Fine Needle Aspiration Cytology Diagnosis, Flow Cytometry Immunophenotyping and Histology in Clinically Suspected Lymphoproliferative Disorder

Objective To evaluate advantages and drawbacks of fine needle aspiration cytology (FNAC) with flow cytometry (FC) in our routine, using, whenever possible, histology as the gold standard. Study Design From November 2003 to April 2005, we studied, by FNAC and FC, 113 patients with a tentative clinical diagnosis of lymphoproliferative disorder. Excision was performed in 43 patients. Results Excluding the 7 cases in which FNAC/FC made the diagnosis of metastatic carcinoma, a conclusive diagnosis was obtained with FNAC/FC in 87.7% (93 of 106) of patients. Most of these (n = 48) corresponded to reactive processes. Histologic study of 8 cases confirmed FNAC/FC diagnosis of reactive process. Insufficient material was obtained in 8 (7.1%) patients, and discordance between FNAC and FC occurred in 5 (4.4%), leading to inconclusive diagnosis. There was concordance in benign and malignant diagnoses between FNAC/FC and histology in every case in which conclusive diagnosis of FNAC/FC was advanced. Conclusion FNAC and FC together provide a reliable, definitive diagnosis in most cases, obviating, whenever a reactive process is found, unnecessary surgery or follow-up. Histology was useful in the few cases in which FNAC/FC could not reach conclusive diagnosis and in subclassification of specific lymphomas.