Histopathological and immunohistochemical clues in the differential diagnosis of benign and malignant focal lymphocytic aggregates in paraffin sections of the bone marrow biopsies
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Date
1998
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Abstract
One of the problems in evaluating bone marrow trephine biopsies is to determine whether a focal lymphocytic aggregate is benign or not. To assess the value of anti-bcl-2 monoclonal antibody on the differential diagnosis, bone marrow biopsies with focal lymphocytic aggregates were evaluated by conventional histopathological criteria and an immunohistochemical study using anti-bcl-2 monoclonal antibody was performed. Of the 27 bone marrow trephine biopsies from patients with lymphoproliferative disorders malignant aggregates were found in 14. The remaining 13 contained benign aggregates according to the conventional criteria and in none of these cases malignancy was confirmed. Conventional criteria were tested by comparing the histopatological characteristics of benign and malignant aggregates. The trephine biopsies of all 27 cases were immunostained with anti-bcl-2 antibody. A moderate to intense nuclear staining in the mononuclear calls of the aggregates was observed in 12 of 14 malignant cases. None of the cases diagnosed as benign stained with the anti-bcl-2 monoclonal antibody. It is concluded that positive immunostaining with this antibody strongly suggests that a focal lymphocytic aggregate is malignant.