy was the most sensitive tool for the diagnosis of bone marrow involvement in malignant lymphoma, 2 cases(6%) with bone marrow infiltration
was documented by bone marrow aspiration smear only.
4. Eight of nine cases of diffuse bone marrow involvement showed extensive disease with replacement of greater than 70% of trephine biopsy section and in all ten cases of
focal involvement, the degree of marrow involvement was less than 30%. Therefore we thought that there was a significant correlation between the pattern and extent of bene marrow involvement.
5. The factors most significantly correlated with bone marrow involvement were low platelet count(<10,000/mm3) and high serum alkaline phosphatase(≥25IU/L).
With the above results, it is stressed on bilateral bone marrow biopsy because of its being more sensitive tool than unilateral biopsy for the diagnosis of marrow involvement
in malignant lymphoma. Further study is needed for the evaluation of correlation in pattern and extent of bone marrow involvement by lymphoma and the survival.
Keywords: Bone marrow involvement, Malignant lymphoma,
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