Abstract
Lymphocytes are commonly present in any SCF, admixed with mesothelial cells and lymphocytes. When a predominant population of lymphocytes is observed, a careful evaluation of the morphologic features should permit distinction between a reactive process and lymphoproliferative disorder. However, in effusions where a large amount of small mature lymphocytes are encountered, a statement should be added to the cytologic report stating the diagnostic possibilities. Predominant lymphocytosis in an effusion caused by small mature lymphocytes can be seen in cases of an underlying tuberculosis (such as in the lung), a low-grade lymphoproliferative disorder, or an occult malignancy. In cases where a lymphoproliferative process is suspected, it is best to send a fresh portion of SCF for flow cytometric analysis. It is agreed that serous cavity involvement by a low-grade lymphoma is notoriously difficult to differentiate from a reactive process on cytopathology alone. Several studies have demonstrated the sensitivity of flow analysis when morphologic evaluation alone cannot provide a conclusive diagnosis of lymphoma.
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Ali, S.Z., Cibas, E.S. (2012). Lymphocytic Effusions. In: Serous Cavity Fluid and Cerebrospinal Fluid Cytopathology. Essentials in Cytopathology, vol 11. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-1776-7_8
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DOI: https://doi.org/10.1007/978-1-4614-1776-7_8
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