A case of primary effusion lymphoma-like lymphoma for which a cell block was useful for diagnosis

• Published in: Japanese Journal of Medical Technology Vol. 68; no. 3; pp. 602 - 606
• Main Authors: SUZUKI, Yu, UEMATSU, Miyuki, OGATA, Shin-ya, WATANABE, Izumi, KURONUMA, Sayaka, UENO, Hiroki, GOKON, Shuhei, YANAGAWA, Naoki
• Format: Journal Article
• Language: Japanese
• Published: Japanese Association of Medical Technologists 25.07.2019; 一般社団法人 日本臨床衛生検査技師会
• Subjects: cell-block; cytology; human herpes virus type 8 (HHV-8); primary effusion lymphoma (PEL); primary effusion lymphoma-like lymphoma (PEL-LL); セルブロック; ヒトヘルペスウイルス8型; 原発性滲出液リンパ腫; 原発性滲出液リンパ腫様リンパ腫; 細胞診
• ISSN: 0915-8669; 2188-5346
• DOI: 10.14932/jamt.19-22

Background: Primary effusion lymphoma (PEL) is a rare malignant lymphoma observed as an effusion in the body cavity without forming any tumor masses and is associated with human herpes virus type 8 (HHV-8) infection. We report a case of PEL-like lymphoma (PEL-LL) observed as a pleural effusion in the absence of HHV-8 infection. A cytology cell block of the pleural effusion was useful for diagnosis. Case: A female in her 90s complained of dyspnea. A chest X-ray examination showed a large amount of bilateral pleural effusion, and thoracic drainage was performed. Pleural effusion cytology showed a large number of atypical cells with large irregular nuclei. Immunocytochemical analysis using a cell block showed CD20, CD79a, and bcl-2 positivities. Therefore, the patient was diagnosed as having diffuse large B cell malignant lymphoma. No tumor mass or lymph node swelling was detected by enhanced computed tomography and no HHV-8 was detected. Therefore, this patient was diagnosed as having PEL-LL. Conclusion: In the present case, the use of a cytology cell block from pleural effusion drained for the first time enabled rapid immunocytochemical analysis, resulting in early diagnosis. Several previous studies have shown that PEL-LL disappeared following effusion drainage. Therefore, constructing a cytology cell block from the initial drained effusions is important for the diagnosis of PEL-LL.