Posttransplantation lymphoproliferative disorder mimicking a nonspecific lymphocytic pleural effusion in a bone marrow transplant recipient - A case report

BACKGROUND: Serous effusions are rare complications of bone marrow transpla ntation (BMT) and result mainly from infections or tumor relapse. CASE: We report a case of posttransplantation lymphoproliferative disorder (PTLD) revealed by cytodiagnostic examination of serious effusions in a BMT recipient. The effusion was initially considered reactive, but morphologic , immunocytologic and molecular studies subsequently revealed PTLD. CONCLUSION: This case demonstrates the importance of cytologic examination of effusions in BMT or organ recipients. Since most PTLDs are Epstein-Barr virus (EBV)-associated B-cell lymphoproliferative disorders and T cells pre dominate in reactive effusions, appropriate initial immunostaining, includi ng CD3, CD79a and EBV latent membrane protein, should aid in their early de tection.