Analysis of Under-Diagnosed Malignancy during Fine Needle Aspiration Cytology of Lymphadenopathies

Fine needle aspiration cytology (FNAC) is a useful tool in the evaluation of lymphadenopathy. It is a safe and minimally invasive procedure that provides preoperative details for subsequent treatment. It can also diagnose the majority of malignant tumors. However, there are some instances where the diagnosis of tumors remains obscure. To address this, we re-analyzed the misinterpreted patients' samples using mRNA sequencing technology and then identified the characteristics of non-Hodgkin's lymphoma that tend to be under-diagnosed. To decipher the involved genes and pathways, we used bioinformatic and biological analysis approaches, identifying the response to oxygen species, inositol phosphate metabolic processes, and peroxisome and PPAR pathways as possibly being involved with this type of tumor. Notably, these analyses identified FOS, ENDOG, and PRKAR2B as hub genes. cBioPortal, a multidimensional cancer genomics database, also confirmed that these genes were associated with lymphoma patients. These results thus point to candidate genes that could be used as biomarkers to minimize the false-negative rate of FNAC diagnosis. We are currently pursuing the development of a gene chip to improve the diagnosis of lymphadenopathy patients with the ultimate goal of improving their prognosis.

Automated summary

Fine needle aspiration cytology (FNAC) is a valuable tool for evaluating lymphadenopathy and diagnosing malignant tumors. However, some tumor diagnoses may still be unclear. In this study, we used mRNA sequencing technology to re-analyze misinterpreted patient samples and identified under-diagnosed characteristics of non-Hodgkin's lymphoma. Through bioinformatic and biological analysis, we identified genes and pathways potentially involved in this type of tumor. FOS, ENDOG, and PRKAR2B were identified as hub genes, and their association with lymphoma was confirmed by the cBioPortal database. These findings suggest the potential use of these candidate genes as biomarkers to improve the accuracy of FNAC diagnosis in lymphadenopathy, ultimately leading to better prognosis for patients.