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Blood, Vol. 94 No. 11 (December 1), 1999:
pp. 3889-3896
Immunophenotypic Analysis of Peripheral Blood and Bone Marrow in the
Staging of B-Cell Malignant Lymphoma
Curtis A. Hanson,
Paul J. Kurtin,
Jerry A. Katzmann,
James D. Hoyer,
Chin-Yang Li,
Janice M. Hodnefield,
Cecelia H. Meyers,
Thomas M. Habermann, and
Thomas E. Witzig
From the Departments of Laboratory Medicine and Pathology and of
Internal Medicine, Mayo Clinic, Rochester, MN.
This study evaluated the contributing roles of flow cytometric
immunophenotyping of blood and bone marrow and immunohistochemical paraffin section staining of bone marrow biopsies in the staging of
B-cell malignant lymphoma. Flow immunophenotyping was performed on a
marrow specimen in 175 cases; a corresponding blood specimen was also
immunophenotyped in 135 of these cases. Morphologic marrow involvement
by lymphoma was found in 59 cases; flow immunophenotyping identified 54 cases with a monoclonal B-cell process:
morphology-positive/flow-positive (n = 49),
morphology-positive/flow-negative (n = 10),
morphology-negative/flow-positive (n = 5), and
morphology-negative/flow-negative (n = 111). The 10 morphology-positive/flow-negative cases included 5 follicular and 5 large-cell lymphomas with minimal marrow involvement. All 5 morphology-negative/flow-positive cases were from patients with large-cell lymphomas and bulky clinical disease. Because the blood contained the same B-cell clone in 2 of 2 morphology-negative/flow-positive cases studied, blood contamination of
marrow may account for these findings. Blood flow cytometric
immunophenotyping studies were positive in 32 cases; 30 had marrow
involvement by morphology and were from patients with follicular,
mantle cell, lymphoplasmacytic, small lymphocytic, or marginal zone
lymphomas. From our results, we conclude that (1) bone marrow flow
cytometric immunophenotyping is not a cost-effective replacement for
good morphologic evaluation in lymphoma staging and that (2) a positive
peripheral blood flow cytometric immunophenotyping study when performed
in low-grade lymphomas correlates with marrow involvement.
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