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The spectrum of the cytopathological features of primary effusion lymphoma and human herpes virus 8‐related lymphoproliferative disorders
Author(s) -
Verga Luisa,
Leni Davide,
Cazzaniga Giorgio,
Crosta Simona,
Seminati Davide,
Rossi Marianna,
L'Imperio Vincenzo,
Pagni Fabio
Publication year - 2020
Publication title -
cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.512
H-Index - 48
eISSN - 1365-2303
pISSN - 0956-5507
DOI - 10.1111/cyt.12820
Subject(s) - primary effusion lymphoma , medicine , lymphoma , pathology , lymphoproliferative disorders , cytopathology , effusion , pleural effusion , virus , immunology , cytology , surgery
Human herpes virus 8‐related lymphoproliferative disorders are a complex and heterogeneous group of entities and some of them are eminently diagnosed by cytopathology. In a routine laboratory, these lesions account for less than 1% of the effusion fluids samples. However, they represent up to 30% of all the lymphoma diagnosis from effusion cytological samples and their consideration in the diagnostic flow chart is mandatory, especially in human immunodeficiency virus‐positive patients. Methods A retrospective series of cytological specimens from cavity effusions (n = 605) were analysed. Five human herpes virus 8‐related lymphoproliferative processes were recruited. A combination of morphological criteria (enhanced with May‐Grünwald Giemsa staining), cell block‐based immunocytochemistry and flow cytometry were undertaken for final characterisation. Results The identification of malignant cells may be difficult. Some specimens are particularly rich, easily leading to suspect a lymphoproliferative process, whereas in other cases, the presence of abundant reactive mesothelial cells, histiocytes, neutrophils, small reactive T and B lymphocytes may obscure the neoplastic process. The biological behaviour may be very heterogeneous and a standardised therapy for these cases is still lacking, although some patients may benefit from antiretroviral therapy in a human immunodeficiency virus setting. Conclusions The present case series highlights some characteristic findings of these entities to reaffirm useful cytopathological diagnostic criteria, stressing the crucial role of the appropriate technical processing of effusion fluids to obtain the best performances.