Guide to the Diagnosis of Lymphoid Neoplasms in Blood and Bone Marrow: A Bone Marrow Pathology Group Approach

Authors

• Kathryn Foucar, Department of Pathology, University of New Mexico, Albuquerque, NM, United States.
• Adam Bagg, Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, United States.
• Daniel A. Arber, Department of Pathology, University of Chicago, Chicago, IL, United States.
• Carlos E. Bueso-Ramos, Department of Hematopathology, University of Texas MD Anderson Cancer Center, Houston, TX, United States.
• Julia T. Geyer, Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, United States.
• Robert P. Hasserjian, Department of Pathology, Massachusetts General Hospital, Boston, MA, United States.
• Attilio Orazi, Department of Pathology, Texas Tech University, El Paso, TX, United States.
• Kaaren K. Reichard, Department of Pathology, Mayo Clinic, Rochester, MN, United States.
• Wayne Tam, Department of Pathology and Laboratory Medicine, Donald and Barbara Zucker School of Medicine, Hofstra/Northwell, Greenvale, NY, United States.
• Sa A. Wang, Department of Hematopathology, University of Texas MD Anderson Cancer Center, Houston, TX, United States.
• Olga K. Weinberg, Department of Pathology, University of Texas, Southwestern, Dallas, TX, United States.
• Eric D. Hsi, Department of Pathology, Mayo Clinic, Rochester, MN, United States.

Document Type

Article

Publication Date

11-19-2025

Abstract

OBJECTIVE: The successful diagnosis and classification of lymphoid neoplasms in blood and bone marrow is the responsibility of the practicing pathologist. This guide provides a general "roadmap" for this process, from initial case recognition to final classification.

METHODS: The integration of hematologic, morphologic, immunophenotypic, and genetic features for the full spectrum of precursor and mature B-cell, T-cell, and natural killer-cell neoplasms that typically manifest in blood and bone marrow is included.

RESULTS: Classification systems for lymphoid neoplasms provide criteria for pathologists to render a diagnosis that is optimal for patient care, treatment, and outcome prediction.

CONCLUSIONS: This guide provides diagnostic strategies for lymphoid neoplasms encountered in blood and bone marrow specimens using both the International Consensus Classification and the World Health Organization fifth edition classification systems. Key tips are provided for each entity along with testing requirements, differential diagnosis, nonneoplastic mimics, and other unique features based on the experience of the Bone Marrow Pathology Group members.

Recommended Citation

Foucar K, Bagg A, Arber DA, Bueso-Ramos CE, Geyer JT, Hasserjian RP, Orazi A, Reichard KK, Tam W, Wang SA, Weinberg OK, Hsi ED. Guide to the diagnosis of lymphoid neoplasms in blood and bone marrow: A Bone Marrow Pathology Group approach. Am J Clin Pathol. 2025 Nov 19;164(5):650-693. doi: 10.1093/ajcp/aqaf068. PMID: 40994023.