{"id":1962,"date":"2017-07-31T19:34:55","date_gmt":"2017-07-31T19:34:55","guid":{"rendered":"http:\/\/cytologystuff1.wpengine.com\/non-gyn-atlas\/effusions-hematologic-malignancies\/"},"modified":"2025-02-10T20:03:05","modified_gmt":"2025-02-10T20:03:05","slug":"effusions-hematologic-malignancies","status":"publish","type":"page","link":"https:\/\/cytologystuff.com\/zh-hans\/non-gyn-atlas\/effusions-hematologic-malignancies\/","title":{"rendered":"Effusions – Hematologic Malignancies"},"content":{"rendered":"

[vc_row 0=””][vc_column 0=”” offset=”vc_hidden-lg vc_hidden-md”][vc_raw_html 0=””]JTNDY2VudGVyJTNFJTNDYSUyMGNsYXNzJTNEJTIyc2hpZnRuYXYtdG9nZ2xlJTIwc2hpZnRuYXYtdG9nZ2xlLWJ1dHRvbiUyMiUyMGRhdGEtc2hpZnRuYXYtdGFyZ2V0JTNEJTIyc2hpZnRuYXYtbWFpbiUyMiUzRSUzQ2klMjBjbGFzcyUzRCUyMmZhJTIwZmEtYmFycyUyMiUzRSUzQyUyRmklM0UlMjBUYWJsZSUyMG9mJTIwQ29udGVudHMlMjAlM0MlMkZhJTNFJTNDJTJGY2VudGVyJTNF[\/vc_raw_html][\/vc_column][\/vc_row][vc_row][vc_column][vc_custom_heading text=”Cytology of Pleural, Pericardial and Peritoneal Cavity Effusions – Effusions – Hematologic Malignancies” font_container=”tag:h1|text_align:center” use_theme_fonts=”yes”][\/vc_column][\/vc_row][vc_row el_id=”acknowledgements”][vc_column width=”2\/3″][vc_column_text]<\/a><\/p>\n

EFFUSIONS – HEMATOLOGIC MALIGNANCIES<\/p>\n

<\/a><\/p>\n

\n

Reminder: You may click on any slide image
\nfor an enlarged view.<\/strong><\/p>\n


\n\"Image<\/a><\/p>\n
\n

Figure 29<\/strong><\/p>\n

Pleural effusion: Non-Hodgkin’s lymphoma. 20X<\/p>\n<\/div>\n<\/div>\n

Figure 29
\n<\/strong>Pleural effusion:
\nNon-Hodgkin’s lymphoma.
\n20X<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
\n

Figure 30<\/strong><\/p>\n

Pleural effusion: Non-Hodgkin’s lymphoma. 40X<\/p>\n<\/div>\n<\/div>\n

Figure 30
\n<\/strong> Pleural effusion:
\nNon-Hodgkin’s lymphoma.
\n40X<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 31<\/strong>
\nPleural effusion: Non-Hodgkin’s lymphoma. 60X<\/div>\n<\/div>\n
Figure 31
\n<\/strong>
\nPleural effusion:
\nNon-Hodgkin’s lymphoma.
\n60X<\/div>\n
<\/div>\n

Figures 29-31:<\/strong>
\nBy nature these cells are most often single or in small loosely adherent clusters. Non-Hodgkin’s lymphoma cells are present as a distinct population of cells which must be distinguished from mesothelial cells and from inflammatory cells or blood born leukocytes. In this set of three photomicrographs, the neoplastic population consists of lymphoid blasts, of variable size, with prominent nucleoli and irregular nuclear membrane clefts. The cells vary markedly in size but show similar cytologic characteristics.<\/p>\n

 <\/p>\n


\n\"Image<\/a><\/p>\n
\n

Figure 32<\/strong><\/p>\n

Pleural effusion: Non-Hodgkin’s lymphoma. 60X<\/p>\n<\/div>\n<\/div>\n

Figure 32
\n<\/strong>
\nPleural effusion:
\nNon-Hodgkin’s lymphoma.
\n60X<\/div>\n
<\/div>\n

This pleural effusion also has a distinct population of discohesive mononuclear cells, allowing the diagnosis of lymphoma. Note the necrotic background.<\/p>\n


\n\"Image<\/a><\/p>\n
\n

Figure 33<\/strong><\/p>\n

Pleural effusion: Chronic lymphocytic leukemia. 60X<\/p>\n<\/div>\n<\/div>\n

Figure 33
\n<\/strong>Pleural effusion:
\nChronic lymphocytic leukemia.
\n60X<\/div>\n
<\/div>\n

The presence of small uniform lymphocytes in a pleural effusion may indicate tuberculosis, thoracic duct obstruction or leukemia\/lymphoma. Chronic lymphocytic leukemia and well-differentiated lymphocytic lymphomas may include a pleural effusion consisting of small, round lymphocyte. When a question exists, flow cytometry can confirm the clonal nature of these cells.<\/p>\n

 <\/p>\n


\n\"Image<\/a><\/p>\n
\n

Figure 34<\/strong><\/p>\n

Pleural effusion: Chronic lymphocytic leukemia. 60X<\/p>\n<\/div>\n<\/div>\n

Figure 34
\n<\/strong>Pleural effusion:
\nChronic lymphocytic leukemia.
\n60X<\/div>\n
<\/div>\n

An example of small, round lymphocytes in a pleural effusion. The differential diagnosis includes inflammatory conditions such as tuberculosis, and autoimmune diseases.<\/p>\n


\n\"Image<\/a><\/p>\n
\n

Figure 35<\/strong><\/p>\n

Pleural effusion: Non-Hodgkin’s lymphoma. 20X<\/p>\n<\/div>\n<\/div>\n

Figure 35
\n<\/strong>
\nPleural effusion:
\nNon-Hodgkin’s lymphoma.
\n20X<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
\n

Figure 36<\/strong><\/p>\n

Pleural effusion: Non-Hodgkin’s lymphoma. 60X<\/p>\n<\/div>\n<\/div>\n

Figure 36
\n<\/strong>
\nPleural effusion:
\nNon-Hodgkin’s lymphoma.
\n60X<\/div>\n
<\/div>\n

Figures 35-36:<\/strong>
\nThe neoplastic lymphocytes in these two photos may appear small and monotonous, but compared to the background lymphocytes, they are considerably larger. Nuclei are vesicular, with nuclear clefting and lobation and variably prominent nucleoli.<\/p>\n


\n\"Image<\/a><\/p>\n
\n

Figure 37<\/strong><\/p>\n

Pleural effusion: Multiple myeloma. 20X<\/p>\n<\/div>\n<\/div>\n

Figure 37
\n<\/strong>
\nPleural effusion:
\nMultiple myeloma.
\n20X<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
\n

Figure 38<\/strong><\/p>\n

Pleural effusion: Multiple myeloma. 40X<\/p>\n<\/div>\n<\/div>\n

Figure 38
\n<\/strong>
\nPleural effusion:
\nMultiple myeloma.
\n40X<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
\n

Figure 39<\/strong><\/p>\n

Pleural effusion: Multiple myeloma. 60X<\/p>\n<\/div>\n<\/div>\n

Figure 39
\n<\/strong>
\nPleural effusion:
\nMultiple myeloma.
\n60X<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
\n

Figure 40<\/strong><\/p>\n

Pleural effusion: Multiple myeloma. 60X<\/p>\n<\/div>\n<\/div>\n

Figure 40
\n<\/strong>
\nPleural effusion:
\nMultiple myeloma.
\n60X<\/div>\n
<\/div>\n

Figures 37-40:<\/strong>
\nCells of plasmacytoma or multiple myeloma superficially resemble lymphocytes, but exhibit eccentric nuclei. The open chromatin pattern with variable nucleoli are features of plasmablasts. Again, if there is a doubt, flow cytometry can establish monoclonality.<\/p>\n


\n\"Image<\/a><\/p>\n
\n

Figure 41<\/strong><\/p>\n

Pleural effusion: Malignant melanoma. 20X<\/p>\n<\/div>\n<\/div>\n

Figure 41
\n<\/strong>
\nPleural effusion:
\nMalignant melanoma.
\n20X<\/div>\n
<\/div>\n

Malignant melanoma cells may present in effusions with or without an antecedent skin tumor. They often metastasize to unusual places such as small bowel serosa.<\/p>\n


\n\"Image<\/a><\/p>\n
\n

Figure 42<\/strong><\/p>\n

Pleural effusion: Malignant melanoma. 60X<\/p>\n<\/div>\n<\/div>\n

Figure 42
\n<\/strong>
\nPleural effusion:
\nMalignant melanoma.
\n60X<\/div>\n<\/div>\n
<\/div>\n

Cells are discohesive because these are not true epithelial cells. Nuclei are large and vesicular and may include a pseudo-inclusion, which is in reality cytoplasm indenting the nuclear membrane. Pigmentation of the cytoplasm is often but not always present. Immunohistochemistry can confirm the identity of these cells either on ThinPrep slides or cell block material.[\/vc_column_text][vc_column_text css=”.vc_custom_1500390293825{margin-top: 30px !important;}” el_class=”back-to-top”]Back to Top<\/a><\/strong>[\/vc_column_text][\/vc_column][vc_column width=”1\/3″ offset=”vc_hidden-sm vc_hidden-xs”][vc_widget_sidebar sidebar_id=”consulting-right-sidebar”][\/vc_column][\/vc_row]<\/p>\n","protected":false},"excerpt":{"rendered":"

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