Journal of Cytology & Histology

A Case of Fluid Overload-associated Large B-cell Lymphoma in a Human T-cell Leukemia Virus-1 Carrier

Abstract

Shinsuke Inoue, Keiji Sato, Shou Maruono, Haruto Nishida* and Tsutomu Daa

Fluid Overload-Associated Large B-Cell Lymphoma (FO-LBCL) is a rare B-cell malignancy primarily found in body fluids without obvious mass formation or Human Herpes Virus type 8 (HHV-8) involvements. We report a case in which cell block specimens were useful for the diagnosis of FO-LBCL in the primary pericardial effusion of a human T-lymphotropic virus type 1 carrier patient. A 75-year-old man presented at our hospital complaining of fatigue and anorexia. Computed tomography revealed a massive pericardial effusion, but no mass lesions or enlarged lymph nodes. Analysis of the drained pericardial fluid revealed numerous solitary atypical cells with a high nuclear/cytoplasmic ratio and irregularly shaped nuclei of various sizes on Papanicolaou staining and blast-like and large atypical cells with multiple lobulated, clover-shaped and floating nuclei on Giemsa staining. Immunohistological staining of cell block specimens showed CD20 positivity and CD3 and HHV-8 negativity. The lesion was confined to the pericardial effusion and there was no obvious mass formation; hence, the patient was diagnosed with FO-LBCL. We observed the characteristic cytological features of FO-LBCL, such as clover-like or floating nuclei, in this case.