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Peer-reviewedCC BY 4.0Diagnostic Cytopathology

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

  • Hiroyuki Okanishi1
  • Hiroko Kuwabara1
  • Hiroko Nakayama1
  • Mayo Odaka1
  • Kozue Ariga1
  • Isako Kataoka1
  • Mari Tomiuka1
  • Mayumi Uragami1
  • Chihiro Deguchi1
  • Shizuka Ono1
  • Reika Takeda1
  • Yoshitaka Kurisu1
3 more authors
  • Yoshinobu Hirose1
  • Yuuki Kinoshita2
  • Taiji Yokote2
  1. 1Division of Diagnostic Pathology Osaka Medical and Pharmaceutical University Hospital Osaka Japan
  2. 2Division of Hematology Osaka Medical and Pharmaceutical University Hospital Osaka Japan
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Abstract

Fluid overload‐associated B‐cell lymphoma (FO‐LBCL) is a B‐cell neoplasm that presents as serous effusions without detectable tumor masses and Kaposi sarcoma‐associated herpesvirus (KSHV)/human herpesvirus 8 (HHV8) infection. Here, we report a case of an 81‐year‐old female patient with FO‐LBCL (Stage IVA) who presented with pericardial and pleural effusions. The patient had no underlying medical condition that could lead to fluid overload. Cytological examination of both effusions revealed medium‐ to large‐sized lymphoid cells with high nucleocytoplasmic ratios, irregular nuclei, dense chromatin, prominent nucleoli, mitotic figures, basophilic cytoplasm, and lymphoglandular bodies. A cell block of the pleural fluid effusion showed that atypical lymphoid cells were positive for CD20 and CD79a, and negative for CD3, KSHV/HHV‐8, and Epstein–Barr virus. The Ki‐67 labeling index was 95%. The patient underwent systemic chemotherapy and achieved complete remission without pleural or pericardial recurrence during the 3‐year follow‐up period. As FO‐LBCL is diagnosed based on cytological material, together with clinical and imaging findings, immunohistochemical analysis of the cell block is useful for confirming the diagnosis and selecting tailored therapies.

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Cite

BibTeXRIS
BibTeX
@article{okanishi2026diagnostic,
  title = {{Diagnostic Usefulness of Cell Block Samples in Fluid Overload‐Associated Large B‐Cell Lymphoma}},
  author = {Hiroyuki Okanishi and Hiroko Kuwabara and Hiroko Nakayama and Mayo Odaka and Kozue Ariga and Isako Kataoka and Mari Tomiuka and Mayumi Uragami and Chihiro Deguchi and Shizuka Ono and Reika Takeda and Yoshitaka Kurisu and Yoshinobu Hirose and Yuuki Kinoshita and Taiji Yokote},
  journal = {Diagnostic Cytopathology},
  year = {2026},
  month = aug,
  doi = {10.1002/dc.70198},
  url = {https://doi.org/10.1002/dc.70198},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Diagnostic Usefulness of Cell Block Samples in Fluid Overload‐Associated Large B‐Cell Lymphoma
AU  - Hiroyuki Okanishi
AU  - Hiroko Kuwabara
AU  - Hiroko Nakayama
AU  - Mayo Odaka
AU  - Kozue Ariga
AU  - Isako Kataoka
AU  - Mari Tomiuka
AU  - Mayumi Uragami
AU  - Chihiro Deguchi
AU  - Shizuka Ono
AU  - Reika Takeda
AU  - Yoshitaka Kurisu
AU  - Yoshinobu Hirose
AU  - Yuuki Kinoshita
AU  - Taiji Yokote
PY  - 2026
DA  - 2026/08/11
JO  - Diagnostic Cytopathology
DO  - 10.1002/dc.70198
UR  - https://doi.org/10.1002/dc.70198
AB  - Fluid overload‐associated B‐cell lymphoma (FO‐LBCL) is a B‐cell neoplasm that presents as serous effusions without detectable tumor masses and Kaposi sarcoma‐associated herpesvirus (KSHV)/human herpesvirus 8 (HHV8) infection. Here, we report a case of an 81‐year‐old female patient with FO‐LBCL (Stage IVA) who presented with pericardial and pleural effusions. The patient had no underlying medical condition that could lead to fluid overload. Cytological examination of both effusions revealed medium‐ to large‐sized lymphoid cells with high nucleocytoplasmic ratios, irregular nuclei, dense chromatin, prominent nucleoli, mitotic figures, basophilic cytoplasm, and lymphoglandular bodies. A cell block of the pleural fluid effusion showed that atypical lymphoid cells were positive for CD20 and CD79a, and negative for CD3, KSHV/HHV‐8, and Epstein–Barr virus. The Ki‐67 labeling index was 95%. The patient underwent systemic chemotherapy and achieved complete remission without pleural or pericardial recurrence during the 3‐year follow‐up period. As FO‐LBCL is diagnosed based on cytological material, together with clinical and imaging findings, immunohistochemical analysis of the cell block is useful for confirming the diagnosis and selecting tailored therapies.
SN  - 8755-1039
SN  - 1097-0339
ER  -