Hodgkin's disease: diagnosis by fine-needle aspiration biopsy. Analysis of cytologic criteria from a selected series.

Two hundred thirteen cases in which a lymph node aspirate and subsequent surgical biopsy had been performed were studied independently by four observers. Each observer attempted to discriminate involvement by Hodgkin's disease from involvement by other processes. The material included 18 cases of histologically confirmed Hodgkin's disease. The remaining 195 cases included a wide range of pathologic processes. All four observers were able to distinguish Hodgkin's disease from other processes in the great majority of cases. Two observers reviewed the aspirate material from the 18 cases of Hodgkin's disease to determine the presence and significance of elements known to characterize this disease, i.e., multinuclear and mononuclear Reed-Sternberg cells, polyploidal cells, granulomatous elements, metachromatic material, necrosis, eosinophils, neutrophils, and plasma cells. Reed-Sternberg cells were present in most but not all cases. Reed-Sternberg-like cells also were occasionally encountered in other processes. Polyploidal cells were invariably present and were useful in recognizing the disease. Granulomatous elements, metachromatic material, necrosis, eosinophils, and neutrophils were frequently present and, while not specific for the process, helped to draw attention to or substantiate the diagnosis of Hodgkin's disease.