Cytologic findings of peripheral T-cell lymphoma (PTCL) with high epitheloid cell content (Lennert's lymphoma) in imprint smear. A case report

BACKGROUND: Lymphoepitheloid lymphoma is a T-cell lymphoma with peculiar histologic picture with massive proliferation of epitheloid cell clusters intermingled with many, mostly small-sized lymphoid cells. The cytomorphologic features in imprint of a case of lymphoepitheloid T-cell lymphoma is described together with diagnostic pitfalls. CASE REPORT: A 74 years old man presented with weight loss, anemia and fever. Physical examination showed bilateral cervical lymphadenopathy with hepatosplenomegaly. With the clinical impression of hypersplenic syndrome vs lymphoma, excisional biopsy of a lymph node was performed and both imprints and histologic sections made. Cytologic findings showed uniform isolated small lympocytes with closely intermingled scattered and aggregates of epitheloid cells. Histologic sections were diagnosed as lymphoepitheloid lymphoma (Lennert's lymphoma). CONCLUSION: Cytologic findings of this variant of lymphoma is distinctive enough for a correct initial suggestive diagnosis. However the presence of high content of epitheloid cell clusters can cause cytologic misinterpretation with other benign and malignant conditions.