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Annals of Oncology Advance Access published online on August 21, 2008
Annals of Oncology, doi:10.1093/annonc/mdn563
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© The Author 2008. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

Bone marrow histology in marginal zone B-cell lymphomas: correlation with clinical parameters and flow cytometry in 120 patients

E. Boveri1,*, L. Arcaini2, M. Merli2, F. Passamonti2, S. Rizzi2, L. Vanelli2, E. Rumi2, S. Rattotti2, M. Lucioni1, C. Picone2, A. Castello1, C. Pascutto2, U. Magrini1, M. Lazzarino2 and M. Paulli1

1 Institute of Surgical Pathology
2 Division of Hematology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy

* Correspondence to: Dr E. Boveri, Institute of Surgical Pathology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Via Forlanini 14, 27100 Pavia, Italy. Tel: +39-0382-501483; Fax: +39-0382-525866; E-mail: embover{at}tin.it

Background: Among marginal zone lymphomas (MZLs), bone marrow (BM) involvement features are well established in the splenic marginal zone lymphoma (SMZL); few data are available for extranodal marginal zone lymphoma (EMZL) and nodal marginal zone lymphoma (NMZL).

Patients and methods: Incidence and patterns of histologic BM involvement are studied in 120 MZL patients (48 SMZL, 59 EMZL, 13 NMZL) at onset and during follow-up; relationships between clinical features, BM histology and flow cytometry (FC) are analyzed.

Results: At diagnosis, BM involvement occurs in 90% SMZL, 22% EMZL and 54% NMZL (P < 0.0001); at reevaluation, incidence raises to 96% in SMZL and 34% in EMZL. Concordance between histology and FC is found in 87% of cases; most discordant cases have positive histology but negative FC. SMZL and EMZL show a nodular BM infiltration; the interstitial pattern is frequent in NMZL (P < 0.0001); sinusoidal localization is typical of SMZL, frequent in NMZL and occasional in EMZL (P = 0.0001). Stage, leukemic disease, B symptoms, more than one extranodal involved site, splenomegaly, elevated β2-microglobulin, serum monoclonal component, International Prognostic Index (IPI) and age-adjusted IPI are directly related to BM infiltration.

Conclusions: The different prevalence of BM involvement in MZL subtypes reflects their heterogeneous dissemination modalities; histology seems more sensible than FC to detect BM infiltration; development of BM involvement during follow-up is typical of EMZL.

bone marrow histology, flow cytometry, hepatitis C virus (HCV), marginal zone lymphoma

Received for publication April 10, 2008. Revision received July 13, 2008. Accepted for publication July 16, 2008.


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