In all cases, bone marrow biopsy evaluation was performed as a part of the staging workup for MM at iliac spine. In selected patients (cases 16, 17, and 18), typical HU < 0 LBLs underwent to needle biopsy. In detail, 3-μm-thick slides were obtained from formalin-fixed, decalcified paraffin-embedded marrow samples. Following the routine protocol for bone marrow examination, the slices were stained with H&E, PAS, and Giemsa. Marrow fibrosis was assessed by reticulin stain. The immunohistochemical characterization of plasma cells was performed using the following antibodies:
anti-CD138 (clone MI15 Dako, Glostrup, Denmark),
anti-MUM1 (clone MUM1p, Dako, Glostrup, Denmark), anti-CD56 (clone 504 Leica, Milan, Italy), anti-cyclin D1 (clone EP12, Dako, Glostrup, Denmark),
anti-CD20 (clone L26, Dako, Glostrup, Denmark), anti-CD79a (clone 11E3, Leica, Milan, Italy), anti-CD3 (clone LN10, Novocastra, Milan, Italy), and
Mib1 (clone Mib1 Dako, Glostrup, Denmark). An
anti-CD68 antibody (clone PGM1, Dako, Glostrup, Denmark) was used to assess the presence and distribution of peri-trabecular osteoclasts.
Zambello R., Crimì F., Lico A., Barilà G., Branca A., Guolo A., Varin C., Vezzaro R., Checuz L., Scapin V., Berno T., Pizzi M., Ponzoni A., De Biasi E., Vio S., Semenzato G., Zucchetta P, & Lacognata C. (2018). Whole-body low-dose CT recognizes two distinct patterns of lytic lesions in multiple myeloma patients with different disease metabolism at PET/MRI. Annals of Hematology, 98(3), 679-689.