THE VALUE OF TRANSFORMED LYMPHOCYTE COUNT IN SUBCLASSIFICATION OF NON-HODGKINS-LYMPHOMA BY FINE-NEEDLE ASPIRATION

No established criteria exist for predicting lymphoma grade or transfo rmation in cytologic material. We counted transformed lymphocytes in f ine-needle aspiration (FNA) biopsy specimens to determine whether the percentage of these cells in the smear could predict the histologic gr ade, the biologic behavior, or both. The percentage of transformed lym phocytes out of total lymphoid cells was determined on Papanicolaou-st ained smears. Afterward, a cytodiagnosis was based on clinical informa tion available at the time of the FNA, cytomorphologic data, and flow cytometry data. Results were correlated with results of examination of the surgical biopsy specimen, clinical behavior of the lymphoma, or b oth. The percentage of transformed lymphocytes was 10% or less in all low-grade or indolent lymphomas. Aspirates with transformed lymphocyte counts of 20% or greater were aggressive lymphomas. We also report ou r experience in the diagnosis of non-Hodgkin's lymphoma by FNA using c ytomorphologic examination and immunophenotyping by flow cytometry at a cancer referral hospital. This is a preliminary study, and larger se ries may help establish the ranges of transformed lymphocyte counts th at correlate with the lymphoma subtype.