Cytological findings from pericardial fluid of malignant lymphoma, suspiciously arise from the heart-A case report-

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  • 心嚢液細胞診にて悪性リンパ腫を推定し心臓原発が疑われた１例

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Background : Primary cardiac lymphoma is very rare. We report cytological findings for pericardial fluid from a patient with primary cardiac lymphoma.<br>Case : A 63-year-old Japanese woman admitted for dyspnea on effort was found in ultrasonic cardiography to have a large amount of pericardial fluid and a tumor in the right ventricle. Pericardial fluid cytology specimens showed numerous large lymphoid cells with scant cytoplasm. Some had intracytoplasmic vacuoles. They had round or irregular nuclei with small but conspicuous nucleoli. Cytology results suggested diffuse large B-cell lymphoma (DLBCL). Myocardial biopsy yielded only crushed specimens. Flow cytometry showed a distinct clonal B-cell population--CD19+, CD20+, and kappa-light chain+.<br>Conclusion : Cytological diagnostics between cardiac DLBCL and small round cell sarcoma included angiosarcoma, rhabdomyosarcoma, small cell carcinoma, and adenocarcinoma. Our case indicates that combined cytological findings and flow cytometry information appear useful in diagnosing DLBLC in pericardial fluid.

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