Roh J-L, Lee Y-W, Kim J-M
Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap-dong, Songpa-gu, Seoul 138-736, Republic of Korea.
Eur J Surg Oncol. 2008 Jul;34(7):817-21. doi: 10.1016/j.ejso.2007.07.200. Epub 2007 Sep 5.
Although fine-needle aspiration (FNA) is currently used for the diagnosis of lymphoma, its diagnostic utility in patients with head and neck (HN) lymphoma is unclear. We therefore assessed the utility of initial clinical and FNA diagnoses for HN lymphoma in a clinician's perspective.
We conducted a retrospective study of total 109 patients with HN lymphoma underwent both FNA and tissue diagnoses from January 2000 through December 2005. The diagnostic sensitivity of FNA was compared with that of histopathology. FNA diagnosis was based on cytomorphology alone in 69 patients and on immunophenotyping plus morphology in 40.
On clinical diagnosis, lymphoma was suspected in 54 patients, nonlymphoma/metastatic malignancy in 31, and benign disease in 24. FNA diagnosed lymphoma in 41 patients; suspicious of lymphoma in 23; atypical lymphoma in 20; benign disease in 19; and was nondiagnostic in 6 patients. Diagnostic accuracy of FNA was not significantly improved by repeat core needle biopsy and immunophenotyping. Delay from FNA to tissue diagnosis was significant in the benign FNA-diagnostic group, with a mean 49 days.
The clinical and FNA diagnoses of HN lymphoma may be incomplete and include the potential pitfall of significant diagnostic delay.
尽管细针穿刺抽吸活检（FNA）目前用于淋巴瘤的诊断，但其在头颈部（HN）淋巴瘤患者中的诊断效用尚不清楚。因此，我们从临床医生的角度评估了HN淋巴瘤初始临床诊断和FNA诊断的效用。
我们对2000年1月至2005年12月期间共109例接受FNA和组织诊断的HN淋巴瘤患者进行了回顾性研究。将FNA的诊断敏感性与组织病理学的诊断敏感性进行比较。69例患者的FNA诊断仅基于细胞形态学，40例患者基于免疫表型分析加形态学。
临床诊断时，54例患者怀疑为淋巴瘤，31例怀疑为非淋巴瘤/转移性恶性肿瘤，24例怀疑为良性疾病。FNA诊断41例为淋巴瘤；23例怀疑为淋巴瘤；20例为非典型淋巴瘤；19例为良性疾病；6例诊断不明确。重复粗针活检和免疫表型分析并未显著提高FNA的诊断准确性。在FNA诊断为良性的组中，从FNA到组织诊断的延迟显著，平均为49天。
HN淋巴瘤的临床诊断和FNA诊断可能不完整，且存在显著诊断延迟的潜在风险。
