Lymphoproliferative disorder involving body fluid: diagnostic approaches and roles of ancillary studies
Lymphocyte-rich effusions represent benign reactive process or neoplastic condition. Involvement of lymphoproliferative disease in body cavity is not uncommon, and it often causes diagnostic challenge. In this review, we suggest a practical diagnostic approach toward lymphocyte-rich effusions, share...
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| Format: | Article |
| Language: | English |
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Korean Society of Pathologists & the Korean Society for Cytopathology
2022-07-01
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| Series: | Journal of Pathology and Translational Medicine |
| Subjects: | |
| Online Access: | http://www.jpatholtm.org/upload/pdf/jptm-2022-05-16.pdf |
| _version_ | 1811218237763878912 |
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| author | Jiwon Koh Sun Ah Shin Ji Ae Lee Yoon Kyung Jeon |
| author_facet | Jiwon Koh Sun Ah Shin Ji Ae Lee Yoon Kyung Jeon |
| author_sort | Jiwon Koh |
| collection | DOAJ |
| description | Lymphocyte-rich effusions represent benign reactive process or neoplastic condition. Involvement of lymphoproliferative disease in body cavity is not uncommon, and it often causes diagnostic challenge. In this review, we suggest a practical diagnostic approach toward lymphocyte-rich effusions, share representative cases, and discuss the utility of ancillary tests. Cytomorphologic features favoring neoplastic condition include high cellularity, cellular atypia/pleomorphism, monomorphic cell population, and frequent apoptosis, whereas lack of atypia, polymorphic cell population, and predominance of small T cells usually represent benign reactive process. Involvement of non-hematolymphoid malignant cells in body fluid should be ruled out first, followed by categorization of the samples into either small/medium-sized cell dominant or large-sized cell dominant fluid. Small/medium-sized cell dominant effusions require ancillary tests when either cellular atypia or history/clinical suspicion of lymphoproliferative disease is present. Large-sized cell dominant effusions usually suggest neoplastic condition, however, in the settings of initial presentation or low overall cellularity, ancillary studies are helpful for more clarification. Ancillary tests including immunocytochemistry, in situ hybridization, clonality test, and next-generation sequencing can be performed using cytologic preparations. Throughout the diagnostic process, proper review of clinical history, cytomorphologic examination, and application of adequate ancillary tests are key elements for successful diagnosis. |
| first_indexed | 2024-04-12T07:06:29Z |
| format | Article |
| id | doaj.art-d5328bc9c2c641aeb14bcfcabc66d95c |
| institution | Directory Open Access Journal |
| issn | 2383-7837 2383-7845 |
| language | English |
| last_indexed | 2024-04-12T07:06:29Z |
| publishDate | 2022-07-01 |
| publisher | Korean Society of Pathologists & the Korean Society for Cytopathology |
| record_format | Article |
| series | Journal of Pathology and Translational Medicine |
| spelling | doaj.art-d5328bc9c2c641aeb14bcfcabc66d95c2022-12-22T03:42:47ZengKorean Society of Pathologists & the Korean Society for CytopathologyJournal of Pathology and Translational Medicine2383-78372383-78452022-07-0156417318610.4132/jptm.2022.05.1617031Lymphoproliferative disorder involving body fluid: diagnostic approaches and roles of ancillary studiesJiwon Koh0Sun Ah Shin1Ji Ae Lee2Yoon Kyung Jeon3 Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, KoreaLymphocyte-rich effusions represent benign reactive process or neoplastic condition. Involvement of lymphoproliferative disease in body cavity is not uncommon, and it often causes diagnostic challenge. In this review, we suggest a practical diagnostic approach toward lymphocyte-rich effusions, share representative cases, and discuss the utility of ancillary tests. Cytomorphologic features favoring neoplastic condition include high cellularity, cellular atypia/pleomorphism, monomorphic cell population, and frequent apoptosis, whereas lack of atypia, polymorphic cell population, and predominance of small T cells usually represent benign reactive process. Involvement of non-hematolymphoid malignant cells in body fluid should be ruled out first, followed by categorization of the samples into either small/medium-sized cell dominant or large-sized cell dominant fluid. Small/medium-sized cell dominant effusions require ancillary tests when either cellular atypia or history/clinical suspicion of lymphoproliferative disease is present. Large-sized cell dominant effusions usually suggest neoplastic condition, however, in the settings of initial presentation or low overall cellularity, ancillary studies are helpful for more clarification. Ancillary tests including immunocytochemistry, in situ hybridization, clonality test, and next-generation sequencing can be performed using cytologic preparations. Throughout the diagnostic process, proper review of clinical history, cytomorphologic examination, and application of adequate ancillary tests are key elements for successful diagnosis.http://www.jpatholtm.org/upload/pdf/jptm-2022-05-16.pdfcytologybody fluidmalignant lymphomalymphoproliferative disorderimmunocytochemistrypolymerase chain reactionnext-generation sequencing |
| spellingShingle | Jiwon Koh Sun Ah Shin Ji Ae Lee Yoon Kyung Jeon Lymphoproliferative disorder involving body fluid: diagnostic approaches and roles of ancillary studies Journal of Pathology and Translational Medicine cytology body fluid malignant lymphoma lymphoproliferative disorder immunocytochemistry polymerase chain reaction next-generation sequencing |
| title | Lymphoproliferative disorder involving body fluid: diagnostic approaches and roles of ancillary studies |
| title_full | Lymphoproliferative disorder involving body fluid: diagnostic approaches and roles of ancillary studies |
| title_fullStr | Lymphoproliferative disorder involving body fluid: diagnostic approaches and roles of ancillary studies |
| title_full_unstemmed | Lymphoproliferative disorder involving body fluid: diagnostic approaches and roles of ancillary studies |
| title_short | Lymphoproliferative disorder involving body fluid: diagnostic approaches and roles of ancillary studies |
| title_sort | lymphoproliferative disorder involving body fluid diagnostic approaches and roles of ancillary studies |
| topic | cytology body fluid malignant lymphoma lymphoproliferative disorder immunocytochemistry polymerase chain reaction next-generation sequencing |
| url | http://www.jpatholtm.org/upload/pdf/jptm-2022-05-16.pdf |
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