Re: pleural effusion

From: Te Chih Liu (liutc@pacific.net.sg)
Date: Sat Mar 13 1999 - 05:13:42 EST


Based on the clinical information, my guess is a HTLV-1 T-cell lymphoma. Theses cells are of course typically CD3+/CD4+/CD25+/CD7±.



Te-Chih Liu, MD
Haematology
NUH, Singapore




>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 prominentI have always found flow analysis of pleural or ascitic fluid a little
unpredictable. Many times, the analysis is un-characteristic and the
diagnosis has to be made on other information.  The description of the
morphology of the cells can go for mesothelial cells and the immuno-type
would not be too inconsistent with this. The distinction from lymphoma
cells is however primarily by morphology.
 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:



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