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JPTM > Volume 19(2); 2008 > Article
The Korean Journal of Cytopathology 2008;19(2): 168-172.
doi: https://doi.org/10.3338/kjc.2008.19.2.168
Cytologic Features of Ascitic Fluid Complicated by Small Cell Variant T-cell Prolymphocytic Leukemia: A Case Report.
Mee Ja Park, Insun Kim, Seung Yong Paik
Department of Clinical Pathology, College of Medicine, Korea University, Seoul, Korea.
T-cell prolymphocytic leukemia (T-PLL) is a rare, mature T-cell lymphoproliferative disorder with a post-thymic mature T-cell phenotype. The disease is characterized by rapidly rising lymphocytosis, lymphadenopathy, and splenomegaly. The clinical course is usually aggressive and progresses with frequent skin lesions and serous effusions. In 25% of cases, leukemic cells are small and tumor cells may not have a discrete nucleolus under light microscopy. Although the presence of characteristic cytoplasmic protrusions or blebs in tumor cells is a common morphologic finding in the peripheral blood film irrespective of the nuclear features, small cell variants lacking the typical nuclear features can cause diagnostic problems in clinical cytology. Furthermore, the small leukemic cells can share some cytologic findings with lymphocyte-rich serous effusions caused by non-neoplastic reactive lymphocytosis as well as other small lymphocytic lymphoproliferative disorders. Here, we describe the cytological findings of ascitic fluid complicated by small cell variant T-PLL in a 54-year-old man, the cytology of which was initially interpreted as small lymphocytic malignancy such as small lymphocytic lymphoma/chronic lymphocytic leukemia.
Key Words: Leukemia; Prolymphocytic; T-cell; Cytology; Ascitic fluid