Lymphoma of serous cavity: a clinicopathologic analysis of 21 cases

FU Xin; YANG Li; WANG Zhe

doi:10.3969/j.issn.1007-8096.2018.01.002

Abstract：Objective To analyze the clinicopathologic features,immunophenotype,diagnosis,differential diagnosis,treatment and prognosis of 21 cases of lymphoma in serous cavity effusion.Methods 21 cases of lymphoma diagnosed in serous cavity effusion in our hospital from January 2014 to May 2016 were collected;the cases were analyzed by conventional smear and staining,centrifugal embedding and immunohistochemical staining and immunoglobulin (Ig) or T cell receptor (TCR) gene rearrangement analysis in some cases;at the same time,the coincidence rate of cytological diagnosis and biopsy pathological diagnosis was compared.Results Of the 21 patients,there were fourteen males and seven females,aged 2-87 years,with a median age of 64 years.14 cases were pleural effusion,and the other was peritoneal effusion in 6 cases,and pericardial effusion in 1 cases.All 21 cases were non-Hodgkin's lymphoma.13 cases with immunocytochemical staining or gene rearrangement were explicited typing.These cases included 2 cases of lymphoplasmacytoid lymphoma,3 cases of diffuse large B cell lymphoma,1 case of primary effusion lymphoma,2 cases of plasmablastic lymphoma,1 cases of angioimmunoblastic T cell lymphoma,1 case of T lymphoblastic lymphoma,1 case of B lymphoblastic lymphoma,and 2 cases of small lymphocytitc lymphoma/chronic lymphocytic leukemia.In the other 8 cases,there were 4 cases with known lymphoma history,and 2 cases were confirmed as B cell lymphoma by immunocytochemistry.Conclusion Serous effusion lymphoma is rare,often presents with atypical clinical symptoms,and it is easily misdiagnosed as metastatic carcinoma or tuberculous effusion;the morphology of serous effusion,centrifugal embedding immunocytochemical staining and Ig or TCR gene rearrangement detection may be helpful in the diagnosis and typing.