4. Hrvatski kongres kliniËke citologije 4th Croatian Congress ... - Penta

Clinical Cytology - Posters
FINE NEEDLE ASPIRATION OF INTRA-ABDOMINAL LYMPH NODES IN THE
DIAGNOSIS AND FOLLOW UP OF MALIGNANT LYMPHOMA
Šušterčić D1 , Kardum-Skelin I1 , Jelić-Puškarić B1 , Milas M1 , Odak D2 , Vidjak V2 ,
Minigo H3 , Planinc-Peraica A3 , Radić-Krišto D3 , Ostojić Kolonić S3 , Jakšić B3 1Merkur University Hospital, Department of Medicine, Laboratory for Cytology and Hematology,
Zagreb, Croatia
2 Merkur University Hospital, Department of Diagnostic and Interventional Radiology
3 Merkur University Hospital, Department of Medicine, Zagreb, Croatia
Aim of the study. To assess appropriateness of the material obtained by fine-needle biopsy
of intra-abdominal lymph nodes and the possibility of malignant lymphoma differentiation
from other malignant tumors by cytomorphology supplemented by smear immunocytochemistry
and flow cytometry using cytogenetic and molecular analysis (PCR)
of cell suspension of sample obtained by fine-needle biopsy. Patients and methods. During
a 10-year period, 242 intra-abdominal lymph nodes were examined. US-guided biopsy
was done in 226 and CT-guided biopsy in two cases; biopsy was done blindly in only
one patient. Biopsy was performed by 22-gauge CHIBA needle, length 15-20 cm, depending
on lesion localization. Samples were analyzed on May-Grünwald-Giemsa stained
smears by determination of cellular markers by smear immunocytochemistry and flow
cytometry using cytochemical, cytogenetic and/or molecular analysis (PCR). Results.
The material was inadequate for cytologic analysis in 8 cases. Malignant lymphoma was
found in 97 patients (non-Hodgkin’s lymphoma (NHL) in 85 and Hodgkin’s lymphoma
(HL) in 12 cases). In 81 patients, the diagnosis of malignant lymphoma was made for the
first time (NHL in 72 and HL in nine patients). In cases of newly detected lymphoma,
diagnostic work-up was supplemented by smear immunocytochemistry in 66, phenotyping
on flow cytometer in 48, PCR in 13 and FISH in two cases. Out of 16 patients with previously
diagnosed malignant lymphoma, NHL was present in 13 and HL in three cases.
A tumor of another genesis was detected in three patients with previously diagnosed
lymphoma (carcinoma in two patients with HL and bronchial small cell carcinoma in one
patient with NHL), acute inflammation was found in 14 and elements of granulomatous
lesion in three patients. Conclusion. Visualization of intra-abdominal lymph nodes by imaging
methods enables target sampling for cytologic analysis as a reliable method in the
diagnosis and follow up of malignant lymphoma, when supplemented by some adjuvant
sophisticated technologies.
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4 th Croatian Congress of Clinical Cytology / 1 st Croatian Symposium of Analytical Cytology / 2 nd Croatian Symposium of Cytotechnology