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Abstract
The initial evaluation of patients with NHL serves to establish the correct diagnosis and extent of the disease. Information assembled through a history, physical examination, relevant radiographic studies, laboratory investigations, and necessary invasive procedures, identify the site of the disease, estimate prognosis, and develop a rational therapeutic approach. In our study, we evaluated laboratory diagnostic tools used in 44 NCI patients with bone marrow infiltrated by malignant lymphoma cells (Stage IV NHL). The majority of patients were diagnosed with DLBCL (50%) by lymph node histopathology. Most of the patients had hemogram abnormalities and elevated serum LDH. Around two-thirds of the cases (63.6%) showed BMA picture suggestive of BM infiltration. BMB assessment showed the majority of the cases infiltrated by lymphoma cells in an interstitial pattern (52.3%) and diffuse pattern (29.5%). In the DLBCL, 59.1% of the cases showed morphological concordance between the LN and BM. By comparing BMA, FCM and BMB, there was an agreement in detecting lymphoma cells in 72.2% of the cases, while discrepancies between the 3 tools were found in 27.8%. Patients >60 years and those with a higher PS had a decreased OS. Patients whose interim follow-up showed the BM to be positive for lymphoma cells had a lower OS. DLBCL patients with a concordant BMB and LN biopsy morphology had a poorer outcome than patients with discordant DLBCL in terms of OS and DFS