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Fine needle aspiration biopsy of Ki-1-positive large-cell "anaplastic" lymphoma
Insights
This study details a Ki-1-positive lymphoma case, highlighting its unique cell morphology on fine needle aspiration (FNA) biopsy. Immunocytochemical studies are crucial for differentiating it from other cancers like anaplastic carcinoma.
Area of Science:
- Hematopathology
- Cytopathology
- Oncology
Background:
- Ki-1-positive lymphoma is a rare hematologic malignancy.
- Accurate diagnosis is essential for appropriate treatment and patient outcomes.
- Fine needle aspiration (FNA) biopsy is a common diagnostic tool.
Observation:
- Cytopathologic analysis of FNA smears revealed large, isolated cells with irregular nuclei and abundant cytoplasm.
- Histologic sections showed cell cohesion, mimicking anaplastic carcinoma.
- Binucleated and multilobed cells were also observed.
Findings:
- Immunohistochemical and ultrastructural analyses confirmed the diagnosis of Ki-1-positive lymphoma.
- Differential diagnoses on FNA included Hodgkin's disease, malignant melanoma, and undifferentiated carcinoma.
- Cytologic features alone can be misleading, necessitating ancillary studies.
Implications:
- This case underscores the importance of integrating cytologic, immunocytochemical, and ultrastructural findings for accurate lymphoma diagnosis.
- Recognizing the distinct cytomorphology of Ki-1-positive lymphoma on FNA aids in early detection.
- Distinguishing this entity from carcinomas and other lymphomas is critical for therapeutic decisions.
Abstract:
The cytopathologic, immunohistochemical and ultrastructural features of a case of Ki-1-positive lymphoma are presented and discussed. On fine needle aspiration (FNA) biopsy smears, the Ki-1-positive lymphoma was characterized by large isolated cells with abundant dense/vacuolated cytoplasm and large nuclei with irregular profiles. Although most cells contained one nucleus, binucleated and multilobed/multinucleated cells were also seen. The cohesion of the malignant cells in histologic sections of a biopsied lymph node suggested an anaplastic carcinoma. The discrepancy was resolved by ultrastructural and immunologic analyses. The main differential diagnoses on FNA material include Hodgkin's disease, malignant melanoma and undifferentiated carcinoma; the cytologic suspicion should be confirmed by immunocytochemical studies.
