Feasibility of fine needle aspiration for diagnosis of b-cell lymphoma of the thyroid: a case series and review of the literature

Abstract

Background Primary thyroid lymphoma (PTL) is a rare cancer accounting for approximately 5% of thyroid malignancies. Historically, incisional biopsy has been the gold standard for definitive diagnosis of PTL, however, the use of cell block as an adjunct to fine needle aspiration (FNA) provides a high sensitivity and specificity for diagnosis and classification. Methods Three patients presented with a symptomatic enlarging thyroid mass. Patient 1 underwent incisional biopsy under general anesthesia, Patient 2 underwent core needle biopsy to avoid high risk intubation, and Patient 3 underwent fine needle aspiration alone with the use of cell block. Results All patients were diagnosed with a fully classified non-Hodgkin’s lymphoma using immunohistochemistry, flow cytometry, and fluorescence in situ hybridization (FISH) analysis. Conclusions FNA for diagnosis of some subtypes of PTL is feasible and preferred in cases that are particularly high risk for general anesthesia. This minimally invasive technique is safe and cost effective as it avoids expenses associated with operative intervention.

Performance of MYC, BCL2, and BCL6 break-apart FISH in small biopsies with large B-cell lymphoma: a retrospective Cytopathology Hematopathology Interinstitutional Consortium study

“…Additionally, cell blocks (CB) and smear slides from FNAB can effectively be used for FISH in various neoplasms ( 14 – 17 ). However, only a few, small single institutional studies have described FISH (such as MYC ) in FNAB smears and cell block for lymphoma ( 18 – 21 ) and no comparisons to core biopsy or the gold standard excisional biopsy exist to our knowledge. We have two principal aims in this multi-institutional study of FISH performance in diffuse large B-cell lymphoma and high-grade B-cell lymphoma: 1) compare the success rate of MYC, BCL2 , and BCL6 FISH hybridization across FNAB with cell block, core biopsy, and excisional biopsy, 2) compare FNAB to either core biopsy or excisional biopsy for FISH from the same patient.…”