Lymph node fine‐needle cytology in the era of personalised medicine. Is there a role?

Abstract

The 2016 World Health Organisation revised classification of lymphoma has sub‐classified well‐defined entities and added a number of provisional entities on the basis of new knowledge on genetic, epigenetics and phenotypical data; prognostic and predictive features are also part of this classification. New knowledge on well‐defined entities further enlightens the mechanisms of lymphomagenesis, which are more complex and multifactorial than once believed. Therapies are also more complex because traditional clinical trials have been integrated with new drugs and compounds with unique mechanisms of actions against distinct molecular targets. As lymphoma acquires additional genetic and phenotypic features over the time, pathological assessment is also necessary. Histological evaluation and tissue collection by surgical biopsies are necessary for phenotypical and molecular purposes; however, these are demanding procedures for both the patient and the health care system. At the same time, the choice of the best treatment for a specific entity, in different phases and different patients requires information that may not be available when the biopsy is performed. Fine needle aspiration cytology (FNAC) is successfully used in lymph nodes (LNs) in combination with different ancillary techniques and might be used to assess the phenotypic and genetic profile of specific targets and to get key information for therapy, in different phases and stages of the disease, with the option to re‐check the same target over time, without surgical excision. This brief review describes LN‐FNAC diagnostic criteria, current therapies for lymphomas and the potential role of LN‐FNAC in selecting non‐Hodgkin lymphomas patients for specific targeted treatments.

Testing EGFR with Idylla on Cytological Specimens of Lung Cancer: A Review

“…A true positive, on the other hand, would give the patient access to a more effective treatment [ 82 ]. If supported by future studies, immunocytochemically-stained smears could also be digitized to allow sacrification of the biologic material for molecular tests [ 83 ].…”

Flow cytometry aneuploidy and cell cycle indexing as a possible tool for differentiating between CD10+ diffuse large B‐cell lymphoma and follicular lymphoma

“…Characterization of the antigenic profile by multiparameter flow cytometry (FC) is an important and valuable diagnostic tool in the era of modern pathology (Cozzolino et al, ; O'Donnell, Ernst, & Hingorani, ). The high resolution of FC, which is performed on single cell suspension, is most advantageous when only a limited tissue sample is available, or when the tissue architecture is inadequate for a detailed IHC analysis (Martinez et al, ).…”

CD15, CD30, and PAX5 evaluation in Hodgkin's lymphoma on fine‐needle aspiration cytology samples

“…All the patients underwent RT and CHOP chemotherapy. 25 In all cases, FNAC and rapid on-site evaluation on Diff-Quik stained slides were performed, as described previously. 26 Additional passes were used to prepare three or four smears that were negative, regardless of signal intensity.…”

“…[2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Since the percentage of diagnostic cells is generally low and not always straightforward (especially in the early stages of the disease), their phenotypical identification is necessary for the diagnosis of HL. 2 25 In all cases, FNAC and rapid on-site evaluation on Diff-Quik stained slides were performed, as described previously. 2,3,5,8,9,11,13,14,17 Therefore, the phenotypical identification of diagnostic cells plays a crucial role in the diagnosis of HL on FNAC.…”