Fine-needle aspiration of extranodal and extramedullary hematopoietic malignancies

There is relatively little information concerning the use of fine-needle as piration (FNA) to diagnose extranodal and extramedullary hematopoietic mali gnancies. Seventy-one such cases diagnosed by FNA form the basis of this st udy. Seventy-one cases of FNAs performed between 1988 and 1998 on extranoda l and extramedullary hematopoietic malignancies were reviewed in order to e valuate the usefulness of this technique in diagnosing these entities as we ll as to assess patterns of relapse. There were 45 male and 26 female patie nts ranging in age from 29-86 years (mean, 68 years). Sixty-six patients ha d a previous history of a hematopoietic malignancy. Aspirates from 65 of th ese patients were consistent with the patient's known primary. One aspirate of a paravertebral mass from a multiple myeloma patient showed extramedull ary hematopoiesis. The remaining five aspirates were cases of multiple myel oma that first presented as soft tissue masses. The most common malignancie s were lymphoma. 52 cases (73%), 48 large cell lymphomas, forts mixed small and large cell lymphoma; followed by multiple myeloma: 12 cases (17%); leu kemia: four cases (5.4%); Hodgkin disease: two cases (2.8%); and one case o f extramedullary hematopoiesis. The aspirate sites were soft tissue: 23 cas es (32%); bone: 17 cases (24%); kidney: 14 cases (20%); liver: 11 cases (15 %); lung: three cases (4%); adrenal: two cases (3%); and eye: one case. The interval between primary diagnosis and FNA was 1-36 months (mean, 23 month s). In conclusion, 98% of the aspirates were neoplastic in patients with a known history of hematopoietic malignancies. The most common site of involv ement was soft tissue in 23 (32%) cases. In Jive patients with multiple mye loma the FNA diagnosis prompted a work-lip to find the primary site of invo lvement. FNA is a useful technique in assessing extranodal and extramedulla ry hematopoietic malignancies. Diagn. Cytopathol. 2000;23:318-321. (C) 2000 Wiley-Liss, Inc.