Peripheral T-cell lymphoma presenting as ascites: a case report and review of the literature.
Here we report an unusual case of T-cell lymphoma presenting as ascites. A 49-yr-old woman was admitted to the hospital for abdominal discomfort associated with increasing abdominal girth over the course of 3 mo. She also complained of nausea, vomiting, and diarrhea. On physical examination, a tense and distended abdomen and edema of the lower extremities were noted. Neither hepatosplenomegaly nor lymphadenopathy was found. A CT scan of the abdomen and pelvis showed a large abdominal/pelvic mass surrounding the small bowel and omentum and small nodes in the para-aortic and mesenteric regions. The cytospin prepared from the peritoneal fluid was hypercellular and composed of a population of monotonous, noncohesive cells with a high nuclear/cytoplasmic ratio and a single prominent central nucleolus. The cells were positive for leukocyte common antigen and Leu-22 (CD43) but negative for keratin, L26, UCHL-1, kappa, lambda, CD3, Ki-1 (CD30), S-100, and carcinoembryonic antigen. Morphologic and immunologic findings were suggestive of T-cell immunoblastic lymphoma. Peripheral T-cell lymphomas rarely present as ascites; this case demonstrates the value of effusion cytology in making this diagnosis.
Vakar-López
F
F
Department of Pathology and Laboratory Medicine, University of Texas, Houston, USA. fvakar@casper.med.uth.tmc.edu
Yang
M
M
D001201:Ascites / Q000209:etiology* / Q000473:pathology; D001202:Ascitic Fluid; D005260:Female; D006801:Humans; D016399:Lymphoma, T-Cell / Q000150:complications* / Q000473:pathology; D008875:Middle Aged; D010537:Peritoneum / Q000473:pathology