pleural effusion

From: Brent Dorsett (brentd@nyct.net)
Date: Thu Mar 11 1999 - 21:27:50 EST


I would appreciate any input anyone might have into this unusual case.

The patient is a 48 yr. old male, HIV positive, with osteolytic lesions
in the head, cervical vertebrae and ribs, hypercalcemic and with a
pleural effusion.

We received  the pleural effusion, which showed microscopically many
medium to large sized cells with basophilic cytoplasms, somewhat
eccentric nuclei and prominent pale golgi. There were some small
vacuoles but no granules.

Because of some reported geographical exposure and the bone lesions, we
wondered about a HTLV I T- cell lymphoma.

Light scatter analysis showed a medium to large sized cell population
with a little increased ssc. The immunophenotype of these cells was:

CD45 bright
CD3 neg
CD4 98% bright
CD8 neg
CD5 neg
CD19 38%
CD10 neg
HLA DR neg
CD2 neg
CD7 neg
CD13 neg
CD14 neg
CD15 neg
CD33 neg
CD34 neg
CD24 neg
Glycophorin neg
CD9 85%
CD20 neg
CD11b neg
CD61 neg
cCD3 neg
CD22 neg
CD38 100% bright
CD11c neg
CD56 neg
cKappa neg
cLambda neg

The patient has no serum protein abnormalities.

Brent Dorsett
Lenox Hill Hospital -- NYC



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