Grading Follicular Lymphoma on Fine Needle Aspiration Specimens: Comparison with Proliferative Index by DNA Image Analysis and Ki-67 Labeling Index

Wei Sun, Nancy P. Caraway, Hua Zhong Zhang, Abha Khanna, Linda G. Payne, Ruth L. Katz

Research output: Contribution to journalArticle

31 Scopus citations


OBJECTIVE: To determine whether follicular lymphoma (FL) can be graded on fine needle aspiration (FNA) biopsies by determining the percentage of centroblasts in the neoplastic follicles on the smears. STUDY DESIGN: Eighty-nine cases of histologically confirmed cases of FL, including 31 grade 1, 46 grade 2 and 12 grade 3, were evaluated. Proliferative index (PI) by DNA image analysis (DIA) and Ki-67 labeling index (LI) were obtained on all cases. A minimum of 200 cells were counted per case (range, 200-800 cells) at 40× magnification, and the number of large cells (centroblasts) was expressed as a percentage of the total number of cells counted within the follicles. RESULTS: The percentage of centroblasts in the follicular aggregates was 9.7± 2.9% in grade 1 FLs, 24.7±5.6% in grade 2 and 48.4 ± 7.5% in grade 3. These differences were significant (P <.05). DNA image analysis of PI and Ki-67 LI differed significantly between grade 1 FLs and grade 2 and 3 FLs (P<.05), but there were no significant differences between grade 2 and 3 FLs. CONCLUSION: Determining the percentage of centroblasts in the follicular aggregates on FNA specimens is a good method of grading FLs. Using the percentage of centroblasts per follicular structure, FL grades 1, 2 and 3 were adequately distinguished. PI by DIA and Ki-67 LI clearly distinguished FL grade 1 from FL grades 2 and 3; however, it did not clearly distinguish between grades 2 and 3.

Original languageEnglish (US)
Pages (from-to)119-126
Number of pages8
JournalActa Cytologica
Issue number2
StatePublished - Jan 1 2004



  • Aspiration biopsy
  • Computer assisted
  • Follicular
  • Image analysis
  • Ki-67 antigen
  • Lymphoma
  • Proliferative index

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

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