A step forward in the diagnosis of B-cell lymphomas in the bone marrow

Bone marrow (BM) examinations are carried out as a cornerstone procedure for diagnosis, staging and monitoring of non-Hodgkin lymphomas (NHL). This chapter will deal with the current investigations focusing on the BM findings in secondary involvement of B-cell lymphomas. Recent World Health Organization (WHO) Classification of Tumours of Haematopoietic and Lymphoid Tissues includes morphologic, immunophenotypic, cytogenetic, and molecular genetic data that define the disease entities [1]. Each entity described in this chapter will be discussed on the basis of a combination of these studies used in routine diagnosis of lymphoid malignancies. BM is occasionally examined for primary diagnosis of lymphoma patients, initial assessment of cytopenias of unknown etiology, especially when there's no accessible site of extramedullary disease or when surgical procedures are risky because of hazardous complications of anesthesia due to the general condition of the patients or diseases leading to bleeding diathesis. However, most BM examination, in the context of NHL, are performed to determine stage of disease, assessment of minimal residual disease (MRD) or relapse during follow-up, monitoring response to therapy, evaluation of hematopoietic reserve, and evaluation of pre-transplant status of patients.