[Value and limits of fine needle aspiration biopsy in Hodgkin disease. Usefulness in developing countries]

The efficiency of a diagnostic procedure is evaluated by the percentage of subjects accurately identified, as either suffering from the disease looked for (true positive, TP) or not (true negative, TN). Sensitivity and specificity are the percentage of TP or TN, respectively, accurately identified. Cytological diagnosis of Hodgkin's disease (HD) was evaluated; smears were made from fine-needle aspiration. One hundred and nine smears were examined independently by two cytologists; adenopathies were benign in 43 cases (tuberculosis 25, non-specific reactive hyperplasia 16, sarcoidosis 2) and malignant in 66 cases (HD 36, Non-Hodgkin's lymphoma 22, malignant histiocytosis 2, metastasis 5, blast crisis of chronic myeloid leukemia 1). Benign and malignant diseases were diagnosed by lymph node biopsy; diagnosis of HD was made in 36 TP patients; the 73 others are TN. Sensitivity, specificity and efficiency are: 75, 90.4, 85.3, respectively for one observer; 77.7, 91.8, 87.1 respectively for the other: 63.8, 90.4, 81.6 respectively when diagnosis was the same for the two cytologists. Fine-needle aspiration permits the diagnosis of HD in eight out of 10 cases; it is useful when biopsy is difficult or too expensive, as is often the case in developing countries.