Binucleate Cells in Cytosmears: What do They Signify?

Area of Science:

• Pathology
• Cytopathology
• Oncology

Background:

• Classic Reed-Sternberg (RS) cells are hallmarks of Hodgkin's disease (HD).
• RS-like cells can be present in diverse benign and malignant conditions, complicating diagnosis.
• Distinguishing RS-like cells from true RS cells is a significant diagnostic challenge in cytology.

Purpose of the Study:

• To investigate the occurrence of RS-like cells in non-Hodgkin lymphoma (NHL) and other conditions.
• To determine the proportion of binucleated cells in various benign and malignant lesions.
• To evaluate the diagnostic utility of cytomorphological features in predicting Hodgkin lymphoma (HL).

Main Methods:

• Retrospective analysis of 2086 cytology cases.
• Screening of cytosmears for binucleated cells.
• Detailed cytomorphological analysis of positive cases to assess diagnostic criteria for HL.

Main Results:

• Binucleated RS/RS-like cells were identified in 2.6% (55/2086) of cases.
• These included Hodgkin lymphoma (HL), non-Hodgkin lymphoma (NHL), sarcoma, carcinoma, and benign/inflammatory lesions.
• Prominent eosinophilic nucleoli, granulomas, and eosinophils demonstrated good sensitivity and specificity for predicting HL.

Conclusions:

• Cytomorphological analysis alone has limited value for categorizing RS and RS-like cells.
• Specific features like prominent eosinophilic nucleoli, eosinophils, granulomas, and lack of cell clustering can aid in predicting HL.
• Accurate identification of RS-like cells requires careful evaluation of cytomorphological features in conjunction with clinical context.