Lymph node aspiration in the management of Hodgkin's disease

Diagnosing recurrent Hodgkin's disease is an important oncologic problem. When relapse does not occur in peripheral nodal sites, then a major surgical exploration is often considered. Lymph node aspiration is proposed as a less invasive approach capable of establishing a diagnosis in some instances. In this retrospective study, 19 patients with Hodgkin's disease underwent 64 lymph node aspirations. Of these patients, 17 had suspected Hodgkin's disease with involvement at an inaccessible site. Two patients with a primary diagnosis of Hodgkin's disease underwent aspiration of a peripheral site. Of these 19 patients, five (26.3%) had a positive aspirate and only two (10.5%) had an unsatisfactory aspirate. No patient had a false-positive aspirate. Of 15 patients with a negative aspirate, five (33%) had a false-negative aspirate. In no case did a false-negative aspirate delay appropriate therapy. In those patients with a positive aspirate, surgical exploration was avoided. We conclude that lymph node aspiration cytology is useful as an initial step to document clinical relapse of Hodgkin's disease at a site that might require a major surgical procedure for diagnosis.