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Fitzpatrick MJ, Sohani AR, Ly A. Uses and limitations of small-volume biopsies for the diagnosis of lymphoma. Cytopathology 2024; 35:454-463. [PMID: 38462899 DOI: 10.1111/cyt.13372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 02/14/2024] [Accepted: 02/27/2024] [Indexed: 03/12/2024]
Abstract
Although surgical biopsy remains the gold standard for the diagnosis of lymphoma, small-volume biopsies including fine-needle aspiration and core needle biopsy are increasingly being used as a first line diagnostic tool. Small-volume biopsies are safe, rapid and cost effective; however, diagnostic utility varies by lymphoma subtype. It is important for pathologists and clinicians to recognize both the strengths and limitations of such biopsies.
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Affiliation(s)
- Megan J Fitzpatrick
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Aliyah R Sohani
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Amy Ly
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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2
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Blom M, Magarey MJR, Flatman S. Diagnostic adequacy and accuracy of surgeon-performed ultrasound guided fine needle aspiration in lateral neck masses. ANZ J Surg 2024; 94:117-121. [PMID: 38205558 DOI: 10.1111/ans.18857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 11/19/2023] [Accepted: 12/23/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Surgeon-performed ultrasound guided fine needle aspiration (SUS-FNA) reduces the time to diagnosis and treatment of head and neck pathology. Although it has been validated in the investigation of thyroid pathology, there is a paucity of evidence to support its use in lateral neck masses. This study aims to determine the accuracy and adequacy of SUS-FNA in the investigation of lateral neck masses. METHODS A retrospective cohort analysis was performed of patients who underwent a SUS-FNA for lateral neck mass between June 2018 and October 2022 at a single institution. Pathologist reports were reviewed to determine the rate of FNA sample adequacy. A comparison was made between FNA cytology results and final histopathological diagnosis following surgical excision in a subset of patients to determine FNA accuracy. RESULTS A total of 110 SUS-FNAs were performed on lateral neck masses. Diagnostic adequacy of SUS-FNA was determined to be 91% (100/110). When analysing the subset of patients who proceeded to surgical excision, the diagnostic accuracy of SUS-FNA was determined to be 88% (38/43). CONCLUSION SUS-FNA results in high adequacy rates with good diagnostic accuracy in the investigation of lateral neck masses. This tool has great potential in reducing treatment delay in the management of head and neck cancer.
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Affiliation(s)
- Megan Blom
- Department of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Matthew J R Magarey
- Department of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Department of Medical Education, University of Melbourne, Melbourne, Victoria, Australia
| | - Samuel Flatman
- Department of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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Incorporation of ultrasound-guided core biopsy with flow cytometry to assist the diagnosis of cervical lymphoma. Eur Arch Otorhinolaryngol 2023; 280:1437-1446. [PMID: 36322178 DOI: 10.1007/s00405-022-07705-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/12/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE The main purpose of surgery for cervical lymphoma is only for tissue sampling. To establish a patient-friendly diagnostic approach, we investigated the feasibility of ultrasound-guided core biopsy with flow cytometry in the patients with suspected cervical lymphoma. METHODS We prospectively recruited patients with suspected cervical lymphoma from Nov 2017 till Jan 2021 in a referral medical center and performed retrospective interpretation of the prospectively acquired data. Ultrasound-guided core biopsy as the tissue sampling approach for the targeted lesions was performed in all patients. The ultrasound-guided core biopsy samples were analyzed by immunohistochemical stains and flow cytometry. The sample quality and the rate of definite and decisive diagnosis obtained by ultrasound-guided core biopsy alone and ultrasound-guided core biopsy with flow cytometry were evaluated. RESULTS Total 81 consecutive patients were recruited for analysis. All ultrasound-guided core biopsy samples were qualified for analysis of pathology and flow cytometry. Pathologically, the diagnoses were definite and compatible with their flow cytometry results in 70 patients (86.42%). Either newly-diagnosed or recurrent cervical lymphoma/lymphoproliferative disorders with histologic transformation could be diagnosed by ultrasound-guided core biopsy with flow cytometry. Nine of the 11 patients with pathologically indefinite diagnosis became clinically decisive when flow cytometry was incorporated into the process, which improved the rate of decisive diagnosis to 98.77% (Odds ratio [95% CI]: 6.21 [1.28, 58.96]). CONCLUSION Ultrasound-guided core biopsy combined with flow cytometry is suggested to serve as the first-line and patient-friendly diagnostic approach for the patients with suspected cervical lymphoma.
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Parente P, Zanelli M, Zizzo M, Carosi I, Di Candia L, Sperandeo M, Lacedonia D, Fesce VF, Ascani S, Graziano P. Primary pulmonary Hodgkin lymphoma presenting as multiple cystic lung lesions: diagnostic usefulness of cell block. Cytopathology 2020; 31:236-239. [PMID: 32112490 DOI: 10.1111/cyt.12814] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 02/04/2020] [Accepted: 02/24/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Paola Parente
- Pathology Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Magda Zanelli
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maurizio Zizzo
- Surgical Oncology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Illuminato Carosi
- Pathology Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Leonarda Di Candia
- Pathology Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Marco Sperandeo
- Unit of Interventional and Diagnostic Ultrasound of Internal Medicine, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Donato Lacedonia
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Vincenza Fernanda Fesce
- Struttura Complessa di Ematologia e Trapianto di Cellule Staminali Ematopoietiche, Ospedali Riuniti Foggia, Foggia, Italy
| | - Stefano Ascani
- Pathology Unit Hospital of Terni, University of Perugia, Perugia, Italy
| | - Paolo Graziano
- Pathology Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
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Griesel C, Desmirean M, Esterhuizen T, Pasca S, Petrushev B, Selicean C, Roman A, Fetica B, Teodorescu P, Swanepoel C, Tomuleasa C, Grewal R. Differential Diagnosis of Malignant Lymphadenopathy Using Flow Cytometry on Fine Needle Aspirate: Report on 269 Cases. J Clin Med 2020; 9:jcm9010283. [PMID: 31968576 PMCID: PMC7019747 DOI: 10.3390/jcm9010283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 01/03/2020] [Accepted: 01/13/2020] [Indexed: 12/29/2022] Open
Abstract
Introduction: Fine needle aspiration (FNA) is frequently the first noninvasive test used for the diagnostic workup of lymphadenopathy. There have been many studies showing its usefulness, especially in conjunction with other techniques for the diagnosis of lymphoma, but it remains inferior to histological examination. The data regarding this subject have mostly been reported mostly from first-world countries, but are scarce for emerging economies. Thus, the current study assesses the agreement between fine needle aspiration flow cytometry (FNA FC) and histology in the aforementioned region. Material and Methods: We conducted a retrospective study including the FNA FC adenopathy diagnoses made between January 2011 and December 2016 at the Tygerberg Hospital, Cape Town, South Africa. Additional variables included were the histological diagnosis, sex and age of the included patients. Results: In the descriptive part of the current study, 269 FNA FC samples were included. The most frequent diagnoses made on these were represented by B-cell lymphoma, reactive adenopathy, no abnormality detected (NAD), and non-hematological malignancy. In the analytical part of the current study, there were 115 cases included that had both valid FNA FC and histological diagnoses. It could be observed that FNA FC can correctly diagnose B-cell lymphoma in most cases, but it is a poor diagnostic tool especially for Hodgkin lymphoma in this setting as only a four-color flow cytometer was available for diagnosis. Moreover, FNA FC diagnosis of reactive adenopathy and of no abnormalities detected was shown to frequently hide a malignant disease. Conclusion: In countries with scarce resources, FNA FC represents a useful diagnostic tool in the case of B-cell lymphoma, but may misdiagnose reactive adenopathy. Thus, FNA FC should be used in a case-specific manner, in addition to as a screening tool, with the knowledge that in cases with a high clinical suspicion of lymphoma, histological diagnosis is a necessity.
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Affiliation(s)
- Carla Griesel
- National Health Laboratory Services, Tygerberg Hospital, Cape Town 7505, South Africa; (C.G.); (T.E.); (C.S.); (R.G.)
| | - Minodora Desmirean
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania; (M.D.)
- Department of Pathology, Constantin Papilian Military Hospital, 400001 Cluj Napoca, Romania
| | - Tonya Esterhuizen
- National Health Laboratory Services, Tygerberg Hospital, Cape Town 7505, South Africa; (C.G.); (T.E.); (C.S.); (R.G.)
| | - Sergiu Pasca
- Research Center for Functional Genomics and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400337 Cluj Napoca, Romania;
| | - Bobe Petrushev
- Department of Pathology, Octavian Fodor Regional Institute for Gastroenterology, 400111 Cluj Napoca, Romania;
| | - Cristina Selicean
- Department of Hematology, Ion Chiricuta Clinical Cancer Center, 400015 Cluj Napoca, Romania
| | - Andrei Roman
- Department of Hematology, Ion Chiricuta Clinical Cancer Center, 400015 Cluj Napoca, Romania
- Department of Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania
| | - Bogdan Fetica
- Department of Hematology, Ion Chiricuta Clinical Cancer Center, 400015 Cluj Napoca, Romania
| | - Patric Teodorescu
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania; (M.D.)
- Department of Hematology, Ion Chiricuta Clinical Cancer Center, 400015 Cluj Napoca, Romania
| | - Carmen Swanepoel
- National Health Laboratory Services, Tygerberg Hospital, Cape Town 7505, South Africa; (C.G.); (T.E.); (C.S.); (R.G.)
| | - Ciprian Tomuleasa
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania; (M.D.)
- Department of Hematology, Ion Chiricuta Clinical Cancer Center, 400015 Cluj Napoca, Romania
- Correspondence:
| | - Ravnit Grewal
- National Health Laboratory Services, Tygerberg Hospital, Cape Town 7505, South Africa; (C.G.); (T.E.); (C.S.); (R.G.)
- Faculty of Natural Sciences, University of Western Cape, Belville 7535, South Africa
- The South African National Bioinformatics Institute, Medical Research Council, University of the Western Cape, Belville 7535, South Africa
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Calaminici M, Pomplun S. The role of cytology in the diagnosis of haematological malignancies. Cytopathology 2019; 30:345-347. [PMID: 31216089 DOI: 10.1111/cyt.12713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 04/23/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Maria Calaminici
- Department of Cellular Pathology, Barts Health NHS Trust and Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Sabine Pomplun
- Department of Histopathology, University College Hospital, London, UK
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