title: Serous fluid cytology of multicentric Castleman's disease and other lymphoproliferative disorders associated with Kaposi sarcoma-associated herpes virus: a review with case reports.
abstract: OBJECTIVE
  The aim of this study is to describe and review the cytological features of Kaposi sarcoma-associated herpes virus (KSHV) related entities, such as multicentric Castleman's disease (MCD), plasmablastic-lymphoma (PBL) and primary effusion lymphoma (PEL), which all may present as body cavity effusions. Serous fluid cytology of MCD and PBL has not, to our knowledge, thus far been described. Although different in nature, MCD, PBL and PEL are characterized by similar morphological features.
  
  
  METHODS
  Body cavity effusions from four different patients with previously known or unknown KSHV-related lymphoproliferations have been examined by routine cytology, immunocytochemistry (IC) and polymerase chain reaction (PCR).
  
  
  RESULTS
  MCD, PBL and PEL are all characterized by increased cellularity, comprising mainly lymphoid and plasmacytoid cells with variable proportions of immunoblasts. Immunocytochemistry and PCR results show the MCD to be CD138 and KSHV positive, CD30 negative, IgM, IgH and lambda restricted but IgH polyclonal. PBL was CD138 positive, kappa restricted, weakly positive with VS38 and over 80% positive with MIB 1. PEL was CD45, EMA, CD138, KSHV, p53 and CD3 positive, CD20, EBV, CD30, CD2, CD4, ALK1, epithelial and mesothelial markers negative, and PCR monoclonal B-cell expanded (Ig-kappa bands).
  
  
  CONCLUSIONS
  Cytological examination of effusions in KSHV-related lymphoproliferative disorders may show similar morphological features but clonality studies and immunocytochemistry are very helpful in distinguishing between these rare benign and malignant lymphoproliferative diseases.
authors.affiliation: Department of Pathology, Portuguese Oncology Institute, Porto (I.P.O.P.), Portugal Department of Cellular Pathology, University College London, London, UK. cslobo_77@hotmail.com
authors.forename: C
authors.initials: C
authors.lastname: Lobo
authors.forename: S
authors.initials: S
authors.lastname: Amin
authors.forename: A
authors.initials: A
authors.lastname: Ramsay
authors.forename: T
authors.initials: T
authors.lastname: Diss
authors.forename: G
authors.initials: G
authors.lastname: Kocjan
mesh_terms: D001826:Body Fluids / Q000166:cytology* / Q000821:virology*; D005871:Castleman Disease / Q000150:complications* / Q000821:virology*; D019288:Herpesvirus 8, Human / Q000502:physiology*; D006801:Humans; D007150:Immunohistochemistry; D054685:Lymphoma, Primary Effusion / Q000150:complications / Q000821:virology; D008232:Lymphoproliferative Disorders / Q000150:complications* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000150:complications / Q000821:virology