Lymphoma presenting as the first finding in pleural fluid cytology: A rare cytologic presentation

Abstract

Malignant hemato-lymphoid neoplasms presenting as the initial finding in pleural effusion cytology is one of the rare challenges a pathologist may encounter in practice among lymphocyte-rich effusions. Meanwhile, effusion cytology is an easily available, inexpensive diagnostic tool in our setting. Cytomorphological features provide crucial insights into the nature of the disease, which along with immunocytochemistry may help in solidifying the diagnosis. Here we present a rare case of a 17-year-old patient, who initially presented with pleural effusion that turned out to be lymphoma on cytological examination. Cell blocks were prepared and immunocytochemistry was performed for CD5 and CD23. Tumor cells showed positivity for both CD5 and CD23, confirming the diagnosis of small lymphocytic lymphoma.