Plevralni, abdominalni in perikardialni limfocitni izliv Pleural, abdominal, and pericardial lymphocytic effusion

Abstract

Limfocitni izliv je zaplet različnih bolezni. Malignomi in tuberkuloza sta najpogostejši vzrok za večino limfocitnih izlivov. Limfociti v izlivu so lahko reaktivni ali neoplastični. Reaktivni limfocitni izliv nastane zaradi vnetij, sistemskih ali avtoimunskih bolezni, karcinoze ali drugih redkih vzrokov. Maligni limfocitni izliv najpogosteje nastane pri bolnikih z napredovalimi nodalnimi in ekstranodalnimi limfomi, ki so se razširili v plevralni, perikardialni ali abdominalni prostor. Zelo redko nastane zaradi limfomov, ki vzniknejo na seroznih površinah. Diagnozo limfoma v izlivu postavimo na podlagi kliničnih podatkov, mikroskopske slike in dodatnih imunofenotipskih ter molekularnih preiskav. V skladu z mednarodnimi smernicami limfoproliferativne bolezni v izlivih razdelimo v pet diagnostičnih kategorij: nediagnostično, benigno, atipične celice neopredeljene, sumljivo za malignom in maligno.

Abstract (Eng)

Lymphocytic effusion is a complication of several diseases. The main causes of most lymphocytic effusions are malignomas and tuberculosis. Lymphocytes in effusion can be reactive or neoplastic. Reactive lymphocytic effusion develops due to inflammation, systemic and autoimmune diseases, carcinosis, and other rare causes. Malignant lymphocytic effusions are mostly found in patients during the progression of nodal and extranodal lymphomas to the pleural, pericardial or abdominal cavity while effusions caused by lymphomas evolving from serous surfaces are very rare. Cytopathological diagnostic of lymphomas in effusions is based on clinical, morphological, immunophenotypic and molecular features of the disease. According to the international guideless we categorize lymphoproliferative diseases in effusions in five categories: nondiagnostic, benign, atypical cells of undetermined significance, suspicious for malignancy and malignant.