Immunocytochemical Study of Malignant Lymphoma in Serous Effusions

Santos, Gilda da Cunha; Longatto‐Filho, Adhemar; Carvalho, Leda Viegas de; Neves, José Ivanildo; Alves, Aderaldo Costa

doi:10.1159/000328526

Cited by 26 publications

(31 citation statements)

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“…Although Das et al (27) found a high positivity in cases of non-Hodgkin's lymphomas (16/17; 94%), Celikoglu et al (28) reported positive results in only two cases of a series of 26 pleural effusion samples. In our study, we obtained positive results in 51.8%, a result that is similar to those reported by Santos et al (26) However, if we add to that the cases that were considered suspicious and whose diagnosis was confirmed by histology or by immunophenotyping, our positivity rate increases to 75.9%, if we consider all of the patients with lymphoma, and to 81.5% if we consider only those with non-Hodgkin's lymphomas. It is of note that the use of hematologic staining for cytological examination facilitates the identification of malignant lymphoid cells, mainly the high-grade subtypes.…”

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confidence: 90%

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É possível diferenciar derrames pleurais linfocíticos secundários a tuberculose ou linfoma através de variáveis clínicas e laboratoriais?

et al. 2012

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Objective: To describe clinical and laboratory characteristics in patients with tuberculosis-related or lymphomarelated lymphocytic pleural effusions, in order to identify the variables that might contribute to differentiating between these diseases. Methods: This was a retrospective study involving 159 adult HIV-negative patients with tuberculosis-related or lymphoma-related lymphocytic effusions (130 and 29 patients, respectively), treated between October of 2008 and March of 2010 at the Pleural Diseases Outpatient Clinic of the University of São Paulo School of Medicine Hospital das Clínicas Heart Institute, in the city of São Paulo, Brazil. Results: Mean age and the mean duration of symptoms were lower in the tuberculosis group than in the lymphoma group. The levels of proteins, albumin, cholesterol, amylase, and adenosine deaminase (ADA) in pleural fluid, as well as the serum levels of proteins, albumin, and amylase, were higher in the tuberculosis group, whereas serum cholesterol and triglycerides were higher in the lymphoma group. Pleural fluid leukocyte and lymphocyte counts were higher in the tuberculosis group. Of the tuberculosis group patients, none showed malignant cells; however, 4 showed atypical lymphocytes. Among the lymphoma group patients, cytology for neoplastic cells was positive, suspicious, and negative in 51.8%, 24.1%, and 24.1%, respectively. Immunophenotyping of pleural fluid was conclusive in most of the lymphoma patients. Conclusions: Our results demonstrate clinical and laboratory similarities among the patients with tuberculosis or lymphoma. Although protein and ADA levels in pleural fluid tended to be higher in the tuberculosis group than in the lymphoma group, even these variables showed an overlap. However, none of the tuberculosis group patients had pleural fluid ADA levels below the 40-U/L cut-off point.Keywords: Pleural effusion; Tuberculosis; Lymphoma; Adenosine deaminase; Diagnosis, differential. ResumoObjetivo: Descrever características clínicas e laboratoriais em pacientes com derrames pleurais linfocíticos secundários a tuberculose ou linfoma, a fim de identificar as variáveis que possam contribuir no diagnóstico diferencial dessas doenças. Métodos: Estudo retrospectivo com 159 pacientes adultos HIV negativos com derrame pleural linfocítico secundário a tuberculose ou linfoma (130 e 29 pacientes, respectivamente) tratados no Ambulatório da Pleura, Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo (SP), entre outubro de 2008 e março de 2010. Resultados: A média de idade e de duração dos sintomas foi menor no grupo tuberculose que no grupo linfoma. Os níveis pleurais de proteínas, albumina, colesterol, amilase e adenosina desaminase (ADA), assim como os níveis séricos de proteínas, albumina e amilase, foram maiores no grupo tuberculose, enquanto os níveis séricos de colesterol e triglicérides foram maiores no grupo linfoma. As contagens de leucócitos e linfócitos no líquido pleural foram maiores no grupo tub...

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“…(2) According to Billingham et al, (25) exfoliative cytology represents an excellent method for diagnosing the condition, with an accuracy that is similar to that of histological examination. Santos et al (26) evaluated 256 serous effusions (pleural or ascitic fluid) associated with lymphomas.…”

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confidence: 99%

É possível diferenciar derrames pleurais linfocíticos secundários a tuberculose ou linfoma através de variáveis clínicas e laboratoriais?

et al. 2012

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“…2 These antibodies have also been used with success in phenotyping NHL in fine needle aspiration (FNA) cytology [3][4][5][6] and serous effusions. 7 While using these antibodies on FNA smears of lymphoma cases, 8 we observed the usual cytoplasmic positive reaction for CD3 and CD20 in Tand B-cell neoplasms, respectively. In addition, there was nucleolar positivity for CD20 in 2 T-cell neoplasms and 1 of probable T-cell lineage.…”

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confidence: 77%

Nucleolar Positivity for CD20

Das¹

2005

Acta Cytologica

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“…Usually, the malignant cells in effusions keep the same cytomorphologic characteristics as in primary tumors, but in some cases the cytology varies from the original picture. [1][2][3] For identifying the cells' origin, ancillary techniques, such as immunocytochemistry, flow cytometry, morphometry and cytogenetics, may be implemented. 1,2,[4][5][6] Pleural effusions in malignant lymphomas (MLs) are observed mostly as a result of a direct infiltration of the pleura by lymphoma, though one should keep in mind that primary MLs with pleural effusions are rare and affect usually HIV-positive patients.…”

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confidence: 99%

“…[1][2][3] For identifying the cells' origin, ancillary techniques, such as immunocytochemistry, flow cytometry, morphometry and cytogenetics, may be implemented. 1,2,[4][5][6] Pleural effusions in malignant lymphomas (MLs) are observed mostly as a result of a direct infiltration of the pleura by lymphoma, though one should keep in mind that primary MLs with pleural effusions are rare and affect usually HIV-positive patients. 2,5,7 In the majority of pleural effusions in ML, cytology reveals a cell-rich picture; however, there are some cases where poor cellularity makes the correct diagnosis difficult.…”

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confidence: 99%