Fine needle aspiration diagnosis of intraabdominal and retroperitoneal lymphomas by a morphologic and immunocytochemical approach

Cancer. 1990 Jan 1;65(1):72-7. doi: 10.1002/1097-0142(19900101)65:1<72::aid-cncr2820650116>3.0.co;2-q.

Abstract

We reviewed 238 fine needle aspiration biopsies (FNA) of intraabdominal or retroperitoneal (IA/RP) masses in 192 patients with known or suspected lymphoma. A limited battery of immunocytochemical stains, including kappa (k) and lambda (l) light chains and Leu-4, was performed in 104 aspirates. On hundred twenty-eight of the FNA were diagnostic of or consistent with lymphoma, and three were diagnostic of carcinoma. Twenty-eight were considered negative for malignancy and 79 were suspicious for lymphoma or were nondiagnostic. For 135 of the FNA, a histologic biopsy specimen was available for comparison purposes. Overall, only one false-positive result was seen in a specimen lacking immunocytochemical data. The sensitivity of FNA lymphoma diagnosis was 66%. False-negative results due to sampling error were not uncommon, giving a predictive value of a negative result as 42%. The classification of the lymphomas by FNA was identical to that of the surgical biopsy in 86% of specimens and concurrently discrepant in 6%. We conclude that the routine performance of immunocytochemical studies on FNA of IA/RP masses is a feasible and valuable technique. Whereas suboptimal sensitivity and sampling error may make a negative diagnosis unreliable, lymphoma marker studies (combined with morphology) allow for an accurate and confident diagnosis and subclassification of lymphoma in the majority of cases.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdominal Neoplasms / diagnosis*
  • Abdominal Neoplasms / immunology
  • Abdominal Neoplasms / pathology
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antigens, Differentiation / analysis
  • Biomarkers, Tumor / analysis
  • Biopsy, Needle
  • Female
  • Follow-Up Studies
  • Humans
  • Immunohistochemistry
  • Lymphoma / diagnosis*
  • Lymphoma / immunology
  • Lymphoma / pathology
  • Male
  • Middle Aged
  • Retroperitoneal Neoplasms / diagnosis*
  • Retroperitoneal Neoplasms / immunology
  • Retroperitoneal Neoplasms / pathology

Substances

  • Antigens, Differentiation
  • Biomarkers, Tumor