Pleural, Pericardial, and Peritoneal Fluids

Cibas, Edmund S.

doi:10.1016/b978-1-4160-5329-3.00004-9

Cited by 20 publications

(47 citation statements)

References 51 publications

(58 reference statements)

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“…24 True splenic cysts will have definite epithelial lining and will be positive for cytokeratin, while the cells lining a mesothelial cyst will be positive for mesothelial cell markers such as Wilms tumor 1 (WT-1) and calretinin. 26 To exclude a hydatid cyst in a patient with a cystic splenic mass, a serologic test for Echinococcus should be performed. If removed, the cyst will consist of 3 layers (innermost germinal layer, intermediate laminated membrane, and outer fibrous layer) and contain protoscolices (attached or separated) with a double row of refractile, birefringent, acid-fast hooklets 22 to 40 lm in size and 4 round suckers that comprise the ''hydatid sand.''…”

Section: Differential Diagnosismentioning

confidence: 99%

Splenic Lymphangioma

Ioannidis

Kahn

2015

Archives of Pathology &Amp; Laboratory Medicine

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Splenic lymphangioma is a rare malformation of the splenic lymphatic channels, mostly seen in children. It is characterized by the presence of cysts, resulting from increases in the size and number of thin-walled lymphatic vessels that are abnormally interconnected and dilated. The condition may be restricted to the spleen, but in most cases it involves multiple organs (systemic lymphangiomatosis). The clinical picture is variable; small lesions are often incidentally detected through imaging studies, while larger lesions can result in compression of organs, causing pain or rupture even after minor trauma. Therefore, splenic lymphangiomas should be considered in the differential diagnosis of splenomegaly or left upper quadrant pain even among adults and should be immediately treated with splenectomy; delay in the therapeutic intervention can lead to life-threatening complications.

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Section: Differential Diagnosismentioning

confidence: 99%

Splenic Lymphangioma

Ioannidis

Kahn

2015

Archives of Pathology &Amp; Laboratory Medicine

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“…As with cytopathological evaluation in general, the presence of mitotic figures should not lead to a false interpretation of malignancy. [1415] Recently, benign mesothelial proliferative conditions are increasingly reported, because benign mesothelial conditions are occasionally difficult to distinguish from malignant cells[16] due to their severe nuclear changes, including enlargement and irregularity of nuclei with coarse chromatin and conspicuous nucleoli and the presence of mitotic figures. Clinical data with respect to such diseases as anemia, cirrhosis, systemic lupus erythematosus, pulmonary infarction, renal failure, and AIDS can help interpretation of these conditions; however, in many cases, especially outpatients, clinical data is not easily available.…”

Section: Discussionmentioning

confidence: 99%

Proliferative index using Ki-67 index in reactive mesothelial versus metastatic adenocarcinoma cells in serous fluid

et al. 2012

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Background:The cytological diagnoses of serous effusions are usually made by routine cytomorphology with certainty. However, overlapping cases sometimes exist between reactive mesothelial and adenocarcinoma cells. We tried to evaluate the diagnostic utility of proliferative index using a Ki-67 monoclonal antibody in distinguishing between reactive mesothelial cells and adenocarcinoma in serous effusions.Materials and Methods:Paraffin blocks and H and E stained slides of peritoneal and pleural fluid cell blocks were retrieved from cytology archive of Alzahra Hospital, Medical University of Isfahan, between 2006 and 2010, from among 1025 slides which were screened to ascertain their appropriate diagnoses. Among of these 80 paraffin-embedded cell blocks, 40 cases for each reactive and adenocarcinoma groups were selected. The proliferative index was calculated by using the Ki 67 monoclonal antibody against nuclear proteins.Results:The mean ages of the patients in the reactive mesothelial and adenocarcinoma groups were 60.58 and 58.45 years, respectively. The gender distribution for the malignant group included 23 cases (%57.5) of females and 17 cases (42.5%) of males. This ratio for reactive group included 14 cases (35%) and 26 cases (65%). The mean of Ki-67 index in adenocarcinomatous cells was 17.15 (SD=15.11) and in reactive mesothelial cells was 3.58 (SD= 3.59) (P=0.001). We consider to using the proliferative marker of Ki-67 on benign and malignant lesions revealed 12% as cut off level. The means of Ki-67 index according to serousal spaces were included: Pleura: 10.56 (SD= 13.06) and peritoneum: 10.03 (SD= 12.78), (P=0.9).Conclusion:Ki-67 index is useful immunostaining panel for differentiation of mesothelial and adenocarcinoma cells in malignancy like ovarian carcinoma that sometimes mimics mesothelial morphology.

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“…9 Massive karyorrhexis in lymphocytic fluids usually suggests lymphoma, particularly high-grade, or previously treated lymphoma. 3,4,6,8,10 Even though karyorrhexis is a well-known phenomenon in lymphoma effusions, its clinical and cytological significance in lymphocytic-rich effusions was not studied in details in the literature. We attempted to investigate the prevalence and importance of this phenomenon in lymphocytic serous effusion fluids in our institution using TP liquid-based cytology.…”

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confidence: 99%

“…3,4,6,7 One such presentation is nuclear abnormality manifested as single lymphoid cell necrosis, which results from nonspecific breakdown of DNA and eventually results in nuclear fragmentation. 3,4,6,8 This is called karyorrhexis, which is a well-known feature of highgrade non-Hodgkin lymphomas and certain small round cell tumors (SRCT), for example small cell carcinoma and neuroblastoma. 9 Massive karyorrhexis in lymphocytic fluids usually suggests lymphoma, particularly high-grade, or previously treated lymphoma.…”

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The prevalence and importance of karyorrhexis in lymphocytic effusions

AbdullGaffar

2010

Diagnostic Cytopathology

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One of the merits of ThinPrep 1 (TP) liquid-based preparation in nongynecology cytology is the clarity of the cytomorphology of the nuclear details as well as a clear background upon which nuclear debris, for example, karyorrhexis can be easily noticed and evaluated. This is achieved by reducing the presence of obscuring hemorrhage in the background, and by virtue of the rapid fixation that allows clear viewing of the cellular details. 1,2 Serous effusion is a wellknown complication of lymphomas. 3-5 A conspicuous feature of lymphoid neoplasms in serous effusions is that they frequently demonstrate necrosis. 3,4,6,7 One such presentation is nuclear abnormality manifested as single lymphoid cell necrosis, which results from nonspecific breakdown of DNA and eventually results in nuclear fragmentation. 3,4,6,8 This is called karyorrhexis, which is a well-known feature of highgrade non-Hodgkin lymphomas and certain small round cell tumors (SRCT), for example small cell carcinoma and neuroblastoma. 9 Massive karyorrhexis in lymphocytic fluids usually suggests lymphoma, particularly high-grade, or previously treated lymphoma. 3,4,6,8,10 Even though karyorrhexis is a well-known phenomenon in lymphoma effusions, its clinical and cytological significance in lymphocytic-rich effusions was not studied in details in the literature. We attempted to investigate the prevalence and importance of this phenomenon in lymphocytic serous effusion fluids in our institution using TP liquid-based cytology.We conducted a retrospective study over a 3-year period to investigate the prevalence of karyorrhexis in lymphoid-rich serous effusions. A computer-based search system was used to retrieve all pleural, pericardial, and peritoneal effusion fluids from October 2006 to September 2009. Effusions with lymphocytic-rich fluids were selected. We also included metastatic carcinomas, SRCTs, and mesotheliomas effusions for comparison. The TP slides were retrieved and scanned for the presence of karyorrhexis. The cases were stratified according to the presence or absence of karyorrhexis and according to the primary cytological diagnosis. Rough estimation of the amount of karyorrhexis was based on the number of karyorrhectic bodies in an area of one high-power field (HPF). One to two karyorrhectic bodies were used for minimal karyorrhexis, 3 to 10 for moderate, 11 to 19 for marked, and more than 20 karyorrhectic bodies per one HPF were used for massive karyorrhexis. For the effusions that were involved by lymphomas, the clinical data, the confirmed histological and immunohistochemical diagnosis of the primary site lymphoma, and the bone marrow status for each case were collected.The study covered 197 cases of lymphocytic effusions. They included 144 pleural fluids, 50 peritoneal fluids, and 3 pericardial fluids. Of these, 11 (5.6%) cases showed lymphoid-rich effusions with karyorrhexis. These cases were involved by high-grade lymphomas (Table I). Seven were diffuse large B-cell lymphomas (DLBCL), one Burkitt lymphoma (BL), one T-cell lymphoma, one ...

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Pleural, Pericardial, and Peritoneal Fluids

Cited by 20 publications

References 51 publications

Splenic Lymphangioma

Splenic Lymphangioma

Proliferative index using Ki-67 index in reactive mesothelial versus metastatic adenocarcinoma cells in serous fluid

The prevalence and importance of karyorrhexis in lymphocytic effusions

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