Efficacy of cell block immunocytochemistry in the diagnostic workup of non hodgkin lymphoma-experience from a tertiary care hospital in North India

The WHO 2016 update on lymphoid neoplasms incorporates criteria independent of tissue architecture in the diagnosis and sub-classification of non-Hodgkin lymphoma. Thus, lymphoid neoplasms with characteristic immunophenotypes and/or cytomorphology could be classified with FNA material with appropriate use of ancillary methods. We analysed the efficacy of cytomorphology and cell block immunocytochemistry (CB-ICC) in in diagnostic workup of non-Hodgkin lymphoma diagnosis on FNA material. 65 clinically suspected cases of lymphoma presenting with lymphnode enlargements were analysed. FNAC and CB-ICC were performed and compared with the subsequent biopsy. The sensitivity, specificity, PPV and NPV of CBICC in the diagnosis of NHL were 84.6%, 75%, 95.6%, and 42.8%, respectively in our study. We also observed that use of CB-ICC can have significant logistic implications in patient management in terms of reducing the turn-around time to diagnosis and improving the accuracy in diagnosis on FNAC. ICC on cell blocks can easily be done on FNA material and is a very useful adjunct to FNAC in establishing the diagnosis in a suspected case of NHL especially when a biopsy is not available.