Chest wall lymphomas: Fine needle aspiration cytodiagnosis and review of the literature

Cytopathology. 2017 Oct;28(5):364-370. doi: 10.1111/cyt.12433. Epub 2017 Jul 21.

Abstract

Objective: Compared to other chest wall malignancies, lymphoma is a common disease. However, published literature on a series of lymphoma cases involving the chest wall is scarce. The aim of the present study, was to describe experience with chest wall swellings diagnosed as lymphoid neoplasms on fine needle aspiration (FNA) cytology.

Methods: Eleven chest wall swellings were diagnosed as lymphoid neoplasms on FNA over a period of 15 years (January 2000-December 2014). The age of patients ranged from 19 to 73 years (median, 46). The male-to -emale ratio was 7:4. Ten cases had an anterior or lateral chest wall mass, and one swelling was in the scapular region. Six cases had concurrent lymphadenopathy, and one had bone involvement. The FNA smears were reviewed and classified under WHO Classification of Hematopoietic Neoplasms. The histopathological diagnoses were available in eight cases.

Results: The preliminary cytodiagnoses in 11 cases of chest wall lymphoid neoplasms were anaplastic large cell lymphoma (ALCL) in two cases, and ALCL/malignant melanoma, ALCL/T-cell-rich-B-cell lymphoma (TCRBCL)/Hodgkin's lymphoma (HL), plasmacytoma/neuroendocrine carcinoma, Hodgkin's lymphoma, small cell NHL/CLL, NHL, suggestive of NHL, post-transplant peripheral T-cell lymphoma (PTCL), and a malignant plasma cell tumour in one case each. The reviewed cytodiagnoses of lymphoid neoplasms were as follows: ALCL ( five cases), centroblastic lymphoma (two cases), and small cell lymphoma/CLL, post-transplant peripheral T-cell lymphoma, Hodgkin's lymphoma and plasmacytoma (one case each). Histopathological diagnoses available in eight cases confirmed the presence of lymphoid neoplasms.

Conclusion: A variety of lymphoid neoplasms involved the chest wall, and among them, ALCL was a common form.

Keywords: Hodgkin's lymphoma; chest wall; fine needle aspiration cytology; non-Hodgkin's lymphoma.

MeSH terms

  • Adult
  • Aged
  • Biopsy, Fine-Needle*
  • Cytodiagnosis*
  • Diagnosis, Differential*
  • Female
  • Hodgkin Disease / diagnosis
  • Hodgkin Disease / pathology
  • Humans
  • Lymphoma / classification
  • Lymphoma / diagnosis*
  • Lymphoma / pathology
  • Lymphoma, Large B-Cell, Diffuse / diagnosis
  • Lymphoma, Large B-Cell, Diffuse / pathology
  • Lymphoma, Large-Cell, Anaplastic / diagnosis
  • Lymphoma, Large-Cell, Anaplastic / pathology
  • Male
  • Melanoma / diagnosis
  • Melanoma / pathology
  • Middle Aged
  • Thoracic Wall / pathology
  • Young Adult