Large‐cell lymphoma with features intermediate between Hodgkin’s, primary mediastinal B‐cell and grey‐zone lymphoma: a conundrum on fine needle aspiration cytology

Vitagliano, Giulio; Cretella, Pasquale; Zeppa, Pio; Caputo, Alessandro

doi:10.1111/cyt.12865

Cited by 8 publications

(5 citation statements)

References 17 publications

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“…Finally, some issues can only be resolved on histological samples, and thus errors of this kind on cytological material are expected. Examples include the distinction between high‐grade FL and DLBCL, as well as the diagnosis of grey‐zone lymphomas (Figure 6), which requires exclusion of numerous other entities through a wide immunohistochemical panel 20 …”

Section: Discussionmentioning

confidence: 99%

Real‐world experience with the Sydney System on 1458 cases of lymph node fine needle aspiration cytology

et al. 2021

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Introduction Lymph node (LN) fine needle aspiration cytology (FNAC) is a safe, quick, inexpensive, reliable, and minimally invasive technique for the diagnosis of lymphadenopathies. Recently, an international committee of experts proposed guidelines for the performance, classification, and reporting of LN‐FNAC: the Sydney System. We set out to analyse the diagnostic performance of the Sydney System in a retrospective study. Methods We retrieved 1458 LN‐FNACs, reformulated the diagnoses according to the Sydney System, and compared them to the histological control where available (n = 551, 37.8%). Results The risk of malignancy for each of the five categories was 66.7% for inadequate/insufficient, 9.38% for benign (overall: 0.84%), 28.6% for atypical, 100% for suspicious and 99.8% for malignant. LN‐FNAC showed a sensitivity of 97.94%, a specificity of 96.92%, a positive predictive value of 99.58%, and a negative predictive value of 86.30%. Conclusions These data support the usage of LN‐FNAC as an agile first‐level technique in the diagnosis of lymphadenopathies. The Sydney System supports and enhances this role of LN‐FNAC, and its adoption is encouraged. In negative cases, coupled with ancillary techniques, LN‐FNAC can reassure the clinician regarding the benignity of a lymphadenopathy and indicate the need for clinical follow‐up, which will catch possible false negatives. In positive cases, LN‐FNAC can provide sufficient information, including predictive biomarkers, to initiate management and obviate the need for subsequent, more invasive procedures. Given its speed, minimal invasiveness, and low cost, LN‐FNAC can be performed in most cases, even when more invasive techniques are not feasible.

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Section: Discussionmentioning

confidence: 99%

Real‐world experience with the Sydney System on 1458 cases of lymph node fine needle aspiration cytology

et al. 2021

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“…In these contexts, pathologists are often reluctant to sacrifice their best (or only) diagnostic smear to molecular methods [ 66 , 74 , 75 ]. Because it is the smear with the highest tumor cellularity, however, the best smear is often the most suitable for molecular tests [ 76 , 77 ]. This problem may be solved by the digitalization of the smear, to capture its morphology indefinitely (for medico-legal or teaching purposes) [ 78 ].…”

Section: Discussionmentioning

confidence: 99%

Testing EGFR with Idylla on Cytological Specimens of Lung Cancer: A Review

Caputo

D'Ardia

Sabbatino

et al. 2021

IJMS

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The current standard of care for advanced non-small-cell lung cancer is based on detecting actionable mutations that can benefit from targeted therapy. Comprehensive genetic tests can have long turn-around times, and because EGFR mutations are the most prevalent actionable mutation, a quick detection would enable a prompt initiation of targeted therapy. Furthermore, the scarcity of diagnostic material means that sometimes only cytologic material is available. The Idylla™ EGFR assay is a real-time PCR–based method able to detect 51 EGFR mutations in 2.5 h. Idylla is validated for use only on FFPE sections, but some researchers described their experiences with cytological material. We reviewed the relevant literature, finding four articles describing 471 cases and many types of cytological input material: smears, cell-block sections, suspensions, and extracted DNA. The sensitivity, specificity, and limit of detection appear comparable to those obtained with histological input material, with one exception: the usage of scraped stained smears as input may reduce the accuracy of the test. In conclusion, usage of cytological material as input to the Idylla EGFR test is possible. A workflow where common mutations are tested first and fast, leaving rarer mutations for subsequent comprehensive profiling, seems the most effective approach.

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“…The disease is often widespread at diagnosis, with multiple affected sites, including bone marrow and extranodal disease. HGBLs have variable morphology, with areas of overlap among DLBCL, BL, and ALL/LBL [1, 16, 17].…”

Section: Resultsmentioning

confidence: 99%

Cytological Diagnosis of Aggressive Small-Cell Lymphomas

et al. 2022

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Background: Despite their sometimes deceivingly bland appearance, some small-cell lymphomas are very aggressive and the prognosis of patients depends on a prompt diagnosis that allows the initiation of appropriate therapy. Summary: The present review discusses the salient cytological features of the most common aggressive small-cell lymphomas and then proceeds to analyze their main diagnostic criteria, including the usage of ancillary techniques. Key Messages: Lymph node fine-needle aspiration cytology is a fast, safe, cheap, minimally invasive, and accurate procedure that can be used for a prompt and accurate diagnosis of lymphomas.

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Large‐cell lymphoma with features intermediate between Hodgkin’s, primary mediastinal B‐cell and grey‐zone lymphoma: a conundrum on fine needle aspiration cytology

Cited by 8 publications

References 17 publications

Real‐world experience with the Sydney System on 1458 cases of lymph node fine needle aspiration cytology

Real‐world experience with the Sydney System on 1458 cases of lymph node fine needle aspiration cytology

Testing EGFR with Idylla on Cytological Specimens of Lung Cancer: A Review

Cytological Diagnosis of Aggressive Small-Cell Lymphomas

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