This study retrospectively reviewed the findings in laparoscopic biopsy specimens from 51 consecutive patients with suspected abdominal lymphoproliferative disorders. Histologic evaluation was supplemented (as necessary) by paraffin-section or frozen-section immunohistochemical analysis or by Southern blot hybridization. The laparoscopic procedure was diagnostic of a lymphoproliferative disorder in 24 patients (47%), of other neoplasms in 5 patients (10%), and of reactive tissue in 11 patients (22%); no tissue could be obtained for technical reasons (adhesions and inaccessible lesions) in 11 patients (22%). The 24 patients with lymphoproliferative disorders diagnosed by laparoscopic techniques included 14 patients with a new diagnosis of lymphoma and 10 patients with recurrent disease; pathologic findings were diagnostic of diffuse large cell lymphoma (11 patients), follicular lymphoma (11 patients), chronic lymphocytic leukemia (1 patient), and lymphocyte-predominant Hodgkin's disease (1 patient). Previous abdominal cytologic or core-needle biopsy specimens from 11 lymphoma patients did not yield an unequivocal diagnosis or subtype of lymphoma. The 11 patients (22%) in whom laparoscopic techniques did not produce a tissue sample needed laparotomy (10 patients) or femoral lymph node biopsy (1 patient) to document the diagnosis of large cell lymphoma (2 patients), follicular lymphoma (5 patients), composite lymphoma (1 patient), myeloma (1 patient), neurofibroma (1 patient), and reactive lymph nodes (1 patient). In the majority of patients with suspected abdominal lymphoma, laparoscopic techniques provide sufficient tissue for the diagnosis and classification of lymphoma and for the diagnosis of other causes of abdominal lymphadenopathy.