Expert: Neha Dahiya MD - 11/3/2009

Question
I had a fine needle biopsy performed on an enlarged lymph node. The results were clear of malignancy according to my doctor. My greatest concern prior to the biopsy was follicular lymphoma because I had several enlarged nodes that were permanent but not growing. I have since read that follicular lymphoma is unreliable to diagnose with a fine needle biopsy. Is this still true or is this old statistical data (I read several research papers from the late 1990s)? Also, even if there wasn't a definitive diagnosis, would they have seen something suspicious or worth further investigation if follicular lymphoma was a possibility?

Thanks for your time. I greatly appreciate it.

Answer
Hello Ryan:

If there was the slightest suspicion of Lymphoma further investigation would be done to confirm the type of lymphoma. FNA generally helps arrive at the diagnosis of lymphoma. However to further classify the type of lymphoma a biopsy (excision  of the lymph node) is required.

The FNA interpretation is based on what material is aspirated and seen on the slides. If clinically there is a suspicion of lymphoma the doctor will go ahead and do an excision biopsy