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Cytomorphological characterisation of angioimmunoblastic T cell lymphoma: a case–control study
  1. Parikshaa Gupta1,
  2. Nalini Gupta1,
  3. Amanjit Bal2,
  4. Pulkit Rastogi3,
  5. Gaurav Prakash4,
  6. Pankaj Malhotra5,
  7. Pranab Dey1,
  8. Radhika Srinivasan1,
  9. Ashim Das2
  1. 1Cytology and Gynecologic Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  2. 2Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  3. 3Hematology Department, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  4. 4Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  5. 5Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  1. Correspondence to Dr Nalini Gupta, Department of Cytology and Gynecologic Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India; nalini203{at}gmail.com

Abstract

Aims Angioimmunoblastic T cell lymphoma (AITL) is often misdiagnosed in cytology. Hence, the present study was conducted to identify the distinctive cytomorphological features of AITL in lymph node fine-needle aspirates (LN-FNA).

Methods This was a 4-year retrospective case–control study. Cases included LN-FNAs from patients with histopathologically confirmed AITL. The controls included LN-FNAs from patients with histopathologically confirmed reactive lymphoid hyperplasia (RLH; n=25). Eleven cytomorphological features were assessed in all the aspirates; the strength of association was determined by OR, Cramer’s V and multiple correspondence analysis (MCA).

Results Of a total of 22 cases of AITL reported on histopathology, 19 adequate aspirates from 14 patients (63.6%) were available for review. On univariate analysis, 5 of 11 cytomorphological variables were found to be significant for AITL; however, on MCA, 3 of these parameters, viz absence of tingible body macrophages (OR=0.014; V=0.74), presence of atypical lymphoid cells (OR=10.8; V=0.41) and singly scattered epithelioid cells (OR=19.3; V=0.31), were found to be the strongest predictors of AITL.

Conclusions The absence of tingible body macrophages, presence of atypical lymphoid cells and singly scattered epithelioid cells in polymorphic LN-FNAs are significant cytomorphological predictors of AITL in comparison with RLH. Knowledge of these diagnostic predictors, supplemented by clinicoradiological correlation and appropriate ancillary studies, can help diagnose AITL on aspiration cytology.

  • lymphoma
  • cytology
  • flow cytometry
  • cytological techniques

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Footnotes

  • Handling editor Mary Frances McMullin.

  • Contributors PG: conceptualisation, data curation, data interpretation, formal analysis, methodology, supervision, validation, visualisation, writing - original draft, and writing - review, editing and approval. NG: conceptualisation, data curation, data interpretation, formal analysis, methodology, supervision, validation, visualisation, manuscript review and approval. GP, PM: clinical patient management, review and approval of the manuscript. PR, PD, RS, AB, AD: data interpretation, review and approval of the manuscript. Guarantor: NG

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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