Lymphoid cell aggregates: a useful clue in the fine-needle aspiration diagnosis of follicular lymphomas

Diagn Cytopathol. 1997 Dec;17(6):467-71. doi: 10.1002/(sici)1097-0339(199712)17:6<467::aid-dc17>;2-k.


Among the various types of lymphoma, follicular lymphoma (FL) is known to have significant limitations in cytologic diagnosis by the fine-needle aspiration (FNA) method. The diagnostic accuracy (DA) for non-Hodgkin's lymphoma (NHL) by FNA was evaluated by review of 82 cases of histologically proved NHL after prior FNA. The DA for all NHLs was 66% (54/82), and that for low-grade lymphomas, including small lymphocytic lymphoma, follicular small-cleaved cell lymphoma, and follicular mixed cell lymphoma, was 71% (12/17). The DA for FL was 69% (11/16). Review of individual surgical and cytologic materials from FLs revealed a tendency to show fibrosis in the cytologically false-negative group and diffuse areas of lymphoma in the true-positive group. The presence of "aggregation" of uniform lymphoid cells, probably due to cell adhesions with the support of dendritic reticulum cells, was seen in 55% of true-positive FL (6/11). In contrast, only 28% of true-positive diffuse large cell lymphomas (5/18) showed a mild degree of aggregation, and none of 7 cases of true-positive diffuse small-cleaved cell lymphoma showed this feature. The aggregation of cells was not pathognomonic of FL, but its presence with a homogeneous cellular constituent and the paucity of tingible-body macrophages helped us to predict FL. Also, it was a feature distinguishing FL from diffuse small-cleaved cell lymphoma (P = 0.025).

Publication types

  • Comparative Study

MeSH terms

  • Biopsy, Needle
  • Cell Aggregation
  • Cytodiagnosis / standards
  • Fibrosis
  • Humans
  • Lymphocytes / cytology
  • Lymphocytes / pathology
  • Lymphoid Tissue / cytology*
  • Lymphoid Tissue / pathology*
  • Lymphoma, Follicular / diagnosis
  • Lymphoma, Non-Hodgkin / diagnosis
  • Macrophages / cytology
  • Macrophages / pathology