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Background: The optimal management of patients with follicular lymphoma Grade 3 (FLG3) is controversial., Patients and Methods: This is a case series of 45 patients with FLG3 treated with first-line R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) and observed for an extended time interval., Results: The overall response rate was 100% and the median progression-free survival (PFS) has not been reached, with a 3-year PFS of 70%; 14 (31%) patients relapsed, nearly all within 3 years. The baseline characteristic more strongly associated with a shorter PFS were lymph >4 node sites and presence of B symptoms. Three patients later progressed to diffuse large B cell lymphoma, all had baseline elevated serum lactate dehydrogenase level and high International Prognostic Index score. Median overall survival has not been reached. All 4 patients who later developed acute myeloid leukemia were older than 60 years at the time of start of therapy., Conclusion: R-CHOP is an effective first-line treatment for patients with FLG3, and might provide extended PFS, comparable with outcomes observed in diffuse large B-cell lymphoma, particularly in subgroups with limited nodal disease., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Introduction: The aim of this study was to evaluate the diagnostic accuracy of salivary gland fine-needle aspiration (FNA) in comparison to histologic examination and to recognize possible pitfalls in diagnosis., Materials and Methods: The diagnoses and demographics of all cases of salivary gland FNAs with concurrent or subsequent histologic correlation at our institution over a 6-year period (2006-2011) were retrospectively reviewed and compared for discrepancies. Discrepancies were categorized as either major or minor and due to sampling or interpretive variance., Results: Overall, the following values were calculated: sensitivity 80.6%, specificity 97.5%, positive predictive value 92.6%, negative predictive value 92.8%, accuracy 92.7%, and concordance rate 90.9%. In addition, concordance rates were calculated for the 2 most common diagnoses: pleomorphic adenoma (97.1%, n = 35) and Warthin tumor (88.9%, n = 9). Five major and 5 minor discrepancies were found. Most of the major discrepancies and all of the minor discrepancies were due to sampling and interpretive variances, respectively. Sampling issues occurred in FNAs with and without ultrasound guidance. The interpretive variance included interpretative discrepancies in monomorphic cellular lesions, abundant inflammation and reactive atypia, cystic changes, abundant matrix deposition or fibrosis, and difficulty in diagnosing mucoepidermoid carcinoma or lymphoma on cytology., Conclusions: FNA of salivary gland lesions is a procedure with high specificity, positive predictive value, negative predictive value, accuracy, and concordance with histologic examination; however, discrepancies do exist. Recognizing potential pitfalls is key to avoiding discrepancies., (Copyright © 2015 American Society of Cytopathology. Published by Elsevier Inc. All rights reserved.)