Fine needle aspiration cytology of CD56‐positive natural killer/T‐cell lymphoma of soft tissue

• Published in: Cancer Vol. 96; no. 6; pp. 344 - 350
• Main Authors: Cho, Eun Yoon, Gong, Gyungyub, Khang, Shin Kwang, Kang, Yoon‐Koo, Huh, Jooryung
• Format: Journal Article
• Language: English
• Published: New York Wiley Subscription Services, Inc., A Wiley Company 25.12.2002; Wiley-Liss
• Subjects: Adult; Aged; apoptotic body; Biological and medical sciences; Biopsy, Needle - methods; CD56 Antigen - analysis; Female; fine needle aspiration; Hematology; Humans; Investigative techniques, diagnostic techniques (general aspects); Killer Cells, Natural - pathology; lymphoma; Lymphoma, T-Cell - immunology; Lymphoma, T-Cell - pathology; Male; Medical sciences; Middle Aged; natural killer/T‐cell; Nose Neoplasms - immunology; Nose Neoplasms - pathology; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Skin - immunology; Skin - pathology; soft tissue; Human; Skin disease; apoptotic body; lymphoma; Biological marker; Malignant hemopathy; natural killer/T-cell; Non Hodgkin lymphoma; Fine needle aspiration biopsy; Natural killer cell; Pathology; Cell death; Lymphoproliferative syndrome; T-Lymphocyte; fine needle aspiration; Cytopathology; Soft tissue; Diagnosis; Apoptosis
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.10885

BACKGROUND Extranodal natural killer (NK)/T‐cell lymphoma, nasal type, is a rare form of lymphoma with a predilection for Southeast Asians, including Koreans, and Central and South Americans. It has a high association with Epstein‐Barr virus (EBV) and expression of CD56 antigen. In the current study, the authors reviewed the fine needle aspiration (FNA) cytology of NK/T‐cell lymphoma involving soft tissue to identify characteristic cytologic features. METHODS Ten FNAs of soft tissue involvement by histologically documented NK/T‐cell lymphoma from eight patients (three nasal primary and five extranasal primary tumors) were included in the retrospective study of a six‐year period (1996‐2002). Diff‐Quik‐ and Papanicolaou‐stained smears were reviewed, as was the biopsy material, including immunohistochemical stains and in situ hybridization studies for EBV. Clinical information was obtained from the patients' medical records. RESULTS Specimen sources were skin and subcutaneous tissue of the neck (3), arm (3), breast (2), and abdominal wall (1) and soft tissue of the buccal area (1). The smears were moderately to highly cellular in the extensively necrotic background, with an abundance of apoptotic debris. Single, scattered tumor cells had pleomorphic nuclei, coarse chromatin, indistinct or several small nucleoli, and eccentric bluish cytoplasm. Neutrophils were typically rare in most cases except in one case complicated by abscess. CONCLUSIONS Fine needle aspiration can be a useful adjunct in the diagnosis of the nasal and extranasal NK/T‐cell lymphoma. The presence of malignant lymphoid cells in a necrotic background with an abundance of apoptotic bodies is a highly characteristic and consistent finding in FNA of NK/T‐cell lymphoma involving soft tissue. Cancer (Cancer Cytopathol) 2002. © 2002 American Cancer Society. Fine needle aspiration cytology can be helpful in the diagnosis of CD56‐positive natural killer/T‐cell lymphomas involving soft tissue and in the differential diagnosis between primary or recurrent lymphoma and an inflammatory condition. The smear is characterized by extensive necrosis, an abundance of highly characteristic apoptotic bodies, and discohesive, variably anaplastic lymphoma cells.