Subclassification of lymphoproliferative disorders in serous effusions

A 10-year experience

Authors

  • Leung Chu Tong MD, FRCPC,

    1. Department of Laboratory Medicine and Pathobiology, University of Toronto, Ontario, Canada
    2. Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada
    Current affiliation:
    1. Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York
    Search for more papers by this author
  • Hyang-Mi Ko MD, PhD,

    1. Department of Laboratory Medicine and Pathobiology, University of Toronto, Ontario, Canada
    2. Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada
    Search for more papers by this author
  • Mauro Ajaj Saieg MD, PhD,

    1. Department of Laboratory Medicine and Pathobiology, University of Toronto, Ontario, Canada
    2. Department of Pathology, Santa Casa Medical School, Sao Paulo, Brazil
    Search for more papers by this author
  • Scott Boerner MD, FRCPC,

    1. Department of Laboratory Medicine and Pathobiology, University of Toronto, Ontario, Canada
    2. Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada
    Search for more papers by this author
  • William R. Geddie MD, FRCPC,

    1. Department of Laboratory Medicine and Pathobiology, University of Toronto, Ontario, Canada
    2. Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada
    Search for more papers by this author
  • Gilda da Cunha Santos MD, PhD, FRCPC, FIAC

    Corresponding author
    1. Department of Laboratory Medicine and Pathobiology, University of Toronto, Ontario, Canada
    2. Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada
    • Corresponding author: Gilda da Cunha Santos, MD, PhD, FRCPC, FIAC, Department of Laboratory Medicine and Pathobiology, University of Toronto, University Health Network, 200 Elizabeth Street, 11th Floor, Eaton Wing, Toronto, Ontario M5G 2C4; Fax: (416) 340-5517; gilda.santos@uhn.ca

    Search for more papers by this author

Abstract

BACKGROUND

Rare studies have reported the application of multiple ancillary tests to the diagnosis of lymphoproliferative disorder in serous effusions. In the current study, the authors evaluated the effectiveness of using an algorithm for the triage of serous effusions and the contribution of ancillary studies to achieve a specific subtype of lymphoproliferative disorder.

METHODS

Serous effusion samples that had a final diagnosis of lymphoproliferative disorder or suspicious for lymphoma were selected from cases that were diagnosed between 2001 and 2010. Data were collected on patient and sample characteristics as well as results from immunophenotype and molecular studies.

RESULTS

In total, 168 serous effusions were identified from 110 patients. The most common site of involvement was the pleural cavity (n = 133) followed by the peritoneal cavity (n = 30) and pericardial cavity (n = 5). The volume of serous effusions ranged from 2 mL to 1000 mL (mean, 238 mL). In 42 patients (38.2%), serous effusions were the primary source of diagnosis. In 129 patients who had a diagnosis of LPD, either generic (n = 82) or specific (n = 47) ancillary tests were performed as a single test in 58 samples (67.4%) or as a combination of multiple studies in 19 samples (23.2%). Immunophenotyping was successful in almost all samples that had a specific subtype with 16 B-cell and 4 T-cell lymphomas being diagnosed. More samples with a specific subtype of lymphoma underwent molecular tests compared with those who had a generic diagnosis (19.1% vs 13.4%).

CONCLUSIONS

Successful, specific subtyping of lymphoproliferative disorders was achieved in approximately 33% of cases that were tested for ancillary studies following an approach for the triage and aliquoting of serous effusion samples. Cancer (Cancer Cytopathol) 2013;121:261–70. © 2012 American Cancer Society.

Ancillary