Pleural fluid cytology of Hodgkin's disease: Cytomorphologic features and the value of immunohistochemical studies

Olson, Peter; Silverman, Jan F.; Powers, Celeste N.

doi:10.1002/(sici)1097-0339(200001)22:1<21::aid-dc6>3.0.co;2-s

Cited by 18 publications

(10 citation statements)

References 26 publications

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“…There are only a few reports in the literature documenting involvement of effusion fluids by HL 18 . Hunter et al, in their study found pleural effusions in 24% patients with HL.…”

Section: Discussionmentioning

confidence: 96%

Lymphoreticular malignancies in serous effusions: Cytomorphologic, flow cytometric and immunocytochemical analysis

Gupta

Pandey

Gautam

et al. 2021

Diagnostic Cytopathology

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Introduction Involvement of body fluids by lymphoreticular malignancies (LRM) is rare and often associated with poor prognosis and decreased overall survival. The present study was conducted to analyze the characteristic cytomorphologic, flow cytometric and immunocytochemical features of LRMs in serous effusions. Materials and methods This was a three‐year retrospective study. A total of 218 effusion samples, reported as involved by lymphoreticular malignancies, on cytology, were reviewed. All the cases wherein the cytological diagnosis was confirmed by flow cytometric (FCM) and/or immunocytochemical (ICC) studies were retrieved and studied in detail. FCM and/or ICC were performed in a total of 51/218(23.4%) samples, including 30 pleural (58.8%), 18 peritoneal (35.3%), and 3 pericardial fluid (5.9%) samples. Results The cytomorphologic diagnoses included infiltration by non‐Hodgkin lymphoma (NHL;n = 27), infiltration by LRM (n = 19), infiltration by chronic lymphocytic leukemia (CLL;n = 2), Hodgkin's lymphoma (HL;n = 1) and suggestive of infiltration by LRM (n = 2). FCM and/or ICC confirmed the diagnoses as infiltration by T‐cell lymphoblastic lymphoma in 18; mature B‐cell NHL in 10; Burkitt lymphoma in 7; diffuse large B‐cell lymphoma in 4; follicular lymphoma, T‐ cell NHL and CLL in 2 samples each and hairy cell leukemia, plasmablastic lymphoma and HL in 1 sample each. 94.1% concordance was noted between the initial and final cytologic diagnosis. Conclusions Involvement of body fluids and effusions by LRMs, though rare, carries an immense prognostic significance and hence the prompt detection is crucial. Detection of these malignancies by cytologic examination of effusions is challenging yet potentially useful and the least invasive method available to establish an early diagnosis.

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“…There are only a few reports in the literature documenting involvement of effusion fluids by HL 18 . Hunter et al, in their study found pleural effusions in 24% patients with HL.…”

Section: Discussionmentioning

confidence: 96%

Lymphoreticular malignancies in serous effusions: Cytomorphologic, flow cytometric and immunocytochemical analysis

Gupta

Pandey

Gautam

et al. 2021

Diagnostic Cytopathology

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“…There were no cases of Hodgkin lymphoma in our series, though an occasional example is rarely cited. [ 24 ]…”

Section: Discussionmentioning

confidence: 99%

Preliminary cytomorphologic diagnosis of hematolymphoid malignancies in effusions: A cyto-histo correlation with lessons on restraint

Patel¹,

Gochhait²,

Jinkala³

et al. 2022

J Cytol

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Background: Effusions as part of hematologic neoplasms are rare and as a primary presentation, rarer. In standalone laboratories of developing countries, resorting to techniques such as flow cytometry or immunohisto/cytochemistry may not be possible. A near definitive diagnosis on cytomorphology would, therefore, be an ideal beginning. To that end, we compiled our cases of primary hematolymphoid effusions, devising reproducible reporting categories and looked at their concordance with the final histopathology. Subjects and Methods: Fifty-four cases of primary hematolymphoid effusions over 10 years with cytology-histopathology correlation were chosen. Post morphology assessment, the cases were organized into six categories: suspicious of hematolymphoid malignancy, non-Hodgkin lymphoma-high-grade (NHL-HG), low-grade NHL (NHL-LG), Burkitt lymphoma, acute leukemias, and plasma cell dyscrasias. Discordance with histology was assigned as major and minor based mainly on therapeutic implications. Results: Concordance was seen in a good number (81.5%) of cases. The NHL-HG and NHL-LG categories contributed to 33.3% each of major discordance. Tuberculosis and epithelial malignancies comprised the bulk of the major discordance. Overdiagnosis of a high-grade lymphoma for a histologically proven low-grade follicular lymphoma was the only case with minor discordance. Conclusion: The cytologic categories used are not foolproof for hematologic neoplasms but have a fairly good concordance. A scanty abnormal population should always be viewed with suspicion and definitive labels should be avoided. While morphologic examination is fraught with danger, a good assessment directs the judicious selection of ancillary methods, and hence cannot be supplanted.

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“…2,7 Pleural and pericardial effusions are commonly involved, predominantly due to mediastinal nodular sclerosistype cHL, while peritoneal involvement is rare. [5][6][7][8][9][10] The cytologic diagnostic hallmarks are RSH cells usually with a mixed population of inflammatory cells. They may morphologically overlap with large anaplastic cells of certain non-Hodgkin lymphomas, non-lymphoid malignancies with isolated large cells, and with atypical mesothelial cells.…”

Section: Discussionmentioning

confidence: 99%

Cytologic manifestations of Hodgkin lymphoma in serous effusions

AbdullGaffar

Raman

2022

Diagnostic Cytopathology

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Serous effusions occur in a small group of patients with classic Hodgkin lymphoma (cHL). Most effusions are benign inflammatory fluids. Malignant effusions predominantly in patients with treated relapsed diseases or rarely as a primary manifestation are diagnostically challenging to cytopathologists. Established cases of cHL with effusions were retrieved. Cytology slides were screened looking for Reed-Sternberg-Hodgkin (RSH) cells and patterns of background inflammatory cells. Cellblocks and their corresponding immunocytochemistry (ICC) slides were examined. The cytologic findings were correlated with nodal biopsy histopathologic and immunohistochemical features. We found six cases of benign and malignant pleural and pericardial effusions in patients with mediastinal nodular sclerosis-type cHL. Various cytomorphologic patterns were observed. Slides revealed sparsely scattered either isolated or aggregated mononuclear, binucleated and multinucleated RSH-like cells. Some may have been either disregarded as reactive mesothelial or histiocytic cells, or confused with other RSH-like malignant cells. The background varied between characteristic mixed inflammatory milieu, predominantly small lymphocytic or lymphohistiocytic with or without reactive mesothelial cells. Cytologic examination showed three positive cases (two cases with RSH cells confirmed by cellblock section ICC, one case with a mixed inflammatory infiltrate), and three benign effusions (one case with atypical RSH-like reactive mesothelial cells confirmed by ICC). Effusions associated with cHL exhibit different cytologic patterns. A high level of vigilance with utility of ICC has an important role in suspecting primary cases and confirming recurrences in known cases. The various cytologic patterns of cHL-associated benign and malignant effusions might reflect parallel pathophysiologic mechanisms.

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Pleural fluid cytology of Hodgkin's disease: Cytomorphologic features and the value of immunohistochemical studies

Cited by 18 publications

References 26 publications

Lymphoreticular malignancies in serous effusions: Cytomorphologic, flow cytometric and immunocytochemical analysis

Lymphoreticular malignancies in serous effusions: Cytomorphologic, flow cytometric and immunocytochemical analysis

Preliminary cytomorphologic diagnosis of hematolymphoid malignancies in effusions: A cyto-histo correlation with lessons on restraint

Cytologic manifestations of Hodgkin lymphoma in serous effusions

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