The significance of fine needle aspiration cytology for the diagnosis and treatment of malignant lymphomas.

Fine needle aspiration biopsy of a laesion, thought to be a lymph node, is a minor procedure, which provides quick and valuable information. It should be performed with a fine needle (0.6 mM outer diameter = 23 Gauge) and a special syringe, which needs only one hand during the aspiration itself. From the experience obtained in over 6000 own patients a f.n.a.b. gives the first place information whether the laesion actually is a lymph node, or a cyst, a salivary gland, a chemodectoma or any other lesion which can mimic a lymph node, In 3000 cases a benign lymph node was found and this finding often is as important as reporting malignancy. In 2000 cases metastatic malignancy was found. In 90% of these the primary tumour could be ascertained by coupling the clinical and the cytological data. False-negatives and false-positives practically do not occur with our technique. In 1023 patients primary lymphoma was found; 523 of them being Hodgkin's disease and 500 non-Hodgkin's lymphoma. In fresh cases of lymphoma surgical biopsies should always be done. In relapses cytology alone will as a rule be sufficient. In case of doubt repeat the f.n.a.b. after one week and do not immediately proceed to histological biopsy.