title: Fine needle aspiration of lymphoblastic lymphoma. A multiparameter diagnostic approach.
abstract: Sixteen fine needle aspiration (FNA) biopsies of lymphoblastic lymphoma (LBL) that were used to either initially diagnose disease (12) or document relapse (4) were reviewed. Cellular aspirates (2 x 10(7) cells) were readily obtained for immunologic, DNA/RNA flow cytometric and immunoglobulin and/or T-cell receptor gene rearrangement studies. Cytologically, aspirates were characterized by intermediate-sized cells (9.5-18.5 microns) with fine nuclear chromatin, small, inconspicuous nucleoli, irregular nuclear contours and scant basophilic cytoplasm. Frequent mitotic figures were seen (1-14 figures per 1,000 cells). Fourteen cases demonstrated a T-cell phenotype with considerable phenotypic variability. One case demonstrated a precursor B-cell phenotype, and another demonstrated biphenotypic expression with both T-cell and myeloid differentiation. Eleven of 14 cases (79%) were positive for terminal deoxynucleotidyl transferase. Thirteen of 15 cases (87%) manifested diploid DNA content by flow cytometric analysis and were characterized by intermediate proliferative activity (S+G2M 12.7 +/- 8.7% SD) and intermediate mean RNA index (1.3 +/- .5 SD). T beta gene rearrangements were demonstrated in four of five phenotypic T-cell LBL cases analyzed, with concomitant JH gene rearrangements observed in three cases, confirming that bigenotypic rearrangements characterize some T-cell LBLs. We conclude that FNA samples are adequate for accurate characterization of LBL and may obviate the need for surgical biopsy.
authors.affiliation: Department of Pathology, University of Texas M. D. Anderson Cancer Center, Houston 77030.
authors.forename: J C
authors.initials: JC
authors.lastname: Jacobs
authors.forename: R L
authors.initials: RL
authors.lastname: Katz
authors.forename: N
authors.initials: N
authors.lastname: Shabb
authors.forename: A
authors.initials: A
authors.lastname: el-Naggar
authors.forename: N G
authors.initials: NG
authors.lastname: Ordonez
authors.forename: W
authors.initials: W
authors.lastname: Pugh
mesh_terms: D000293:Adolescent; D000328:Adult; D001707:Biopsy, Needle; D005260:Female; D005434:Flow Cytometry; D015321:Gene Rearrangement; D006801:Humans; D007124:Immunoenzyme Techniques; D016130:Immunophenotyping; D008297:Male; D008875:Middle Aged; D008940:Mitotic Index; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000235:genetics / Q000276:immunology / Q000473:pathology*