Cytomorphology of Hematolymphoid Neoplasms in Body Cavity Effusions: Diagnostic Value and Prognostic Implications - A Case Series.
4 affiliations
- 1Histopathology and Cytopathology Laboratory, Department of Pathology, King George's Medical University, Lucknow, India, [email protected].
- 2Histopathology and Cytopathology Laboratory, Department of Pathology, King George's Medical University, Lucknow, India.
- 3Hematology and LL Laboratory, Department of Pathology, King George's Medical University, Lucknow, India.
- 4Department of Clinical Haematology, King George's Medical University, Lucknow, India.
Abstract
Introduction
Involvement of the pleural and peritoneal cavities by hematolymphoid malignancies is relatively infrequent compared to epithelial malignancies, though reported rates vary widely depending on institutional and demographic factors. When present, they may or may not be the first manifestation of disease; however, they usually indicate an advanced stage. Cytological recognition is often challenging due to morphological overlap with reactive processes, yet it remains a valuable, minimally invasive diagnostic tool. This study describes the cytomorphological spectrum, diagnostic contribution, and clinical outcomes of hematolymphoid malignancies detected in effusion cytology and contextualizes findings with published literature.Case presentations
A retrospective review was conducted of all effusion cytology samples reported between August 2024 and August 2025 at a tertiary care center. Cases demonstrating atypical hematolymphoid cells were analyzed for clinical presentation, cytomorphology, and follow-up. A review of published English literature was also undertaken. Four hematolymphoid malignancies were identified, comprising 12.9% (4/31) of malignant effusions and 0.22% (4/1,807) of all effusion samples. Cytology was the initial diagnostic clue in 2 patients: a 16-year-old male with gastric myeloid sarcoma (alive and stable post-chemotherapy) and a 41-year-old male with ileocecal diffuse large B-cell lymphoma (died before treatment). Two additional cases represented follow-up effusions: a 60-year-old female with acute myeloid leukemia and a 62-year-old male with chronic myeloid leukemia on imatinib therapy, both of whom died shortly after effusion development. Morphological hallmarks included blasts, atypical lymphoid cells, hand-mirror forms, and immature myeloid elements.Conclusion
Though infrequently positive in hematolymphoid malignancies, effusion cytology can provide pivotal early diagnostic information and guide clinical management. Recognition of subtle cytomorphological features is essential as effusion involvement typically reflects aggressive disease and adverse outcomes.
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BibTeX
@article{agarwal2026cytomorphology,
title = {{Cytomorphology of Hematolymphoid Neoplasms in Body Cavity Effusions: Diagnostic Value and Prognostic Implications - A Case Series.}},
author = {Preeti Agarwal and Mamta Dwivedi and Geeta Yadav and Madhu Kumar and Rashmi Kushwaha and Debarati Mitra and Himanshu Mohan and Mitali Rawat and Shailendra Prasad Verma},
journal = {Acta cytologica},
year = {2026},
month = oct,
doi = {10.1159/acy/abjag009},
url = {https://europepmc.org/article/MED/42853724},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Cytomorphology of Hematolymphoid Neoplasms in Body Cavity Effusions: Diagnostic Value and Prognostic Implications - A Case Series.
AU - Preeti Agarwal
AU - Mamta Dwivedi
AU - Geeta Yadav
AU - Madhu Kumar
AU - Rashmi Kushwaha
AU - Debarati Mitra
AU - Himanshu Mohan
AU - Mitali Rawat
AU - Shailendra Prasad Verma
PY - 2026
DA - 2026/10/09
JO - Acta cytologica
DO - 10.1159/acy/abjag009
UR - https://europepmc.org/article/MED/42853724
AB - Introduction Involvement of the pleural and peritoneal cavities by hematolymphoid malignancies is relatively infrequent compared to epithelial malignancies, though reported rates vary widely depending on institutional and demographic factors. When present, they may or may not be the first manifestation of disease; however, they usually indicate an advanced stage. Cytological recognition is often challenging due to morphological overlap with reactive processes, yet it remains a valuable, minimally invasive diagnostic tool. This study describes the cytomorphological spectrum, diagnostic contribution, and clinical outcomes of hematolymphoid malignancies detected in effusion cytology and contextualizes findings with published literature.Case presentations A retrospective review was conducted of all effusion cytology samples reported between August 2024 and August 2025 at a tertiary care center. Cases demonstrating atypical hematolymphoid cells were analyzed for clinical presentation, cytomorphology, and follow-up. A review of published English literature was also undertaken. Four hematolymphoid malignancies were identified, comprising 12.9% (4/31) of malignant effusions and 0.22% (4/1,807) of all effusion samples. Cytology was the initial diagnostic clue in 2 patients: a 16-year-old male with gastric myeloid sarcoma (alive and stable post-chemotherapy) and a 41-year-old male with ileocecal diffuse large B-cell lymphoma (died before treatment). Two additional cases represented follow-up effusions: a 60-year-old female with acute myeloid leukemia and a 62-year-old male with chronic myeloid leukemia on imatinib therapy, both of whom died shortly after effusion development. Morphological hallmarks included blasts, atypical lymphoid cells, hand-mirror forms, and immature myeloid elements.Conclusion Though infrequently positive in hematolymphoid malignancies, effusion cytology can provide pivotal early diagnostic information and guide clinical management. Recognition of subtle cytomorphological features is essential as effusion involvement typically reflects aggressive disease and adverse outcomes.
SN - 0001-5547
SN - 1938-2650
ER -