The diagnostic value of biopsy of small peripheral lymph nodes in patients with suspected lymphoma

Abstract

In a patient with suspected lymphoma, it is considered desirable to confirm the diagnosis by excisional biopsy of enlarged lymph nodes. However, sometimes the ideal nodes are positioned internally, requiring a deep invasive procedure for access, or the patient may have underlying medical conditions that make it risky to perform such an invasive procedure. Under a protocol approved by our institution's review board (IRB), we reviewed five patients in whom superficial lymph nodes were biopsied which were smaller than usually considered optimal for diagnosis (=2 cm). In each of these cases, the biopsy yielded diagnostic information upon which treatment could be based, sparing the patient a deep invasive procedure. We suggest that in situations in which large internal lymph nodes are not easily accessible and/or the patient's clinical situation precludes more invasive procedures, including deep core needle biopsy of a large mass, it is worthwhile to consider the removal of smaller, superficial lymph nodes with minimal risk which may suffice for diagnosis. © 2011 Wiley Periodicals, Inc.

Lymph node fine needle aspiration cytology in systemic mastocytosis: cytological features with ancillary tests and literature review

“…Indeed, the risk of complications is not uncommon, mainly in the case of deep-seated lymph nodes or in elderly patients suffering from SM systemic symptoms or other diseases. 17,18 FNA combined with ancillary techniques may conveniently be used to diagnose lymph node involvement in SM -as in the few cases described in the literature (Table 1) -mainly because all the suggested diagnostic criteria may be applied on the corresponding samples. [8][9][10][11] Nonetheless, cytological diagnosis may be extremely difficult in cases for which there is still no diagnosis of CM or SM at the time of FNA.…”

Prevalence and Predictors of Bacterial Contamination in Excisional Lymph Node Biopsies

“…Distinguishing between these possibilities is crucial for informing appropriate therapy yet often difficult to accomplish through clinical and radiologic means alone 3–5. Definitive diagnosis often requires excisional biopsy of an affected lymph node, which provides sufficient tissue for optimal histopathologic review and additional diagnostic studies 6–10. Standard processing of excised lymph nodes includes allocation of tissue fragments for flow cytometry, cytogenetics, molecular diagnostics (if indicated), and microbiological cultures when infection is suspected 11.…”

“…[3][4][5] Definitive diagnosis often requires excisional biopsy of an affected lymph node, which provides sufficient tissue for optimal histopathologic review and additional diagnostic studies. [6][7][8][9][10] Standard processing of excised lymph nodes includes allocation of tissue fragments for flow cytometry, cytogenetics, molecular diagnostics (if indicated), and microbiological cultures when infection is suspected. 11 While this multiparametric approach is necessary for comprehensive evaluation, the physical handling associated with excision and allocation may expose the tissue to environmental microbes or the bacterial flora of the patient or involved personnel.…”