EFFUSION CYTOLOGY IN BURKITTS-LYMPHOMA

The American form of Burkitt's lymphoma is a high-grade malignancy whi ch usually involves the abdomen in children and young adults. There is only a limited literature which describes the cytologic features of B urkitt's lymphoma in serous effusions. We present three children with Burkitt's lymphoma initially diagnosed by effusion cytology. The first patient, an 11-yr-old boy, presented with bilateral pleural effusions , ascites, and abdominal masses and had diagnostic pleural fluid cytol ogy without tissue confirmation (ultrastructural examination was perfo rmed on the effusion specimen). He died 7 months after the initial dia gnosis. The second patient, a 9-yr-old boy, presented with ascites and abdominal masses and had diagnostic peritoneal fluid cytology with a subsequent confirmatory chest wall biopsy. The third patient, a 16-yr- old girl, presented with a 2-month history of irregular menses, a larg e pelvic mass, lymphadenopathy, and liver masses. Although an ovarian malignancy was clinically suspected, cytologic examination of her peri toneal fluid revealed Burkitt's lymphoma. Surgical exploration reveale d involvement of her right ovary, cecum, and terminal ileum. The secon d and third patients are currently alive with no apparent disease foll owing chemotherapy. In all three patients, effusion cytology revealed Burkitt's lymphoma, characterized by a uniform population of noncohesi ve lymphoid cells with noncleaved nuclei, prominent multiple nucleoli, and scanty-to-moderate basophilic cytoplasm. Cytoplasmic and/or nucle ar vacuoles were also seen, more prominent in Diff-Quik-stained, air-d ried smears. These cases demonstrate the importance of recognizing the cytologic features of Burkitt's lymphoma, as serous fluid may be the initial diagnostic specimen.