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Immunocytochemical study of malignant lymphoma in serous effusions
G C Santos1, A Longatto-Filho, L V de Carvalho
1Department of Pathology, Medicine School, Federal University of São Paulo State, Brazil.
Insights
Cytology effectively evaluates serous effusions in malignant lymphoma (ML). Immunophenotyping lymphoid cells aids in confirming cytologic diagnoses, showing high accuracy with no false positives in this study.
Area of Science:
- Cytopathology
- Hematopathology
- Immunohistochemistry
Background:
- Serous effusions are commonly associated with malignant lymphoma (ML).
- Accurate cytological evaluation and subclassification of ML in effusions are crucial for patient management.
- Immunophenotyping aids in differentiating lymphoid cell types.
Purpose of the Study:
- To cytologically evaluate serous effusions linked to ML.
- To determine immunoreaction patterns of lymphoid cells in effusions.
- To correlate cytomorphology with tissue diagnoses.
Main Methods:
- Retrospective review of 4,297 serous effusions (256 with ML) from 1966-1990.
- Immunocytochemical staining of Papanicolaou-stained cytocentrifuge slides using L-26 (pan-B) and UCHL-1 (pan-T) markers.
- Immunohistochemical staining of tissue sections for comparison.
Main Results:
- Cytology showed no false positive diagnoses for ML.
- Immunocytochemistry identified pan-B positivity in 22/54 cases and pan-T in 10/54.
- Immunohistochemistry confirmed lymphoid markers in tissue, with good correlation to cytology in most cases, though some discrepancies were noted.
Conclusions:
- Cytology is a reliable method for diagnosing ML in serous effusions.
- Immunophenotyping of lymphoid cells in effusions is valuable for confirming and classifying ML diagnoses.
- High concordance between cytological and tissue-based immunophenotyping supports diagnostic accuracy.
Objective:
To cytologically evaluate a large series of serous effusions associated with malignant lymphoma (ML), identify the immunoreaction patterns of the cells from selected positive cases and to investigate the correlation of cytomorphology with tissue section diagnosis.
Study Design:
From 1966 to 1990, a review of the files of the Department of Anatomic Pathology, A. C. Camargo Hospital, disclosed 4,297 cases of serous effusions, 256 of which were associated with ML. Cytopathologically positive cases were selected for immunocytochemical study. All paraffin sections stained with hematoxylin and eosin were reviewed to confirm the malignancy of the cases. Immunostaining was performed on both cytocentrifuge slides previously stained with Papanicolaou stain and new sections of the biopsy samples using the immunoperoxidase method and avidin-biotin complex with monoclonal mouse antihuman B-cell marker L-26 and monoclonal (mouse) antihuman T-cell marker UCHL-1.
Results:
Immunocytochemical reactions were performed in 54 cases: 22 were pan-B positive and 10 pan-T positive; 24 cases showed no reactivity for either monoclonal antibody. Immunohistochemical reactions were performed in 24 available cases: 15 were pan-B positive and pan-T positive; 3 cases showed no reactivity for either monoclonal antibody. Cytohistoimmunoreactions were similar in 11 pan-B positive cases and 2 pan-T positive cases. Three cases were negative for both markers, 4 cases were pan-T positive in tissue samples and negative in cytocentrifuge smears, 3 cases were pan-B positive in tissue and negative on cytology and 3 cases were negative for both markers in both tissue and cytologic specimens.
Conclusion:
Cytology is an effective method of evaluating serous effusions associated with malignant lymphoma: no false positive diagnosis was observed in this series. Immunophenotyping of lymphoid cells is useful to classify and confirm the cytologic diagnosis.