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Fine Needle Aspiration of Intra-Abdominal Lymph Nodes in the Diagnosis and Follow Up of Malignant Lymphoma

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.

fine-needle aspiration cytology; intra-abdominal lymph nodes; malignant lymphoma

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