Yk. Suh et al., LYMPHOID-CELL AGGREGATES - A USEFUL CLUE IN THE FINE-NEEDLE ASPIRATION DIAGNOSIS OF FOLLICULAR LYMPHOMAS, Diagnostic cytopathology, 17(6), 1997, pp. 467-471
Among the various types of lymphoma, follicular lymphoma (FL) is known
to have significant limitations in cytologic diagnosis by the fine-ne
edle aspiration (FNA) method. The diagnostic accuracy (DA) for non-Hod
gkin's lymphoma (NHL) by FNA was evaluated by review of 82 cases of hi
stologically proved NHL after prior FNA. The DA for all NHLs was 66% (
54/82), and that for low-grade lymphomas, including small lymphocytic
lymphoma, follicular small-cleaved cell lymphoma, and follicular mixed
cell lymphoma, was 71% (12/17). The DA for FL was 69% (11/16). Review
of individual surgical and cytologic materials from FLs revealed a te
ndency to show fibrosis in the cytologically false-negative group and
diffuse areas of lymphoma in the true-positive group. The presence of
''aggregation'' of uniform lymphoid cells, probably due to cell adhesi
ons with the support of dendritic reticulum cells, was seen in 55% of
true-positive FL (6/11). Irt contrast, only 28% of true-positive diffu
se large cell lymphomas (5/18) showed a mild degree of aggregation, an
d none of 7 cases of true-positive diffuse small-cleaved cell lymphoma
showed this feature. The aggregation of cells was not pathognomonic o
f FL, but its presence with a homogeneous cellular constituent and the
paucity of tingible-body macrophages helped us to predict FL. Also, i
t was a feature distinguishing FL from diffuse small-cleaved cell lymp
homa (P = 0.025). (C) 1997 Wiley-Liss, Inc.