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.
STUDY DESIGN: 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.
CONCLUSION: 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.
Published In/Presented At
Abraham, M. G., Levin, K. A., Balasubramanian, M., Minimo, C., Galindo, L. M., & Hou, J. S. (2007). Diagnosis of T-cell lymphoma in body fluids: cytologic features and unusual flow cytometric findings. Analytical And Quantitative Cytology And Histology, 29(5), 333-338.
Department of Pathology and Laboratory Medicine