DIAGNOSIS OF HODGKINS-DISEASE BY FINE-NEEDLE ASPIRATION - USEFULNESS IN DEVELOPING-COUNTRIES

The efficiency of a diagnostic procedure is evaluated by the percentag e of subjects accurately identified, as either suffering from the dise ase looked for (true positive, TP) or not (true negative, TN). Sensiti vity and specificity are the percentage of TP or TN, respectively, acc urately identified. Cytological diagnosis of Hodgkin's disease (HD) wa s evaluated; smears were made from fine-needle aspiration. One hundred and nine smears were examined independently by two cytologists; adeno pathies were benign in 43 cases (luberculosis 25, non-specific reactiv e hyperplasia 16, sarcoidosis 2) and malignant in 66 cases (HD 36, Non -Hodgkin's lymphoma 22, malignant histiocytosis 2, metastasis 5, blast crisis of chronic myeloid leukemia 1). Benign and malignant diseases were diagnosed by lymph node biopsy; diagnosis of HD was made in 36 TP patients; the 73 others are TN. Sensitivity, specificity and efficien cy are: 75, 90.4, 85.3, respectively for one observer; 77.7, 91.8, 87. 1 respectively for the other. 63.8, 90.4, 81.6 respectively when diagn osis was the same for the two cytologists. Fine-needle aspiration perm its the diagnosis of HD in eight out of 10 cases, it is useful when bi opsy is difficult or too expensive, as is often the case in developing countries.