Malignant lymphoma of the tongue with unusual cytology in a pleural effusion: a case report.

BACKGROUND

The diagnosis of maligan phoma (ML) in pleural effusions is often difficult. In some cases, the cytomorphology of lymphoma cells in pleural fluid differs from the histomorphology ofthe primary tumor. We report a case of ML cells in the pleural fluid with a cytomorphology and immunocytochemistry different from the morphology and immunophenotype of the original site in the tongue.

CASE: A 61-year-old male was admitted with an infiltration of the tongue. The biopsy result was ofa large, B cell ML, supported by immunohistochemistry. No pleural effusion was observed at that time. Fifteen months later a small, subcutaneous tumor appeared on the abdomen, and pleural fluid was detected. Cytology revealed cells with different morphology and immunophenotype than the histomorphology and immunohistochemistry of the primary infiltrate in the tongue.

CONCLUSION

The cytologic diagnosis of pleural efflsions with lymphoid cells is always difficult. One should keep in mind that in some cases the cytomorphology and even the immunopheno-type may vary from the picture of the primary tumor.