SMALL NONCLEAVED CELL LYMPHOMA PRESENTING AS A MASSIVE PERICARDIAL-EFFUSION - A CASE-REPORT

BACKGROUND: Non-Hodgkin's lymphoma (NHL) is commonly associated with c ardiac involvement, especially in cases of advanced stages with medias tinal involvement. Much rarer is the initial presentation of NHL as a pericardial effusion: there ae only 12 cases reported. In addition, on ly 5 of these 12 cases were correctly diagnosed based on examination o f pericardial fluid prior to death: 3 were based on routine cytology; 1 on immunoperoxidase staining and 1 on an immunofluorescent slide met hod. CASE: A 71-year-old, white female presented with a massive perica rdial effusion. Small noncleaved cell lymphoma was expeditiously diagn osed by cytologic examination combined with flow cytometric immunophen otyping. No further diagnostic tissue was obtained; the patient was st aged and offered treatment with a protocol for high grade lymphoma. CO NCLUSION: Combining cytomorphology and flow cytometric immunophenotypi ng in such cases results in an expeditious, nonsurgical diagnosis, upo n which therapeutic decision making may be based.