UTILIZATION OF FINE-NEEDLE ASPIRATION CYTOLOGY AND FLOW-CYTOMETRY IN THE DIAGNOSIS AND SUBCLASSIFICATION OF PRIMARY AND RECURRENT LYMPHOMA

BACKGROUND. The primary diagnosis of non-Hodgkin's lymphoma/leukemia ( NHL) by fine-needle aspiration (FNA) is controversial. The authors rev iewed their experience with FNA and flow cytometry (FC) to determine t he usefulness and limitations of these techniques in the diagnosis of NHL. METHODS. Slides and reports from all lymph node and extranodal FN As performed during the period July 1993 to January 1997 with a diagno sis of lymphoma or benign lymphoid process were reviewed. Clinical and biopsy follow-up data were recorded. Results were tabulated and the u sefulness of cytology was analyzed. RESULTS. There were 100 adequate a spirates from 87 patients. These included 72 cases of NHL, 58 (80%) of which were diagnosed by FNA and FC without the need for histologic sa mpling (69% of the primary lymphomas and 88% of the recurrent lymphoma s). There were 22 aspirates suspicious for lymphoma, 12 equivocal resu lts, and 7 benign diagnoses. Eighty-six percent of malignant FNAs (50 of 58) had flow cytometry (FC) as compared with only 15% (5 of 34) of the suspicious or equivocal FNAs. CONCLUSIONS. FNA is a valuable metho d for diagnosing and subclassifying NHL, although immunophenotyping by FC is often an essential ancillary rest. In our experience, correlati ng the FNA results with the FC results can eliminate the need for a mo re invasive surgical biopsy in many cases. Cancer (Cancer Cytopathol) 1998;84:252-61. (C) 1998 American Cancer Society.