T-CELL-RICH B-CELL LYMPHOMA - FINE-NEEDLE ASPIRATION CYTOLOGY AND IMMUNOCYTOCHEMISTRY

Cytomorphologic and immunocytochemical characteristics of FNA aspirate s from 5 patients with T-cell-rich B-cell lymphoma are described. The aspirates were dominated (over 90%) by small mature lymphocytes, but t here was a sparse admixture of large, immature lymphoid cells, some of which mimicked Hodgkin's or Reed Sternberg's cells. The cytologic pic ture of 3 cases was similar to that of Hodgkin's disease of lymphocyti c predominance. Two cases presented, in addition to the components des cribed above, fragments of small vessels and epithelioid cells, which raised the possibility of true T-cell lymphoma. Immunocytochemical ana lysis of cytospin preparations showed that the mature small lymphocyte s were of T-phenotype, while the large cells were of B-phenotype. Ligh t-chain restriction was demonstrated in all cases, and monoclonality f or kappa and lambda was shown, in 4 cases and I case, respectively. Th ree cases had a previous histological diagnosis of Hodgkin's disease, which was revised to T-cell-rich B-cell lymphoma as a consequence of t he cytologic and immunologic findings in aspirates from reccurent/rema ining lymphoma manifestations. It can thus be concluded that immunocyt ochemistry in conjunction with cytomorphology on fine-needle aspirates will allow a conclusive diagnosis of T-cell-rich B-cell lymphoma and its differentiation from Hodgkin's disease and T-cell lymphomas. This distinction, from a prognostic and therapeutic standpoint, is of utmos t importance. (C) 1988 Wiley-Liss, Inc.