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Caputo A, Ciliberti V, Zeppa P, D'Antonio A. Cytological Diagnosis of Aggressive Small-Cell Lymphomas. Acta Cytol 2022; 66:269-278. [PMID: 35385847 DOI: 10.1159/000524270] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 03/18/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Despite their sometimes deceivingly bland appearance, some small-cell lymphomas are very aggressive and the prognosis of patients depends on a prompt diagnosis that allows the initiation of appropriate therapy. SUMMARY The present review discusses the salient cytological features of the most common aggressive small-cell lymphomas and then proceeds to analyze their main diagnostic criteria, including the usage of ancillary techniques. KEY MESSAGES Lymph node fine-needle aspiration cytology is a fast, safe, cheap, minimally invasive, and accurate procedure that can be used for a prompt and accurate diagnosis of lymphomas.
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Affiliation(s)
- Alessandro Caputo
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Valeria Ciliberti
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Pio Zeppa
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
- University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Antonio D'Antonio
- University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
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Al-Abbadi MA, Barroca H, Bode-Lesniewska B, Calaminici M, Caraway NP, Chhieng DF, Cozzolino I, Ehinger M, Field AS, Geddie WR, Katz RL, Lin O, Medeiros LJ, Monaco SE, Rajwanshi A, Schmitt FC, Vielh P, Zeppa P. A Proposal for the Performance, Classification, and Reporting of Lymph Node Fine-Needle Aspiration Cytopathology: The Sydney System. Acta Cytol 2020; 64:306-322. [PMID: 32454496 DOI: 10.1159/000506497] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 02/06/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND The evaluation of lymph nodes (LN) by fine-needle aspiration cytology (FNAC) is routinely used in many institutions but it is not uniformly accepted mainly because of the lack of guidelines and a cytopathological diagnostic classification. A committee of cytopathologists has developed a system of performance, classification, and reporting for LN-FNAC. METHODS The committee members prepared a document that has circulated among them five times; the final text has been approved by all the participants. It is based on a review of the international literature and on the expertise of the members. The system integrates clinical and imaging data with cytopathological features and ancillary techniques. The project has received the endorsement and patronage of the International Academy of Cytology and the European Federation of the Cytology Societies. RESULTS Clinical, imaging, and serological data of lymphadenopathies, indications for LN-FNAC, technical procedures, and ancillary techniques are evaluated with specific recommendations. The reporting system includes two diagnostic levels. The first should provide basic diagnostic information and includes five categories: inadequate/insufficient, benign, atypical lymphoid cells of undetermined/uncertain significance, suspicious, and malignant. For each category, specific recommendations are provided. The second diagnostic level, when achievable, should produce the identification of specific benign or malignant entities and additional information by utilizing ancillary testing. CONCLUSION The authors believe that the introduction of this system for performing and reporting LN-FNAC may improve the quality of the procedure, the report, and the communication between cytopathologists and the clinicians. This system may lead to a greater acceptance and utilization of LN-FNAC and to a better interdisciplinary understanding of the results of this procedure.
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Affiliation(s)
- Mousa A Al-Abbadi
- Department of Pathology, Microbiology and Forensic Medicine, the University of Jordan, Amman, Jordan
| | - Helena Barroca
- Serviço de Anatomia Patológica, Hospital S João-Porto, Porto, Portugal
| | | | - Maria Calaminici
- Department of Cellular Pathology, Barts Health NHS Trust and Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Nancy P Caraway
- Department of Anatomic Pathology, the University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - David F Chhieng
- Department of Pathology, University of Washington Medical Center, Seattle, Washington, USA
| | - Immacolata Cozzolino
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Mats Ehinger
- Department of Clinical Sciences, Pathology, Skane University Hospital, Lund University, Lund, Sweden
| | - Andrew S Field
- University of NSW Medical School, Sydney, New South Wales, Australia
- University of Notre Dame Medical School, Sydney, New South Wales, Australia
- Department of Anatomical Pathology, St Vincent's Hospital, Sydney, New South Wales, Australia
| | - William R Geddie
- University Health Network, UHN, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | | | - Oscar Lin
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - L Jeffrey Medeiros
- Department of Hematopathology, the University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sara E Monaco
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Arvind Rajwanshi
- Department of Cytopathology and Gynecologic Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Fernando C Schmitt
- Institute of Molecular Pathology and Immunology of Porto University (IPATIMUP), Instituto de Investigação e Inovação em Saúde and Medical Faculty, University of Porto, Porto, Portugal
| | | | - Pio Zeppa
- Department of Medicine and Surgery, Università degli Studi di Salerno, Fisciano, Salerno, Italy,
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Cozzolino I, Rocco M, Villani G, Picardi M. Lymph Node Fine-Needle Cytology of Non-Hodgkin Lymphoma: Diagnosis and Classification by Flow Cytometry. Acta Cytol 2016; 60:302-314. [PMID: 27554776 DOI: 10.1159/000448389] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 07/11/2016] [Indexed: 12/31/2022]
Abstract
In the last decades, lymph node fine-needle cytology (FNC), coupled with flow cytometry (FC), has gained a role in the diagnosis and classification of non-Hodgkin lymphoma (NHL). The combination of FNC/FC allows the diagnosis and classification of NHL in lymph node samples with a high sensitivity and specificity by combining cytological features and specific phenotypic profiles. The present review provides a brief technical description of FC and a detailed analysis of the current markers and their combinations (diagnostic algorithm) for the diagnosis and classification of NHL. The basic principles of clonality assessment, as well as the diagnostic strengths and weaknesses of the procedure, are reported. The current diagnostic algorithms for NHL classification are critically reviewed with a focus on specific problems related to single entities. Moreover, this review provides a detailed analysis of the different clinical contexts in which FNC/FC is performed and related implications. Future and further applications of FNC/FC for NHL are also discussed.
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Vigliar E, Cozzolino I, Picardi M, Peluso AL, Fernandez LVS, Vetrani A, Botti G, Pane F, Selleri C, Zeppa P. Lymph node fine needle cytology in the staging and follow-up of cutaneous lymphomas. BMC Cancer 2014; 14:8. [PMID: 24393425 PMCID: PMC3890503 DOI: 10.1186/1471-2407-14-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Accepted: 12/13/2013] [Indexed: 11/10/2022] Open
Abstract
Background Lymph nodal involvement is an important clinical-pathological sign in primary cutaneous lymphoma (PCL), as it marks the transformation/evolution of the disease from localized to systemic; therefore the surveillance of lymph nodes is important in the staging and follow up of PCL. Fine needle cytology (FNC) is widely used in the diagnosis of lymphadenopathies but has rarely been reported in PCL staging and follow-up. In this study an experience on reactive and neoplastic lymphadenopathies arisen in PCL and investigated by FNC, combined to ancillary techniques, is reported. Methods Twenty-one lymph node FNC from as many PCL patients were retrieved; 17 patients had mycosis fungoides (MF) and 4 a primary cutaneous B-cell lymphoma (PBL). In all cases, rapid on site evaluation (ROSE) was performed and additional passes were used to perform flow cytometry (FC), immunocytochemistry (ICC) and/or polymerase chain reaction (PCR) to assess or rule out a possible clonality of the corresponding cell populations. Results FNC combined with FC, ICC, and PCR identified 12 cases of reactive, non specific, hyperplasia (BRH), 4 dermatopathic lymphadenopathy (DL), 4 lymph nodal involvement by MF and 1 lymph nodal involvement by cutaneous B-cell lymphoma. Conclusions FNC coupled with ancillary techniques is an effective tool to evaluate lymph node status in PCL patients, provided that ROSE and a rational usage of ancillary techniques is performed according to the clinical context and the available material. The method can be reasonably used as first line procedure in PCL staging and follow up, avoiding expensive and often ill tolerated biopsies when not strictly needed.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Pio Zeppa
- Department of Medicine and Surgery, Azienda Ospedaliera Universitaria "San Giovanni di Dio e Ruggi d'Aragona", Largo città d'Ippocrate n,1, 84131 Salerno, (IT), Italy.
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