Fine needle aspiration cytology diagnosis of malignant lymphoma and reactive lymphoid hyperplasia.

Abstract

Aims-To assess the diagnostic accuracy of lymph node fine needle aspiration (FNA) cytology to distinguish reactive lymphoid hyperplasia from malignant lymphoma, and to evaluate the contribution of ancillary techniques applied to cytological material. Methods-Two hundred and seventy seven consecutive lymph node FNA specimens reported to be consistent with reactive lymphoid hyperplasia (n = 213) or suggestive/diagnostic of malignant lymphoma (n = 64) were reviewed. Follow up data were obtained by case record review or by histological correlation. The value of immunocytochemistry, in situ hybridisation for immunoglobulin light chain mRNA, and polymerase chain reaction (PCR) towards the final clinicopathological diagnosis was assessed in 92, 61, and 45 cases, respectively. Results-Sixty one of 67 lymphomas and 207 of 209 reactive lymph nodes were accurately diagnosed by FNA cytology. There were six false negative aspirates including three cases of follicular lymphoma, two cases of Hodgkin's disease, and one chronic lymphocytic leukaemia. Two FNA specimens considered suspicious of lymphoma proved reactive on histology or clinical follow up. One metastatic small cell carcinoma was wrongly diagnosed as lymphoma. Ancillary studies contributed to the correct diagnosis in most cases although occasional misleading results were obtained, particularly with PCR. Conclusions-FNA cytology accurately distinguished reactive lymphoid hyperplasia from malignant lymphoma in 97% of cases. However, occasional wrong diagnoses occurred owing to sampling error or misinterpretation. Ancillary studies can be applied to cytological samples and contribute to the diagnosis in most cases. (J Clin Pathol 1998;51:197-203)

Accuracy of Fine Needle Aspiration Cytology of Salivary Gland Lesions: Routine Diagnostic Experience in Bangkok, Thailand

“…The FNA specimen with predominantly lymphocytes without salivary epithelium was frequently associated with lowgrade lymphoma on final histological diagnosis in both suspicious and malignant cytological diagnosis so it should prompt further study for lymphoma (Cohen et al, 2004). FNA cytology along with various ancillary studies, such as immunocytochemistry and flow cytometry can be helpful to diagnostic and classification lymphomas and separate them from reactive hyperplasia (Stewart et al, 1998;Dong et al, 2001). One adenocarcinoma case was misdiagnosed as negative for malignancy.…”

Evaluation of peripheral lymphadenopathy by fine needle aspiration cytology: a one year study at tertiary centre

“…[7] Early reports suggested that FNA produced high false negative rates in patients with Hodgkin's disease and low grade nonHodgkin's lymphoma. 8 We are presenting our experience with 555 cases of lymphadenopathy gathered over a period of one year. The pattern of benign lesion seen in our study consists of reactive hyperplasia, tuberculous lymphadenitis, acute lymphadenitis and malignant lesion includes metastatic carcinoma and malignant lymphoma/leukemia.…”

Fine-Needle Aspiration Cytology of Retroperitoneal Lesions: A 5-Year Experience with an Emphasis on Cytohistological Discrepancy

“…Similar mistakes have also been reported and care should be given to the improvement of skills regarding cellular appreciation of malignancy. Immunocytochemistry in this set-up is unique regarding the distinction of neoplastic and activated lymphocytes [24,25]. …”