Table of Contents
ISRN Hematology
Volume 2014 (2014), Article ID 363854, 5 pages
http://dx.doi.org/10.1155/2014/363854
Research Article

Phagocytized Neutrophil Fragments in the Bone Marrow: A Phenomenon Most Commonly Associated with Hodgkin Lymphoma

Department of Pathology and Laboratory Medicine, Nationwide Children’s Hospital, 700 Children's Drive, Columbus, OH 43205, USA

Received 19 December 2013; Accepted 28 January 2014; Published 18 March 2014

Academic Editors: H. Knecht and L. Visser

Copyright © 2014 Michael A. Arnold and Samir B. Kahwash. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Bone marrow macrophages containing other cells, or large pieces of other cells, represent a distinctive feature of diseases such as Hemophagocytic Lymphohistiocytosis (HLH) and Rosai-Dorfman disease. We describe a distinct variation of phagocytic histiocyte morphology, featuring histiocytes containing predominantly fragments of neutrophil nuclei. We retrospectively reviewed initial bone marrow samples for Hodgkin lymphoma, Burkitt lymphoma, Ewing sarcoma, or evaluation for nonneoplastic conditions, scoring the presence or absence of the above-described histiocytes. We find that these histiocytes, which we term “fragmentophages,” are associated with staging marrow sampling for malignancy, especially Hodgkin lymphoma (Hodgkin lymphoma: 28/34 or 82.4%, Ewing sarcoma: 11/26 or 42.3%, Burkitt lymphoma: 4/13 or 30.8%). These cells are significantly less common in marrow samples for nonneoplastic conditions (4/21 or 19.0%). Fragmentophages are significantly associated with malignancy, especially Hodgkin lymphoma, and their recognition has the potential to provide a clue to an underlying malignancy.