{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T14:51:13Z","timestamp":1747147873345,"version":"3.40.5"},"reference-count":12,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,10,29]],"date-time":"2022-10-29T00:00:00Z","timestamp":1667001600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diagnostic Cytopathology"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Acute myeloid leukemic pleural effusions are uncommon with heterogenous cytomorphology and variable immunoprofiles. This imposes a difficult cytologic diagnosis. In particular, acute myeloid leukemia of monocyte lineage mimicking benign and malignant lymphoid and non\u2010lymphoid lesions is challenging. Few cases of acute myeloid monocyte\u2010lineage leukemia have been reported. Our aim is to report a case of a 54\u2010year\u2010old female patient who presented with pancytopenia and bilateral pleural effusions. We highlight the characteristic cytomorphologic features, diagnostic pitfalls and helpful hints of acute monoblastic leukemia. Initially, the cells were misinterpreted as chronic inflammatory histiocytic infiltrates with reactive mesothelial cells. The presence of frequent mitotic figures, apoptotic bodies and a two\u2010cell population raised the possibility of neoplastic cells. The cellular infiltrate simulated lymphoma, carcinoma and melanoma tumor cells. Cellblock immunocytochemistry however showed negative B\u2010cell, T\u2010cell, myeloid, Langerhans cell, plasma cell and dendritic cell lineage markers. They were positive for LCA, CD68, CD4 and CD117 with a high Ki67 index. The cytologically suggested impression of acute myeloid leukemia of monocyte origin favoring monoblastic variant was confirmed by flow cytometry and bone marrow trephine biopsy. Cytomorphologic clues included agranular amphophilic cytoplasm, occasional grooved indented nuclei, tingible body macrophages, associated plasma cells and absent granulocytes. The cytologic and cellblock findings matched the bone marrow trephine biopsy features. Cytopathologists should be aware of this unusual and challenging cytologic diagnosis in patients with pancytopenia and utilize at least two monocyte markers when formulating their differential diagnosis. Certain cytomorphologic features are helpful hints for their correct recognition.<\/jats:p>","DOI":"10.1002\/dc.25068","type":"journal-article","created":{"date-parts":[[2022,10,29]],"date-time":"2022-10-29T13:10:15Z","timestamp":1667049015000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Acute monoblastic myeloid leukemic pleural effusion: Pitfalls and clues"],"prefix":"10.1002","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6350-1214","authenticated-orcid":false,"given":"Badr","family":"AbdullGaffar","sequence":"first","affiliation":[{"name":"Pathology Section Dubai Hospital  Dubai United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rabiah","family":"Farhan","sequence":"additional","affiliation":[{"name":"Cytology Unit Dubai Hospital  Dubai United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pankhi","family":"Dutta","sequence":"additional","affiliation":[{"name":"Hematology Unit Dubai Hospital  Dubai United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,10,29]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.24772"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12288-014-0350-z"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000335058"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2014.00130"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.25259\/Cytojournal_12_2020"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.22859"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2006.06462.x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.24649"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1984.tb04002.x"},{"key":"e_1_2_6_11_1","first-page":"43","article-title":"Reactive plasmacytosis and lymphocytosis in acute myeloid leukemia","volume":"8","author":"Rosenthal NS","year":"1994","journal-title":"Hematol Pathol"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.4103\/0971-5851.68853"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s002770050401"}],"container-title":["Diagnostic Cytopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dc.25068","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/dc.25068","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dc.25068","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T03:00:23Z","timestamp":1692586823000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/dc.25068"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,29]]},"references-count":12,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,2]]}},"alternative-id":["10.1002\/dc.25068"],"URL":"https:\/\/doi.org\/10.1002\/dc.25068","archive":["Portico"],"relation":{},"ISSN":["8755-1039","1097-0339"],"issn-type":[{"type":"print","value":"8755-1039"},{"type":"electronic","value":"1097-0339"}],"subject":[],"published":{"date-parts":[[2022,10,29]]},"assertion":[{"value":"2022-06-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}