A 73-year-old man with chronic lymphocytic leukaemia and a haemorrhagic pleural effusion

Berge, M. van den; Tinga, Cor J.; Bieger, R.

doi:10.1007/s002770000266

Cited by 12 publications

(12 citation statements)

References 11 publications

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“…Patients reported to have pleural involvement with CLL are known to have the disease for several years before the development of effusion . Malignant pleural effusion due to CLL was confirmed in 7% of hospitalized CLL‐patients .…”

Section: Discussionmentioning

confidence: 99%

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Concurrent pleural infiltration by chronic lymphocytic leukemia and adenocarcinoma of unknown primary site diagnosed by effusion cytology

Vrettos

Kamposioras

Peridis

et al. 2012

Diagnostic Cytopathology

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Synchronous malignancies in a pleural effusion are rare. A case of concurrent pleural infiltration by adenocarcinoma of unknown primary site and chronic lymphocytic leukemia (CLL) is presented in this case study, which was diagnosed by effusion cytology. Pleural effusion is not an uncommon complication in patients with B-CLL. Even in a pleural effusion rich in monoclonal lymphocytes, the presence of a second cancer must be excluded because this can be the main cause of mortality. The role of cytology in such cases is of paramount importance.

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Section: Discussionmentioning

confidence: 99%

“…Malignant pleural effusion due to CLL was confirmed in 7% of hospitalized CLL‐patients . The pleural fluid can be either hemorrhagic due to pleural involvement with B‐CLL or chylous (chylothorax) . In addition to B cells, “reactive” T cells may also be seen in pleural involvement .…”

Section: Discussionmentioning

confidence: 99%

Concurrent pleural infiltration by chronic lymphocytic leukemia and adenocarcinoma of unknown primary site diagnosed by effusion cytology

Vrettos

Kamposioras

Peridis

et al. 2012

Diagnostic Cytopathology

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“…Pleural effusions in clinical series of CLL patients have been described mostly in patients with advanced disease [25,26]. The largest series reviewed pulmonary complications in CLL and studied 110 patients hospitalized over 9 years (636 hospital admissions) [25].…”

Section: Chronic Lymphocytic Leukemiamentioning

confidence: 99%

“…The largest series reviewed pulmonary complications in CLL and studied 110 patients hospitalized over 9 years (636 hospital admissions) [25]. Immunophenotyping is paramount for diagnosis, as morphology alone is often insufficient to differentiate them from those seen in reactive inflammatory conditions, particularly pleural effusions associated with tuberculosis and pulmonary emboli that can have a predominance of T-cell lymphocytes [26][27][28][29][30]. Of these 10 patients, seven had CLL (confirmed by flow cytometry), two had Richter's transformation of large cell lymphoma and one had adenocarcinoma.…”

Section: Chronic Lymphocytic Leukemiamentioning

confidence: 99%

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Pleural effusions in acute and chronic leukemia and myelodysplastic syndrome

Faiz

Sahay

Jiménez

2014

Current Opinion in Pulmonary Medicine

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Pleural effusions may occur with acute and chronic leukemia and MDS. Infection remains the most common cause. Malignant pleural effusions tend to occur in advanced disease in chronic leukemia, but they can be seen at any time with acute leukemia and MDS. With standard precautions, pleural procedures may be performed safely in this population. In cases of unclear cause, pleural and bone marrow biopsy should be considered.

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The efficacy of voice therapy in patients after treatment for early glottic carcinoma

Gogh

Leeuw

Boon-Kamma

et al. 2005

Cancer

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CD3/CD20 immunostains are often performed in the initial cytological evaluation of lymphoid‐rich pleural effusions (LR‐PE). Most benign LR‐PE are predominantly composed of T(CD3+) cells while most malignant LR‐PE are of B(CD20+) cell lineage. As part of the effort to contain laboratory costs and improve diagnostic accuracy, there is increasing interest in applying principles of evidence‐based pathology to the use of immunostains. In this retrospective study, we reviewed the effectiveness of CD3/CD20 immunostains as a diagnostic or triage tool during the initial evaluation of 258 consecutive LR‐PE. 196 (76%) of the LR‐PE were ultimately diagnosed as reactive lymphocytosis and 62 (24%) as lymphoma/leukemia (L/L). There was a previous diagnosis of L/L, concurrent diagnostic tissue, and/or clinical evidence of L/L in 44 (71%) of the L/L effusions. An initial diagnosis of L/L was made in the remaining 18 (29%) cases. Sixteen of these 18 cases showed large cells with high‐grade features that mandated L/L workup. In only 2 (0.8%) of the 258 LR‐PE, CD3/CD20 stains were helpful to identify small cell lymphocytic lymphoma (SLL) in patients without concurrent peripheral lymphocytosis. CD3/CD20 immunostains do not appear to provide a cost‐effective method to diagnose or triage the vast majority of LR‐PE submitted to a clinical cytology laboratory. An algorithm that considers history, blood counts, and cytomorphology allows for cost‐effective selection of LR‐PE that warrant comprehensive hematopathologic workup. Our findings underscore the feasibility of applying evidence‐based principles to develop guidelines for the cost‐effective utilization of immunostains in cytology. Diagn. Cytopathol. 2012. © 2010 Wiley Periodicals, Inc.

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A 73-year-old man with chronic lymphocytic leukaemia and a haemorrhagic pleural effusion

Cited by 12 publications

References 11 publications

Concurrent pleural infiltration by chronic lymphocytic leukemia and adenocarcinoma of unknown primary site diagnosed by effusion cytology

Concurrent pleural infiltration by chronic lymphocytic leukemia and adenocarcinoma of unknown primary site diagnosed by effusion cytology

Pleural effusions in acute and chronic leukemia and myelodysplastic syndrome

The efficacy of voice therapy in patients after treatment for early glottic carcinoma

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