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Grading follicular lymphomas in fine-needle aspiration biopsies

The role of ThinPrep slides and flow cytometry

  1. Guilherme D.A. Brandao MD1,
  2. Ruth Rose BS2,
  3. Susan Mckenzie BS2,
  4. Peter Maslak MD2,
  5. Oscar Lin MD, PhD1,†,*

Article first published online: 25 AUG 2006

DOI: 10.1002/cncr.22173

Issue

Cancer Cytopathology

Cancer Cytopathology

Volume 108, Issue 5, pages 319–323, 25 October 2006

Additional Information

How to Cite

Brandao, G. D.A., Rose, R., Mckenzie, S., Maslak, P. and Lin, O. (2006), Grading follicular lymphomas in fine-needle aspiration biopsies. Cancer, 108: 319–323. doi: 10.1002/cncr.22173

Author Information

  1. 1

    Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York

  2. 2

    Department of Medicine, Hematology Service, Memorial Sloan-Kettering Cancer Center, New York, New York

  1. †

    Fax: (212) 639-6318

*Cytology Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, C-518, New York, NY 10021

  1. †

    Fax: (212) 639-6318

Publication History

  1. Issue published online: 11 OCT 2006
  2. Article first published online: 25 AUG 2006
  3. Manuscript Accepted: 23 FEB 2006
  4. Manuscript Revised: 9 FEB 2006
  5. Manuscript Received: 12 DEC 2005

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Keywords:

  • follicular;
  • cytology;
  • grade;
  • flow cytometry

Abstract

BACKGROUND.

The World Health Organization (WHO) recommends a 3-tier grading system (Grades 1–3) for follicular lymphomas (FLs) based on the absolute number of centroblasts per high-power microscopic field (HPF) in 10 neoplastic follicles. Grades 1 and 2 FL are still managed as indolent FLs, whereas Grade 3 FL is thought to behave more aggressively. In this study, the feasibility of grading FL using ThinPrep (TP) slides and flow cytometry (FC) was evaluated.

METHODS

Fifty-three cases of lymph node fine-needle aspiration (FNA) from patients with histologically confirmed FL (20 Grade 1, 17 Grade 2, and 16 Grade 3) were included. The number of centroblasts present in 300 lymphoid cells and in 10 HPF in TP Papanicolaou-stained slides was evaluated. The percentage of CD10-positive small cells was calculated with FC results. Statistical analysis was performed with the Jonckheer-Terpstra nonparametric trend test and the Wilcoxon rank sum test.

RESULTS

The statistical analysis demonstrated a significant upward trend in the number of centroblasts as the grades increased. Also, all 3 methods had statistically significant results to distinguish different grades of FL, except when FC was used to distinguish Grade 2 from Grade 3 FL.

CONCLUSIONS

Counting centroblasts, either in 300 lymphoid cells or per 10 HPF in TP slides, represented a statistically significant method to separate different grades of FL in FNA samples. Analysis of cell size by FC was not as reliable to distinguish different grades of FL, especially Grade 2 from 3. Cancer (Cancer Cytopathol) 2006;108:. © 2006 American Cancer Society.

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