Extranodal lymphomas: Review of clinicopathologic and cytologic features

Abstract

Extranodal lymphomas can be challenging for a practicing cytopathologist, especially in the fine needle aspiration clinic setting. These lymphomas can vary in type from one extranodal site to another. A variety of these lymphomas have very specific clinicopathologic features. They also may be associated with underlying autoimmune diseases, immunodeficiency syndromes, infection, or be noted in unique ethnic communities. This article reviews some of the commonly encountered lymphomas in extranodal sites with an emphasis on clinicopathologic and cytologic features.

Comparison of Diagnostic Cytomorphology of Natural Killer/T-Cell Lymphoma (Nasal Type) in Conventional Smears, Liquid-Based Preparations, and Histopathology

“…Lymphoma cells with elongated and twisted nuclei, recapitulating the cellular morphology seen in biopsies of the usual nasal-type NK/T-cell lymphoma, are common [10]. The NK/T-cell lymphoma cells show similar features in the previous case reports, including rich and pale blue cytoplasm with azurophilic granules and characteristic tongue-like cytoplasmic protrusions [7–14]. The azurophilic granules are easily recognized in Giemsa stain [11].…”

“…To the best of our knowledge, the cytological features of NK/T-cell lymphoma, nasal type, are not well established in the published literature [7–14]. NK/T-cell lymphoma is marked by a wide cytological spectrum, which varies from a predominance of small cells to a predominance of large cells.…”

“…NK/T-cell lymphoma is marked by a wide cytological spectrum, which varies from a predominance of small cells to a predominance of large cells. On FNA smears, a mixture of benign-appearing small lymphocytes and variable numbers of small to large atypical lymphoid cells is usually seen [7–14]. Plasma cells and, less often, eosinophils and histiocytes are also present.…”

“…The presence of cytoplasmic “tongue-like” protrusions may serve as a useful diagnostic clue [11, 12]. Cytoplasmic azurophilic granules are often identified in touch preparations of the tissue samples [7, 9, 11, 12, 14]. Abundant necrotic areas and karyorrhectic debris may be present.…”

Malignant lymphoma of the head and neck

“…Cytodiagnosis of HL is generally thought to be easier than that of NHL. Appropriate interpretation of cytological features, together with the use of immunocytochemical parameters, can aid in reducing the margin of error in cytodiagnosis (Das et al , 2009; Siddiqui et al , 2009). However, histopathological examination of the node via complete adenectomy is necessary to establish a definitive diagnosis.…”