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Open Access Research article

Lymph node fine needle Cytology in the staging and follow-up of Cutaneous Lymphomas

Elena Vigliar1, Immacolata Cozzolino1, Marco Picardi2, Anna Lucia Peluso2, Laura Virginia Sosa Fernandez4, Antonio Vetrani1, Gerardo Botti3, Fabrizio Pane2, Carmine Selleri4 and Pio Zeppa4*

Author Affiliations

1 Departments of Advanced Biomedical Sciences of Public Health, University of Naples "Federico II", Naples, Italy

2 Advanced Biotechnologies, Biochemistry and Medical Biotechnologies, University of Naples “Federico II”, University of Naples, CEINGE, Naples, Italy

3 Istituto Nazionale Tumori Fondazione "G. Pascale", Naples, Italy

4 Department of Medicine and Surgery, Azienda Ospedaliera Universitaria “San Giovanni di Dio e Ruggi d’Aragona”, Largo città d’Ippocrate n.1, 84131 Salerno, (IT), Italy

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BMC Cancer 2014, 14:8  doi:10.1186/1471-2407-14-8

Published: 6 January 2014

Abstract

Background

Lymph nodal involvement is an important clinical-pathological sign in primary cutaneous lymphoma (PCL), as it marks the transformation/evolution of the disease from localized to systemic; therefore the surveillance of lymph nodes is important in the staging and follow up of PCL. Fine needle cytology (FNC) is widely used in the diagnosis of lymphadenopathies but has rarely been reported in PCL staging and follow-up. In this study an experience on reactive and neoplastic lymphadenopathies arisen in PCL and investigated by FNC, combined to ancillary techniques, is reported.

Methods

Twenty-one lymph node FNC from as many PCL patients were retrieved; 17 patients had mycosis fungoides (MF) and 4 a primary cutaneous B-cell lymphoma (PBL). In all cases, rapid on site evaluation (ROSE) was performed and additional passes were used to perform flow cytometry (FC), immunocytochemistry (ICC) and/or polymerase chain reaction (PCR) to assess or rule out a possible clonality of the corresponding cell populations.

Results

FNC combined with FC, ICC, and PCR identified 12 cases of reactive, non specific, hyperplasia (BRH), 4 dermatopathic lymphadenopathy (DL), 4 lymph nodal involvement by MF and 1 lymph nodal involvement by cutaneous B-cell lymphoma.

Conclusions

FNC coupled with ancillary techniques is an effective tool to evaluate lymph node status in PCL patients, provided that ROSE and a rational usage of ancillary techniques is performed according to the clinical context and the available material. The method can be reasonably used as first line procedure in PCL staging and follow up, avoiding expensive and often ill tolerated biopsies when not strictly needed.

Keywords:
Lymph node; Cutaneous lymphoma; Fine needle cytology; Flow cytometry; PCR