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[Contribution of immunohistochemical technics to the study of malignant infiltration of bone marrow].

Immunohistochemistry using monoclonal antibodies has been proved of diagnostic value in bone marrow pathology. Several monoclonal antibodies identifying antigens not denatured by fixation are now available. In anaplastic tumors infiltrating bone marrow these antibodies allow the distinction of large cell lymphomas which express the leucocyte common antigen (Dako-LC+) from undifferentiated carcinomas which are reactive with anti-cytokeratin antibodies (KL-1+, Dako-EMA+), neuroblastoma (NSE+) and rhabdomyosarcoma (desmin+). KL-1 and Dako-EMA antibodies are also considered to be powerful tools to disclose micrometastases from carcinoma, particularly breast carcinoma, which otherwise may be undiagnosed. The detection of residual or minimal bone marrow involvement in malignant lymphomas (particularly Burkitt type) remains difficult. However, in some cases, Dako-LC and MB2 (anti-B) antibodies are useful to detect bone marrow involvement in some lymphoproliferative disorders composed of small or medium-sized cells scattered among hematopoietic cells, and in some large cell lymphomas (i.e. centroblastic or immunoblastic types). These antibodies allow the detection of minimal or residual involvement by malignant cells, which can be confused with immature hematopoietic cells, on routine stainings. No anti-T antibody was found to react satisfactorily with T cell on decalcified biopsy specimens. In anaplastic large cell lymphomas (so-called malignant histiocytosis), malignant cells coexpress Ki-1 and EMA antigens. Antibodies recognizing these two antigens were found to be of value to demonstrate scarce neoplastic cell in bone marrow.