Skip to main content
PMC home page
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1998 Mar;51(3):189–196. doi: 10.1136/jcp.51.3.189

Fine needle aspiration cytology in the investigation on non-Hodgkin's lymphoma.

M D Jeffers 1, J Milton 1, R Herriot 1, M McKean 1
PMCID: PMC500637  PMID: 9659258

Abstract

AIMS: To assess the value of flow cytometry (FCM) in the diagnosis and classification of reactive lymphoid hyperplasia and malignant lymphoma by fine needle aspiration (FNA) cytology. METHODS: Forty six fine needle aspirates of lymphoproliferative disorders were examined by FCM as well as routine cytological assessment. An immunoglobulin light chain ratio (LCR) was calculated for clonality analysis. Additional immunophenotyping was performed in 15 cases. RESULTS: All 25 cases of reactive lymphoid hyperplasia were polyclonal by FCM (LCR < 2/1); 17 of 20 cases of B cell non-Hodgkin's lymphoma were monoclonal (LCR > 3/1). Analysis of cells based on size facilitated detection of small populations of clonal neoplastic cells. Analysis of CD5, CD10, and CD23 expression by FCM facilitated subclassification of mantle cell lymphoma, small lymphocytic lymphoma, and some lymphomas of follicle centre cell origin. One case of T cell non-Hodgkin's lymphoma was correctly classified by FCM. CONCLUSIONS: FNA cytology is a reliable method for investigation of lymphoproliferative disorders. Although excision biopsy and histopathological examination remain the gold standard for primary diagnosis and classification of non-Hodgkin's lymphoma, FNA cytology with clonality analysis and immunophenotyping by FCM is useful for distinguishing reactive from neoplastic lymphoid populations, and can facilitate lymphoma classification.

Full text

PDF
189

Images in this article

190Image
on p.190
191Image
on p.191
192Image
on p.192
192Image
on p.192
193Image
on p.193

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Cafferty L. L., Katz R. L., Ordonez N. G., Carrasco C. H., Cabanillas F. R. Fine needle aspiration diagnosis of intraabdominal and retroperitoneal lymphomas by a morphologic and immunocytochemical approach. Cancer. 1990 Jan 1;65(1):72–77. doi: 10.1002/1097-0142(19900101)65:1<72::aid-cncr2820650116>3.0.co;2-q. [DOI] [PubMed] [Google Scholar]
  2. Cartagena N., Jr, Katz R. L., Hirsch-Ginsberg C., Childs C. C., Ordóez N. G., Cabanillas F. Accuracy of diagnosis of malignant lymphoma by combining fine-needle aspiration cytomorphology with immunocytochemistry and in selected cases, Southern blotting of aspirated cells: a tissue-controlled study of 86 patients. Diagn Cytopathol. 1992;8(5):456–464. doi: 10.1002/dc.2840080506. [DOI] [PubMed] [Google Scholar]
  3. Carter T. R., Feldman P. S., Innes D. J., Jr, Frierson H. F., Jr, Frigy A. F. The role of fine needle aspiration cytology in the diagnosis of lymphoma. Acta Cytol. 1988 Nov-Dec;32(6):848–853. [PubMed] [Google Scholar]
  4. Chan J. K., Banks P. M., Cleary M. L., Delsol G., De Wolf-Peeters C., Falini B., Gatter K. C., Grogan T. M., Harris N. L., Isaacson P. G. A proposal for classification of lymphoid neoplasms (by the International Lymphoma Study Group). Histopathology. 1994 Dec;25(6):517–536. doi: 10.1111/j.1365-2559.1994.tb01371.x. [DOI] [PubMed] [Google Scholar]
  5. Chan W. C., Greiner T. C. Diagnosis of lymphomas by the polymerase chain reaction. Am J Clin Pathol. 1994 Sep;102(3):273–274. doi: 10.1093/ajcp/102.3.273. [DOI] [PubMed] [Google Scholar]
  6. Chan W. C., Greiner T. C. Diagnosis of lymphomas by the polymerase chain reaction. Am J Clin Pathol. 1994 Sep;102(3):273–274. doi: 10.1093/ajcp/102.3.273. [DOI] [PubMed] [Google Scholar]
  7. Clatch R. J., Walloch J. L. Multiparameter immunophenotypic analysis of fine needle aspiration biopsies and other hematologic specimens by laser scanning cytometry. Acta Cytol. 1997 Jan-Feb;41(1):109–122. doi: 10.1159/000332314. [DOI] [PubMed] [Google Scholar]
  8. Das D. K., Gupta S. K., Datta B. N., Sharma S. C. FNA cytodiagnosis of non-Hodgkin's lymphoma and its subtyping under working formulation of 175 cases. Diagn Cytopathol. 1991;7(5):487–498. doi: 10.1002/dc.2840070510. [DOI] [PubMed] [Google Scholar]
  9. Daskalopoulou D., Harhalakis N., Maouni N., Markidou S. G. Fine needle aspiration cytology of non-Hodgkin's lymphomas. A morphologic and immunophenotypic study. Acta Cytol. 1995 Mar-Apr;39(2):180–186. [PubMed] [Google Scholar]
  10. Galindo L. M., Havlioglu N., Grosso L. E. Cytologic findings in a case of T-cell rich B-cell lymphoma: potential diagnostic pitfall in FNA of lymph nodes. Diagn Cytopathol. 1996 May;14(3):253–258. doi: 10.1002/(SICI)1097-0339(199604)14:3<253::AID-DC11>3.0.CO;2-K. [DOI] [PubMed] [Google Scholar]
  11. Geary W. A., Frierson H. F., Innes D. J., Normansell D. E. Quantitative criteria for clonality in the diagnosis of B-cell non-Hodgkin's lymphoma by flow cytometry. Mod Pathol. 1993 Mar;6(2):155–161. [PubMed] [Google Scholar]
  12. Hajdu S. I., Melamed M. R. Limitations of aspiration cytology in the diagnosis of primary neoplasms. Acta Cytol. 1984 May-Jun;28(3):337–345. [PubMed] [Google Scholar]
  13. Hanson C. A. Fine-needle aspiration and immunophenotyping. A role in diagnostic hematopathology? Am J Clin Pathol. 1994 May;101(5):555–556. doi: 10.1093/ajcp/101.5.555. [DOI] [PubMed] [Google Scholar]
  14. Katz R. L., Hirsch-Ginsberg C., Childs C., Dekmezian R., Fanning T., Ordóez N., Cabanillis F., Sneige N. The role of gene rearrangements for antigen receptors in the diagnosis of lymphoma obtained by fine-needle aspiration. A study of 63 cases with concomitant immunophenotyping. Am J Clin Pathol. 1991 Oct;96(4):479–490. doi: 10.1093/ajcp/96.4.479. [DOI] [PubMed] [Google Scholar]
  15. Leong A. S., Stevens M. Fine-needle aspiration biopsy for the diagnosis of lymphoma: a perspective. Diagn Cytopathol. 1996 Nov;15(4):352–357. doi: 10.1002/(SICI)1097-0339(199611)15:4<352::AID-DC21>3.0.CO;2-M. [DOI] [PubMed] [Google Scholar]
  16. Levitt S., Cheng L., DuPuis M. H., Layfield L. J. Fine needle aspiration diagnosis of malignant lymphoma with confirmation by immunoperoxidase staining. Acta Cytol. 1985 Sep-Oct;29(5):895–902. [PubMed] [Google Scholar]
  17. Levy N., Nelson J., Meyer P., Lukes R. J., Parker J. W. Reactive lymphoid hyperplasia with single class (monoclonal) surface immunoglobulin. Am J Clin Pathol. 1983 Sep;80(3):300–308. doi: 10.1093/ajcp/80.3.300. [DOI] [PubMed] [Google Scholar]
  18. Martin S. E., Zhang H. Z., Magyarosy E., Jaffe E. S., Hsu S. M., Chu E. W. Immunologic methods in cytology: definitive diagnosis of non-Hodgkin's lymphomas using immunologic markers for T- and B-cells. Am J Clin Pathol. 1984 Dec;82(6):666–673. doi: 10.1093/ajcp/82.6.666. [DOI] [PubMed] [Google Scholar]
  19. North L., Katz R., Carrasco H., Wallace S. What is the role of fine needle biopsy in the diagnosis of lymphoma? AJR Am J Roentgenol. 1995 Nov;165(5):1299–1299. doi: 10.2214/ajr.165.5.7572526. [DOI] [PubMed] [Google Scholar]
  20. Palutke M., Schnitzer B., Mirchandani I., Tabaczka P. M., Franklin R., Eisenberg L., So K., Carrillo G. Increased numbers of lymphocytes with single class surface immunoglobulins in reactive hyperplasia of lymphoid tissue. Am J Clin Pathol. 1982 Sep;78(3):316–323. doi: 10.1093/ajcp/78.3.316. [DOI] [PubMed] [Google Scholar]
  21. Pontifex A. H., Klimo P. Application of aspiration biopsy cytology to lymphomas. Cancer. 1984 Feb 1;53(3):553–556. doi: 10.1002/1097-0142(19840201)53:3<553::aid-cncr2820530330>3.0.co;2-m. [DOI] [PubMed] [Google Scholar]
  22. Robins D. B., Katz R. L., Swan F., Jr, Atkinson E. N., Ordonez N. G., Huh Y. O. Immunotyping of lymphoma by fine-needle aspiration. A comparative study of cytospin preparations and flow cytometry. Am J Clin Pathol. 1994 May;101(5):569–576. doi: 10.1093/ajcp/101.5.569. [DOI] [PubMed] [Google Scholar]
  23. Russell J., Orell S., Skinner J., Seshadri R. Fine needle aspiration cytology in the management of lymphoma. Aust N Z J Med. 1983 Aug;13(4):365–368. doi: 10.1111/j.1445-5994.1983.tb04482.x. [DOI] [PubMed] [Google Scholar]
  24. Saddik M., el Dabbagh L., Mourad W. A. Ex vivo fine-needle aspiration cytology and flow cytometric phenotyping in the diagnosis of lymphoproliferative disorders: a proposed algorithm for maximum resource utilization. Diagn Cytopathol. 1997 Feb;16(2):126–131. doi: 10.1002/(sici)1097-0339(199702)16:2<126::aid-dc6>3.0.co;2-f. [DOI] [PubMed] [Google Scholar]
  25. Sewell H. F., Milton J. I., MacKenzie R., King D. J., Dawson A. A., Lessels S. E., Bennett B., Davidson R. L., Walker F. Immunophenotyping of leukaemias by flow cytometry and APAAP: a two-year comparative analysis in hospital practice. Dis Markers. 1988 Oct-Dec;6(4):221–229. [PubMed] [Google Scholar]
  26. Sneige N., Dekmezian R. H., Katz R. L., Fanning T. V., Lukeman J. L., Ordoñez N. F., Cabanillas F. F. Morphologic and immunocytochemical evaluation of 220 fine needle aspirates of malignant lymphoma and lymphoid hyperplasia. Acta Cytol. 1990 May-Jun;34(3):311–322. [PubMed] [Google Scholar]
  27. Sneige N., Dekmezian R., el-Naggar A., Manning J. Cytomorphologic, immunocytochemical, and nucleic acid flow cytometric study of 50 lymph nodes by fine-needle aspiration. Comparison with results obtained by subsequent excisional biopsy. Cancer. 1991 Feb 15;67(4):1003–1007. doi: 10.1002/1097-0142(19910215)67:4<1003::aid-cncr2820670424>3.0.co;2-w. [DOI] [PubMed] [Google Scholar]
  28. Sneige N. Diagnosis of lymphoma and reactive lymphoid hyperplasia by immunocytochemical analysis of fine-needle aspiration biopsy. Diagn Cytopathol. 1990;6(1):39–43. doi: 10.1002/dc.2840060109. [DOI] [PubMed] [Google Scholar]
  29. Steel B. L., Schwartz M. R., Ramzy I. Fine needle aspiration biopsy in the diagnosis of lymphadenopathy in 1,103 patients. Role, limitations and analysis of diagnostic pitfalls. Acta Cytol. 1995 Jan-Feb;39(1):76–81. [PubMed] [Google Scholar]
  30. Stewart C. J., Farquharson M. A., Kerr T., McCorriston J. Immunoglobulin light chain mRNA detected by in situ hybridisation in diagnostic fine needle aspiration cytology specimens. J Clin Pathol. 1996 Sep;49(9):749–754. doi: 10.1136/jcp.49.9.749. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Tani E. M., Christensson B., Porwit A., Skoog L. Immunocytochemical analysis and cytomorphologic diagnosis on fine needle aspirates of lymphoproliferative disease. Acta Cytol. 1988 Mar-Apr;32(2):209–215. [PubMed] [Google Scholar]
  32. Tani E., Liliemark J., Svedmyr E., Mellstedt H., Biberfeld P., Skoog L. Cytomorphology and immunocytochemistry of fine needle aspirates from blastic non-Hodgkin's lymphomas. Acta Cytol. 1989 May-Jun;33(3):363–371. [PubMed] [Google Scholar]
  33. Wan J. H., Sykes P. J., Orell S. R., Morley A. A. Rapid method for detecting monoclonality in B cell lymphoma in lymph node aspirates using the polymerase chain reaction. J Clin Pathol. 1992 May;45(5):420–423. doi: 10.1136/jcp.45.5.420. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Witzig T. E., Banks P. M., Stenson M. J., Griepp P. R., Katzmann J. A., Habermann T. M., Colgan J. P., Gonchoroff N. J. Rapid immunotyping of B-cell non-Hodgkin's lymphomas by flow cytometry. A comparison with the standard frozen-section method. Am J Clin Pathol. 1990 Sep;94(3):280–286. doi: 10.1093/ajcp/94.3.280. [DOI] [PubMed] [Google Scholar]
  35. Wojcik E. M., Katz R. L., Fanning T. V., el-Naggar A., Ordonez N. G., Johnston D. Diagnosis of mantle cell lymphoma on tissue acquired by fine needle aspiration in conjunction with immunocytochemistry and cytokinetic studies. Possibilities and limitations. Acta Cytol. 1995 Sep-Oct;39(5):909–915. [PubMed] [Google Scholar]
  36. Zander D. S., Iturraspe J. A., Everett E. T., Massey J. K., Braylan R. C. Flow cytometry. In vitro assessment of its potential application for diagnosis and classification of lymphoid processes in cytologic preparations from fine-needle aspirates. Am J Clin Pathol. 1994 May;101(5):577–586. doi: 10.1093/ajcp/101.5.577. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES