Aspiration cytology of malignant lymphomas

Abstract

Cytological diagnoses on aspirated materials of lymph nodes were compared with histological diagnoses made on the excised nodes in 208 cases. Cytological diagnosis of malignant lymphoma was made in 40 of 62 finally diagnosed cases of malignant lymphoma, 2 of 79 cases of metastatic cancer, 2 of 12 cases of atypical hyperplasia or so-called reticulosis, and 1 of 55 cases of non-malignant diseases. There were some variations in accuracy of cytologic diagnosis of malignant lymphomas by the histologic types. The highest accuracy was found in lymphosarcoma, the second highest in reticulum cell sarcoma and Hodgkin's disease, and the lowest in follicular lymphoma.Lymphosarcoma and reticulum cell sarcoma were predominantly monocellular, but in occasional cases of reticulum cell sarcoma, sarcoma cells were not very dominant. In these cases the differential cell counts of lymph node aspirates may be useful for cytologic diagnosis. In reticulum cell sarcoma, cells resembling immunoblasts or immature reticulum cells accounted for more than 30% of all the cells. However, immature reticulum cells made up less than 30% of the cells in the other types of malignant lymphomas and other diseases.Follicular lymphoma was of mixed cell type, composed of lymphocytic cells and immature reticulum cells in variable proportions. In some cases lymphocytic cells had irregular nuclei and cleaved appearances.The cytologic pattern of Hodgkin's disease was pleomorphic, consisting of a variable number of lymphocytes, granulocytes, and plasma cells, in addition to the characteristic mononuclear Hodgkin's cells or multinucleated Sternberv-Reed cells.