Don’t request a fine-needle aspirate (FNA) for the evaluation of suspected lymphoma.

The diagnosis of lymphoma requires specimens with intact cellular architecture for accurate histopathologic and immunophenotypic classification. FNA is associated with a low sensitivity and potentially results in delays in lymphoma diagnosis. Although excisional biopsy is the gold standard for lymphoma diagnosis, depending on the lymph node location, excisional biopsy may be associated with complications and the need for general anesthesia. At a minimum, an imaging-guided core biopsy should be obtained to improve the accuracy and timeliness of lymphoma diagnosis.

 

Sources:

de Kerviler E, et al. Image-guided core-needle biopsy of peripheral lymph nodes allows the diagnosis of lymphomas. Eur. Radiol. Mar 2007;17(3):843-849. PMID: 17021708.

Demharter J, et al. Percutaneous core-needle biopsy of enlarged lymph nodes in the diagnosis and subclassification of malignant lymphomas. Eur. Radiol. 2001;11(2):276-283. PMID: 11218028.

Health Quality Ontario. The Diagnostic Accuracy of Fine-Needle Aspiration Cytology in the Diagnosis of Lymphoma: A Rapid Review [Internet]. 2014 (cited 2014 Jul 21].

Swerdlow SH. WHO classification of tumours of haematopoietic and lymphoid tissues. 4th ed. World Health Organization; 2008. PMID: 22683202.