Gh. Yu et Cm. Mcgrath, Follow-up of morphologically reactive lymphoid proliferations in fine-needle aspirates of elderly patients, DIAGN CYTOP, 23(4), 2000, pp. 249-252
Fine-needle aspiration (FNA) is an effective tool in evaluating the cause o
f lymphadenopathy While the morphologic diagnosis of a reactive lymphoid pr
oliferation is common in younger patients, this diagnosis should be made ca
refully in older patients (those over the age of 50 yr) in light of the fac
ts that such purely reactive conditions occur much less frequently in this
population, and that follow-up of these patients reveals a malignancy (usua
lly lymphoma) in a significant number of cases. In this series, we identifi
ed 40 patients with a morphologic diagnosis of reactive lymphoid proliferat
ion on FNA and obtained their follow-up information. Of 19 patients under t
he age of 50 yr, 5 underwent subsequent biopsies and only one revealed a de
finitive malignancy (5%). In contrast, 7 of 21 patients over the age of 50
yr underwent a subsequent biopsy, and 6 were found to have a malignancy (5
malignant lymphomas, 1 metastatic melanoma). The higher rate of positive fo
llow-up (29%) in this age group supports previous suggestions that morpholo
gically reactive (mixed) lymphoid proliferations be viewed with increased s
uspicion in the elderly patient, and that additional studies, such as flow
cytometry, be performed when material is available. (C) 2000 Wiley-Liss, In
c.