Diagnostic Usefulness of Cell Block Samples in Fluid Overload-Associated Large B-Cell Lymphoma

Area of Science:

• Hematology
• Oncology
• Pathology

Background:

• Fluid overload-associated B-cell lymphoma (FO-LBCL) is a distinct B-cell neoplasm.
• It characteristically presents as serous effusions without solid tumor masses.
• FO-LBCL is typically negative for Kaposi sarcoma-associated herpesvirus (KSHV)/human herpesvirus 8 (HHV8).

Purpose of the Study:

• To report a case of FO-LBCL in an 81-year-old female patient.
• To detail the diagnostic approach using cytological and immunohistochemical analysis.
• To illustrate the effectiveness of systemic chemotherapy in achieving remission.

Main Methods:

• Cytological examination of pericardial and pleural effusions.
• Immunohistochemical analysis of a pleural fluid cell block.
• Clinical and imaging findings assessment.
• Systemic chemotherapy administration.

Main Results:

• Cytology revealed medium- to large-sized atypical lymphoid cells.
• Immunohistochemistry confirmed CD20 and CD79a positivity, and negativity for CD3, KSHV/HHV-8, and Epstein-Barr virus.
• The Ki-67 labeling index was high at 95%.
• The patient achieved complete remission with no recurrence over a 3-year follow-up.

Conclusions:

• FO-LBCL diagnosis relies on cytological, clinical, and imaging data.
• Immunohistochemical analysis of cell blocks is crucial for accurate diagnosis and treatment planning.
• Systemic chemotherapy is an effective treatment modality for FO-LBCL.