Diagnosis of T-cell lymphoma in body fluids: cytologic features and unusual flow cytometric findings.
OBJECTIVE
To demonstrate the unique morphologic and phenotypic features observed in cases of T-cell lymphomas presenting as effusions.


METHODS
Cytologic slides and flow cytometric histograms of 8 cases of body fluids with T-cell lymphoma were retrospectively reviewed. Morphologic features, flow cytometric histograms and immunophenotypes of the cells were evaluated.


RESULTS
Three of the 8 cases showed 1 or more of the following: intermediate-to-large cells with an increased nuclear-cytoplasmic ratio, finely granular or vacuolated cytoplasm and round or convoluted vesicular nuclei with a prominent single or multiple nucleoli. Flow cytometric studies of these 3 cases showed an abnormal scatter pattern in the myelomonocytic region of the histograms. Phenotypic analysis revealed variable expression of a T-cell phenotype. The remaining cases showed the conventional morphologic and flow cytometric features of a T-cell lymphoma.


CONCLUSIONS
Morphologic alterations of neoplastic T-cells in body fluids can result in a variety of potentially incorrect diagnoses. The unusual flow cytometric histogram can serve as a useful clue for the diagnosis of T-cell lymphoma in body fluids but could be a potential pitfall for a false negative. Detailed cytologic evaluation combined with flow cytometric study can improve diagnostic accuracy.
Abraham
Mini G
MG
Department of Pathology, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.
Levin
Kimberly A
KA
Balasubramanian
Manjula
M
Minimo
Corrado
C
Galindo
Lorenzo M
LM
Hou
J Steve
JS
D000368:Aged; D001826:Body Fluids / Q000166:cytology; D003581:Cytodiagnosis; D005434:Flow Cytometry; D006801:Humans; D007150:Immunohistochemistry; D016399:Lymphoma, T-Cell / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010641:Phenotype