Fine-needle aspiration cytology of lymphoproliferative disorders in the immunosuppressed patient: the diagnostic utility of in situ hybridization for Epstein-Barr virus.
We examined the diagnostic utility of fine-needle aspiration (FNA) in the immunosuppressed patient with particular attention to the value of in situ hybridization for Epstein-Barr virus encoded RNA (EBER), a test frequently performed on tissue sections in this setting. Six patients with adenopathy were identified: three with prior solid organ transplantation, two with prior bone marrow transplantation, and one with human immunodeficiency virus. Cytologic findings in involved tissues were positive for non-Hodgkin's lymphoma in one case, suspicious or atypical in three cases, negative/reactive in one case, and nondiagnostic in one case due to insufficient material. Two aspirates had a polymorphous lymphoid appearance; three showed predominantly monomorphous lymphoid morphology. Retrospectively, 4/4 FNA cell blocks were positive for EBER in a large proportion of atypical lymphoid cells. Together with the cytologic findings, EBER detection allows for more specific classification of these FNA samples as EBV-associated lymphoid proliferations.
Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
Jonathan L
JL
Hecht
Edmund S
ES
Cibas
Jeffery L
JL
Kutok
D000328:Adult; D001707:Biopsy, Needle; D016026:Bone Marrow Transplantation; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000276:immunology / Q000473:pathology / Q000821:virology*; D005260:Female; D015658:HIV Infections / Q000821:virology; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D016867:Immunocompromised Host; D016130:Immunophenotyping; D017403:In Situ Hybridization; D008232:Lymphoproliferative Disorders / Q000150:complications / Q000276:immunology / Q000473:pathology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation; D012367:RNA, Viral / Q000032:analysis*
D012367:RNA, Viral