Cytological diagnosis of lymphoma in serous effusions.

Spriggs, A I; Vanhegan, R I

doi:10.1136/jcp.34.12.1311

Cited by 41 publications

(26 citation statements)

References 20 publications

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“…73 In excellent images of the cardiac base. In a comparison study, TEE was superior to TTE in evaluating the parts the current review, a diagnostic cytologic sample was obtained in only 67% of PCL patients with clinically of the heart in which PCL frequently was reported.…”

Section: Discussionmentioning

confidence: 97%

Primary cardiac lymphoma in immunocompetent patients

Ceresoli

Ferreri

Bucci

et al. 1997

Cancer

259

308

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The diagnosis of PCL should be considered in patients with a cardiac mass and/or unexplained refractory pericardial effusion. Adequate diagnostic workup, including TEE and MRI, allows confirmation of the early suspicion of PCL. In the absence of a diagnostic cytology, an open biopsy may be indicated to avoid treatment delay. There is no evidence that PCL should be treated differently from other bulky aggressive lymphomas arising at other anatomic sites.

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Section: Discussionmentioning

confidence: 97%

Primary cardiac lymphoma in immunocompetent patients

Ceresoli

Ferreri

Bucci

et al. 1997

Cancer

259

308

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“…The cytomorphology in effusion correlated with that in FNA smears in 13 out of 14 cases, the lone exception being the Burkitt-type lymphoma, in which the cells in effusion were larger and more pleomorphic. Although Spriggs and Vanhegan 57 did not claim that the type of lymphoma be readily diagnosed from cytology of pleural or peritoneal fluid, according to them, an opinion could be provided to the grade (high or low) and in some cases it was also possible to give an indication of the cell type involved. According to Naylor, 2 in reality, not being able to type lymphoma or leukemic cells precisely in serous effusions is rarely a disadvantage, because virtually all Figure 1A (CD-20, 31,000).…”

Section: Cytodiagnosis Of Lymphoma Subtypesmentioning

confidence: 98%

Serous effusions in malignant lymphomas: A review

Das

2006

Diagnostic Cytopathology

206

237

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Serous effusions are a common complication of lymphomas. Although the frequency of pleural effusion is 20-30% in non-Hodgkin's lymphoma (NHL) and Hodgkin's disease (HD), the involvement of peritoneal and pericardial cavities is uncommon. Among lymphoma subtypes, T-cell neoplasms, especially the lymphoblastic lymphomas, more frequently involve the serous fluids. The thoracic duct obstruction and impaired lymphatic drainage appear to be the primary mechanism for pathogenesis of pleural effusion in HD and direct pleural infiltration is the predominant cause in NHL. There is wide variation in rate of positive cytologic findings of NHL in pleural effusion (22.2-94.1%). Cytologic features of specific lymphoma subtypes such as lymphoblastic lymphoma, follicular center cell lymphoma, including Burkitt-type lymphoma, marginal zone lymphoma, MALT lymphoma, and anaplastic large-cell lymphoma, etc., have been described in the literature. The differential diagnostic problems of lymphomas in serous effusions include reactive lymphocytoses, early involvement by lymphomatous process, small round-cell tumors (SRCT), and presence of look-alike of Reed-Sternberg cells. To overcome these difficulties, various ancillary studies, including immunocytochemistry (ICC), morphometry, flow cytometry (FCM), and cytogenetics/molecular genetics (PCR, in-situ hybridization, and Southern blotting), have been performed on effusion specimens. ICC not only distinguishes lymphomas from reactive lymphocytoses and SRCTs, it significantly modifies the morphologic diagnosis to achieve a better classification of lymphomas. Combined morphology and immunophenotyping by FCM, has a sensitivity as well as specificity of 100%. Morphometry also distinguishes reactive lymphocytoses from malignant lymphoma with a high degree of sensitivity (>85%) and specificity (>95%). Limitations of individual ancillary techniques can be overcome by using multiple parameters. Although lymphomas rarely present as serous effusions without the involvement of other thoracic and extrathoracic sites, a small group of lymphomas called primary effusion lymphomas (PEL) exhibit exclusive or dominant involvement of serous cavities, without a detectable solid tumor mass. This body cavity based lymphoma (BCBL) is a distinct clinicopathologic entity and is found predominantly in AIDS patients with preexisting Kaposi sarcoma. In the absence of obstructive or infiltrative tumor mass, its pathogenesis has been attributed to stimulation by vascular endothelial growth factor (VEGF)/vascular permeability factor (VPF), leading to vascular leakage. Cytomorphologically, PEL is usually a large-cell lymphoma, which appears to bridge features of large-cell immunoblastic and anaplastic large-cell lymphoma (ALCL). Most of these cases comprise a unique subgroup of B-cell lymphoma, with features of both high-grade anaplastic and B-immunoblastic lymphoma, but T-cell and/or natural killer cell immunophenotypes are described. Its association with various viral DNAs has been studied in detail by molecular techn...

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“…3 One study claimed that with few exceptions, the cytologic picture well fits the histologic one, so a cytologic report on a lymphoma effusion can reasonably provide an opinion as to the grade (high or low), and in some cases it is also possible to give an indication of the cell type involved. 11 Diagnostic accuracy is dependent largely on discrimination between reactive and malignant lymphoid cells. 1 In recent years, the use of immunocytochemical reactions with polyclonal and monoclonal antibodies has greatly improved the accuracy of cytologic investigations of effusions with lymphomatous infiltration.…”

Section: Discussionmentioning

confidence: 99%