title: Endoscopic/Endobronchial Ultrasound-Guided Fine Needle Aspiration and Ancillary Techniques, Particularly Flow Cytometry, in Diagnosing Deep-Seated Lymphomas.
abstract: Evaluation of deep-seated lymphomas by fine-needle aspiration (FNA) can be challenging due to their reduced accessibility. Controversy remains as to whether FNA and ancillary techniques can be used to diagnose deep-seated lymphomas reliably and sufficiently for clinical management. Most published studies are favorable that endobronchial ultrasound (EBUS)/endoscopic ultrasound (EUS)-FNA plays an important role in the diagnosis of deep-seated lymphomas. The addition of ancillary techniques, particularly flow cytometry, increases diagnostic yield. While subclassification is possible in a reasonable proportion of cases, the reported rates of successful subclassification are lower than those for lymphoma detection/diagnosis. The diagnostic limitation exists for Hodgkin's lymphoma, grading of follicular lymphoma, and some T-cell lymphomas. The role of FNA in deep-seated lymphomas is much better established for recurrent than primary disease. It remains unclear whether the use of large-sized-needle FNA or a combination of core needle biopsy and FNA improves subclassification. It is important for cytopathologists to have considerable understanding of the WHO lymphoma classification and develop a collaborative working relationship with hematopathologists and oncologists. As EUS/EBUS-FNA techniques advance and sophisticated molecular techniques such as next- generation sequencing become possible, the role of FNA in the diagnosis of deep-seated lymphomas will possibly increase.
authors.affiliation: Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
authors.forename: Ming
authors.initials: M
authors.lastname: Jin
authors.forename: Paul E
authors.initials: PE
authors.lastname: Wakely
mesh_terms: D044963:Biopsy, Fine-Needle / Q000379:methods*; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods*; D019160:Endosonography / Q000379:methods*; D005434:Flow Cytometry / Q000379:methods*; D006801:Humans; D008223:Lymphoma / Q000175:diagnosis* / Q000473:pathology*