What is the role of excisional lymph node biopsy in the workup of lymphoblastic lymphoma?

Updated: Sep 10, 2019
  • Author: Joseph M Tuscano, MD; Chief Editor: Emmanuel C Besa, MD  more...
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The diagnosis of lymphoblastic lymphoma is based on excisional lymph node biopsy. Fine-needle aspirate (FNA) or core-needle biopsy usually provides inadequate tissue for diagnosis.

Note that diagnosis of any lymphoma requires an excisional biopsy to preserve the architecture of the lymph node. An FNA biopsy disrupts the natural lymph node structure and often alters the appearance, resulting in an incorrect diagnosis (eg, carcinoma).

Immunophenotyping of the lymphoblastic lymphoma specimen is nearly always positive for terminal deoxynucleotidyl transferase (TdT), whereas small noncleaved cell lymphoma is negative for TdT.

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