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.