Cytological diagnosis of lymphocyte-rich effusion in the serosal cavity

TANG Fu-ting; GE Feng-lin; ZHANG Yi-fen

doi:10.3969/j.issn.1007-8096.2024.10.005

Abstract：Objective To explore the cytological diagnostic characteristics of lymphocyte-rich serosal effusion(LRSE).Methods The clinical data,cytological smears,and immunophenotypes of 43 cases of LRSE were retrospectively analyzed,and relevant literatures were reviewed.Results There were 25 cases of reactive lymphocyte effusion(RLE),13 cases of B-cell lymphoma effusion(BCLE),and 5 cases of T-cell lymphoma effusion(TCLE).2/25 cases of RLE showed cellular atypia.In the RLE group,the median T-cells and B-cells proportion was 80%and 5%,respectively,the medium CD4:CD8 ratio was 3,and the median Ki-67 index was 6%.23/25 cases showed CD3 positive,and 25/25 cases CD5 positive.In the BCLE group,the median B-cells and T-cells proportion was 80%and 10%,respectively and the median Ki-67 index was 50%.Compared with the RLE group,the median B-cells and T-cells proportion,and Ki-67 index were all significantly different(P＜0.001).In the TCLE group,the median B-cells and T-cells proportion was 0 and 95%,respectively,the median Ki-67 index was 70%,and 5 cases had abnormal CD4/CD8 ratio.Compared with the RLE group,the Ki-67 index,CD4/CD8 ratio were significant differences in TCLE group(P＜0.001).Conclusion RLE is dominated by mature T lymphocytes with low proliferation index.When B-cells proportion and Ki-67 index increase and CD4:CD8 ratio is abnormal,it indicates lymphoma/leukemia effusion,and further examination is needed.