Fine needle aspiration cytology in the management of lymphoma

The use of fine needle aspiration (FNA) cytology in the management of patients with lymphadenopathy was investigated. The cases of non-Hodgkin's lymphoma were classified using the Kiel classification, which is based strictly on cytological criteria. Of the 59 cases of biopsy confirmed lymphoma, FNA of nodes showed lymphoma in 53 (90%), no definite diagnosis in five (8%), and false negative diagnosis in one (2%). During the follow-up of patients FNA was positive in seven of the eight cases with a suspected recurrence which was later confirmed by lymph node biopsy. Results suggest that FNA is useful on the initial presentation of a patient with lymphadenopathy. If the diagnosis is unequivocal it helps in planning staging procedures and in selecting involved nodes for biopsy. In some cases with intra-abdominal disease it may obviate laparotomy. However, because false negative diagnoses do occur and because cytological classification of lymphoma is not always accurate FNA should not replace lymph node biopsy at initial presentation, but it can be used as the only investigation to confirm suspected recurrence.