Value of fine-needle aspiration cytology in diagnosis of Hodgkin's lymphoma and anaplastic large cell lymphoma: one centre experience [Važnost citološke aspiracijske punkcije tankom iglom u dijagnostici Hogkinovog limfoma i anaplastičnog velikostaničnog limfoma: iskustvo jednog kliničkog centra]

Ostojić Kolonić, Slobodanka and Prašek-Kudrna, Katja and Roso, Vinko and Radić-Krišto, Delfa and Planinc-Peraica, Ana and Džebro, Sonja and Kardum-Skelin, Ika and Jakšić, Branimir (2010) Value of fine-needle aspiration cytology in diagnosis of Hodgkin's lymphoma and anaplastic large cell lymphoma: one centre experience [Važnost citološke aspiracijske punkcije tankom iglom u dijagnostici Hogkinovog limfoma i anaplastičnog velikostaničnog limfoma: iskustvo jednog kliničkog centra]. Collegium Antropologicum, 34 (1). pp. 75-79. ISSN 0350-6134

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Abstract

The aim of the study was to determine the value and limitations of cytology in diagnosis of Hodgkin’s lymphoma (HL) and anaplastic large cell lymphoma (ALCL) as well as differentiation between these two entities. We analysed the FNA cytodiagnoses and histopathological reports, as well as treatment and survival in 89 newly diagnosed consecutive patients with these lymphomas treated in our clinical department. These patients (40 male, 49 female; age range 16–93 years; 44 in clinical stages I–II; 38 with B symptoms) were diagnosed and treated during a period of 64 months (1.1. 2004–1.5.2009). The FNA cytodiagnoses were available in 86 patients and the pathohistological diagnoses were available in 84 patients. Cytology revealed 65 classic HL, 18 ALCL and three patients in which diagnosis was not informative. Among 65 FNA cytodiagnoses of HL, comparison with histopathology was made in 61 cases and the histopathological diagnoses were as follows: 56 (91.8%) HL; three ALCL; one diffuse large B cell lymphoma and one marginal zone B cell lymphoma. In the group of 18 FNA cytodiagnoses of ALCL eight patients (53.3%) had definitive diagnosis of ALCL (either as T-cell or O type), five (33.3%) of HL and in three cases a histopathological diagnosis could not be made. These results confirm the value of FNA in diagnostic procedure in patients with HL and ALCL, especially in HL group of patients. Since we have an almost uniform group of patients according to therapeutic approach, we did univariate analyses and found out that patients with FNA cytodiagnoses of HL, younger than 55 years, with early stage of the disease and without B symptoms had significantly longer overall survival (OS). FNA cytodiagnosis has clinical relevance in differentiation between HL and ALCL.

Abstract in Croatian

Cilj studije bio je procijeniti vrijednost i ograničenja citologije u dijagnostici i razlikovanju Hodgkinovog limfoma (HL) i anaplastičnog velikostaničnog limfoma (ALCL). Analizirali smo početne citološke dijagnoze, rezultate patohistološke obrade, učinke terapije i preživljenje u 89 novodijagnosticiranih bolesnika s tim limfomima koji su liječeni na našem kliničkom odjelu. U 89 bolesnika (40 muškaraca, 49 žena; u dobi od 16 do 93 godine; 44 u kliničkom stadiju I–II, 38 s B simptomima) bila je postavljena dijagnoza i liječeni su u vremenskom razdoblju od 64 mjeseca (1.1.2004.–1.5. 2009. god.). Citološka dijagnostika bila je moguća u 86 bolesnika, a patohistološku dijagnozu bilo je moguće postaviti kod 84 bolesnika. Citološka aspiracijska punkcija otkrila je 65 klasičnih HL-a, 18 ALCL-a, a u 3 bolesnika dijagnoza nije bila informativna. U skupini 65 citoloških dijagnoza HL-a, usporedba s patohistologijom je napravljena u 61 slučaju, a pripadajuće patohistološke dijagnoze bile su: 56 (91,8%) HL-a, tri ALCL-a, jedan difuzni velikostanični B limfom i jedan B- stanični limfom marginalne zone. U grupi od 18 citotoških dijagnoza ALCL-a, patohistološke dijagnoze bile su sljedeće: osam bolesnika (53,3%) imalo je definitivnu dijagnozu ALCL-a (bilo T-stanični ili 0-tip), pet bolesnika (33,3%) imalo je dijagnozu HL-a, dok u tri slučaja nije bilo moguće postaviti patohistološku dijagnozu. Ti rezultati potvrđuju vrijednost citološke dijagnostike u dijagnostičkom postupku kod bolesnika sa HL-om i ALCL-om, naročito kod bolesnika sa HL-om. S obzirom da imamo gotovo jednoliku skupinu bolesnika s obzirom na primijenjenu terapiju, napravili smo univarijatne analize koje su pokazale da pacijenti s citološkom dijagnozom HL-a, mlađi od 55 godina, u ranom stadiju bolesti i bez B simptoma imaju znatno duže ukupno preživljenje. Citološka dijagnostika ima kliničku važnost u razlikovanju HL-a i ALCL-a.

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