Histology and immunohistology of bone marrow biopsy in multiple myeloma

S. Pileri, S. Poggi, P. Baglioni, M. Montanari, E. Sabattini, P. Galieni, P. L. Tazzari, M. Gobbi, M. Cavo, B. Falini, H. Stein, S. Tura

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B5-fixed/paraffin-embedded Jamshidi needle biopsies from 125 multiple myeloma patients were reviewed according to both morphological and immunohistological criteria. At microscopic examination, the following parameters were evaluated: i) grade of malignancy (low = 56; intermediate = 50; high = 19); ii) growth pattern (interstitial +/- sheets/nodules = 90; nodular = 13; packed marrow = 18; sarcomatous = 4); III) histological stage (I = 64; II = 35; III = 26). Comparison of the findings in trephine biopsies and aspirates showed that in 30% of the cases the latter led to an understimation of the tumor burden. Immunohistochemical determination of Ig easily allowed: i) differential diagnosis from exuberant reactive plasmacytosis; ii) recognition and counting of neoplastic plasma cells; iii) detection of minimal residual disease after treatment. Immunohistochemistry also confirmed phenotypic aberration of neoplastic plasma cells, showing positivity for CD45, EMA, and cytokeratins in 14%, 59%, and 25% of the cases, respectively. Furthermore, it displayed expression of the P-glycoprotein in 4/8 resistant cases. These findings underline that routinely processed Jamshidi needle biopsies can be of great value in the study of patients with multiple myeloma.

Original languageEnglish
Pages (from-to)52-59
Number of pages8
JournalEuropean Journal of Haematology, Supplement
Issue number51
Publication statusPublished - 1989

ASJC Scopus subject areas

  • Hematology


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