Background: Lymph nodal involvement is an important clinical-pathological sign in primary cutaneous lymphoma\r\n(PCL), as it marks the transformation/evolution of the disease from localized to systemic; therefore the surveillance\r\nof lymph nodes is important in the staging and follow up of PCL. Fine needle cytology (FNC) is widely used in the\r\ndiagnosis of lymphadenopathies but has rarely been reported in PCL staging and follow-up. In this study an\r\nexperience on reactive and neoplastic lymphadenopathies arisen in PCL and investigated by FNC, combined to\r\nancillary techniques, is reported.\r\nMethods: Twenty-one lymph node FNC from as many PCL patients were retrieved; 17 patients had mycosis\r\nfungoides (MF) and 4 a primary cutaneous B-cell lymphoma (PBL). In all cases, rapid on site evaluation (ROSE) was\r\nperformed and additional passes were used to perform flow cytometry (FC), immunocytochemistry (ICC) and/or\r\npolymerase chain reaction (PCR) to assess or rule out a possible clonality of the corresponding cell populations.\r\nResults: FNC combined with FC, ICC, and PCR identified 12 cases of reactive, non specific, hyperplasia (BRH),\r\n4 dermatopathic lymphadenopathy (DL), 4 lymph nodal involvement by MF and 1 lymph nodal involvement by\r\ncutaneous B-cell lymphoma.\r\nConclusions: FNC coupled with ancillary techniques is an effective tool to evaluate lymph node status in PCL\r\npatients, provided that ROSE and a rational usage of ancillary techniques is performed according to the clinical\r\ncontext and the available material. The method can be reasonably used as first line procedure in PCL staging and\r\nfollow up, avoiding expensive and often ill tolerated biopsies when not strictly needed.
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