Comparative evaluation of combined application of fine needle aspiration cytology and flow cytometry with histopathology for the diagnosis of Non-Hodgkin lymphoma

Authors : Deepti Varshney, Manju Kaushal, Minakshi Bhardwaj, Vijay Kumar, Palak Agarwal

DOI : 10.18231/j.jdpo.2020.038

Volume : 5

Issue : 2

Year : 2020

Page No : 192-199

Context: Fine needle aspiration cytology (FNAC) is widely used in the investigation of lymphadenopathy.
A combination of FNAC and Flow cytometric immunophenotyping (FCI) can help to establish an accurate
diagnosis and classification in most cases of NHL (Non-Hodgkin lymphoma).
Aims: We evaluated the effectiveness of FNAC along with flow cytometry (FCM) with histopathology in
the diagnosis and classification of NHL by applying FCI on a sample obtained from the FNAC of lymphoid
tissue.
Settings and Design: A cross-sectional study was conducted in the Department of Pathology. Patients
of all ages presenting peripheral lymphadenopathy were screened on FNAC. All Cases suggested as NHL
were taken up for FCM as well as for excision biopsy.
Methods and Material: FCI of lymph node aspirate was performed by using four-color FCM
(FACScalibur; Becton Dickinson). The sections were processed in Shandon Citadel 2000 tissue processor
for histopathology.
Statistical analysis used: Descriptive statistics were used to describe the study sample. Data were analyzed
using SPSS.
Results: A total of 30 patients, 27 (90%) male, and 3(10%) female were included in the study. Generalized
lymphadenopathy (46.7%) was prominent followed by cervical lymphadenopathy(40%). Out of the 30
cases, eight cases were not analyzed due to the paucity of events. Out of 22 cases, a total of 18 cases
were diagnosed as B-cell lymphoma, two cases as T-cell lymphoma, and two cases as reactive lymphoid
hyperplasia.
Conclusions: FNAC in conjunction with FCI is a reliable method that can be used as a first-line
investigation to give rapid results, which can guide further investigation and facilitate cost-effective patient
management.
Key Messages: Excision biopsy and histopathological examination remain the gold standard for the
classification of NHL. However, the need for anesthesia and possible complications of excision biopsy
limits its role. FNAC in conjunction with FCI is a reliable method that can be used as a first-line
investigation to give rapid results.

Keywords: Fine needle aspiration cytology, Flow cytometry, Immunophenotyping Histopathology, lymphadenopathy, NonHodgkin lymphoma.


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