2010•白血病·淋巴瘤Requires access
Bone marrow pathologicfeatures and differentiation of Waldenstr(o)m macroglobulinemia
Enbin Liu, Peihong Zhang, Zhanqi Li, Qi Sun, Qing-ying Yang, Li-huan Fang, Fujun Sun
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Abstract
：Objective To explore thebone marrow pathology ,diagnosis and differential diagnosis of Waldenstrommacroglobulinemia(WM). Methods 19 WM patients was examined by bone marrow aspiration (BMA)and bone marrow biopsy (BMB) for morphology. Flow cytometry (FCM) and immunohistochemistry(IHC) for immunophenotyping. Results Plasmacytoid lymphocytes were identified in 11 BMA.All of 19 BMB were involved by lymphoma cells. 17 cases showed a predominance of smalllymphocytes and 2 of plasmacytoid lymphocytes. Typically plasmacytoid lymphocytes were notseen in 4 cases. Patterns of bone marrow involvement were as follow: diffuse (12 cases),nodular (4 cases), interstitial (3 cases). Immunophenotypically, FCM showed all cases wereCD_(19)~+, CD_(20)~+, CD_(22)~+, CD_5~- and CD_(10)~-. IHC revealed small lymphocytes andplasmacytoid lymphocytes were Pax5~+ CD_(20)~+ and plasma cells were CD_(38) CD_(138)~+CD_(20)~- Pax5~-. Conclusion Small lymphocytes proliferation with plasmacyticdifferentiation is the typical bone marrow pathologic features of WM. IHC is benefit foridentifying lymphocytes and plasma cells components. The Combination of morphology, FCMand IHC is contributive to the diagnosis and differentiation of WM.