Diagnostic impact of core-needle biopsy on fine-needle aspiration of non-Hodgkin lymphoma.
We retrospectively reviewed 74 fine-needle aspiration (FNA) cases of presumptive non-Hodgkin lymphoma (NHL). All the cases had cytology and core-needle biopsy and 53 cases had concurrent flow cytometric analysis. FNA (cytology and flow cytometry) and core-needle biopsy were evaluated independently. FNA was diagnostic of diffuse large B-cell lymphoma (DLBL) in 25% (13/53) of cases and small B-cell NHL in 15% (8/53) of cases, whereas core-needle biopsy was diagnostic of DLBL in 37% (27/74) of cases and small B-cell NHL in 8% (6/74) of cases. Subclassification of small B-cell NHL was reached in 3/6 cases by core-needle biopsy. Insufficient cases were observed in both FNA (47%; 25/53) and core-needle biopsy (28%; 21/74) groups. With the combination of FNA and core-needle biopsy, diagnostic cases of DLBL increased to 43% (32/74) and insufficient samples were reduced to 16% (12/74). There was no clear advantage in the diagnosis and classification of small B-cell NHL by adding core-needle biopsy to FNA (14%; 10/74). We conclude that core-needle biopsy is a useful adjunct to FNA in the diagnosis of DLBL and shall be encouraged. In small B-cell NHL, core-needle biopsy does not add to the diagnostic ability of FNA. Cases insufficient for diagnosis may be seen in both core-needle biopsy and FNA. A combined approach reduces the number of insufficient cases and is recommended in routine FNA practice.
Gong
Jerald Z
JZ
Department of Pathology, Duke University Medical Center, Durham, North Carolina 27710, USA. gong0001@mc.duke.edu
Snyder
Matthew J
MJ
Lagoo
Anand S
AS
Vollmer
Robin T
RT
Dash
Raj R
RR
Madden
John F
JF
Buckley
Patrick J
PJ
Jones
Claudia K
CK
D000465:Algorithms; D044963:Biopsy, Fine-Needle; D001707:Biopsy, Needle; D003937:Diagnosis, Differential; D005434:Flow Cytometry; D006801:Humans; D007150:Immunohistochemistry; D016393:Lymphoma, B-Cell / Q000145:classification / Q000175:diagnosis* / Q000378:metabolism; D016403:Lymphoma, Large B-Cell, Diffuse / Q000145:classification / Q000175:diagnosis* / Q000378:metabolism; D008228:Lymphoma, Non-Hodgkin / Q000145:classification / Q000175:diagnosis* / Q000378:metabolism; D012189:Retrospective Studies