Clinical utility of fine-needle aspiration for diagnosis of head and neck lymphoma

• Published in: European journal of surgical oncology Vol. 34; no. 7; pp. 817 - 821
• Main Authors: Roh, J.-L, Lee, Y.-W, Kim, J.-M
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.07.2008
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Analysis of Variance; Biopsy, Needle; Diagnostic utility; Female; Fine-needle aspiration; Head and neck; Head and Neck Neoplasms - pathology; Hematology, Oncology and Palliative Medicine; Humans; Lymphoma; Lymphoma - pathology; Male; Middle Aged; Retrospective Studies; Sensitivity and Specificity; Surgery; Time Factors; Head and neck; Fine-needle aspiration; Lymphoma; Diagnostic utility
• ISSN: 0748-7983; 1532-2157
• DOI: 10.1016/j.ejso.2007.07.200

Abstract Background Although fine-needle aspiration (FNA) is currently used for the diagnosis of lymphoma, its diagnostic utility in patients with head and neck (HN) lymphoma is unclear. We therefore assessed the utility of initial clinical and FNA diagnoses for HN lymphoma in a clinician's perspective. Methods We conducted a retrospective study of total 109 patients with HN lymphoma underwent both FNA and tissue diagnoses from January 2000 through December 2005. The diagnostic sensitivity of FNA was compared with that of histopathology. FNA diagnosis was based on cytomorphology alone in 69 patients and on immunophenotyping plus morphology in 40. Results On clinical diagnosis, lymphoma was suspected in 54 patients, nonlymphoma/metastatic malignancy in 31, and benign disease in 24. FNA diagnosed lymphoma in 41 patients; suspicious of lymphoma in 23; atypical lymphoma in 20; benign disease in 19; and was nondiagnostic in 6 patients. Diagnostic accuracy of FNA was not significantly improved by repeat core needle biopsy and immunophenotyping. Delay from FNA to tissue diagnosis was significant in the benign FNA-diagnostic group, with a mean 49 days. Conclusions The clinical and FNA diagnoses of HN lymphoma may be incomplete and include the potential pitfall of significant diagnostic delay.