A Rare Case of Follicular Lymphoma with both Malignant Pleural Effusion and Ascites.

Background: Follicular lymphoma (FL), a type of non-Hodgkin's lymphoma (NHL) originating from follicular center B cells, is clinically highly heterogeneous. Its typical immunophenotype is CD5- CD10+ CD19+ with t(14;18) (q32;q21). Liquid-based preparation and smear microscopic examination are common laboratory methods in patients with tumor invasion in the serous cavity.

Methods: Pleural effusion and ascites were collected and sent to the laboratory for liquid-based preparation and smear microscopic examination.

Results: "Ascites" liquid-based preparation and cell wax blocks: found scattered heteromorphic cells, IHC: Bcl-2 (+), Bcl-6 (-), CD20 (-), CD3 (slight+), CD79a (+), Ki 67 (40%+), c-myc (part+). Rivalta test of pleural effusion and ascites was positive, the nucleated cell counts were 1,105 x 106/L and 3,960 x 106/L, and lymphoma cells accounted for 20% and 10%, respectively.

Conclusions: FL, in which lymphoma cells infiltrate both thorax and abdomen, is rarely seen clinically and develops rapidly. Early FL patients are expected to get long-term disease control, but late FL cannot be cured, so we should adhere to annual physical examination for early detection and treatment.