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Originally published as JHC exPRESS on June 23, 2008.
doi:10.1369/jhc.2008.951087
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Journal of Histochemistry and Cytochemistry
Volume 56 (10): 893-900, 2008
Copyright ©The Histochemical Society, Inc.

Role of Immunohistochemistry in Staging Diffuse Large B-cell Lymphoma (DLBCL)

Dipti Talaulikar, Jane Esther Dahlstrom, Bruce Shadbolt, Amy Broomfield and Anne McDonald

Department of Haematology (DT), Australian National University Medical School (DT,JED,BS), Department of Anatomical Pathology (JED,AB), and Department of Epidemiology (BS), The Canberra Hospital, Canberra, Australia, and National Capital Private Hospital, Canberra, Australia (AM)

Correspondence to: D. Talaulikar, MBBS, FRACP, FRCPA, GradCertHE, Department of Haematology, The Canberra Hospital, PO Box 11, Woden, ACT 2606, Australia. E-mail: dipti.talaulikar{at}act.gov.au

The use of immunohistochemistry (IHC) in staging bone marrow in non-Hodgkin's lymphoma (NHL) is largely limited to ambiguous cases, particularly those with lymphoid aggregates. Its role in routine clinical practice remains unestablished. This study aimed to determine whether the routine use of IHC in diffuse large B-cell lymphoma (DLBCL) would improve the detection of lymphomatous involvement in the bone marrow. It also sought to determine the impact of IHC on predicting survival compared with routine histological diagnosis using hematoxylin and eosin (H&E), Giemsa, and reticulin staining. The bone marrow trephines of 156 histologically proven DLBCL cases were assessed on routine histology, and IHC using two T-cell markers (CD45RO and CD3), two B-cell markers (CD20 and CD79a), and {kappa} and {lambda} light chains. IHC detected lymphomatous involvement on an additional 11% cases compared with histology alone. Although both routine histology and IHC were good predictors of survival, IHC was better at predicting survival on stepwise multivariate Cox regression analysis. IHC performed routinely on bone marrow trephines has the ability to improve detection of occult lymphoma in experienced hands. Furthermore, it is a better predictor of survival compared with routine histological examination alone. (J Histochem Cytochem 56:893–900, 2008)

Key Words: immunohistochemistry • histology • staging • bone marrow trephine biopsy • diffuse large B-cell lymphoma • International Prognostic Index


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