Diagnosis of Lymphoma Using Fine-Needle Aspiration Biopsy and Core-Needle Biopsy: A Single-Institution Experience

Abstract

Objective: The objective is to study the efficacy of fine-needle aspiration biopsy (FNAB) and core-needle biopsy (CNB) in the diagnosis of lymphoma in a single institution. Study Design: We retrospectively reviewed 635 FNAB/CNB cases performed in our institution to rule out lymphoma during a 4-year period and collected the relevant clinical and pathological information for statistical analysis. Results and Conclusions: This cohort comprised 275 males and 360 females, with a median age of 57 years. Among the 593 cases with adequate diagnostic materials for lymphoma work-up, 226 were positive for lymphoma, 286 were negative for lymphoma, and 81 were nondiagnostic. Each case had an FNAB, and 191 cases also underwent a CNB. The subclassification rate according to the WHO (2008) was 67% overall, 81% for the FNAB with CNB group, and 40% for the FNAB group. In the FNAB with CNB group, the subclassification rates for cases with and without a history of lymphoma were not significantly different. A definitive diagnosis of lymphoma relied on ancillary studies, but was not affected by location, or the needle gauge of CNB. Follow-up data revealed a high diagnostic accuracy of FNAB with CNB. In conclusion, the use of FNAB and CNB with ancillary studies is effective in providing a definitive diagnosis of lymphoma in our experience at the Northwell Health System.

Lymph node FNA cytology: Diagnostic performance and clinical implications of proposed diagnostic categories

“…Some reports of lower diagnostic accuracy with LN‐FNAC and core biopsy have resulted in an enduring preference for excisional biopsy by some practitioners, 4,5 whereas the routine addition of flow cytometry (FC) and immunohistochemistry to LN‐FNAC has improved its diagnostic accuracy significantly enough to increase its acceptance by others 6‐8 . More recently, a combined core and fine‐needle aspiration (FNA) biopsy approach has been advocated to maximize the diagnostic accuracy of small tissue samples, 3,9 Nevertheless, controversy remains regarding the application of diagnoses yielded from LN‐FNAC to patient management 5,10 …”

Role of Flow Cytometric Immunophenotyping for Classic Hodgkin Lymphoma in Small Biopsy and Cytology Specimens

“…[5][6][7][8][9][10][11][12] However, FNA specimens have higher rates of nondiagnostic specimens and may not allow for complete subclassification of lymphoproliferative disorders due to loss of tissue architecture, particularly in deep-seated lesions. [13][14][15] Evaluation of CHL in particular may pose challenges in small biopsy specimens because of low numbers of diagnostic neoplastic HRS cells. 2,12 In addition to low numbers of diagnostic cells, the evaluation of small samples can be confounded by extensive fibrosis, particularly in the nodular sclerosis subtype of CHL.…”

Small volume biopsy diagnostic yield at initial diagnosis versus recurrence/transformation of follicular lymphoma: A retrospective Cyto‐Heme Interinstitutional Collaborative study

“…FNA preparations allow for cytologic evaluation, but in the absence of a histologic cell block (CB) do not allow for immunohistochemistry (IHC) or assessment of histologic architecture important for certain types of lymphoma including FL, which can lead to decreased sensitivity 7 . In comparison, NCB enables IHC evaluation and partial preservation of tissue architecture, but requires a larger needle gauge 8 . Although small volume biopsies (SVB) such as FNA and NCB show some limitations relative to surgical biopsy, the use of these less invasive techniques has risen in recent years as rapid and cost‐effective alternative diagnostic procedures with relatively fewer risks.…”