Grading follicular lymphomas in fine-needle aspiration biopsies: The role of ThinPrep slides and flow cytometry Journal Article


Authors: Brandao, G. D. A.; Rose, R.; McKenzie, S.; Maslak, P.; Lin, O.
Article Title: Grading follicular lymphomas in fine-needle aspiration biopsies: The role of ThinPrep slides and flow cytometry
Abstract: BACKGROUND. The World Health Organization (WHO) recommends a 3-tier grading system (Grades 1-3) for follicular lymphomas (FLs) based on the absolute number of centroblasts per high-power microscopic field (HPF) in 10 neoplastic follicles. Grades 1 and 2 FL are still managed as indolent FLs, whereas Grade 3 FL is thought to behave more aggressively. In this study, the feasibility of grading FL using ThinPrep (TP) slides and flow cytometry (FC) was evaluated. METHODS. Fifty-three cases of lymph node fine-needle aspiration (FNA) from patients with histologically confirmed FL (20 Grade 1, 17 Grade 2, and 16 Grade 3) were included. The number of centroblasts present in 300 lymphoid cells and in 10 HPF in TP Papanicolaou-stained slides was evaluated. The percentage of CD10-positive small cells was calculated with FC results. Statistical analysis was performed with the Jonckheer-Terpstra nonparametric trend test and the Wilcoxon rank sum test. RESULTS. The statistical analysis demonstrated a significant upward trend in the number of centroblasts as the grades increased. Also, all 3 methods had statistically significant results to distinguish different grades of FL, except when FC was used to distinguish Grade 2 from Grade 3 FL. CONCLUSIONS. Counting centroblasts, either in 300 lymphoid cells or per 10 HPF in TP slides, represented a statistically significant method to separate different grades of FL in FNA samples. Analysis of cell size by FC was not as reliable to distinguish different grades of FL, especially Grade 2 from 3. © 2006 American Cancer Society.
Keywords: adult; human tissue; aged; middle aged; major clinical study; histopathology; microscopy; flow cytometry; cancer grading; sensitivity and specificity; cytology; statistical analysis; statistical significance; evaluation; feasibility studies; biopsy, fine-needle; intermethod comparison; reliability; eosin; hematoxylin; aspiration biopsy; grade; follicular lymphoma; lymphoma, follicular; rank sum test; cytological techniques; calculation; lymphoid cell; papanicolaou test; nonparametric test; follicular; smear; analyzer
Journal Title: Cancer
Volume: 108
Issue: 5
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2006-10-25
Start Page: 319
End Page: 323
Language: English
DOI: 10.1002/cncr.22173
PUBMED: 16937377
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 5" - "Export Date: 4 June 2012" - "CODEN: CANCA" - "Source: Scopus"
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  1. Oscar Lin
    307 Lin
  2. Peter Maslak
    197 Maslak
  3. Ruth A Rose
    4 Rose