• Annals of Clinical Neurophysiology
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• v.25 no.1
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• pp.45-49
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• 2023

Neurolymphomatosis is the direct endoneurial infiltration of lymphoma cells. Bone marrow biopsy is a widely practiced procedure that is generally considered to be relatively safe. However, bone marrow biopsy can also result in pain and long-term consequences such as nerve injury. Here we report a case of a 68-year-old male who presented with lumbosacral plexopathy due to neurolymphomatosis that was superimposed on a probable traumatic lumbosacral plexopathy mostly involving the sciatic nerve immediately after a bone marrow biopsy.

• Clinical and Experimental Pediatrics
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• v.59 no.1
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• pp.43-46
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• 2016

We present a case of tuberculosis-associated hemophagocytic lymphohistiocytosis in a 14-year-old girl. The patient presented with weight loss, malaise, fatigue, prolonged fever, and generalized lymphadenopathy. Laboratory investigation revealed pancytopenia (white blood cells, $2,020cells/{\mu}L$; hemoglobin, 10.2 g/dL; platelets, $52,000cells/{\mu}L$), hypertriglyceridemia (229 mg/dL), and hyperferritinemia (1,420 ng/mL). Bone marrow biopsy showed a hypocellular bone marrow with a large numbers of histiocytes and marked hemophagocytosis; based on these findings, she was diagnosed with hemophagocytic lymphohistiocytosis. Polymerase chain reaction (PCR) with both the bone marrow aspiration and sputum samples revealed the presence of Mycobacterium tuberculosis. Antitubercular therapy with immune modulation therapy including dexamethasone and intravenous immunoglobulin was initiated. The results of all laboratory tests including bone marrow biopsy and PCR with both the bone marrow aspiration and sputum samples were normalized after treatment. Thus, early bone marrow biopsy and the use of techniques such as PCR can avoid delays in diagnosis and improve the survival rates of patients with tuberculosis-associated hemophagocytic lymphohistiocytosis.

• The Korean Journal of Nuclear Medicine
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• v.37 no.3
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• pp.171-177
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• 2003

PURPOSE: To asess the ability of FDG PET for the detection of bone marrow infiltration compared to iliac crest biopsy in patients with lymphoma. MATERIALS AND METHODS: Seventy-three patients (30 females and 43 males, mean age of 47 years old) with malignant lymphoma (4 Hodgkin's disease, HD and 69 Non-Hodgkin's lymphoma, NHL) were included. FDG PET was performed for staging in 53 patients and to assess treatment response after the completion of chemotherapy in 20 patients. Final conclusions were based on biopsy, other imaging studies, or clinical follow-up. RESULTS: There were 54 (74%) of the 73 patients in whom FDG PET and iliac crest biopsy were concordant. Forty-seven of the 54 patients showed concordant negative results while the remaining 7 patients had concordant positive results. Of 19 patients with discordant results, FDG PET accurately detected bone marrow infiltration in 6 patients with negative iliac crest biopsy. On the contrary, iliac crest biopsy identified bone marrow infiltration in 12 or the 19 patients. In remaining one of the 19 patients with discordant results, iliac crest biopsy was true negative but FDG PET was falsely positive. CONCLUSION: FDG PET seems to be an adjunct in detecting marrow infiltration that may not be revealed by iliac crest biopsy at staging. For the assessment of treatment roponse, it may be less helpful than biopsy in detecting microscopic residual disease in the bone marrow.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.1
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• pp.35-39
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• 2009

Purpose: Increased FDG uptake in the bone marrow has been reported in patients taking erythropoietin or granulocyte-colony stimulating factor (G-CSF). The aim of this study is to investigate the correlation between F-18 FDG uptake in the bone marrow and bone marrow finding, hematological parameters. Materials and Methods: Twenty patients who had diffuse FOG uptake at the bone marrow and received hematological examinations, bone marrow biopsy within 10 days before or after PET/CT were enrolled in this study. Among them, 11 patients were excluded; 4 patients received G-CSF or erythropoietin before PET/CT. Seven patients showed definite pathology in a bone marrow biopsy. The parameters included the measurement of WBC, hemoglobin, platelet and cellularity of the bone marrow. Results: Bone marrow FDG uptake was correlated with a low hemoglobin but not WBC, platelet. Histopathologic findings in marrow biopsies were various: normal finding (n=3), hyperplasia of granulocytic cells (n=2), eosinophilic hyperplasia (n=1), reactive lymphoid nodules (n=1), hypercelluar marrow (n=1), hypocelluar marrow (n=1). All patients except two, showed normal marrow celluarity. Conclusion: FOG uptake by bone marrow correlated with anemia but not WBC, platelet, bone marrow cellularity.

• BLOOD RESEARCH
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• v.53 no.4
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• pp.281-287
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• 2018

Background Bone marrow involvement (BMI) affects the lymphoma stage, survival, and treatment. Bone marrow biopsy (BMB) and fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT) are useful techniques to detect BMI. Both have advantages and disadvantages. We aimed to identify factors that could be used to predict BMI with positive and negative results on PET/CT compare them with BMB in newly diagnosed patients with lymphoma. Methods We included 22 non-Hodgkin and 16 Hodgkin lymphoma patients in this single center study. All patients had PET/CT examination and BMB before treatment. BMI in BMB was reported as negative or positive. Bone marrow was classified into 3 types by FDG uptake on PT/CT; diffuse involvement, focal involvement, and normal bone marrow. Results PET/CT and BMB results were concordant (7 positive, 15 negative) in 22 patients (57%). We evaluated concordant and discordant patient characteristics and risk-stratified patients for BMI. Our findings suggest that patients with diffuse FDG uptake on PET/CT, especially patients with advanced age and low platelet and white blood cell counts, are likely to have BMI and could potentially forego BMB. Patients with negative PET/CT findings and no significant laboratory abnormalities are very unlikely to have BMI. Conclusion Our results suggest that BMI should not be decided solely based PET/CT or BMB findings. It is reasonable to use both diagnostic assays along with clinical and laboratory findings. PET/CT result, clinical and laboratory findings could be useful for predicting BMI in patient for whom BMB is contraindicated.

• The Korean Journal of Nuclear Medicine
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• v.27 no.2
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• pp.298-304
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• 1993

To estimate the bone marrow involvement of leukemia, we peformed scintigraphies using $^{99m}Tc$ antimony sulfide colloid and Gallium-67. Total 13 patients were included and obtained 14 study sets of $^{99m}Tc$ antimony sulfide colloid and gallium-67 and compared with bone marrow aspiration biopsy and clinicolaboratory datas. $^{99m}Tc$ Antimony scan showed localized defect in 4 patients who had relapse. No false positive or negative results were observed. Gallium 67 showed localized increased uptake in 2 of 4 relapsed patients. Therefore, bone marrow scan is useful for the evaluation of marrow infiltration in ieukemic patients.

• Korean Journal of Clinical Laboratory Science
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• v.48 no.4
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• pp.371-377
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• 2016

Decalcification is routinely performed to obtain a pathological diagnosis using bone marrow biopsy. During the decalcification process using a conventional acidic solution, such as HCl, the antigenicity of tissue is damaged. Especially DNA and RNA in the bone marrow are impaired. Hence, there is the need for a standardized decalcification protocol that preserves the antigenicity of tissue. To this end, we compared the effects of two commonly used decalcifiers: Commercial decalcifier (Calcl-Clear Rapid, HCl) and the EDTA (12.5%, pH 7.0). Bone marrow biopsies sampled from 71 patients were decalcified in accordance with the protocols of respective groups-HCI versus EDTA. The differences of decalcification protocols were analyzed with respect to Hematoxylin & Eosin staining, Gomori'sreticulum staining, and immunohistochemical staining and molecular analysis. Immunohistochemical staining used Ki-67, CD20 and CD138 as primary antibodies and molecular analysis was conducted through the DNA concentration analysis, in situ hybridization (ISH) and immunoglobulin heavy chain (IGH) gene rearrangement. On the routine histopathology analysis, there was no difference between HCl and EDTA. Moreover, in case of immunohistochemical staining, the cytoplasmic membrane or cytoplasmic CD markers was well preserved. However, nuclear proteins, such as Ki-67, were stained with low quality. Conversely, according to the molecular analysis, the EDTA protocol preserved the DNA and RNA compared with the HCI. The differences of DNA quantity and quality were statistically significant between protocols of HCl and EDTA. We used 38 cases in HCl and 12 cases in EDTA. Consequently, the EDTA protocol maintains the antigenicity of the protein on tissue and is acceptable for examination with molecular base analysis. Decalcification of bone marrow biopsy by EDTA is highly recommended for the examination of immunohistochemical staining and molecular analysis.

• Korean Journal of Clinical Laboratory Science
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• v.47 no.4
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• pp.243-250
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• 2015

A bone marrow biopsy that has undergone decalcification with 10% nitric acid could not be used for various pathological tests and had extremely limited reproducibility. The fixing solution of each experimental group was differentiated in usage, one solution including acid and the other not. The use of the decalcification solution was separated into either acidic or alkaline (EDTA), and further experiments were conducted with differing time phases. When using a fixing solution and decalcification solution which included acid, the specimens were faulty to the extent that all pathological tests were impossible. However specimens that were processed with an EDTA type decalcification solution did not display a non-specific reaction in EBV ISH and were even able to produce results that were at a level suited to various studies or a pathological diagnosis in the FISH, DNA, RNA tests. By improving the fixing and decalcification of bone marrow biopsy, the study was able to make possible ISH, FISH, DNA tests as well as RNA study, and secured the sensitivity, specificity, and reproducibility of various test methods. The stabilization of various test methods that use bone marrow biopsy contributes to the diagnosis, prognosis, prediction, treatment of the patient and provide guidelines for decision-making.

• Journal of Korean Neurosurgical Society
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• v.38 no.1
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• pp.65-67
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• 2005

Intracranial chloroma may occur in leukemia, although they are rare. A 23-year-old female complained diplopia. Brain magnetic resonance MR imaging showed tumors in the both cavernous sinus, both tentorial and anterior falx. Gamma-Knife radiosurgery was performed with maximal dose; 20Gy, marginal dose; 10Gy. Peripheral blood smear revealed leukemia, and bone marrow aspiration biopsy showed acute lymphocytic leukemia. Two weeks later, MR image for the stereotactic biopsy noticed markedly decreased tumor size. Biopsy result was lymphocytic leukemia. She received conventional radiation therapy, chemotherapy, and bone marrow transplantation. Brain involvement by acute lymphocytic leukemia is very rare. Even though chloroma are sensitive to radiation therapy, prognosis is poor because of the gravity of the underlying disease and association with impending blast transformation. The authors reports a intracranial chloroma by acute lymphocytic leukemia.

• Tuberculosis and Respiratory Diseases
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• v.67 no.6
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• pp.560-564
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• 2009

Sarcoidosis is a granulomatous disease that can involve any organ, although it primarily involves the lungs, intrathoracic lymph nodes, skin, and eyes. We present a case of sarcoidosis with pancytopenia, resulting from bone marrow involvement. A 35-year-old man was admitted to hospital for chronic cough and blurred vision. On chest computed tomography, there were multiple pulmonary nodules and mediastinal lymph nodes enlargement. As the patient also showed pancytopenia, we performed a bone marrow biopsy, as well as a transbronchial lung biopsy. Both biopsies showed non-caseating granulomas. We diagnosed the patient with sarcoidosis with pulmonary, bone marrow, uvea, liver and spleen involvement. After oral steroid therapy, the patient's symptoms as well as his pancytopenia improved. We present this case to demonstrate the significance of bone marrow biopsy in cases of sarcoidosis with pancytopenia, as well the possibility of clinical improvement with steroid treatment.