Diagnostic impact of core‐needle biopsy on fine‐needle aspiration of non‐Hodgkin lymphoma

Abstract

We retrospectively reviewed 74 fine-needle aspiration (FNA) cases of presumptive non-Hodgkin lymphoma (NHL). All the cases had cytology and core-needle biopsy and 53 cases had concurrent flow cytometric analysis. FNA (cytology and flow cytometry) and core-needle biopsy were evaluated independently. FNA was diagnostic of diffuse large B-cell lymphoma (DLBL) in 25% (13/53) of cases and small B-cell NHL in 15% (8/53) of cases, whereas core-needle biopsy was diagnostic of DLBL in 37% (27/74) of cases and small B-cell NHL in 8% (6/74) of cases. Subclassification of small B-cell NHL was reached in 3/6 cases by core-needle biopsy. Insufficient cases were observed in both FNA (47%; 25/53) and core-needle biopsy (28%; 21/74) groups. With the combination of FNA and core-needle biopsy, diagnostic cases of DLBL increased to 43% (32/74) and insufficient samples were reduced to 16% (12/74). There was no clear advantage in the diagnosis and classification of small B-cell NHL by adding core-needle biopsy to FNA (14%; 10/74). We conclude that core-needle biopsy is a useful adjunct to FNA in the diagnosis of DLBL and shall be encouraged. In small B-cell NHL, core-needle biopsy does not add to the diagnostic ability of FNA. Cases insufficient for diagnosis may be seen in both core-needle biopsy and FNA. A combined approach reduces the number of insufficient cases and is recommended in routine FNA practice.

Value of CT-guided core-needle biopsy in diagnosis and classification of malignant lymphomas using automated biopsy gun

“…CT-guided core-needle biopsy is therefore widely regarded as a quick, safe, and efficient alternative to excisional biopsy in patients without enlarged superficial lymph nodes [10,14] . The core-needle can acquire a relatively large specimen, which allows a better immunohistochemical staining [26,27] . CT-guided core-needle biopsy obviates the need for surgical biopsy in the majority of cases [4,9,25] .…”

“…Guided by CT, an 18-20 G needle is driven forward by the spring-loaded gun, and a biopsy specimen with a size of about 1.5-cm in length is rapidly cut, which is sufficient for imm-ohistochemistry staining for complete subtyping [14,16] . The reliability of CT-guided core-needle biopsy in diagnosis and classification of malignant lymphomas has largely been confirmed, and the opportunity of open biopsy or exploratory operation is greatly reduced [9,26] . In our study, 76.25% (61/80) of patients with malignant lymphoma underwent CT-guided core-needle biopsies and treated on the basis of biopsy results alone.…”

The Advantages and Limitations of the Role of Core Needle and Fine Needle Aspiration Biopsy of Lymph Nodes in the Modern Era

“…However, the utility of core needle biopsy in small cell lymphomas is less clear due to architectural variations within a single process and broader morphologic and phenotypic overlaps between different subtypes. 36 The failure rate of core biopsy ranges from 14% to 58% from various studies. 31,32,35,36 Many factors may lead to inadequate samples, including lesion location, specimen handling, specimen fixation, and biopsy technique of the operator.…”

Fine-needle aspiration is superior to needle core biopsy as a sample acquisition method for flow cytometric analysis in suspected hematologic neoplasms

“…Two methods for obtaining samples from solid tissues for FCI include fine-needle aspiration (FNA) and needle core biopsy (NCB). Minimally invasive FNA and NCB techniques for tissue sampling have led to reduced financial costs and patient morbidity, at the expense of increasingly smaller amounts of diagnostic tissue available for pathologic evaluation (1)(2)(3)(4)(5)(6). FNA utilizes a small-bore needle to acquire variable amount of cellular elements (cellular suspension) for cytologic evaluation.…”

“…Diagnostic usefulness and limitations of FNA and NCB as two separate diagnostic methods are well studied and their respective roles in the diagnosis of lymphoma and other hematologic neoplasms are well characterized (1)(2)(3)(4)(5)7,8). However, there are no large studies specifically comparing the two sampling methodologies and their ability to produce analytically adequate amount of viable cells for FCI, and what impact these individual sampling methods have on the ability either to reach FCI interpretation and/or final diagnosis.…”