Sources of discrepancies in the diagnosis of Hodgkin's disease by fine needle aspiration.

The aim of this study was to assess the value of Fine Needle Aspiration (FNA) Cytology in the diagnosis of Hodgkin's Disease (HD) and to identify the sources and nature of the inaccuracies related to this procedure. We retrospectively studied all cases cytologically diagnosed in our laboratory as HD during a five year period (1990-1994). We also traced cases in which FNA cytology failed to reveal HD and where a subsequent HD diagnosis was made by histology. Of the 99 cases studied, a histological report was available for 93. In 82 cases FNA was carried out as part of the initial evaluation. In the remaining 17 cases the diagnosis of HD was known and FNA was performed in order to confirm or exclude a relapse. The results included 4 false positive for HD, 5 false negative and 3 HD-suspicious cases (only one of which proved histologically to be HD while the remaining two were other neoplasms). The re-evaluation of the last 12 cases identified 3 different sources of error: a) Material adequacy criteria; b) Sampling techniques; c) Interpretation.