Reed–Sternberg Cells in Pericardial Effusion - Rare Finding in a Case of Nodular Sclerosis Classical Hodgkin Lymphoma.

ABSTRACT

Causes of malignant pericardial eff usion include metastatic carcinomas, acute leukemias, chronic leukemias, non-Hodgkin lymphoma, and rarely Hodgkin lymphoma. We report here a case of nodular sclerosis classic Hodgkin lymphoma presenting with massive pericardial eff usion. Cytological fi ndings of the pericardial fl uid and histopathology of the lymph node are presented. A 13-year-old girl came with complaints of a cough and progressive breathlessness for 5 months. She also had B symptoms. Imaging showed massive pericardial eff usion, along with mediastinal, cervical, and abdominal lymphadenopathy. Pericardiocentesis was done. A cytology of the pericardial fl uid showed large atypical Reed–Sternberg (RS) - like cells in a background of lymphocytes, eosinophils and plasma cells – suggestive of Hodgkin lymphoma. Cervical lymph node biopsy and immunohistochemistry confi rmed the diagnosis of classical Hodgkin lymphoma – nodular sclerosis subtype. Th e institution of chemotherapy resulted in signifi cant decrease in pericardial eff usion, and the patient was discharged in a satisfactory condition. Hodgkin lymphoma presenting clinically with massive pericardial eff usion and showing RS cells in the pericardial fl uid is very rare. A cytopathologist needs to be aware of this possibility which will facilitate early diagnosis and treatment.