Fine Needle Aspiration Cytology in the Follow-up of Hodgkin's Lymphoma

Introduction: Hodgkin's lymphoma (HL) is characterized by long survivals and risk of relapses and second neoplasms, therefore a prolonged follow-up is required. Fine needle cytology (FNC) is a controversial tool in HL because of a low sensitivity. The aim of this study has been to improve the sensitivity of FNC in HL follow-up to avoid surgical biopsies. Methods: The study was performed in two consecutive groups of 198 FNCs in HL patients. In the first group FNC of palpable lymph-nodes or extra lymph-nodal masses were performed without ultrasound guide (USG) whereas FNC of deep located masses were performed with USG (non-assisted group); In the second group FNCs were performed with Power Doppler (USG); and evaluated for adequacy (assisted group). Cytological diagnoses were controlled by histology (61) or clinical follow-up (137); sensitivity and specificity were calculated in the two groups.Results: FNC identified 90 negative cases with three false negatives, 70 relapse, 12 inadequate and 14 suspicious; these latter were histologically evaluated resulting HL in 9 cases and negative in the remaining 5 cases; twelve second neoplasias were also diagnosed and all histologically confirmed. Sensitivity and specificity were 64% and 84% in the non-assisted group and 86% and 94% in the assisted group respectively. Conclusions: Sensitivity and specificity in assisted FNC were higher than that obtained in non-assisted ones. The main advantage of assisted FNC in the follow-up of HL is to produce accurate diagnoses avoiding invasive biopsies especially in case of second neoplasia which dramatically changes prognosis and therapeutic procedures.