Singularities in pediatric bone marrow lymphoid processes

There are several unique features of hematopoiesis and hematopoietic diseases in children relative to adults. For example, evaluation of lymphoid lesions in the pediatric population is impacted by the fact that lymphoid cells normally comprise a larger percentage of blood and bone marrow cells in children than in adults. The nature of bone marrow lymphoid infiltrates in children differs to some extent from those in adults. In this chapter on singularities in pediatric bone marrow lymphoid processes, the unique characteristics of lymphoid lesions and diseases specific to children will be emphasized. It is important to note that evaluation of lymphoid lesions should include examination of well prepared and stained specimens of the peripheral blood, bone marrow (BM) aspirate smears, touch imprints of the trephine biopsy, and sections of the trephine biopsy and particles/clot. It is often the combination of clues gleaned from the composite of preparations that allows for diagnosis.