{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T03:04:25Z","timestamp":1791255865915,"version":"4.1.0"},"reference-count":136,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2006,4,7]],"date-time":"2006-04-07T00:00:00Z","timestamp":1144368000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostic Cytopathology"],"published-print":{"date-parts":[[2006,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Serous effusions are a common complication of lymphomas. Although the frequency of pleural effusion is 20\u201330% in non\u2010Hodgkin's lymphoma (NHL) and Hodgkin's disease (HD), the involvement of peritoneal and pericardial cavities is uncommon. Among lymphoma subtypes, T\u2010cell neoplasms, especially the lymphoblastic lymphomas, more frequently involve the serous fluids. The thoracic duct obstruction and impaired lymphatic drainage appear to be the primary mechanism for pathogenesis of pleural effusion in HD and direct pleural infiltration is the predominant cause in NHL. There is wide variation in rate of positive cytologic findings of NHL in pleural effusion (22.2\u201394.1%). Cytologic features of specific lymphoma subtypes such as lymphoblastic lymphoma, follicular center cell lymphoma, including Burkitt\u2010type lymphoma, marginal zone lymphoma, MALT lymphoma, and anaplastic large\u2010cell lymphoma, etc., have been described in the literature. The differential diagnostic problems of lymphomas in serous effusions include reactive lymphocytoses, early involvement by lymphomatous process, small round\u2010cell tumors (SRCT), and presence of look\u2010alike of Reed\u2013Sternberg cells. To overcome these difficulties, various ancillary studies, including immunocytochemistry (ICC), morphometry, flow cytometry (FCM), and cytogenetics\/molecular genetics (PCR, insitu hybridization, and Southern blotting), have been performed on effusion specimens. ICC not only distinguishes lymphomas from reactive lymphocytoses and SRCTs, it significantly modifies the morphologic diagnosis to achieve a better classification of lymphomas. Combined morphology and immunophenotyping by FCM, has a sensitivity as well as specificity of 100%. Morphometry also distinguishes reactive lymphocytoses from malignant lymphoma with a high degree of sensitivity (&gt;85%) and specificity (&gt;95%). Limitations of individual ancillary techniques can be overcome by using multiple parameters. Although lymphomas rarely present as serous effusions without the involvement of other thoracic and extrathoracic sites, a small group of lymphomas called primary effusion lymphomas (PEL) exhibit exclusive or dominant involvement of serous cavities, without a detectable solid tumor mass. This body cavity based lymphoma (BCBL) is a distinct clinicopathologic entity and is found predominantly in AIDS patients with preexisting Kaposi sarcoma. In the absence of obstructive or infiltrative tumor mass, its pathogenesis has been attributed to stimulation by vascular endothelial growth factor (VEGF)\/vascular permeability factor (VPF), leading to vascular leakage. Cytomorphologically, PEL is usually a large\u2010cell lymphoma, which appears to bridge features of large\u2010cell immunoblastic and anaplastic large\u2010cell lymphoma (ALCL). Most of these cases comprise a unique subgroup of B\u2010cell lymphoma, with features of both high\u2010grade anaplastic and B\u2010immunoblastic lymphoma, but T\u2010cell and\/or natural killer cell immunophenotypes are described. Its association with various viral DNAs has been studied in detail by molecular techniques. Pleural effusion due to lymphomas, either primary or otherwise, is considered as one of the factors adversely influencing overall survival. The presence of pleural effusion at the time of presentation is not only associated with extremely poor outcome of lymphomas, it is also a predictor of disease relapse after chemotherapy and decreased survival. When the patients of lymphomatous pleural effusions with and without mediastinal mass present in respiratory distress, thoracocentesis is the initial diagnostic and therapeutic choice in these patients. In such situations, cytology along with ancillary studies not only gives a quick diagnosis of lymphoma, but also offers prognostically significant information such as classification of lymphomas, its grade and immunophenotype, and presence\/absence of viral DNAs and tumor lysis syndrome. Diagn. Cytopathol. 2006; 34:335\u2013347. \u00a9 2006 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/dc.20432","type":"journal-article","created":{"date-parts":[[2006,4,7]],"date-time":"2006-04-07T23:47:43Z","timestamp":1144453663000},"page":"335-347","source":"Crossref","is-referenced-by-count":195,"title":["Serous effusions in malignant lymphomas: A review"],"prefix":"10.1002","volume":"34","author":[{"given":"Dilip K.","family":"Das","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2006,4,7]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.112.4_Supplement.291S"},{"key":"e_1_2_1_3_2","first-page":"551","volume-title":"Comprehensive cytopathology","author":"Naylor B","year":"1997"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19850815)56:4<905::AID-CNCR2820560435>3.0.CO;2-U"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.109.1.158"},{"key":"e_1_2_1_6_2","first-page":"38","article-title":"Clinical features and management of malignant ascites","volume":"41","author":"Malik I","year":"1991","journal-title":"J Pak Med Assoc"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.34.1.106"},{"key":"e_1_2_1_8_2","first-page":"19","article-title":"The diagnostic yield of pleural fluid cytology in malignant pleural effusion","volume":"41","author":"Ong KC","year":"2000","journal-title":"Singapore Med J"},{"key":"e_1_2_1_9_2","first-page":"1429","volume-title":"Fishman's pulmonary diseases and disorders","author":"Sahn SA","year":"1998"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1159\/000332540"},{"key":"e_1_2_1_11_2","first-page":"209","article-title":"Cytology of fluids from pleural, peritoneal and pericardial cavities in children. 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