Monomorphic epitheliotropic intestinal T‐cell lymphoma in pleural effusion: A case report

Abstract

Dissemination of lymphomas in serous effusions is quite common. Cytology aims to contribute in the clinical management of haematologic patients, providing an accurate and rapid diagnosis. Ancillary techniques such as immunocytochemistry and flow cytometry are essential to classify the lymphoma entity. Comprehensive awareness of the clinical picture and previous histologic documentation are essential for a lymphomatous effusion diagnosis. We report an unusual case of monomorphic epitheliotropic intestinal T-cell lymphoma, formerly known as enteropathy associated T-cell lymphoma (EATL) type II, spreading in the pleural cavity. Cell morphology and immunohistochemistry of the pleural fluid were consistent with the histology of a jejunal tumor previously excised. Flow cytometry data were consistent, though not pathognomonic for the disease. Serous effusions with evidence of lymphoma involvement should be thoroughly examined with cytology and adjuvant techniques to provide diagnosis for proper therapeutic strategies.

Truth lies below: A case report and literature review of typical appearing polyps yet with an atypical diagnosis

“…Treatment regimens mainly consisted of various chemotherapy regimens with 33% of patients receiving stem cell transplants. Unfortunately, survival after diagnosis was poor and ranged from 5 d to 3 yr despite therapy (Table 1) [9][10][11][12][13][14] .…”

Lymphomatous effusion of monomorphic epitheliotropic intestinal T‐cell lymphoma is characterized by azurophilic granules and is a dismal sign: Report of two new cases with literature review

“…To date in the literature there are only three cases of MEITL with malignant effusion, including one case each in PE and ascites, and a third case involving both cavities 2,8,9 . Herein we present two new cases and review the previously reported cases.…”

“…Table 1 lists the pertinent clinicocytological features of our two cases and the three cases in the literature 2,8,9 . The median age was 63 (range, 47‐76), and four of the five patients were males.…”

“…Lymphomatous effusion is uncommon, occurring in around 10% lymphoma patients 1,2 . The lymphoma types associated with malignant effusion vary in different studies, with T‐lymphoblastic lymphoma, Burkitt lymphoma, and diffuse large B‐cell lymphoma as the more common entities 3,4 …”

“…Cytological diagnosis of MEITL in effusions is challenging as the tumor cells are small/medium‐sized and might be considered as reactive lymphocytes or other low grade lymphomas. Clinical correlation with detailed cytological examination and ancillary studies (including immunocytochemistry, flow cytometric immunophenotyping, and clonality assay) are usually needed for a correct diagnosis 1,2,8‐11 …”