摘要：

BACKGROUND: (HLH), also known as syndrome, is a rare, fatal hematopoietic disease. Its cytologic features may be subtle because the abnormal histiocytes may not be recognized if one is not aware of this entity. We report a case of HLH involving the ascitic fluid.: A 73-year-old developed weakness, lethargy, decreased appetite and progressive shortness of breath after a cholecystectomy. Physical examination revealed , tachycardia and chest dullness with decreased breath sounds bilaterally. Radiologic examination revealed . The patient accumulated fluid in the peritoneal cavity, lungs, and mediastinum. Bone marrow biopsy showed abundant histiocytes infiltrating the marrow cavity, and many of these histiocytes contained cellular debris. A diagnosis of HLH was therefore made. The abdominal paracentesis specimen contained many similar histiocytes exhibiting erythrophagocytosis and lymphophagocytosis. These abnormal histiocytes were positive for and negative for /, confirming the diagnosis of HLH. The patient died soon after from .: HLH is cytologically characterized by the presence of abnormal histiocytes with ingested cellular debris. In they should not be confused with mesothelial . Immunohistochemical studies may help confirm the diagnosis.

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