CD-30(Ki-1)-positive anaplastic large cell lymphoma in a pleural effusion. A case report with diagnosis by cytomorphologic and immunocytochemical studies.
BACKGROUND
Reports on cytodiagnosis of Ki-1-positive anaplastic large cell lymphoma (ALCL) are rare. This report describes one such case diagnosed by cytologic examination of a pleural effusion and confirmed by immunocytochemistry.


METHODS
An 87-year-old male presented with breathlessness, fever and a cough. Computed tomographic scan of the thorax showed a small, right, pleura-based nodule with infiltration of the immediate surroundings in addition to a massive, right-sided pleural effusion. Cytologic examination of pleural fluid revealed a heterogeneous population of cells comprising small mature lymphocytes, and numerous medium and large atypical lymphoid cells having frequent nuclear irregularity. Occasional very large cells resembling Reed-Sternberg cells or multinucleated cells with a horseshoe or wreathlike arrangement of nuclei (doughnut cells) were also present. Cytomorphology was suggestive of Ki-1 anaplastic large cell lymphoma (ALCL). Immunocytochemistry revealed intense positivity for CD-30, positivity for LCA and EMA in a variable number of cells and a negative result for cytokeratin except for occasional cells.


CONCLUSIONS
Cytologic examination of pleural fluid can serve as a useful tool for the initial diagnosis of Ki-1-positive ALCL.
Das
D K
DK
Institute of Cytology and Preventive Oncology, Maulana Azad Medical College, New Delhi, India.
Chowdhury
V
V
Kishore
B
B
Chachra
K
K
Bhatt
N C
NC
Kakar
A K
AK
D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D007124:Immunoenzyme Techniques; D017730:Ki-1 Antigen / Q000378:metabolism; D017728:Lymphoma, Large-Cell, Anaplastic / Q000378:metabolism / Q000473:pathology*; D008297:Male; D016066:Pleural Effusion, Malignant / Q000378:metabolism / Q000473:pathology*
D017730:Ki-1 Antigen