Hodgkin s Lymphoma with Special Emphasis on Bone Marrow Involvement: A Six Year Report from King Hussein Medical Center

Objective: To determine the frequency and the histopatholgic type of Hodgkin s Lymphoma (HL) in newly diagnosed patients and to determine the frequency of Bone Marrow (BM) involvement by the disease at King Hussein Medical Center (KHMC) over 6 years.Methods: A total of 150 HL patients were diagnosed at the department of pathology KHMC and classified according to the WHO classification of hematological malignancies between January 2001 and December 2006. All cases were reviewed histologically. The available BM Trephine Biopsy (TB) and BM Aspirate Smears (AS) for 98 patients were also reviewed and analyzed.Results: Patients ranged in age from 3 to 64 years with a mean of 31.1. They were 80 males and 70 females. Of the 150 HL patients, nodular sclerosis variant was the commonest subtype 36%, followed by mixed cellularity HL 25.3%, the lymphocytic rich classic subtype 5.3%, and the lymphocytic depleted subtype 2.7%. There were 36 cases of classic HL which could not be further subtyped. For the 98 patients who had available BMTB and BMAS from unilateral site, 12 patients (12.2%) had positive BM involvement which was picked by BMTB. All the corresponding BMAS were negative. Lymphocytic depleted HL showed the highest percentage of BM involvement 50%, followed by mixed cellularity 37.5%.Conclusion: Nodular sclerosis HL is found to be the most common type of disease at our hospital. BMTB is a simple tool for the assessment of the disease spread and is superior to BMAS in detecting BM involvement. The need for bilateral BMTB is emphasized particularly in highly suspicious cases.