Ultrasound-guided fine needle aspiration can greatly improve the quality of flow cytometry specimens, thereby improving the sensitivity and accuracy of relapsed and refractory diffuse large B-cell lymphoma (DLBCL) diagnosis. This is according to a new study published in the European Journal of Radiology

“This method is particularly suitable for [flow cytometry] evaluation of extranodal lesions, lesions that are adjacent to important organs, large in size, and difficult to remove,” the study authors wrote.

Flow cytometry plays a vital role in the diagnosis of relapsed and refractory lymphoma and to guide targeted chemotherapy and cellular immunotherapy. 

Read more about the diagnosis of diffuse large B-cell lymphoma

Here, a team of researchers from China wanted to assess whether ultrasound-guided fine needle aspiration could improve the quality of the flow cytometry specimens.

The team analyzed 20 patients with relapsed and refractory DLBCL who received standard treatment. Both fine needle aspiration and core needle biopsy were used for ultrasound-guided puncture.

Pathology confirmed a diagnosis of DLBCL in 19 cases, while 1 case was diagnosed as inflammatory granuloma.

The researchers reported that among the specimens obtained by core needle biopsy, 14 cases had abnormal mature B cells, while 5 cases were missed. When the specimens obtained by fine needle aspiration were used, 18 cases showed abnormal mature B cells, and only 1 case was missed. 

The sensitivity of flow cytometry with core needle biopsy was 73.68 %, while with fine needle aspiration, it was 94.73%. This difference was statistically significant. 

Similarly, the accuracy of flow cytometry with fine needle aspiration was superior to that with core needle biopsy at 97.14% vs 75%. 

The specificity of both approaches was 100%, with no misdiagnosed cases with either approach.  

The researchers concluded that fine needle aspiration “is of great value” to improve the quality of flow cytometry specimens for the rapid and correct diagnosis of relapsed and refractory DLBCL.


Feng SM, Tan S, Yao XY, et al. The value of ultrasound-guided fine needle aspiration in the diagnosis of diffuse large B-cell lymphoma: a single center experiment. Eur J Radiol. Published online October 19, 2022. doi:10.1016/j.ejrad.2022.110567