The Accuracy of Combined Cytopathologic and Flow Cytometric Analysis of Fine-Needle Aspirates of Lymph Nodes

Abstract

We studied flow cytometry in 156 fine-needle aspirations (FNAs) of lymph nodes performed between June 1993 and September 1998. Information from flow cytometry was combined with cytomorphologic evaluation, and the diagnosis determined by using combined modalities was compared with tissue biopsy results or clinical follow-up. In 74 cases, a combined cytopathologic-flow cytometric diagnosis of lymphoma was made; histologic material was available for 52 patients; in no case was a benign process found. The lymphoma grade assigned agreed with histopathologic findings in 45 of 48 cases with a specific cytologic diagnosis. Treatment was initiated on the basis of the FNA alone for 17 of 52 patients with a history of lymphoma and in 22 additional patients with no follow-up biopsy. Among 71 cases in which the diagnosis using both modalities was benign, the only false-negative was 1 case of Hodgkin disease. Of the 156 cases, 11 were considered atypical or suggestive of lymphoma; biopsies from 8 of 10 patients revealed lymphoma. A combination of flow cytometry and cytomorphology of cells obtained by FNA of lymph nodes can distinguish between benign and malignant lymphoid infiltrates and support a diagnosis of lymphoma that permits definitive therapy in most cases.

Fine-needle cytology and flow cytometry immunophenotyping and subclassification of non-hodgkin lymphoma

“…Inadequate and suspicious case rates in the literature range from 4% to 30% 4,7,8,10,22 ; scant cellularity, necrosis, and excessive blood contamination are the most frequent causes of inadequate cases; as reported earlier, location in splanchnic organs or deeply located lymph nodes also contributed to this group because of the difficulty in performing two or more passes, as in FNCs of the spleen. 21 Moreover, most inadequate cases were obtained in the first year of the examiners' experience and decreased progressively with time.…”

“…1,2,[13][14][15] The possibility of applying a complete panel of antibodies and diagnostic algorithms is the most appreciated advantage of the technique; 4,6,8 consequently, many reports stress the high sensitivity in detecting non-Hodgkin lymphoma (NHL) through the combined application of FNC and FC. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] The most enthusiastic reports hypothesize that, in the near future, histology will not be necessary strictly for the diagnosis of NHL. In fact, in many institutions, FNC coupled with ancillary techniques like FC routinely has replaced histology in the diagnosis of recurrent NHL (rNHL).…”

Cytologic findings of marginal zone lymphoma

“…[5][6][7][8][9][10][11]15 It has been shown repeatedly that FC is a useful tool for evaluating lymphoid FNAB specimens. [15][16][17][18][19][20][21] All eight MZL specimens diagnosed by Young et al had concurrent FC, although specific details, such as the percentage of B-cells versus T-cells and K:L ratios, were not provided. 6 Their MZL specimens showed the expected phenotype of CD20 expression and absence of CD5, CD10, and CD23.…”

Adult T-cell leukemia/lymphoma

“…This has been evidenced by studies showing that nonHodgkin lymphomas can be accurately diagnosed in cytologic specimens utilizing ancillary techniques such as immunocytochemistry and flow cytometry. 4,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] In the REAL classification, ATLL belongs to the category of peripheral T-cell and natural killer cell neoplasms. Although several reports of peripheral Tcell lymphoma have been published in the cytology literature, [33][34][35][36][37] we are aware of only a single cytologic study of T-cell lymphoma in HTLV-1 positive patients.…”