Grading Follicular Lymphoma on Fine Needle Aspiration Specimens

Sun, Wei; Caraway, Nancy P.; Zhang, Hua Zhong; Khanna, Abha; Payne, Linda; Katz, Ruth L.

doi:10.1159/000326303

Cited by 33 publications

(4 citation statements)

References 22 publications

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“…Most non-Hodgkin's lymphomas can be subclassified with this approach, but for Hodgkin's lymphoma, tissue biopsy is still the procedure of choice, rather than FNA [25]. Sun et al [26] used FNA specimens for grading follicular lymphoma by determining the percentage of centroblasts and were able to grade follicular lymphoma accurately.…”

Section: Discussionmentioning

confidence: 99%

Clinical Utility of Endoscopic Ultrasound-Guided Fine-Needle Aspiration in the Diagnosis of Mediastinal and Intra-Abdominal Lymphadenopathy

Mehmood¹,

Loya

Yusuf³

2013

Acta Cytologica

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Introduction: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has proven to be helpful in obtaining tissue samples from enlarged mediastinal and intra-abdominal lymph nodes. This is especially beneficial in the diagnosis and staging of malignancy. We retrospectively reviewed the clinical utility of this method at a tertiary care cancer hospital in Pakistan. Patients and Methods: The medical records of 183 consecutive patients referred to the gastroenterology service from August 2008 to March 2012 were reviewed in this retrospective study. The mean age of the patients at presentation was 46.7 years (range 6-87; 62% males); 119 patients had mediastinal and 64 had intra-abdominal lymphadenopathy. Major indications for referral were diagnosis of lymphadenopathy of unknown origin detected on CT scan or PET-CT, to exclude lymph node metastasis in patients with a known primary tumor and to rule out relapse of lymphoma following treatment or during follow-up. Rapid on-site evaluation (ROSE) was performed in all patients to confirm the adequacy of sampling, followed by definitive cytopathological evaluation. Results: EUS-FNA with ROSE obtained adequate tissue for cytology in 97.3% of the patients in this cohort. These results were further confirmed on final cytopathological analysis in 96.2% of patients. Two patients (1.1%) had inadequate specimens for final interpretation (97.3 vs. 96.2; p = 0.001). Clinical utility was 95% for mediastinal lymphadenopathy and 98.4% for intra-abdominal lymphadenopathy. Only 1 patient had a serious complication requiring hospitalization and this was successfully managed conservatively. Conclusion: EUS-FNA is safe and has a high clinical utility in diagnosing unexplained mediastinal and intra-abdominal lymphadenopathy.

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Section: Discussionmentioning

confidence: 99%

Clinical Utility of Endoscopic Ultrasound-Guided Fine-Needle Aspiration in the Diagnosis of Mediastinal and Intra-Abdominal Lymphadenopathy

Mehmood¹,

Loya

Yusuf³

2013

Acta Cytologica

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“…Studies have attempted to grade follicular lymphoma in fine needle aspirates with some success. 25 The studies still relied on visual counts of centroblasts and/or Ki-67 proliferative indices or DNA analysis. The incorporation of histologic grade with proliferative activity has also been attempted with some degree of success.…”

Section: Discussionmentioning

confidence: 99%

Grading of follicular lymphoma using flow cytometry

Mourad

Rawas

Shoukri

et al. 2006

Annals of Saudi Medicine

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BACKGROUNDThe treatment and prognosis of follicular lymphoma (FL) is dependant on the grade of the disease. In the World Health Organization classification of lymphoma, grading of FL into low grade (1 and 2) and high grade (3) is recommended. Grading of FL is possible in excision biopsy; histological grading is subjective and inconsistent. Grading is extremely difficult in needle core biopsies and fine needle aspirates. We attempted to grade FL using flow cytometry (FCM) and CD19/forward scatter.MATERIALS AND METHODSCases of FL seen in our institution and submitted for FCM were evaluated for the percentage of cells detected beyond the 500-channel mark (on a 1024 scale) on a CD19/forward scatter dot plot. We hypothesized that these cells most likely represent centroblasts and their percentage would reflect the grade of the disease. Histological grading of the lymphoma on the open biopsies constituted the reference for FL grade.RESULTSThirty-six cases of FL, including 22 males and 14 females, ranging in age from 19 to 92 years (median, 42 years), were studied. There were 17 cases of low grade (grade 1; n=10 and grade 2; n=7) and 19 cases of high grade (grade 3) FL. The percentage of cells identified beyond the 500-channel mark on CD19/forward scatter dot plot ranged from 0.12% to 12.55% (median, 4.9%) in low grade (grade 1 and 2) whereas the percentage of those cells in high grade FL ranged from 6.22% to 51.95% (median, 21%; P=0.00001).CONCLUSIONOur findings suggest that using a CD19/forward scatter dot plot can help identify centroblasts in FL making grading possible on FCM, especially in small biopsies and fine needle aspirates.

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“…The resulting DNA histograms were classified according to Auer et al ., Krishnamurthy et al ., and Sun et al . [ 15 16 17 ] For each analysis, the following variables were automatically calculated by the image analysis software: DNA index, ploidy balance, proliferation index, degree of hyperploidy (percentage of cells with a DNA content of >5c), and degree of aneuploidy. According to this classification, there are usually four types of histograms: diploid, low proliferation, and no cells >5c (low grade); broad diploid (diploid or tetraploid), low proliferation, and no more than 10 cells >5c (intermediate grade); aneuploid (diploid or aneuploid; can be multiple aneuploidy stem lines), high proliferation, and numerous cells >5c (high grade); and polyploid, (diploid, tetraploid, and octaploid stem lines, and low proliferation).…”

Section: Methodsmentioning

confidence: 99%

“…[ 10 11 ] DNA image analysis has been shown to be a sensitive and reliable technique for evaluating DNA content and proliferation of tumors. [ 12 13 14 15 16 17 18 19 ] However, abnormal DNA ploidy patterns have not been previously described in EHE. The presence of aneuploid cells may be an indicator of malignancy in serous fluid because background mesothelial cells are usually diploid.…”

Section: Introductionmentioning

confidence: 99%

Cytologic features, immunocytochemical findings, and DNA ploidy in four rare cases of epithelioid hemangioendothelioma involving effusions

et al. 2018

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Background:Epithelioid hemangioendothelioma (EHE) involving serous effusion is extremely rare, and the diagnosis can be challenging. DNA ploidy quantitation of EHE in effusion fluids has not been previously described in the English-language literature.Methods:Specimens of cytological diagnosed with EHE in effusion fluids between 2002 and 2009 were retrieved from the pathology files at MD Anderson Cancer Center. A total of four cases of EHE involving or arising from effusion fluids were found, and we reviewed cytospin, smears, cell block sections, and immunostained slides. DNA image analysis for ploidy and proliferation evaluation was performed on a destained, papanicolaou-stained slide from each case.Results:The tumor cells were epithelioid with prominent cytoplasmic vacuolization and intracytoplasmic inclusions, which could resemble reactive mesothelial cells, mesothelioma, or adenocarcinoma. The tumor cells were positive for endothelial markers. DNA image analysis in three of the four cases revealed predominantly diploid and tetraploid subpopulations, with few aneuploid cells and fairly low proliferation indices, and these patients had fairly prolonged survival.Conclusions:DNA image analysis is useful for differentiating EHE from reactive mesothelial cells and high-grade carcinoma. For accurate diagnosis of EHE in effusion fluids, cytologic features should be considered together with clinical history and ancillary studies.

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Grading Follicular Lymphoma on Fine Needle Aspiration Specimens

Cited by 33 publications

References 22 publications

Clinical Utility of Endoscopic Ultrasound-Guided Fine-Needle Aspiration in the Diagnosis of Mediastinal and Intra-Abdominal Lymphadenopathy

Clinical Utility of Endoscopic Ultrasound-Guided Fine-Needle Aspiration in the Diagnosis of Mediastinal and Intra-Abdominal Lymphadenopathy

Grading of follicular lymphoma using flow cytometry

Cytologic features, immunocytochemical findings, and DNA ploidy in four rare cases of epithelioid hemangioendothelioma involving effusions

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