Diagnostic impact of core‐needle biopsy on fine‐needle aspiration of non‐Hodgkin lymphoma

We retrospectively reviewed 74 fine‐needle aspiration (FNA) cases of presumptive non‐Hodgkin lymphoma (NHL). All the cases had cytology and core‐needle biopsy and 53 cases had concurrent flow cytometric analysis. FNA (cytology and flow cytometry) and core‐needle biopsy were evaluated independently. FNA was diagnostic of diffuse large B‐cell lymphoma (DLBL) in 25% (13/53) of cases and small B‐cell NHL in 15% (8/53) of cases, whereas core‐needle biopsy was diagnostic of DLBL in 37% (27/74) of cases and small B‐cell NHL in 8% (6/74) of cases. Subclassification of small B‐cell NHL was reached in 3/6 cases by core‐needle biopsy. Insufficient cases were observed in both FNA (47%; 25/53) and core‐needle biopsy (28%; 21/74) groups. With the combination of FNA and core‐needle biopsy, diagnostic cases of DLBL increased to 43% (32/74) and insufficient samples were reduced to 16% (12/74). There was no clear advantage in the diagnosis and classification of small B‐cell NHL by adding core‐needle biopsy to FNA (14%; 10/74). We conclude that core‐needle biopsy is a useful adjunct to FNA in the diagnosis of DLBL and shall be encouraged. In small B‐cell NHL, core‐needle biopsy does not add to the diagnostic ability of FNA. Cases insufficient for diagnosis may be seen in both core‐needle biopsy and FNA. A combined approach reduces the number of insufficient cases and is recommended in routine FNA practice. Diagn. Cytopathol. 2004;31:23–30. © 2004 Wiley‐Liss, Inc.

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