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

4. Hrvatski kongres kliniËke citologije / 1. Hrvatski simpozij analitiËke citologije / 2. Hrvatski simpozij citotehnologije
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Klinička citologija - Plenarna i pozvana predavanja
VALUE OF FINE-NEEDLE ASPIRATION CYTOLOGY IN DIAGNOSIS OF HODGKIN’S LYM-
PHOMA AND ANAPLASTIC LARGE CELL LYMPHOMA: ONE CENTRE EXPERIENCE
Ostojić Kolonić S1 , Prašek-Kudrna K1 , Roso V1 , Radić-Krišto D1 , Planinc-Peraica A1 ,
Džebro S2 , Kardum-Skelin I3 , Jakšić B1 1 Department of Medicine, University Hospital Merkur, Zagreb
2 Department of Pathology and Cytology, University Hospital Merkur, Zagreb
3 Laboratory for Cytology and Haematology, University Hospital Merkur, Zagreb
It is commonly believed that cytological diagnosis of Hodgkin’s lymphoma (HL) is much
easier than that of non-Hodgkin’s lymphoma (NHL). Anaplastic large cell lymphoma
(ALCL) is NHL subtype which has created confusion with HL in fine-needle aspiration
(FNA) smears. To study the value and limitations of cytology in diagnosis of HL and ALCL
we analysed the initial FNA diagnosis and histopathological reports, as well as treatment
and survival in 89 newly diagnosed consecutive patients with these lymphomas
treated in our clinical department. These patients (40 male, 49 female; age range 16-93
years, mean 38 years; 44 in clinical stages I-II; 38 with B symptoms) were diagnosed
and treated during a period of 5 years and 4 months (1.1.2004.-1.5.2009.) The initial FNA
diagnoses were available in 86 patients (3 patients were admitted with histopathological
diagnosis and without enlarged lymph nodes suitable for FNA) and the initial pathohistological
diagnosis were available in 84 patients. FNA revealed 65 classic HL, 18 ALCL and
3 patients in which diagnosis was not informative due to inadequate material. Among
65 FNA diagnoses as HL, comparison with histopathology was made in 61 cases (in 3
cases a biopsy of lymph node was not possible and in one case there was no tumour
infiltration in the analysed lymph node) and the histopathological diagnoses were as follows:
56 (91,8%) HL; 3 ALCL; 1 diffuse large B cell lymphoma and 1 marginal zone B cell
lymphoma. In the group of 18 FNA diagnoses of ALCL 2 patients didn’t have a lymph node
biopsy; in 1 case tumour was not found in biopsy material; 8 patients (53,3%) had definitive
diagnosis of ALCL( either as T-cell or O type), and 5 (33,3%) as HL. These results
confirm the value of FNA in diagnostic procedure in patients with HL and ALCL, with very
good results in comparison with histopathology, especially in HL group of patients.
86 (96,6%) patients were treated with chemotherapy, 74 (83,1%) patients with ABVD chemotherapeutic
protocol according to our policy that patients with HL and T-cell ALCL
are treated with the same therapy as well. As we have almost uniform group of patients
according to therapeutic approach, we done the univariante analyses and find out that
patients with FNA diagnoses of HL, younger than 55 years, with early stage of the disease
and without B symptoms had significantly longer overall survival (OS). FNA diagnosis
has clinical relevance in differentiation between HL and ALCL.
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