Precursor T‐lymphoblastic lymphoma: Speedy diagnosis in FNA and effusion cytology by morphology, immunochemistry, and flow cytometry

Abstract

BACKGROUND: Precursor T-lymphoblastic lymphoma (T-LBL) is a rare lymphoma presenting clinically in children and adolescents with a rapidly enlarging mediastinal mass, dyspnea, and cervical lymphadenopathy requiring quick diagnosis.The objective of the current study was to report on the spectrum of cytomorphology and flow cytometric immunopheno-

Flow Cytometry and Effusions in Lymphoproliferative Processes and Other Hematologic Neoplasias

“…Lymphoma/leukemia was reported to be the most frequent cause of malignant effusions in children [3,10,15]. In a study of children younger than 18 years with 226 cases of pleural, peritoneal, and pericardial effusions, 88 (39%) patients were positive or suspicious of malignancy, and among these lymphoma/leukemia was found to be the most frequent cause (52%) of malignant effusions.…”

“…The microscopically atypical lymphocytes should be examined by FC in order to differentiate reactive from neoplastic changes. If the fluid tap was performed in the context of an emergency clinical presentation for symptomatic relief (in adults or in children) and the sample contains an obviously malignant hematologic neoplasia, FC is indispensable since it may be rapidly indicative of lymphoma and it may lead to prompt employment of the proper treatment as shown by Bhaker et al [10] for pediatric patients with a precursor T-lymphoblastic lymphoma.…”

“…Effusions are common in BL patients and occur in up to 60% of pleural fluids and 90% of asctitic fluids in sporadic BL [26]. FC, with its short turnover time, offers a preferable method for the rapid diagnosis of lymphoma types that may present with dramatic symptoms, such as BL or ALL [10,26]. The typical cytomorphology combined with an immunophenotype disclosing a light chain restriction, and CD19+, CD20+, CD10+, in the context of a nearly 100% proliferation index as measured by the Ki67 stain is strongly suggestive of a BL diagnosis and should be confirmed by the presence of rearrangement of the c-myc gene by further testing (FISH).…”

Lymphomas in childhood

“…Bölgesel lenf düğümü tutulumlu tek bir tümör (ekstranodal) Diyaframın aynı tarafında bulunan 2 ya da daha fazla lenf düğümü bölgesi Diyaframın aynı tarafında bölgesel lenf düğümü tutulumu bulunan ya da bulunmayan 2 adet tek (ekstra-nodal) tümör Genellikle ileoçekal bölgede, sadece mezenterik lenf dü-ğümü tutulumu bulunan ya da bulunmayan, gross total olarak çıkartılmış primer sindirim sistemi tümörü Diyaframın her iki tarafında bulunan 2 adet tek (ekstranodal) tümör Diyaframın üzerinde ve altında 2 ya da daha fazla lenf düğümü bölgesi Bütün primer toraks tümörleri (mediastinal, plevral, timik) Bütün geniş çaplı primer karın içi hastalıkları Diğer tümör bölgelerine bakılmaksızın bütün paraspinal ve epidural tümörler Başlangıç merkezi sinir sistemi ve/veya kemik iliği tutulumu ile yukarıdakilerden herhangi biri gularda invazif cerrahilerden kaçınmak, sağaltımın erken başlamasına olanak verecektir (24) . Olguların bir kısmında abdominal, retroperitoneal veya mediasten yerleşimli kitlelerin histopatolojik tanısı için cerrahi kaçınılmaz olmaktadır.…”

Initial Diagnostic Workup of Acute Leukemia: Guideline From the College of American Pathologists and the American Society of Hematology

“…280 Fresh specimens, either fine-needle aspirate, excisional biopsy, or body-effusion fluids, are adequate for leukemia workup. 267,[281][282][283][284][285][286] Similar to the analysis for BM and PB samples, the workup includes morphologic examination, FCI, and cytogenetic and molecular studies. In patients with suspected CNS leukemia, 287 a CSF sample may be obtained.…”