title: Small noncleaved cell lymphoma presenting as a massive pericardial effusion. A case report.
abstract: BACKGROUND
  Non-Hodgkin's lymphoma (NHL) is commonly associated with cardiac involvement, especially in cases of advanced stages with mediastinal involvement. Much rarer is the initial presentation of NHL as a pericardial effusion; there are only 12 cases reported. In addition, only 5 of these 12 cases were correctly diagnosed based on examination of pericardial fluid prior to death: 3 were based on routine cytology; 1 on immunoperoxidase staining and 1 on an immunofluorescent slide method.
  
  
  METHODS
  A 71-year-old, white female presented with a massive pericardial effusion. Small noncleaved cell lymphoma was expeditiously diagnosed by cytologic examination combined with flow cytometric immunophenotyping. No further diagnostic tissue was obtained; the patient was staged and offered treatment with a protocol for high grade lymphoma.
  
  
  CONCLUSIONS
  Combining cytomorphology and flow cytometric immunophenotyping in such cases results in an expeditious, nonsurgical diagnosis, upon which therapeutic decision making may be based.
authors.affiliation: Department of Pathology, St. Louis University Health Sciences Center, Missouri, USA.
authors.forename: C H
authors.initials: CH
authors.lastname: Dunphy
authors.forename: R R
authors.initials: RR
authors.lastname: Ramos
authors.forename: L M
authors.initials: LM
authors.lastname: Galindo
mesh_terms: D000368:Aged; D015703:Antigens, CD / Q000032:analysis; D001853:Bone Marrow; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping; D008228:Lymphoma, Non-Hodgkin / Q000473:pathology*; D010490:Pericardial Effusion / Q000473:pathology*
chemical_list: D015703:Antigens, CD