s. ziadi, md; m. bongiovanni, md, miac; cytopathologie
TRANSCRIPT
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S. Ziadi, MD; M. Bongiovanni, MD, MIAC; Cytopathologie, CHUV, Lausanne
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Male, 88 yo
Presented with abundant pericardial effusion Unremarkable clinical history
Absence of any expanding mass on imaging
Clinical information
Pericardial effusion fluid for cytological examination
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Pap, 400x
Cytological features
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Pap, 600x
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Pap, 600x
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Giemsa, 600x
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Giemsa, 600x
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Cytobloc, 600x
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Cytobloc, 600x
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Immunocytochemistry
CD20, cytobloc, 400x
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Immunocytochemistry
CD3, CD5: BCL-2, MUM-1, CD138, CD23, CD5, Tdt: MYC:
Calretinin, Ber-Ep4, CK7 :
Negatives
Rares T cells positives
Nuclear positivity, 35% of cells
Negatives
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Immunocytochemistry
-EBV ISH EBER
-EBV-LMP1
-HHV-8
Negatives
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FISH sur cytobloc
-BCL2 FISH DNA Probe, Split Signal (18q21)
-BCL6 FISH DNA Probe, Split Signal (3q27)
-MYC Dual Color Break Apart Rearrangement Probe (8q24)
B. Bisig, MD, Molecular Pathology Lab, Institute of Pathology, CHUV, Lausanne
No rearrangements
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Cytological diagnosis
HHV-8 unrelated PEL – LL
-HHV-8 unrelated
primary effusion lymphoma-like lymphoma-
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PEL is a rare type of non-Hodgkin lymphoma arising from a B-cell
lineage
It is confined to lymphomatous effusion in a body cavity
There are not detectable tumor masses
PEL is usually found in HIV-positive immunocompromised patients
PEL is usually positive for HHV-8 infection.
Primary effusion lymphoma- PEL
Discussion
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PEL has poor prognosis and yet no standard treatment exists
The median survival is 4 months
PEL may also occur in HIV-negative individuals who are not
immunosuppressed and in the absence of HHV-8 infection.
Primary effusion lymphoma- PEL
Discussion
HHV-8 unrelated PEL-LL - primary effusion lymphoma-like lymphoma-
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PEL-LL usually occurs in elderly individuals
PEL-LL follows a more indolent prognosis then PEL
HHV-8 unrelated PEL-LL - primary effusion lymphoma-like
lymphoma-
Discussion
Kim HJ, et al. Human herpes virus 8-unrelated primary effusion lymphoma-like lymphoma presenting with cardiac tamponade: A case report. Medicine (Baltimore). 2017 Oct;96(43):e8010.