Primary diagnosis and REAL/WHO classification of XXXX by fine-needle aspiration: cytomorphologic and immunophenotypic approach.

@entity1893 @entity450 @entity5 @entity706
The Revised European @entity706 (REAL) and World Health Organization (WHO) classification of @entity1893 ( @entity1893 ) relies on the constellation of cytologic, phenotypic, genotypic, and clinical characteristics of @entity1893 . For the most part, the classification does not rely on architectural pattern for classification of @entity5 . This classification makes it possible to diagnose and classify @entity706 by fine-needle aspiration (FNA). In this study, we attempted to evaluate the accuracy of FNA in diagnosing and classifying @entity1893 within the context of the REAL/WHO classifications. Cases included only those in which FNA was the primary diagnosis, followed by a surgical biopsy for confirmation. @entity450 ( @entity450 ) for phenotyping was carried out whenever material was available. Two groups of pathologists were identified. Group A consisted of pathologists with background training in cytopathology and/or hematopathology (three pathologists). Group B consisted of experienced surgical pathologists with no training in cytopathology and/or hematopathology (four pathologists). Seventy-four cases were included in the study. @entity450 phenotyping was performed in 53 cases (71%). @entity706 constituted 63% of the cases. The remaining @entity706 included Burkitt's, small lymphocytic, lymphoblastic, follicle center cell, Ki-1, mantle cell, marginal zone, and natural killer cell @entity706 . The diagnosis of @entity706 was rendered for all cases. The correct classification was seen in 63% of the cases. Classification was more accurate in immunophenotyped than in nonimmunophenotyped cases (84% vs 33%; P = 0.00004). Group A pathologists showed higher incidence of proper classification than group B (80% vs 56%; P = 0.046). The diagnosis and classification of @entity1893 can be achieved in a large number of cases on FNA material. This accuracy can be increased if cytomorphologic criteria are established for different entities of @entity1893 aided by @entity450 for phenotyping.
