Bone marrow trephine biopsy in lymphoproliferative disease.

Introduction Examination of bone marrow biopsy specimens is a valuable diagnostic procedure in patients with known or suspected lymphoproliferative disorders. ' A bone marrow biopsy specimen may be diagnostic in patients without lymphadenopathy or when there is no conclusive histological evidence from other sites. In some conditions, such as hairy cell leukaemia,2 it is the primary diagnostic procedure. Bone marrow biopsy is mandatory for staging lymphomas and useful in monitoring treatment.3 Valuable information on the state of haematopoiesis and changes in stromal components is also provided by trephine biopsy specimens.4 Bone marrow biopsy specimens are especially important in the staging of Hodgkin's disease, because pathology in the marrow indicates systemic disease and an unfavourable prognosis,5 6 and they are of confirmed value in histological staging and grading of multiple myeloma where histology has been shown to be more accurate than aspiration cytology for quantifying tumour cell burden.7