title: Subclassification of lymphoproliferative disorders in serous effusions: a 10-year experience.
abstract: BACKGROUND
  Rare studies have reported the application of multiple ancillary tests to the diagnosis of lymphoproliferative disorder in serous effusions. In the current study, the authors evaluated the effectiveness of using an algorithm for the triage of serous effusions and the contribution of ancillary studies to achieve a specific subtype of lymphoproliferative disorder.
  
  
  METHODS
  Serous effusion samples that had a final diagnosis of lymphoproliferative disorder or suspicious for lymphoma were selected from cases that were diagnosed between 2001 and 2010. Data were collected on patient and sample characteristics as well as results from immunophenotype and molecular studies.
  
  
  RESULTS
  In total, 168 serous effusions were identified from 110 patients. The most common site of involvement was the pleural cavity (n = 133) followed by the peritoneal cavity (n = 30) and pericardial cavity (n = 5). The volume of serous effusions ranged from 2 mL to 1000 mL (mean, 238 mL). In 42 patients (38.2%), serous effusions were the primary source of diagnosis. In 129 patients who had a diagnosis of LPD, either generic (n = 82) or specific (n = 47) ancillary tests were performed as a single test in 58 samples (67.4%) or as a combination of multiple studies in 19 samples (23.2%). Immunophenotyping was successful in almost all samples that had a specific subtype with 16 B-cell and 4 T-cell lymphomas being diagnosed. More samples with a specific subtype of lymphoma underwent molecular tests compared with those who had a generic diagnosis (19.1% vs 13.4%).
  
  
  CONCLUSIONS
  Successful, specific subtyping of lymphoproliferative disorders was achieved in approximately 33% of cases that were tested for ancillary studies following an approach for the triage and aliquoting of serous effusion samples.
authors: Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.
authors: Leung Chu
authors: LC
authors: Tong
authors: Hyang-Mi
authors: HM
authors: Ko
authors: Mauro Ajaj
authors: MA
authors: Saieg
authors: Scott
authors: S
authors: Boerner
authors: William R
authors: WR
authors: Geddie
authors: Gilda
authors: G
authors: da Cunha Santos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001202:Ascitic Fluid / Q000378:metabolism / Q000473:pathology*; D003581:Cytodiagnosis / Q000379:methods; D003937:Diagnosis, Differential; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D017404:In Situ Hybridization, Fluorescence; D016393:Lymphoma, B-Cell / Q000145:classification / Q000175:diagnosis / Q000235:genetics; D016399:Lymphoma, T-Cell / Q000145:classification / Q000175:diagnosis / Q000235:genetics; D008232:Lymphoproliferative Disorders / Q000145:classification / Q000175:diagnosis* / Q000235:genetics; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000378:metabolism / Q000473:pathology*; D010996:Pleural Effusion / Q000378:metabolism / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult