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Grading follicular lymphomas in fine‐needle aspiration biopsies
Author(s) -
Brandao Guilherme D.A.,
Rose Ruth,
Mckenzie Susan,
Maslak Peter,
Lin Oscar
Publication year - 2006
Publication title -
cancer cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.22173
Subject(s) - medicine , grading (engineering) , fine needle aspiration , lymph node , wilcoxon signed rank test , nuclear medicine , pathology , radiology , biopsy , mann–whitney u test , civil engineering , engineering
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.