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Cytopathologic Diagnosis of Small B-Cell Lymphomas
Juliet Raine1, Edward S Hookway1, Timothy Farren1
1Department of Cellular Pathology and Cancer Diagnostics, Barts Health NHS Trust, London, UK.
Insights
The World Health Organization (WHO) reporting system standardizes the diagnosis of small B-cell lymphomas using cytological examination. This system aids cytopathologists by integrating morphology, clinical features, and ancillary tests for accurate diagnoses.
Area of Science:
- Cytopathology
- Hematopathology
- Oncology
Background:
- Cytological examination of lymph nodes and serous effusions is crucial for diagnosing small B-cell lymphomas.
- The World Health Organization (WHO) has introduced a standardized reporting system for cytological specimens from lymph nodes, spleen, and thymus.
Purpose of the Study:
- To provide an overview of the WHO reporting system for cytological specimens.
- To highlight the diagnostic challenges posed by small B-cell lymphomas in cytopathology.
- To emphasize the integration of cytomorphology, clinical features, and ancillary testing.
Main Methods:
- Review of the WHO reporting system for cytological specimens.
- Description of cytomorphological features of small B-cell lymphomas.
- Discussion of ancillary testing modalities and their role in diagnosis.
Main Results:
- The WHO system offers a standardized approach to reporting cytological specimens.
- Small B-cell lymphomas present diagnostic challenges due to overlapping morphology.
- Correlation of cytomorphology with clinical data and ancillary tests is essential for accurate diagnosis.
Conclusions:
- The WHO reporting system standardizes the approach to cytological specimens of lymph nodes, spleen, and thymus.
- Accurate diagnosis of small B-cell lymphomas requires integrating cytomorphology with clinical information and ancillary testing.
- The review details cytomorphological features, diagnostic criteria, differential diagnoses, and potential pitfalls.
Background:
Cytologic examination of lymph nodes and serous effusions is of value in the diagnosis of small cell lymphomas. The World Health Organisation (WHO) has recently published a reporting system relating to the cytologic examination of lymph nodes, spleen, and thymus to standardise the approach to reporting such specimens.
Summary:
An overview of the WHO reporting system is given with particular reference to the diagnosis of small B-cell lymphomas. The role of rapid on-site evaluation and ancillary testing is discussed. The cytomorphological features of specific small B-cell lymphomas and associated ancillary testing are described.
Key Messages:
The WHO reporting system provides a standardised approach to the reporting of cytological specimens from lymph nodes, the spleen, and the thymus. Small B-cell lymphomas pose a challenge to the cytopathologist due to their morphologic overlap with each other and reactive conditions. The importance of correlation and integration of cytomorphological appearances with clinical features and ancillary testing modalities to obtain a final diagnosis is emphasised. The present review includes a description of cytomorphological features according to pattern recognition and provides an overview of diagnostic criteria for specific entities based on cytomorphology alone and in combination with ancillary tests in different clinical settings discussing differential diagnoses and potential pitfalls.
