Lymph Nodes

  • John C. Lee
  • Xiaohua QianEmail author
Part of the Practical Anatomic Pathology book series (PAP)


Fine-needle aspiration (FNA) of lymph nodes for the evaluation of suspected lymphoma is a controversial topic. More so than any other organ system, evaluation of lymph nodes requires a multimodal approach including morphology and immunophenotyping. In certain situations, molecular cytogenetic testing is needed for difficult cases and for diagnosis refinement. Although FNA cytomorphology provides important diagnostic clues, histomorphology (architecture) provided by core needle biopsy is often needed in the evaluation of lymphoma. The introduction of additional cytogenetics-based entities in the 2017 World Health Organization (WHO) Classification of Tumors of Hematopoietic and Lymphoid Tissue has made the cytopathological diagnosis of lymphoma even more challenging. Regardless, FNA can still play a valuable role in triaging patients with lymphadenopathy. This is especially impactful for patients who need a rapid diagnosis, have deep-seated site of disease inaccessible to core needle biopsy, or those who cannot tolerate a surgical procedure. Successful interpretation of lymph node FNA can only be achieved with proper clinical and radiological correlation, complete awareness of its limitations, and inputs from hematopathology colleagues.


Fine-needle aspiration Lymph node Lymphadenopathy Lymphadenitis Lymphoma Flow cytometry Rapid on-site evaluation Immunohistochemistry Cytogenetics 


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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Pathology and Laboratory MedicineBoston Medical CenterBostonUSA
  2. 2.Brigham and Women’s Hospital and Harvard Medical SchoolBostonUSA

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