Lab Med Online.  2023 Jul;13(3):172-181. 10.47429/lmo.2023.13.3.172.

Concordance of Current Tests Used for the Diagnosis of Bone Marrow Involvement in B-Lineage Lymphoma with Respect to Various Lymphoma Grade

• Park SH
• Moon S
• Kim H
• Kim IS

• KMID: 2552741
• DOI: http://doi.org/10.47429/lmo.2023.13.3.172

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.

Keyword

B-lineage lymphoma; Bone marrow study; Concordance; Fluorescence in situ hybridization; Karyotyping; Lymphoma grade

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