Diagnostic methodology to reduce the cytomorphologic differential diagnosis of lymphoid neoplasms of predominant small cells

Abstract

A diagnostic interpretative and integrative methodology for small cell lymphomas was designed and implemented in order to consider a more accurate cytomorphologic differential diagnosis, which is further reduced by integrating differential clinical characteristics among each of the diseases defined by the World Health Organization classification of lymphoid neoplasms included in the differential diagnosis. A total of 28 cases were selected. They were diagnosed by fine needle aspiration biopsy with initial diagnostic difficulty or when the methodology was applied, and clinically suspected cases of lymphomas having no known primary tumor. The following criteria were taken into account for the application of the methodology: the cytomorphological similarities and differences, the size and the predominant cell type (or both), and other reactive cell types present in the tumor cell microenvironment. Three cytomorphologic patterns of predominant small cell were identified: small to medium cells with numerous mitosis, with occasional large cell, and mixed. The neoplastic lymphoid illnesses to be considered are reduced in the differential diagnosis, and this methodology is feasible to be implemented in departments with limited technical resources available.