Fine-needle aspirate of primary lymphoma of bone

Primary lymphoma of bone (PLB) is a rare bone tumor. Fine-needle aspirates (FNA) were done on large destructive bone tumors from 2 elderly men, and both were initially read as inconclusive for malignancy because of scant cellularity. On retrospective study of the FNA slides after examining tissue histology, low numbers of diagnostic cells for lymphoma were recognized on the smears. There was extensive crush artifact, and most intact cells were stripped of their cytoplasm. In neither case was enough material harvested to make cell blocks or to perform special studies. Tissue histology disclosed abundant fibroconnective tissue stroma which probably made it difficult to acquire adequate FNA specimens. Another FNA done on a postoperative PLB tissue specimen disclosed similar features. Our experience in the 3 cases is consistent with the view that even though smears show scant cellularity, the diagnosis of PLB can at least be suggested by FNA. It is therefore important not to undercall the specimen because of low cellularity, and recommendation for tissue diagnosis can be given. This process is facilitated by a high index of suspicion based on clinical and radiographic findings.