Systematic review of the effectiveness of fine-needle aspiration and/or core needle biopsy for subclassifying lymphoma

• Published in: Archives of pathology & laboratory medicine (1976) Vol. 139; no. 2; pp. 245 - 251
• Main Authors: Frederiksen, John K, Sharma, Meenal, Casulo, Carla, Burack, W Richard
• Format: Journal Article
• Language: English
• Published: United States College of American Pathologists 01.02.2015
• Subjects: Biopsy, Fine-Needle - methods; Biopsy, Large-Core Needle - methods; Humans; Lymphoma - classification; Lymphoma - pathology; Lymphoma, Follicular - pathology; Non-Hodgkin's lymphomas
• ISSN: 0003-9985; 1543-2165; 1543-2165
• DOI: 10.5858/arpa.2013-0674-RA

The World Health Organization system for lymphoma classification relies on histologic findings from excisional biopsies. In contradistinction to expert guidelines, practitioners increasingly rely on fine-needle aspiration cytology and core needle biopsies rather than excisional biopsies to diagnose lymphomas. To determine a rate at which fine-needle aspiration cytology and core needle biopsies, combined with flow cytometry and/or genetic techniques, can provide a diagnosis sufficient for optimal medical management of lymphoma. The English-language literature on fine-needle aspiration cytology and core needle biopsies for lymphoma was reviewed to identify studies that provided interpretations of all specimens regardless of whether these were deemed diagnostic. Forty-two studies (1989-2012) specified the lymphoma subtypes for each diagnosis or indicated a rate at which the methods failed to provide a diagnosis. The median rate at which fine-needle aspiration cytology and core needle biopsies yielded a subtype-specific diagnosis of lymphoma was 74%. Strictly adhering to expert guidelines, which state that follicular lymphoma cannot be graded by these techniques, decreased the diagnostic yield further to 66%. Thus, 25% to 35% of fine-needle aspirates and/or core biopsies of nodes must be followed by an excisional lymph node biopsy to fully classify lymphoma.