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T h e other received several chemotherapeutic agents, but not cyclophosphamide. Cyclophosphamide is commonly utilized in treating lymphoproliferative disorders, and it is not surprising to find that most of these patients had been treated with it during the course of their disease; no causal relationship between this specific drug and the presence of the ReedSternberg-like cells should be assumed at this time.
In many of the conditions in which Reed-Sternberg cells have been found, the clinical history and other findings can distinguish the disorder from Hodgkin's disease myeloma, mononucleosis, etc.
In nodular lymphoma involving the bone marrow, the distinction is not always easily made. The lesions of nodular lymphoma, as seen in trephine bone marrow biopsies with extensive involvement, frequently have other histologic features similar to Hodgkin's disease involving the bone marrow: fibrosis, histiocyte-like proliferation, and a pleomorphic cell population, which often makes distinction difficult even when Reed-Sternberg-like cells are not present.
In the evaluation of bone marrow biopsies from these cases, the distinction between Reed-Sternberg-like cells and megakaryocytes must be made. Megakaryocytes may be found around the edge of an area involved with lymphoma or in a loose aggregate of tumor cells Fig.
Megakaryocyte nuclei are small relative to the cytoplasm, which is abundant and very eosinophilic. The nucleoli of megakaryocytes, when present, are small and often basophilic. T h e cytoplasm of megakaryocytes shows moderate to marked PAS positivity. Reed-Sternberg cells usually have a high nuclear-cytoplasmic ratio, and the cytoplasm is frequently shrunken from its surrounding environment and slightly eosinophilic.
Nucleoli in Reed-Sternberg cells are always present and are large and intensely eosinophilic. Lymphomatous involvement of bone marrow. Numerous large cells with prominent nucleoli and giant cells with bizarre shapes are present. Megakaryocytes and other normal cells present in a loose aggregate of lymphoma in the bone marrow. Schnitzer 7 suggests that the ReedSternberg-like cells arise from histiocytic cells seen among the neoplastic cells in lymphomas.
Another possibility is that these cells are neoplastic lymphocytes altered as a result of chemotherapy or as part of the natural progression of the disease.
Cancer , 2. J Exp Med , 3. Lancet , 4. Lancet , 5. Cancer, August 6. Am J Dis Child , 7. Schnitzer B: Reed-Sternberg-like cells in lymphocytic lymphoma and chronic lymphocytic leukemia. Lancet , 8. Cancer , 9. The Reed-Sternberg-like cells could be derivatives of these large neoplastic lymphocytes, morphologically altered as a result of chemotherapy. Indeed, Leech 3 and Garvin and associates2 have shown evidence suggesting a B-cell origin of ReedSternberg cells in Hodgkin's disease.
Whatever the origin of the ReedSternberg-like cells, it is clear that their demonstration in neoplastic lesions in the bone marrow should be interpreted with caution, particularly when no other diagnostic tissue is available for examination.
Suggest Documents. Anaplastic large cell Ki-1 lymphoma involving bone marrow: marrow findings and association with reactive hemophagocytosis. Metastatic thymoma involving the bone marrow. Bone marrow biopsy in non-Hodgkin's lymphoma.
Numerous Reed-Sternberg cells in bone marrow aspirate from a patient with the syncytial variant of nodular sclerosis classical Hodgkin lymphoma. Large cell lymphoma with initial presentation in the bone marrow. CDpositive primary bone marrow lymphoma mimicking Hodgkin lymphoma. You can read Marrow Island online or download. Moreover, on our website you may reading the guides and another art eBooks online, either download theirs. We will to attract your regard that our website not store the eBook itself, but we provide url to website where you may download or read online.
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