Reactive Plasmacytosis in Effusions - Not A Rare Occurrence

Abstract

Introduction: Effusions with plasma cells are uncommon. In such effusions reactive plasma cells need to be differentiated from malignant ones. In the literature we came across a single case of plasmacytic effusion in the absence of underlying malignancy. Material and methods: A retrospective analysis of the ascitic and pleural fluid samples received for routine analysis, from Jan 2021 to Dec 2022 was done. Result: Five cases were incidentally detected to have reactive plasmacytosis in effusions, three in pleural fluid and two in ascitic fluid. Number of plasma cells varied between 2% to 30%. In all these cases thorough clinical details were obtained and relevant investigations were studied. All the cases had ailments related to hepatobiliary system. None of these cases had any features of lymphoma or plasma cell neoplasm. In all the cases plasma cells had a reactive morphology. In one of the cases the reason for reactive plasmacytosis was viral hepatitis, in another case it was suspected to be tuberculosis. In two cases some intercurrent infection could be the cause for reactive plasmacytosis in effusion. However, in one case the patient passed away before proper investigations could be made. Discussion: The mechanism for reactive plasmacytosis is not documented yet. Further studies in this regard are needed as the entity is not rare. In our study the incidence was 0.36% (5 cases out of a total of 1397 cases). Key words: Effusions, plasma cells, reactive