Article
T and NK Cell Neoplasms Detected in Bone Marrow Biopsies
American Journal of Clinical Pathology
(2015)
Abstract
T and NK cell neoplasms are relatively uncommon. Although bone marrow biopsy is indicated for staging evaluation of lymphoma, most T and NK cell neoplasms are detected in bone marrow without prior history. At our institute, from 2003 to 2015, 29 patients (male/female = 20/9, ages 46-86 years) had bone marrow biopsies positive for T and NK cell neoplasms. There were 27 T cell neoplasms and 2 chronic lymphoproliferative disorders of NK cells (CLPD-NK). The diagnosis of T cell neoplasm was confirmed by flow cytometry and/or T cell receptor (TCR) gene rearrangement in 26 cases, and immunohistochemical studies in 1 case. Eleven patients (11/27) had prior/concurrent extramedullary T cell lymphoma. Sixteen patients (16/27) showed no evidence of extramedullary involvement, including 7 T cell large granular lymphocytic leukemia (T-LGL), 6 minimal T cell neoplasms (small clonal T cell population) and 3 other T cell lymphomas. Prior/concomitant B cell or plasma cell neoplasm was present in 3 patients. Both patients with CLPD-NK showed no extramedullary involvement. Cytogenetic study revealed abnormal karyotype in only 1 patient with T-LGL. Abnormal CBC findings were the most common causes for bone marrow biopsy, including anemia in 19 patients, neutropenia in 17, and lymphocytosis in 8. Ten patients had splenomegaly. Most patients with prior/concurrent extramedullary lymphoma received chemotherapy with/without allogeneic bone marrow transplantation. Only 1 patient with T-LGL had chemotherapy, and none for minimal T cell neoplasm or CLPD-NK. Although extramedullary T cell lymphoma may involve bone marrow, the majority of T and NK cell neoplasms (18/29) detected in bone marrow biopsies in this study had no prior/concurrent extramedullary involvement. Abnormal karyotype was rare in these patients. Anemia and neutropenia were the most common laboratory findings with frequent lymphocytosis and splenomegaly. Most patients with T-LGL, minimal T cell neoplasm, and CLPD-NK did not have therapeutic intervention after the initial diagnosis.
Disciplines
Publication Date
October 1, 2015
DOI
10.1093/ajcp/144.suppl2.140
Citation Information
Ming Xie, MD, Xia Chen, MD, Elizabeth Wey, MD, T and NK Cell Neoplasms Detected in Bone Marrow Biopsies, American Journal of Clinical Pathology, Volume 144, Issue suppl_2, 1 October 2015, Page A140, https://doi.org/10.1093/ajcp/144.suppl2.140