Comparative evaluation of combined application of fine needle aspiration cytology and flow cytometry with histopathology for the diagnosis of Non-Hodgkin lymphoma

Abstract

Fine needle aspiration cytology (FNAC) is widely used in the investigation of lymphadenopathy. A combination of FNAC and Flow cytometric immunophenotyping (FCI) can help to establish an accurate diagnosis and classification in most cases of NHL (Non-Hodgkin lymphoma). Aims: We evaluated the effectiveness of FNAC along with flow cytometry (FCM) with histopathology in the diagnosis and classification of NHL by applying FCI on a sample obtained from the FNAC of lymphoid tissue. Settings and Design: A cross-sectional study was conducted in the Department of Pathology. Patients of all ages presenting peripheral lymphadenopathy were screened on FNAC. All Cases suggested as NHL were taken up for FCM as well as for excision biopsy. Methods and Material: FCI of lymph node aspirate was performed by using four-color FCM (FACScalibur; Becton Dickinson). The sections were processed in Shandon Citadel 2000 tissue processor for histopathology. Statistical analysis used: Descriptive statistics were used to describe the study sample. Data were analyzed using SPSS.Results: A total of 30 patients, 27 (90%) male, and 3(10%) female were included in the study. Generalized lymphadenopathy (46.7%) was prominent followed by cervical lymphadenopathy(40%). Out of the 30 cases, eight cases were not analyzed due to the paucity of events. Out of 22 cases, a total of 18 cases were diagnosed as B-cell lymphoma, two cases as T-cell lymphoma, and two cases as reactive lymphoid hyperplasia. Conclusions: FNAC in conjunction with FCI is a reliable method that can be used as a first-line investigation to give rapid results, which can guide further investigation and facilitate cost-effective patient management. Key Messages: Excision biopsy and histopathological examination remain the gold standard for the classification of NHL. However, the need for anesthesia and possible complications of excision biopsy limits its role. FNAC in conjunction with FCI is a reliable method that can be used as a first-line investigation to give rapid results.

Automated Classification of Breast Cancer Cells Using High-Throughput Holographic Cytometry

“…The combination of FNAC with FC provides a cheaper, quicker and reliable alternative to the standard histological evaluation for finding cancer cells [33,34]. However, some of the disadvantages of current FC methods include the inaccessibility to single-cell morphological information [35] and fluorescent assays of biochemical markers may be misleading if not exclusively expressed in cancer cells [35][36][37].…”