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Lymph Node Cytology

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Atlas of Non-Gynecologic Cytology

Part of the book series: Atlas of Anatomic Pathology ((AAP))

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Abstract

Lymph nodes are among the most commonly sampled organs. The common causes of lymphadenopathy include metastatic cancers, reactive hyperplasia due to various stimuli, infections, and lymphomas. Fine-needle aspiration (FNA) of a lymph node is a safe, relatively simple, and effective modality in the evaluation of lymphadenopathy. Diff-Quik stain offers rapid provisional assessment and can guide the further workup for the patient. Diff-Quik stain also provides information on cytoplasm and extracellular matrix. Papanicolaou stain reveals nuclear details. Cell block allows histologic sections and immunohistochemical studies. FNA can provide samples for ancillary studies such as flow cytometric analysis and cytogenetic and molecular studies. Ancillary studies are complementary to morphology and can further improve the diagnostic accuracy. This chapter summarizes the cytological features of various lymph node lesions and defines the roles of ancillary studies in the diagnosis and prognosis.

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References

  1. Schafernak KT, Kluskens LF, Ariga R, Reddy VB, Gattuso P. Fine-needle aspiration of superficial and deeply seated lymph nodes on patients with and without a history of malignancy: review of 439 cases. Diagn Cytopathol. 2003;29:315–9.

    Article  PubMed  Google Scholar 

  2. Nasuti JF, Mehrotra R, Gupta PK. Diagnostic value of fine-needle aspiration in supraclavicular lymphadenopathy: a study of 106 patients and review of literature. Diagn Cytopathol. 2001;25:351–5.

    Article  CAS  PubMed  Google Scholar 

  3. Glant MD. Cytopathology of lymph nodes in nonspecific reactive hyperplasia. Prognostication and differential diagnoses. Am J Clin Pathol. 1997;108(4 Suppl 1):S31–55.

    PubMed  CAS  Google Scholar 

  4. O’Dowd GJ, Frable WJ, Behm FG. Fine needle aspiration cytology of benign lymph node hyperplasias. Diagnostic significance of lymphohistiocytic aggregates. Acta Cytol. 1985;29:554–8.

    PubMed  Google Scholar 

  5. Pilotti S, Di Palma S, Alasio L, Bartoli C, Rilke F. Diagnostic assessment of enlarged superficial lymph nodes by fine needle aspiration. Acta Cytol. 1993;37:853–66.

    PubMed  CAS  Google Scholar 

  6. Schwarz R, Chan NH, MacFarlane JK. Fine needle aspiration cytology in the evaluation of head and neck masses. Am J Surg. 1990;159:482–5.

    Article  CAS  PubMed  Google Scholar 

  7. Zhou J, Li F, Meng L, Hao F, Liu X, Zhao C, et al. Fine needle aspiration cytology for lymph nodes: a three-year study. Br J Biomed Sci. 2016;73:28–31.

    Article  PubMed  Google Scholar 

  8. Ramzy I, Rone R, Schultenover SJ, Buhaug J. Lymph node aspiration biopsy. Diagnostic reliability and limitations—an analysis of 350 cases. Diagn Cytopathol. 1985;1:39–45.

    Article  CAS  PubMed  Google Scholar 

  9. Hyun SJ, Kim EK, Yoon JH, Moon HJ, Kim MJ. Adding MRI to ultrasound and ultrasound-guided fine-needle aspiration reduces the false-negative rate of axillary lymph node metastasis diagnosis in breast cancer patients. Clin Radiol. 2015;70:716–22.

    Article  CAS  PubMed  Google Scholar 

  10. Basler GC, Fader DJ, Yahanda A, Sondak VK, Johnson TM. The utility of fine needle aspiration in the diagnosis of melanoma metastatic to lymph nodes. J Am Acad Dermatol. 1997;36:403–8.

    Article  CAS  PubMed  Google Scholar 

  11. Wang H, Liang J, Yong WH, Sullivan P. Metastatic pituitary carcinoma to cervical lymph node: diagnosis by fine needle aspiration and review of the literature. Acta Cytol. 2017;61:242–6.

    Article  CAS  PubMed  Google Scholar 

  12. Stewart CJ, Duncan JA, Farquharson M, Richmond J. Fine needle aspiration cytology diagnosis of malignant lymphoma and reactive lymphoid hyperplasia. J Clin Pathol. 1998;51:197–203.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Das DK. Value and limitations of fine-needle aspiration cytology in diagnosis and classification of lymphomas: a review. Diagn Cytopathol. 1999;21:240–9.

    Article  CAS  PubMed  Google Scholar 

  14. Katz RL. Cytologic diagnosis of leukemia and lymphoma. Values and limitations. Clin Lab Med. 1991;11:469–99.

    Article  PubMed  CAS  Google Scholar 

  15. Katz RL, Caraway NP. FNA lymphoproliferative diseases: myths and legends. Diagn Cytopathol. 1995;12:99–100.

    Article  CAS  PubMed  Google Scholar 

  16. Sneige N. Diagnosis of lymphoma and reactive lymphoid hyperplasia by immunocytochemical analysis of fine-needle aspiration biopsy. Diagn Cytopathol. 1990;6:39–43.

    Article  CAS  PubMed  Google Scholar 

  17. Paull G, Mosunjac M. Fine-needle aspiration biopsy and intraoperative cytologic smear findings in a case of benign mesothelial-cell inclusions involving a lymph node: case report and review of the literature. Diagn Cytopathol. 2003;29:163–6.

    Article  PubMed  Google Scholar 

  18. Gallan AJ, Antic T. Benign müllerian glandular inclusions in men undergoing pelvic lymph node dissection. Hum Pathol. 2016;57:136–9.

    Article  CAS  PubMed  Google Scholar 

  19. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2017. CA Cancer J Clin. 2017;67:7–30.

    Article  Google Scholar 

  20. Stein H, Delsol G, Pileri SA, Poppema S, Jaffe ES. Classical Hodgkin lymphoma. In: Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al., editors. WHO classification of tumours of haematopoietic and lymphoid tissues. 4th ed. Lyon: IARC; 2008. p. 326–9.

    Google Scholar 

  21. The Non-Hodgkin’s Lymphoma Classification Project. A clinical evaluation of the International Lymphoma Study Group classification of non-Hodgkin’s lymphoma. Blood. 1997;89:3909–18.

    Google Scholar 

  22. Dal Bo M, Bulian P, Bomben R, Zucchetto A, Rossi FM, Pozzo F, et al. CD49d prevails over the novel recurrent mutations as independent prognosticator of overall survival in chronic lymphocytic leukemia. Leukemia. 2016;30:2011–8.

    Article  CAS  PubMed  Google Scholar 

  23. Gooden CE, Jones P, Bates R, Shallenberger WM, Surti U, Swerdlow SH, Roth CG. CD49d shows superior performance characteristics for flow cytometric prognostic testing in chronic lymphocytic leukemia/small lymphocytic lymphoma. Cytometry B Clin Cytom. 2018;94(1):129–35. https://doi.org/10.1002/cyto.b.21384.

    Article  PubMed  CAS  Google Scholar 

  24. Strati P, Parikh SA, Chaffee KG, Achenbach SJ, Slager SL, Call TG, et al. CD49d associates with nodal presentation and subsequent development of lymphadenopathy in patients with chronic lymphocytic leukaemia. Br J Haematol. 2017;178:99–105.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Zelenetz AD, Wierda WG, Abramson JS, Advani RH, Andreadis CB, Bartlett N, et al. Non-Hodgkin’s lymphomas, version 3.2012. J Natl Compr Canc Netw. 2012;10:1487–98.

    Article  CAS  PubMed  Google Scholar 

  26. Chen R, Sanchez J, Rosen ST. Clinical management updates in mantle cell lymphoma. Oncology (Williston Park). 2016;30:353–60.

    Google Scholar 

  27. Hashmi AA, Hussain ZF, Faridi N, Khurshid A. Distribution of Ki67 proliferative indices among WHO subtypes of non-Hodgkin’s lymphoma: association with other clinical parameters. Asian Pac J Cancer Prev. 2014;15:8759–63.

    Article  PubMed  Google Scholar 

  28. Katzenberger T, Petzoldt C, Höller S, Mäder U, Kalla J, Adam P, et al. The Ki67 proliferation index is a quantitative indicator of clinical risk in mantle cell lymphoma. Blood. 2006;107:3407.

    Article  CAS  PubMed  Google Scholar 

  29. Hsi ED, Jung SH, Lai R, Johnson JL, Cook JR, Jones D, et al. Ki67 and PIM1 expression predict outcome in mantle cell lymphoma treated with high dose therapy, stem cell transplantation and rituximab: a Cancer and Leukemia Group B 59909 correlative science study. Leuk Lymphoma. 2008;49:2081–90.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Anderson JR, Armitage JO, Weisenburger DD. Epidemiology of the non-Hodgkin’s lymphomas: distributions of the major subtypes differ by geographic locations. Non-Hodgkin’s Lymphoma Classification Project. Ann Oncol. 1998;9:717–20.

    Article  CAS  PubMed  Google Scholar 

  31. Koch K, Hoster E, Ziepert M, Unterhalt M, Ott G, Rosenwald A, et al. Clinical, pathological and genetic features of follicular lymphoma grade 3A: a joint analysis of the German low-grade and high-grade lymphoma study groups GLSG and DSHNHL. Ann Oncol. 2016;27:1323–9.

    Article  CAS  PubMed  Google Scholar 

  32. Mercadal S, Pomares H, Sancho JM, Climent F, García O, Encuentra M, et al. Clinico-biological features, treatment and survival of 457 patients with histological Grades 3A and 1-2 follicular lymphoma mostly treated with immunochemotherapy. Br J Haematol. 2016;172:470–3.

    Article  PubMed  Google Scholar 

  33. Horn H, Ziepert M, Becher C, Barth TF, Bernd HW, Feller AC, et al. German High-Grade Non-Hodgkin Lymphoma Study Group. MYC status in concert with BCL2 and BCL6 expression predicts outcome in diffuse large B-cell lymphoma. Blood. 2013;121:2253–63.

    Article  CAS  PubMed  Google Scholar 

  34. Klopčič U, Lavrenčak J, Gašljević G, Bračko M, Pohar-Marinšek Ž, Kloboves-Prevodnik V. Grading of follicular lymphoma in cytological samples. Cytopathology. 2016;27:390–7.

    Article  PubMed  Google Scholar 

  35. Hans CP, Weisenburger DD, Greiner TC, Gascoyne RD, Delabie J, Ott G, et al. Confirmation of the molecular classification of diffuse large B-cell lymphoma by immunohistochemistry using a tissue microarray. Blood. 2004;103:275–82.

    Article  CAS  PubMed  Google Scholar 

  36. Horn H, Schmelter C, Leich E, Salaverria I, Katzenberger T, Ott MM, et al. Follicular lymphoma grade 3B is a distinct neoplasm according to cytogenetic and immunohistochemical profiles. Haematologica. 2011;96:1327–34.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Snuderl M, Kolman OK, Chen YB, Hsu JJ, Ackerman AM, Dal Cin P, et al. B-cell lymphomas with concurrent IGH-BCL2 and MYC rearrangements are aggressive neoplasms with clinical and pathologic features distinct from Burkitt lymphoma and diffuse large B-cell lymphoma. Am J Surg Pathol. 2010;34:327–40.

    Article  PubMed  PubMed Central  Google Scholar 

  38. McKenna RW, Kyle RA, Kuehl WM, Grogan TM, Harris NL, Coupland RW. Plasma cell neoplasms. In: Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al., editors. WHO classification of tumours of haematopoietic and lymphoid tissues. 4th ed. Lyon: IARC; 2008. p. 200–13.

    Google Scholar 

  39. Cazals-Hatem D, Lepage E, Brice P, Ferrant A, d’Agay MF, Baumelou E, et al. Primary mediastinal large B-cell lymphoma. A clinicopathologic study of 141 cases compared with 916 nonmediastinal large B-cell lymphomas, a GELA (“Groupe d’Etude des Lymphomes de l’Adulte”) study. Am J Surg Pathol. 1996;20:877–88.

    Article  CAS  PubMed  Google Scholar 

  40. Barth TF, Leithäuser F, Joos S, Bentz M, Möller P. Mediastinal (thymic) large B-cell lymphoma: where do we stand? Lancet Oncol. 2002;3:229–34.

    Article  PubMed  Google Scholar 

  41. Poppema S, Delsol G, Pileri SA, Stein H. Nodular lymphocyte predominant Hodgkin lymphoma. In: Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al., editors. WHO classification of tumours of haematopoietic and lymphoid tissues. 4th ed. Lyon: IARC; 2008. p. 323–5.

    Google Scholar 

  42. Delsol G. [The 2008 WHO lymphoma classification]. Ann Pathol. 2008;28 Spec No 1:S20–4.

    Google Scholar 

  43. Pileri SA, Orazi A, Falini B. Myeloid sarcoma. In: Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al., editors. WHO classification of tumours of haematopoietic and lymphoid tissues. 4th ed. Lyon: IARC; 2008. p. 140–1.

    Google Scholar 

  44. Almagro UA, Choi H, Rouse TM. Hemangioma in a lymph node. Arch Pathol Lab Med. 1985;109:576–8.

    PubMed  CAS  Google Scholar 

  45. Reich RF, Moss S, Freedman PD. Intranodal hemangioma of the oral soft tissues: a case report of a rare entity with review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;90:71–3.

    Article  CAS  PubMed  Google Scholar 

  46. Kasznica J, Sideli RV, Collins MH. Lymph node hemangioma. Arch Pathol Lab Med. 1989;113:804–7.

    PubMed  CAS  Google Scholar 

  47. Wakely PE Jr, Frable WJ, Kneisl JS. Aspiration cytopathology of epithelioid angiosarcoma. Cancer. 2000;90:245–51.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pathology, University of New Mexico Hospital, Albuquerque, NM, USA

    Von G. Samedi M.D., Ph.D. & Qian-Yun Zhang M.D., Ph.D.

Authors
  1. Von G. Samedi M.D., Ph.D.
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  2. Qian-Yun Zhang M.D., Ph.D.
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Corresponding author

Correspondence to Qian-Yun Zhang M.D., Ph.D. .

Editor information

Editors and Affiliations

  1. The University of Michigan-Michigan Medicine, Ann Arbor, Michigan, USA

    Xin Jing

  2. Weill-Cornell Medicine, New York, New York, USA

    Momin T. Siddiqui

  3. The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA

    Qing Kay Li

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Samedi, V.G., Zhang, QY. (2018). Lymph Node Cytology. In: Jing, X., Siddiqui, M., Li, Q. (eds) Atlas of Non-Gynecologic Cytology . Atlas of Anatomic Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-89674-8_11

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  • DOI: https://doi.org/10.1007/978-3-319-89674-8_11

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-319-89674-8

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