Cytomorphological characterisation of angioimmunoblastic T cell lymphoma: a case–control study

Abstract

AimsAngioimmunoblastic T cell lymphoma (AITL) is often misdiagnosed in cytology. Hence, the present study was conducted to identify the distinctive cytomorphological features of AITL in lymph node fine-needle aspirates (LN-FNA).MethodsThis was a 4-year retrospective case–control study. Cases included LN-FNAs from patients with histopathologically confirmed AITL. The controls included LN-FNAs from patients with histopathologically confirmed reactive lymphoid hyperplasia (RLH; n=25). Eleven cytomorphological features were assessed in all the aspirates; the strength of association was determined by OR, Cramer’s V and multiple correspondence analysis (MCA).ResultsOf a total of 22 cases of AITL reported on histopathology, 19 adequate aspirates from 14 patients (63.6%) were available for review. On univariate analysis, 5 of 11 cytomorphological variables were found to be significant for AITL; however, on MCA, 3 of these parameters, viz absence of tingible body macrophages (OR=0.014; V=0.74), presence of atypical lymphoid cells (OR=10.8; V=0.41) and singly scattered epithelioid cells (OR=19.3; V=0.31), were found to be the strongest predictors of AITL.ConclusionsThe absence of tingible body macrophages, presence of atypical lymphoid cells and singly scattered epithelioid cells in polymorphic LN-FNAs are significant cytomorphological predictors of AITL in comparison with RLH. Knowledge of these diagnostic predictors, supplemented by clinicoradiological correlation and appropriate ancillary studies, can help diagnose AITL on aspiration cytology.

Cytopathological characteristics of angioimmunoblastic T‐cell lymphoma diagnosed by fine needle aspiration

“…In a study of 16 FNAs from patients with AITL over a 9‐year period 13 the authors noted that the smears showed a heterogeneous population of haematolymphoid cells, including small lymphocytes; non‐descript, medium‐sized lymphoid cells; immunoblasts; plasma cells; eosinophils; and reticulum cells, including follicular dendritic cells. Another 4‐year retrospective case‐control study included patients with histopathologically confirmed reactive lymphoid hyperplasia 8 . Eleven cytomorphological features were statistically analysed as variables; however, three of these parameters, namely, the absence of tingible body macrophages, the presence of atypical lymphoid cells, and singly scattered epithelioid cells, were the strongest predictors of AITL.…”

“…An understanding of the cytopathological characteristics of AITL remains essential for pathologists; however, the literature on the cytopathological features of AITL is scarce. [8][9][10][11][12][13] We retrospectively studied 12 FNA lymph node cytopathological samples from nine patients with AITL diagnosed by histological biopsy and immunohistochemistry between January 2014 and December 2020 to explore how to obtain cytopathological clues for the diagnosis of T-cell lymphoma and, in a limited number of cell samples, AITL.…”

“…Undeniably, due to individual preferences or the unpredictable nature of real‐world circumstances, many patients with AITL may still receive FNA, such as those with cachexia who cannot tolerate tissue biopsy and those undergoing review after remission following AITL. An understanding of the cytopathological characteristics of AITL remains essential for pathologists; however, the literature on the cytopathological features of AITL is scarce 8–13 . We retrospectively studied 12 FNA lymph node cytopathological samples from nine patients with AITL diagnosed by histological biopsy and immunohistochemistry between January 2014 and December 2020 to explore how to obtain cytopathological clues for the diagnosis of T‐cell lymphoma and, in a limited number of cell samples, AITL.…”

“…8 Eleven cytomorphological features were statistically analysed as variables;TA B L E 2Note: -: negative; -/+: suspected; +: small amount; ++: medium amount; +++: full view.…”