The value of cytology in diagnosis of body fluids with lymphoma involvement: a report of 29 cases

Abstract

Abstract Introduction/Objective Lymphoma involving body fluids (pleural, abdominal or pericardial) can be secondary or primary (such as primary effusion lymphoma). The incident rate is variable depending on the hospital setting (general or specialty hospitals), and it is generally low. Due to the large specimen volume, relatively easy collecting sample and stable cellular preservation, body fluids are good sources for diagnosis and classification of lymphoproliferative diseases. Methods/Case Report A retrospective case search from a tertiary academic medical center during 2015 to 2023 were performed for body fluid cytology with diagnosis of lymphoma. The results of cytology, ancillary cellblock, immunohistochemistry and flow cytometry were collected, and the synchronous or follow-up surgical biopsies/resections were cross examined. Results (if a Case Study enter NA) Total 29 cases of body fluids with lymphoma involvement were identified in the study period. There were 22 patients including 9 males and 13 females and age ranged from 16 to 88 years (mean 64.5 years). Only 4 patients (4/22, 18.2%) had history of lymphoma when they presented with body fluids, and the remaining 18 patients (18/22, 81.8%) presented body fluids as the initial or synchronous sign of lymphoma. 26/29 cases had cellblock or flow cytometry done and 13/29 cases had both. All 22 cases had adequate lymphoma diagnosis and classification by combined cytology and ancillary tests and included 5 high grade B cell lymphoma, 3 diffuse large B cell lymphoma, 2 Burkitt, 2 CLL/SLL, 2 small mature B cell lymphoma, NOS, 1 mantel, 1 MYC and BCL-2 double hits lymphoma, 1 primary effusion lymphoma, 1 plasma cell myeloma, 2 T lymphoblastic lymphoma, 1 anaplastic large cell lymphoma, 1 angioimmunoblastic T cell lymphoma. 11 patients had synchronous or follow-up tissue biopsies, and cytology had 100% agreement with the histology diagnosis. Conclusion The majority (81.8%) cases of body fluid involvement with lymphomas presented as the initial or synchronous sign of lymphomas in our study series indicating that high pathologic suspicion and adequate cytomorphological skills for lymphoproliferative disorders are necessary for making the diagnosis. Body fluid samples are excellent sources for diagnosis and classification of lymphomas using the available ancillary tools including immunohistochemistry, flow cytometry and molecular testing.