Diagnostic impact of core-needle biopsy on fine-needle aspiration of non-Hodgkin lymphoma

We retrospectively reviewed 74,fine-needle aspiration (FNA) cases of presumptive non-Hodgkin lymphoma (NHL). All the cases had cytology and core-needle biopsy and 53 cases had concurrent flow cytometric analysis. FNA (cytology and flow cytometry) and core-needle biopsy were evaluated independently. FNA was diagnostic of diffuse large B-cell lymphoma (DLBL) in 25% (13153) of cases and small B-cell NHL in 15% (8153) of cases, whereas core-needle biopsy was diagnostic of DLBL in 37% (27174) of cases and small B-cell NHL in 8% (6174) of cases. Subclassification of small B-cell NHL was reached in 316 cases by cort-needle biopsy. Insufficient cases were observed in both FNA (47%; 25153) and core-needle biopsy (28%; 21174) groups. With the combination of FNA and core-needle biopsy, diagnostic cases of DLBL increased to 43% (32174) and insufficient samples were reduced to 16% (12174). There was no clear advantage it? the diagnosis and classification of small B-cell NHL by adding core-needle biopsy to FNA (14% 110/74). We conclude that core-needle biopsy is a useful adjunct to FNA in the diagnosis of DLBL and shall be encouraged. In small B-cell NHL, core-needle biopsy does not add to the diagnostic ability of FNA. Cases insufficient for diagnosis may be seen in both core-needle biopsy and FNA. A combined approach reduces the number of insufficient cases and is recommended in routine FNA practice. (C) 2004 Wiley-Liss, Inc.