2012 04 Diagnosis Pleural fluid left aspiration cytology

2012 04월 Diagnosis : Pleural fluid, left, aspiration cytology ; Negative for malignancy

2012 10 PET-CT & Chest PA

CB

Cytologic Findings 1. 2. High cellularity Singly scattered large cells 1. Moderately abundant cytoplasm 2. Round to irregular nuclear membrane 3. Small tongue like nuclear projection 4. 1~2 Prominent nucleoli 5. Cytoplasmic vacuoles 3. Lymphoglandular bodies

Differential diagnosis 1. Malignant lymphoma ; 1. Primary effusion lymphoma 2. Pyothorax associated lymphoma 3. Secondary involvement 2. Metastatic tumor ; 1. Carcinoma 2. Malignant melanoma 3. Mesothelial lesion ; 1. Reactive mesothelial cell 2. Malignant mesothelioma

CB ; Immunohistochemistry Positive CD 30 HHV 8 CD 138 Negative CD 3 CD 20 CD 79 a VS 38 Ki-67 EBER-1 m. RNA ISH S-100 Calretinin CK

CD 20 CD 3 CD 79 a EBER-1 m. RNA ISH

CD 30 CD 138 HHV 8 Ki-67

Cytologic Diagnosis • Diagnosis : Pleural fluid, left, aspiration cytology : Malignant lymphoma , primary effusion lymphoma

Primary effusion lymphoma • Definition – A large B-cell neoplasm usually presenting as serous effusions without detectable tumor masses

Primary effusion lymphoma • Epidemiology – In young or middle-aged homo- or bisexual males with HIV(+) and severe immunodeficiency – In the absence of immunodeficiency • Elderly pts • High prevalence for HHV 8 infection – Co-infection with monoclonal EBV * EBV-associated HHV 8(-) large B-cell lymphoma : occuring with chronic suppurative inflammation, such as pyothorax associated lymphoma

Primary effusion lymphoma Chen et al. The oncologist 2007; 12: 569 -576