A stepwise approach to fine needle aspiration cytology of lymph nodes
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The cytological diagnosis of lymph node lesions is extremely challenging because of the diverse diseases that cause lymph node enlargement, including both benign and malignant or metastatic lymphoid lesions. Furthermore, the cytological findings of different lesions often resemble one another. A stepwise diagnostic approach is essential for a comprehensive diagnosis that combines: clinical findings, including age, sex, site, multiplicity, and ultrasonography findings; low-power reactive, metastatic, and lymphoma patterns; high-power population patterns, including two populations of continuous range, small monotonous pattern and large monotonous pattern; and disease-specific diagnostic clues including granulomas and lymphoglandular granules. It is also important to remember the histological features of each diagnostic category that are common in lymph node cytology and to compare them with cytological findings. It is also essential to identify a few categories of diagnostic pitfalls that often resemble lymphomas and easily lead to misdiagnosis, particularly in malignant small round cell tumors, poorly differentiated squamous cell carcinomas, and nasopharyngeal undifferentiated carcinoma. Herein, we review a stepwise approach for fine needle aspiration cytology of lymphoid diseases and suggest a diagnostic algorithm that uses this approach and the Sydney classification system.
Abstract
The cytological diagnosis of lymph node lesions is extremely challenging because of the diverse diseases that cause lymph node enlargement, including both benign and malignant or metastatic lymphoid lesions. Furthermore, the cytological findings of different lesions often resemble one another. A stepwise diagnostic approach is essential for a comprehensive diagnosis that combines: clinical findings, including age, sex, site, multiplicity, and ultrasonography findings; low-power reactive, metastatic, and lymphoma patterns; high-power population patterns, including two populations of continuous range, small monotonous pattern and large monotonous pattern; and disease-specific diagnostic clues including granulomas and lymphoglandular granules. It is also important to remember the histological features of each diagnostic category that are common in lymph node cytology and to compare them with cytological findings. It is also essential to identify a few categories of diagnostic pitfalls that often resemble lymphomas and easily lead to misdiagnosis, particularly in malignant small round cell tumors, poorly differentiated squamous cell carcinomas, and nasopharyngeal undifferentiated carcinoma. Herein, we review a stepwise approach for fine needle aspiration cytology of lymphoid diseases and suggest a diagnostic algorithm that uses this approach and the Sydney classification system.
참고문헌 (24)
- Zhou J, "Fine needle aspiration cytology for lymph nodes : a three-year study", Br J Biomed Sci, 73, pp.28~31 (2016)
- Cibas ES, "Cytology: diagnostic principles and clinical correlates" (2020), Elsevier Inc.
- Rammeh S, "Accuracy of fine-needle aspiration cytology of head and neck masses", Diagn Cytopathol, 47, pp.394~399 (2019)
- Houcine Y, "Evaluation of fine needle aspiration cytology in the diagnosis of cervical lymph node lymphomas", J Craniomaxillofac Surg, 46, pp.1117~1120 (2018)
- Rammeh S, "Cervical node fine needle aspiration : factors influencing the failure rate", Rev Stomatol Chir Maxillofac Chir Orale, 115, pp.85~87 (2014)
- 허일영, "Fine Needle Aspiration Cytology of Parathyroid Lesions", Journal of Pathology and Translational Medicine, 47(5), pp.466~471 (2013), 대한병리학회[DOI]
- Agarwal AM, "Parathyroid fine-needle aspiration cytology in the evaluation of parathyroid adenoma : cytologic findings from 53 patients", Diagn Cytopathol, 37, pp.407~410 (2009)
- Gronkiewicz JJ, "Cervical lymph node fine needle aspiration in patients with no history of malignancy", Ultrasound Q, 29, pp.323~326 (2013)
- 홍순옥, "Current status of cytopathology practice in Korea: impact of the coronavirus pandemic on cytopathology practice", Journal of Pathology and Translational Medicine, 56(6), pp.361~369 (2022), 대한병리학회[DOI]
- Al-Abbadi MA, "A proposal for the performance, classification, and reporting of lymph node fine-needle aspiration cytopathology : the Sydney system", Acta Cytol, 64, pp.306~322 (2020)
- Duraiswami R, "Spectrum of pathologies on FNAC evaluation of peripheral lymph nodes at a tertiary care center in hyderabad : a retrospective study", Int J Adv Med, 4, pp.27~33 (2017)
- Junhun Cho, "Basic immunohistochemistry for lymphoma diagnosis", Blood Research, 57, pp.55~61 (2022), 대한혈액학회[DOI]
- Kuppers R, "The Hodgkin and Reed", Sternberg cell, 2005, pp.37, 511~517
- Jaffe ES, "Peripheral T-cell and NK-cell lymphomas in the WHO classification : pearls and pitfalls", Mod Pathol, 26(Suppl 1), pp.S71~S87 (2013)
- de Leval L, "Peripheral Tcell lymphoma with follicular involvement and a CD4+", bcl-6+ phenotype, 2001, pp.25, 395~400
- Huang Y, "Peripheral T-cell lymphomas with a follicular growth pattern are derived from follicular helper T cells(TFH)and may show overlapping features with angioimmunoblastic T-cell lymphomas", Am J Surg Pathol, 33, pp.682~690 (2009)
- Dobay MP, "Integrative clinicopathological and molecular analyses of angioimmunoblastic T-cell lymphoma and other nodal lymphomas of follicular helper T-cell origin", Haematologica, 102, pp.e148~e151 (2017)
- Rizzo K, "Diagnostic workup of small B cell lymphomas : a laboratory perspective", Lymphoma, 2012, pp.346084~ (2012)
- Jacobs JC, "Fine needle aspiration of lymphoblastic lymphoma : a multiparameter diagnostic approach", Acta Cytol, 36, pp.887~894 (1992)
- Sukswai N, "Diffuse large Bcell lymphoma variants : an update", Pathology, 52, pp.53~67 (2020)
- el-Okda M, "Russell bodies consist of heterogenous glycoproteins in B-cell lymphoma cells", Am J Clin Pathol, 97, pp.866~871 (1992)
- Francis IM, "Lymphoglandular bodies in lymphoid lesions and non-lymphoid round cell tumours : a quantitative assessment", Diagn Cytopathol, 11, pp.23~27 (1994)
- Jimenez-Heffernan JA, "A cytological review of follicular dendritic cell-derived tumors with emphasis on follicular dendritic cell sarcoma and unicentric Castleman disease", Diagnostics (Basel), 12, pp.406~ (2022)
- Gupta P, "Assessment of risk of malignancy by application of the proposed Sydney system for classification and reporting lymph node cytopathology", Cancer Cytopathol, 129, pp.701~718 (2021)