What is the role of biopsy in the workup of cold agglutinin disease?

Updated: Aug 28, 2018
  • Author: Salman Abdullah Aljubran, MD; Chief Editor: Michael A Kaliner, MD  more...
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Perform bone marrow aspiration and biopsy only when they are needed to exclude certain neoplastic or immunoproliferative diseases. Flow cytometry studies of bone marrow are helpful in defining the presence of an abnormal monoclonal population of lymphocytes.

A lymph node biopsy is necessary when unexplained lymphadenopathy is present. Fine-needle aspiration is not reliable in comparison with excision of the largest lymph node for diagnostic purposes; nodal architecture is important for making an accurate diagnosis and is preserved in a lymph node biopsy. The addition of flow cytometry to define the presence of 1 or more abnormal monoclonal lymphocyte populations is also useful.

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