Soft tissue aspiration cytopathology of malignant lymphoma and leukemia

BACKGROUND. Malignant lymphoma (ML) and leukemia infrequently involve soft tissue and, to the authors' knowledge few reports exist regarding the role of fine-needle aspiration biopsy (FNAB) in their diagnosis. In the current study, the authors report their experience with FNAB in patients with soft tissue ML and leukemia. METHODS. AU cases of ML, leukemia, or atypical lymphoid cells from soft tis sue aspirates were reviewed. Masses from lymph node-rich sites, those adjac ent to enlarged lymph nodes, or those associated with cutaneous lesions wer e excluded. RESULTS. Twenty-one patients (male:female ratio of 1:1) who ranged in age f rom 10 months to 87 years (mean age, 51 years) were studied. Seven patients had superficial masses and 14 patients had deep soft tissue masses. Sites included the extremities (10 patients), trunk (8 patients), and head (3 pat ients). Cytologic diagnoses were ML (large cell [1 patients] and Hodgkin [1 patient]), acute leukemia (lymphoblastic [3 patients] and myelogenous [2 p atients]), and atypical lymphoid cells (4 patients). Eight aspirates repres ented the initial diagnosis of ML, three were recurrent ML, four were recur rent leukemia, one was initial leukemia, and one ML aspirate was obtained c oncurrently with core needle biopsy. Four aspirates were diagnosed as atypi cal lymphoid cells. Three subsequently were diagnosed as ML and one aspirat e was diagnosed as acute leukemia. AU ML were of large B-cell type. One cas e of atypical lymphoid cells was found to be a mantle cell lymphoma. The le ukemia cases were T-cell (two cases), pre-B-cell (two cases), and myelogeno us (two cases). Immunophenotyping confirmed the cytology by flow cytometry (five cases), cytospin (three cases), and cell block (four cases). Immunoph enotyping Of eight cases was performed on tissue samples. In one case a cyt opathologic diagnosis of ML reversed a prior tissue core biopsy diagnosis o f liposarcoma. The specificity and sensitivity rates for a definitive diagn osis of ML or leukemia were 100% and 82%, respectively. CONCLUSIONS. In the majority of cases, it is possible to determine a specif ic diagnosis and subtype of soft tissue ML or leukemia using FNAB. Cancer ( Cancer Cytopathol) 2001;93:35-39. (C) 2001 American Cancer Society.