Cytodiagnosis of non-Hodgkin's lymphoma. A morphological analysis of 215 biopsy proven cases.

A cytomorphological analysis using a large number of variables was applied to 136 fine needle aspirations and 122 imprints from 258 biopsy proven lymphoid lesions, including 203 non-Hodgkin's lymphomas (NHL), 12 true histiocytic neoplasms and 43 lymphoid hyperplasias. Characteristics of the various cell types are described using the Kiel classification predominantly. Two blindly performed consecutive cytological analyses, indicated as Cyt I and Cyt II respectively, were compared with histology. False-positive conclusions did not occur. False-negative conclusions were present in 3.7% of cases. The intra-observer reproducibility between Cyt I and Cyt II was 93%. The inter-observer reproducibility between the 4 authors was examined in 50 cases; consensus regarding malignancy, exact NHL type and benign cytology was 88%, 70% and 100% respectively. Cytodiagnosis of NHL is a reliable method with a high sensitivity which can add substantial information to tissue diagnosis in troublesome cases. Fine needle aspirations, if adequately performed, had the same cellularity, quality and cellular composition as imprints. Aspiration cytology is very useful for the selection of a representative lymph node for surgical biopsy, for the diagnosis of recurrent NHL, for staging the extent of disease, for the diagnosis of cases in which tissue biopsy is not possible, and as a variable for monitoring treatment.