Fine needle aspiration evaluation of pancreatic lymphoma: A retrospective study of 25 cases in a single institution

Background Accurate diagnosis of pancreatic lymphoma is crucial for clinical management. We evaluate the role of fine‐needle aspiration (FNA) in the diagnosis of pancreatic lymphoma with the aid of flow cytometry and/or immunohistochemistry on the cell block. Methods Cases of pancreatic lymphoma wer...

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Bibliographic Details
Published in:Diagnostic cytopathology 2018-02, Vol.46 (2), p.131-138
Main Authors: Zhou, Jiehao, Wu, Howard, Lin, Jingmei, Wang, Xiaoyan, Zhang, Shanxiang, Cramer, Harvey, Chen, Shaoxiong
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
B-cell lymphoma
Beta cells
Biopsy, Fine-Needle - standards
Diagnosis
Evaluation
False Negative Reactions
Female
fine needle aspiration
Flow cytometry
Humans
Immunohistochemistry
Information systems
Lymphoma
Lymphoma, Non-Hodgkin - pathology
Male
Middle Aged
Pancreas
pancreatic lymphoma
Pancreatic Neoplasms - pathology
Reviews
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Summary:Background Accurate diagnosis of pancreatic lymphoma is crucial for clinical management. We evaluate the role of fine‐needle aspiration (FNA) in the diagnosis of pancreatic lymphoma with the aid of flow cytometry and/or immunohistochemistry on the cell block. Methods Cases of pancreatic lymphoma were collected by searching our pathology laboratory information system over a period of 16 years. The clinical findings, cytologic features, and immunophenotypic results were reviewed. The diagnoses of FNA were correlated with surgical specimens in a subset of FNA cases. Results A total of 25 FNA cases of pancreatic lymphoma were included. The most common type of pancreatic lymphoma was large B cell lymphoma followed by follicular lymphoma. With the aid of flow cytometry and immunohistochemical work‐up on cell block, 72% (18/25) of the cases were diagnosed as lymphoma and 16% of the cases (4/25) were diagnosed as suspicious for lymphoma by FNA. Only two cases (8%) including one false negative and one nondiagnostic aspirate missed the lymphoma diagnosis and 1 case (4%) was indeterminate by FNA evaluation. Conclusion FNA demonstrated high accuracy in rendering diagnosis of pancreatic lymphoma. The overall sensitivity is 88% and the false negative and nondiagnostic rates are 4%, respectively. Further subtyping of certain lymphomas can be difficult due to the lack of architectural features of FNA specimens.
ISSN:8755-1039
1097-0339
DOI:10.1002/dc.23862