Journal article
Diagnostic Discrepancies in Small-volume Biopsy for the Initial Diagnosis, Recurrence, and Transformation of Follicular Lymphoma: A Multi-Institutional Collaborative Study
The American journal of surgical pathology, Vol.47(2), pp.212-217
02/01/2023
DOI: 10.1097/PAS.0000000000001985
PMCID: PMC10464531
PMID: 36537240
Abstract
Small-volume biopsies (SVBs) including fine-needle aspiration (FNA), cell block, and needle core biopsies (NCB) are increasingly utilized to diagnose and guide the clinical management of lymphoma. We established a multi-institutional interdisciplinary collaboration of cytopathologists, hematopathologists, and oncologists focused on the role of SVB in the management of patients with follicular lymphoma (FL). To assess the performance characteristics of SVB in this setting, we evaluated all consecutive SVBs performed for clinical indications of initial diagnosis, recurrence, or transformation of FL over a 5-year period and focused on the 182 that had at least one subsequent biopsy within 3 months as part of the same clinical work-up. The most common outcome of a subsequent biopsy as part of the same clinical work-up was a more specific diagnosis usually assigning the pathologic grade (111/182, 61%), followed by a complete agreement with the SVB (24/182, 13%), and change from nondiagnostic on initial biopsy to diagnostic on subsequent biopsy (21/182, 12%). A minority resulted in a diagnostic change from benign to lymphoma (17/182, 9%), a change in FL grade (5/182, 3%), or change in the lymphoma diagnostic category (4/182, 2%). There were no cases where an initial diagnosis of lymphoma was overturned. The distribution of discrepancies was similar across initial SVB types (FNA, FNA + cell block, NCB with or without FNA). Tissue limitations were noted in a minority of cases (53/182, 29%) and were enriched among initially nondiagnostic biopsies (16/21, 76%). Flow cytometry immunophenotyping was performed in the majority of cases both at the first and last biopsy (147/182, 81%). SVB can be a powerful method to detect FL in various clinical indications, with discrepant cases mostly resulting from a refinement in the initial diagnosis.
Details
- Title: Subtitle
- Diagnostic Discrepancies in Small-volume Biopsy for the Initial Diagnosis, Recurrence, and Transformation of Follicular Lymphoma: A Multi-Institutional Collaborative Study
- Creators
- Ashley K Volaric - University of Virginia Medical CenterOscar Lin - Departments of PathologyRonald Balassanian - Departments of Pathology and Laboratory MedicineStephen Cook - Department of Pathology, Veteran Affairs Medical Center, San Francisco, CALorenzo Falchi - Memorial Sloan Kettering Cancer CenterMegan J Fitzpatrick - Massachusetts General HospitalAnnabel K Frank - University of California, San FranciscoSrishti Gupta - University of Virginia Medical CenterRobert P Hasserjian - Massachusetts General HospitalSteven Long - Departments of Pathology and Laboratory MedicineAmy Ly - Massachusetts General HospitalJoshua R Menke - Stanford UniversityEric Mou - University of IowaYasodha Natkunam - Stanford UniversityDaniel R Reed - New England Baptist HospitalRoberto Ruiz-Cordero - Departments of Pathology and Laboratory MedicineLinlin Wang - Departments of Pathology and Laboratory MedicineKwun Wah Wen - University of California, San FranciscoYi Xie - Departments of Pathology and Laboratory MedicineSara L Zadeh - University of Virginia Medical CenterDita Gratzinger - Stanford UniversityCyto-Heme Institutional Collaborative (CHIC) Consortium
- Resource Type
- Journal article
- Publication Details
- The American journal of surgical pathology, Vol.47(2), pp.212-217
- DOI
- 10.1097/PAS.0000000000001985
- PMID
- 36537240
- PMCID
- PMC10464531
- NLM abbreviation
- Am J Surg Pathol
- ISSN
- 0147-5185
- eISSN
- 1532-0979
- Language
- English
- Date published
- 02/01/2023
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984363165402771
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