Diagnosis of lymphoma by fine-needle aspiration cytology using the revisedEuropean-American classification of lymphoid neoplasms

BACKGROUND. Recent changes in the classification of non-Hodgkin lymphoma (N HL) emphasize the diagnostic importance of cytomorphology, immunophenotypin g, and molecular findings in addition to histology. These changes have allo wed for a greater role of fine-needle aspiration cytology (FNA) int he diag nosis of NHL. METHODS. A review of the English language literature regarding the use of F NA in the cytodiagnosis of lymphoma was performed. The revised European-Ame rican classification of lymphoid neoplasms (REAL) was reviewed in the conte xt of its adaptability to the cytologic diagnosis of lymphoid neoplasms. RESULTS. FNA is being used more frequently in the diagnosis, staging, and f ollow-up of lymphoma whenever supportive studies are readily available. Cyt omorphologic, immunophenotypic, and molecular criteria as well as pitfalls in the diagnosis of lymphoma by FNA have been delineated. Information was c omplied into tables to facilitate correlation of criteria with the proposed REAL system. CONCLUSIONS. Many cases of NHL can be diagnosed and subclassified by FNA wh en there is adequate immunophenotypic information. [See editorial on pages 322-4, this issue]. Cancer (Cancer Cytopathol) 1999;87-325-45. (C) 1999 Ame rican Cancer Society.