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Related Concept Videos

Pleural Effusion I: Introduction01:25

Pleural Effusion I: Introduction

Pleural effusion is an abnormal fluid accumulation in the pleural cavity, a narrow space between the lungs and the chest wall. It is not a disease per se but rather a symptom or indication of an underlying disease. In normal circumstances, this space contains a small amount of fluid (5 to 15 mL), a lubricant facilitating the non-frictional movement of the pleural surfaces.
There are two main types of pleural effusion: transudative and exudative. They are differentiated using Light's criteria,...
Pleural Effusion II: Symptoms and Management01:28

Pleural Effusion II: Symptoms and Management

Pleural Effusion Overview
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations:
Cytotoxic Edema: Pathophysiology01:21

Cytotoxic Edema: Pathophysiology

Cytotoxic edema is a form of cerebral edema characterized by intracellular swelling of neurons, astrocytes, and other glial cells. It develops when the mechanisms responsible for maintaining ionic gradients across the cell membrane become impaired. Under normal physiological conditions, the sodium–potassium ATPase actively transports sodium ions out of the cell and potassium ions into the cell, preserving osmotic balance and enabling electrical signaling. This pump requires a continuous supply...
Ascites01:19

Ascites

DefinitionAscites is the buildup of fluid inside the peritoneal cavity. It occurs when fluid moves out of the vascular system faster than the peritoneal lymphatics can remove it. This fluid shift is most commonly seen in liver cirrhosis but can also appear in several other systemic disorders.EtiologyCirrhosis remains the leading cause of ascites. Other conditions that can contribute include:Heart failureConstrictive pericarditisAbdominal cancersNephrotic syndromeSevere protein–calorie...

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Related Experiment Video

Updated: Jul 23, 2026

Ultrasonographic Evaluation of Breast Cancer-related Lymphedema
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Serous effusions in malignant lymphomas: a review.

Dilip K Das1

  • 1Department of Pathology, Faculty of Medicine, Kuwait University, Kuwait.

Diagnostic Cytopathology
|April 11, 2006
PubMed
Summary

Serous effusions are common in lymphomas, particularly T-cell neoplasms. Ancillary studies like immunocytochemistry and flow cytometry are crucial for accurate diagnosis and classification of lymphomas in effusions.

Area of Science:

  • Hematology
  • Oncology
  • Cytopathology

Background:

  • Serous effusions, especially pleural effusions, are frequent complications in lymphomas, occurring in 20-30% of non-Hodgkin's lymphoma (NHL) and Hodgkin's disease (HD) cases.
  • While pleural effusions are common, involvement of peritoneal and pericardial cavities is less frequent. T-cell neoplasms, particularly lymphoblastic lymphomas, show a higher propensity for serous fluid involvement.
  • Pathogenesis varies, with thoracic duct obstruction in HD and direct pleural infiltration in NHL being primary mechanisms for pleural effusion.

Purpose of the Study:

  • To review the cytologic features and diagnostic challenges of lymphomas in serous effusions.
  • To highlight the utility of ancillary studies in differentiating lymphomas from other conditions and in classifying lymphoma subtypes.
  • To discuss the clinical significance and prognostic implications of lymphomas presenting as serous effusions, including primary effusion lymphoma (PEL).

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Main Methods:

  • Review of cytologic findings and diagnostic criteria for lymphomas in serous effusions.
  • Evaluation of ancillary techniques including immunocytochemistry (ICC), morphometry, flow cytometry (FCM), and molecular genetics (PCR, in-situ hybridization, Southern blotting).
  • Analysis of pathogenetic mechanisms and clinical presentation of primary effusion lymphoma (PEL).

Main Results:

  • Cytologic diagnosis of NHL in pleural effusion shows wide variation in positive findings (22.2-94.1%).
  • Ancillary studies significantly improve diagnostic accuracy: ICC aids in classification, FCM offers 100% sensitivity/specificity when combined with morphology, and morphometry distinguishes lymphoma from reactive lymphocytosis.
  • Primary effusion lymphoma (PEL), a distinct entity often seen in AIDS patients, presents exclusively in serous cavities and is characterized by large cells with variable immunophenotypes.

Conclusions:

  • Accurate diagnosis of lymphomas in serous effusions relies on a combination of morphology and ancillary studies.
  • The presence of lymphoma in serous effusions, particularly pleural effusion, is associated with a poor prognosis and predicts relapse.
  • Thoracentesis with cytologic and ancillary analysis is crucial for initial diagnosis and prognostication in patients with lymphomatous effusions presenting with respiratory distress.