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Fine-needle aspiration with flow cytometric immunophenotyping for primary diagnosis of intra-abdominal lymphomas
K Liu1, K P Mann, K M Vitellas
1Division of Cytopathology, Department of Pathology, Duke University Medical Center, Durham, North Carolina 27710, USA.
Insights
Diagnosing intra-abdominal non-Hodgkin's lymphomas (NHL) can be accurately achieved using a combination of fine-needle aspiration (FNA) cytology and flow cytometry. This minimally invasive approach is ideal for deep-seated lesions, offering a reliable initial diagnostic strategy.
Area of Science:
- Oncology
- Pathology
- Immunology
Background:
- Intra-abdominal lymphomas pose diagnostic challenges due to invasive biopsy requirements.
- Cytomorphology combined with immunophenotyping offers a less invasive diagnostic alternative.
- Fine-needle aspiration (FNA) with flow cytometry is explored for deep-seated lesions.
Purpose of the Study:
- To evaluate the efficacy of cytomorphology and immunophenotypic analysis via FNA for diagnosing intra-abdominal non-Hodgkin's lymphomas (NHL).
- To establish this combined approach as a primary diagnostic tool for deep-seated lymphomas.
Main Methods:
- Image-guided fine-needle aspiration (FNA) was performed on 22 cases of intra-abdominal lesions.
- Cytologic evaluation and flow cytometry immunophenotyping were conducted on all FNA samples.
- Histologic confirmation was obtained for 10 cases to validate cytologic diagnoses.
Main Results:
- The study successfully classified various subtypes of NHL, including large-cell, follicular center-cell, and small noncleaved-cell lymphomas.
- Accurate classification was achieved in 9 out of 10 cases with histologic confirmation.
- A definitive immunophenotypic pattern was not obtained in 4 cases, but cytomorphology provided indicative features.
Conclusions:
- Combining cytology and flow cytometry via FNA is a successful primary diagnostic approach for intra-abdominal non-Hodgkin's lymphomas.
- This minimally invasive method is particularly advantageous for deep-seated lesions, reducing risks and costs associated with open biopsies.
Abstract:
Cytomorphology in conjunction with immunophenotypic characterization is becoming increasingly used for the primary diagnosis of non-Hodgkin's lymphomas (NHL). This combination is especially advantageous for the diagnosis of intra-abdominal and intrathoracic lymphomas, since unlike superficial lesions, open biopsy of deep-seated tissues is more invasive and more costly, and is associated with a higher risk. We report the cytologic and immunophenotypic features of intra-abdominal NHL obtained by fine-needle aspiration (FNA). Twenty-two cases of intra-abdominal lesions obtained by image-guided FNA where flow cytometry was also performed were reviewed. Of the 22 studied cases, 7 were classified as large-cell lymphoma, 5 as follicular center-cell lymphoma, 2 as small noncleaved-cell lymphoma, 2 as lymphoplasmacytoid lymphoma, one as small lymphocytic lymphoma, and one as marginal-zone lymphoma. In the remaining 4 cases where the immunophenotypic pattern was not definitive, the cytomorphologic features were of small cleaved cells in 3 cases and of mixed small cleaved and large cells in one case. We successfully classified 9 of the 10 patients on whom histologic confirmation was obtained. The successful primary classification of most intra-abdominal non-Hodgkin's lymphomas can be done with a combination of cytology and flow cytometry, and this can be the initial approach in patients with deep-seated lesions. Diagn. Cytopathol. 1999;21:98-104.
