title: A case of peripheral T-cell lymphoma, not otherwise specified in a HCV and HTLV-II-positive patient, diagnosed by abdominal fluid cytology.
abstract: BACKGROUND
  Peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS) is a rare neoplasm that typically presents as generalized lymphadenopathy. PTCL, NOS presenting as malignant ascites is rare.
  
  
  METHODS
  A 61-year-old African-American man with past medical history of HCV, cryoglobulinemia, and cryptococcal pneumonia was admitted for dyspnea on exertion over a period of 1 month and new onset of abdominal distension.
  
  
  RESULTS
  Ascites, splenomegaly, hepatomegaly and extensive lymphadenopathy were found by imaging. Paracentesis obtained 1.3 liter of abdominal fluid, the cytologic evaluation showed a monomorphic population of intermediate-sized lymphoid cells with irregular to convoluted nuclear contours. Fluid sent for flow cytometry showed an abnormal T-lymphocyte population expressing CD4, weak surface CD3 and absence of CD7. PCR studies of ascitic fluid detected a clonal T-lymphocyte population with T-cell receptor gamma gene rearrangement. Serologic testing for human T lymphotropic virus (HTLV) was positive for HTLV-II. Subsequent bone marrow biopsy revealed lymphomatous involvement. CD30 and ALK-1 immunostaining were negative. This case was classified as PTCL, NOS.
  
  
  CONCLUSIONS
  PTCL, NOS can have unusual clinical presentation such as ascites and pleural effusion, and may also occur as a complication of immunodeficiency state. Further studies are needed to determine if HCV or HTLV-II viral infection is associated with PTCL.
authors.affiliation: 1 Department of Pathology, City of Hope National Medical Center, Duarte, USA ; 2 Department of Internal medicine, 3 Department of Pathology, University of Texas Medical Branch, Galveston, USA ; 4 Department of Pathology & Immunology, Baylor College of Medicine, Houston, USA.
authors.forename: Maryam Dadfarnia
authors.initials: MD
authors.lastname: Ameri
authors.affiliation: 1 Department of Pathology, City of Hope National Medical Center, Duarte, USA ; 2 Department of Internal medicine, 3 Department of Pathology, University of Texas Medical Branch, Galveston, USA ; 4 Department of Pathology & Immunology, Baylor College of Medicine, Houston, USA.
authors.forename: Trisha M
authors.initials: TM
authors.lastname: Parekh
authors.affiliation: 1 Department of Pathology, City of Hope National Medical Center, Duarte, USA ; 2 Department of Internal medicine, 3 Department of Pathology, University of Texas Medical Branch, Galveston, USA ; 4 Department of Pathology & Immunology, Baylor College of Medicine, Houston, USA.
authors.forename: You-Wen
authors.initials: YW
authors.lastname: Qian
authors.affiliation: 1 Department of Pathology, City of Hope National Medical Center, Duarte, USA ; 2 Department of Internal medicine, 3 Department of Pathology, University of Texas Medical Branch, Galveston, USA ; 4 Department of Pathology & Immunology, Baylor College of Medicine, Houston, USA.
authors.forename: M Tarek
authors.initials: MT
authors.lastname: Elghetany
authors.affiliation: 1 Department of Pathology, City of Hope National Medical Center, Duarte, USA ; 2 Department of Internal medicine, 3 Department of Pathology, University of Texas Medical Branch, Galveston, USA ; 4 Department of Pathology & Immunology, Baylor College of Medicine, Houston, USA.
authors.forename: Vicki
authors.initials: V
authors.lastname: Schnadig
authors.affiliation: 1 Department of Pathology, City of Hope National Medical Center, Duarte, USA ; 2 Department of Internal medicine, 3 Department of Pathology, University of Texas Medical Branch, Galveston, USA ; 4 Department of Pathology & Immunology, Baylor College of Medicine, Houston, USA.
authors.forename: Ranjina
authors.initials: R
authors.lastname: Nawgiri
keywords: Peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS); ascites; human T lymphotropic virus II (HTLV-II)