Bodies of evidence? Lymphoglandular bodies in aspirate smears of bone marrow involved by aggressive large B-cell lymphoma

A 79-year-old woman presented with hypercalcemia and a mediastinal mass identified by computed tomography scan. Further imaging revealed several intracranial lesions that were not intraparenchymal, as well as a large periaortic mass with diffuse abdominal lymphadenopathy. A biopsy of the mediastinal mass yielded a diagnosis of B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma. A staging bone marrow examination was performed and revealed extensive involvement by an aggressive appearing large B-cell lymphoma. A striking number of lymphoglandular bodies were present in the bone marrow aspirate smears.

Lymphoglandular bodies are cytoplasmic fragments, commonly observed and reported in fine-needle aspiration or cytology preparations of lymphoid tissue, often in association with lymphoid malignancies. They have been less frequently reported in bone marrow aspirate smears. Although not a specific finding, lymphoglandular bodies have been shown to be present in higher numbers in bone marrows involved by B-cell lymphoid malignancies compared with T-cell lymphoid malignancies and myeloid leukemias. Their pale, lightly basophilic color with smooth borders, occasional blebs, and lack of granulation allow them to be distinguished from platelets.