Jm. Fang et al., Diagnosis and classification of lymphoma based on cytospin preparations: Acomparison of hematopathologists and cytopathologists, DIAGN CYTOP, 22(6), 2000, pp. 336-341
The diagnosis of malignant lymphoma based on cytologic preparations is a so
urce of much debate. The purpose of this study was to assess the ability of
a number of pathologists to diagnose and classify lymphoma using cytospin
preparations, and to compare the rate of agreement between cytopathologists
and hematopathologists. One hundred twenty-five cytospins prepared from hi
stologically confirmed hematologic lesions were examined retrospectively an
d independently by four hematopathologists/fellows and two cytopathologists
without knowledge of the final diagnosis; the results were compared with t
he final diagnoses derived from histology and immunophenotyping. Eighty-one
cases were histologically diagnosed as lymphoma (including 67 cases of B-c
ell non-Hodgkin's lymphoma), and 44 cases represented a reactive process hi
stologically. The distinction of a malignant from a benign process was made
in 75% of the cases by cytospin examination, with cytopathologists correct
ly diagnosing 75% and hematopathologists 76% of the cases. The accuracy rat
e for subclassification of the lymphoma cases was 49% (46% for cytopatholog
ists, 52% for hematopathologists). The cytopathologists correctly recognize
d large-cell lymphoma at an increased frequency compared with the hematopat
hologists (70% vs. 56%, P = 0.11), while the hematopathologists showed a gr
eater ability to recognize and classify nonfollicle center low-grade B-cell
lymphomas (57% vs. 28%, P = 0.01). We conclude that cytopathologists and h
ematopathologists generally achieve similar accuracy rates in the morpholog
ic evaluation of cytologic preparations of lymphoid lesions, though some di
fferences in their performance do exist. Diagn. Cytopathol. 2000;22:336-341
. (C) 2000 Wiley-Liss, Inc.