Cytologic studies of sputum, secretions and serous fluids in malignant lymphoma.

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Hodgkin's disease, lymphosarcoma, reticulum cell sarcoma and follicular lymphoma, constituting a group referred to as the lymphomata, are generally believed to be of neoplastic nature, regardless of varying concepts as to their individual or collective pathogenesis. The frequent involvement of thoracic organs, including the tracheobronchial tree, and serous membranes by these diseases is well established. Since definitive recognition of the group is dependent on cytologic and histopathologic features, it might be hoped that these conditions would lend themselves to diagnosis through cytologic examination of sputum, bronchial secretions and serous fluids, a method that has proved to be of considerable use in recognition of bronchogenic carcinoma. The literature gives small encouragement in this regard. Wandall, in his early report on cytologic studies of sputum, illustrated a case of Hodgkin's disease but did not state whether or not a diagnosis was rendered before histologic material became available. Castro-Mendoza also reported recognition of malignant cells in sputum in Hodgkin's disease, and Florentin and his co-workers reported positive identification of Stemberg-Reed cells in bronchial secretions from a patient who later was proved to have Hodgkin's disease on lymph-node biopsy. Jackson and her associates described a case of lymphosarcoma, apparently primary in the lung, in which exfoliated lymphoid cells were found in the sputum and reported as malignant. Foot, in a recent study of neoplastic cells in serous fluids, reported the correct diagnosis of 12 of 18 lymphoid tumors through the cytologic approach. In the course of routine cytologic examination for malignant cells at the Rochester Methodist Hospital, we have coincidentally accumulated some experience in relation to the findings in patients afTected with malignant lymphoma. This report summarizes our experience.