Abstract
Fine needle aspirations (FNAs) and FNA biopsies (FNABs) may be utilized in evaluating tissue involvement by a hematolymphoid malignancy. When combined with flow cytometric immunophenotyping (FCI), the combined approach is useful in the following situations: distinguishing reactive lymph nodes from malignant lymphoma, establishing an initial diagnosis of malignant lymphoma, subclassification of malignant lymphoma in certain subtypes, detecting recurrent lymphoma, detecting the presence of a composite lymphoma [a non-Hodgkin lymphoma (NHL) in the background of a classical Hodgkin lymphoma (cHL) or two simultaneous hematolymphoid malignancies (i.e., a NHL and an acute myelogenous leukemia)], detecting a hematopoietic malignancy, and determining the presence of a nonhematolymphoid malignancy. Fluorescent in situ hybridization and polymerase chain reaction techniques may also be applied to these specimens. Limitations include sampling issues, tumoral necrosis or sclerosis, partial tissue involvement, a T-cell NHL without an aberrant immunophenotype, or a T-cell- or lymphohistiocytic-rich diffuse large B-cell lymphoma (TCR-DLBCL or LHR-DLBCL) without detectable monoclonal B cells, loss of architectural relationships, and an inability to accurately grade follicular lymphomas. Situations requiring biopsy based on the FNA and FCI results include the following:
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