Small noncleaved cell lymphoma presenting as a massive pericardial effusion. A case report

Area of Science:

• Oncology
• Hematology
• Cardiology

Background:

• Cardiac involvement is common in advanced non-Hodgkin's lymphoma (NHL), particularly with mediastinal disease.
• Initial presentation of NHL as pericardial effusion is rare, with only 12 reported cases.
• Prior to this study, only 5 of 12 reported cases were diagnosed antemortem via pericardial fluid analysis.

Purpose of the Study:

• To report a rare case of non-Hodgkin's lymphoma presenting as a massive pericardial effusion.
• To highlight the utility of combined cytomorphology and flow cytometry for rapid diagnosis.

Main Methods:

• A 71-year-old female presented with a massive pericardial effusion.
• Diagnosis of small noncleaved cell lymphoma was achieved through cytologic examination and flow cytometric immunophenotyping of pericardial fluid.
• No surgical tissue biopsy was performed.

Main Results:

• The pericardial effusion was diagnosed as small noncleaved cell lymphoma.
• The diagnostic methods used were expeditious and did not require tissue biopsy.
• The patient was staged and treatment was initiated based on the diagnosis.

Conclusions:

• Combining cytomorphology and flow cytometric immunophenotyping enables rapid, nonsurgical diagnosis of NHL presenting as pericardial effusion.
• This diagnostic approach facilitates timely therapeutic decision-making for high-grade lymphoma.
• This case underscores the importance of considering lymphoma in the differential diagnosis of unexplained pericardial effusions.