title: Diagnosis and classification of lymphoma based on cytospin preparations: a comparison of hematopathologists and cytopathologists.
abstract: The diagnosis of malignant lymphoma based on cytologic preparations is a source of much debate. The purpose of this study was to assess the ability of a number of pathologists to diagnose and classify lymphoma using cytospin preparations, and to compare the rate of agreement between cytopathologists and hematopathologists. One hundred twenty-five cytospins prepared from histologically confirmed hematologic lesions were examined retrospectively and independently by four hematopathologists/fellows and two cytopathologists without knowledge of the final diagnosis; the results were compared with the final diagnoses derived from histology and immunophenotyping. Eighty-one cases were histologically diagnosed as lymphoma (including 67 cases of B-cell non-Hodgkin's lymphoma), and 44 cases represented a reactive process histologically. The distinction of a malignant from a benign process was made in 75% of the cases by cytospin examination, with cytopathologists correctly diagnosing 75% and hematopathologists 76% of the cases. The accuracy rate for subclassification of the lymphoma cases was 49% (46% for cytopathologists, 52% for hematopathologists). The cytopathologists correctly recognized large-cell lymphoma at an increased frequency compared with the hematopathologists (70% vs. 56%, P = 0.11), while the hematopathologists showed a greater ability to recognize and classify nonfollicle center low-grade B-cell lymphomas (57% vs. 28%, P = 0.01). We conclude that cytopathologists and hematopathologists generally achieve similar accuracy rates in the morphologic evaluation of cytologic preparations of lymphoid lesions, though some differences in their performance do exist.
authors.affiliation: Department of Pathology, University of Washington Medical Center, Seattle, Washington, USA.
authors.forename: J
authors.initials: J
authors.lastname: Fang
authors.forename: J W
authors.initials: JW
authors.lastname: Hussong
authors.forename: S L
authors.initials: SL
authors.lastname: Perkins
authors.forename: G H
authors.initials: GH
authors.lastname: Yu
authors.forename: M J
authors.initials: MJ
authors.lastname: Sack
authors.forename: B L
authors.initials: BL
authors.lastname: Wood
mesh_terms: D001707:Biopsy, Needle; D003581:Cytodiagnosis; D003937:Diagnosis, Differential; D006405:Hematology / Q000193:education / Q000379:methods* / Q000592:standards; D008198:Lymph Nodes / Q000473:pathology*; D008223:Lymphoma / Q000145:classification* / Q000175:diagnosis*; D010338:Pathology, Clinical / Q000193:education / Q000379:methods* / Q000592:standards; D011237:Predictive Value of Tests; D019310:Pseudolymphoma / Q000145:classification / Q000175:diagnosis; D015203:Reproducibility of Results