TY - JOUR
TI - Diagnosis and subclassification of follicle center and mantle cell
lymphomas on fine-needle aspirates - A cytologic and immunocytochemical
approach based on the revised European-American lymphoma (REAL)
classification
AU - Rassidakis, GZ
AU - Tani, E
AU - Svedmyr, E
AU - Porwit, A
AU - Skoog, L
JO - Cancer Cytopathology
PY - 1999
VL - 87
TODO - 4
SP - 216-223
PB - John Wiley & Sons, Inc
SN - 1934-662X, 1934-6638
TODO - 10.1002/(SICI)1097-0142(19990825)87:4<216::AID-CNCR9>3.0.CO;2-2
TODO - fine-needle aspiration; follicle center lymphoma; mantle cell lymphoma;
immunocytochemistry
TODO - BACKGROUND. Cytologic distinction between follicle center lymphoma (FCL)
and mantle cell lymphoma (MCL) is difficult with cytomorphology alone
and requires immunophenotyping. The current study describes the
distinction between follicle center and mantle cell lymphoma made with
fine-needle aspiration (FNA) material.
METHODS. One hundred ten cases primarily diagnosed and classified on FNA
material as centroblastic-centrocytic (CBCC) and centrocytic (CC)
non-Hodgkin lymphomas (NHLs) (Kiel classification) were included in the
study. An additional retrospective immunocytochemical analysis was
performed on frozen cytospin preparations using the monoclonal
antibodies Bcl-2, CD10, CD5, CD23, CD43, and immunoglobulin M.
RESULTS. The initial diagnostic workup classified 106 cases as CBCC-NHL
and 4 as CC-NHL. The immunophenotype Bcl-2(+), CD10(+/-), CD5(-),
CD23(-/+), CD43(-) was observed in 93 of 106 previously reported CBCC
NHLs. In 11 of 106 cytospin preparations, neoplastic B cells expressed
the CD5 pan T marker and, as a group, showed the pattern Bcl (+/-),
CD10(-/+), CD5(+), CD23(-), CD43(+), which is considered typical of MCL.
Based on the additional immunocytochemical data, all but 2 of the tumors
were reclassified as FCL (n = 93) and MCL (n = 15). The mean
proliferation fraction measured by MIB-1 (Ki-67) immunoreactivity was
16.3% and 17.5% in FCL and MCL, respectively. The revised
cytopathologic diagnosis correlated significantly (P < 10(-9)) with the
histology of 65 patients who underwent surgical excision biopsy.
CONCLUSIONS. Subclassification of follicle-derived low grade NHL can be
established with high accuracy on FNA material if cytomorphology is
corroborated by a complete immunophenotypic analysis, which can be
performed on both fresh and frozen stored cytospin material. The
currently used criteria can be applied to aspirated cells for a
conclusive cytopathologic diagnosis of MCL, which is of great clinical
importance. (C) 1999 American Cancer Society.
ER -