Premium
Image‐guided fine‐needle aspiration cytology and flow cytometry phenotyping of neck lymphadenopathy for the diagnosis of recurrent lymphoma
Author(s) -
Lumachi F.,
Fassina A.,
Tozzoli R.,
Tregnaghi A.,
Basso S.M.M.,
Ermani M.
Publication year - 2017
Publication title -
clinical otolaryngology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.914
H-Index - 68
eISSN - 1749-4486
pISSN - 1749-4478
DOI - 10.1111/coa.12797
Subject(s) - medicine , fine needle aspiration cytology , lymphoma , fine needle aspiration , flow cytometry , cytology , pathology , radiology , biopsy , immunology
Objective In patients with a history of lymphoma, each lymphadenopathy should be carefully evaluated. The aims of this study were to evaluate (i) the usefulness of high‐resolution ultrasonography ( US ), US ‐guided fine‐needle aspiration cytology ( FNAC ) and flow cytometry phenotyping ( FCP ) together in the diagnosis of recurrent lymphoma and (ii) whether these tools were independent predictors of correct results. Design Retrospective cohort study with stepwise forward logistic regression analysis of results. Setting Tertiary referral centre. Participants A total of 151 patients with a history of lymphoma who developed a cervical mass during follow‐up. Methods On neck US , a lymphadenopathy was shown in 129 (85.4%) patients (median age 57 years, range 18–78 years), and US ‐guided FNAC combined with FCP were immediately performed. All patients had surgical excision and subsequent histological examination of the enlarged node(s), to establish lymphoma subclassification. Results Final histology confirmed recurrence in 82 (63.6%) patients. According to the logistic regression analysis, FNAC and FCP were independent predictors of correct results ( P = 0.009 and 0.028, respectively) and did not interfere with each other. The sensitivity, specificity and accuracy of the combination of all of the tools were 98.8%, 100% and 99.2%, respectively, and the area under the receiver operating characteristic curve was 0.902 (95% CI : 0.797–0.986). Conclusion This minimally invasive procedure is easily performed and should be recommended for all patients with cervical lymphadenopathy and a history of lymphoma, avoiding the need of core‐biopsy or surgical excision if recurrence was excluded.