Chylous pleural effusions simulating leukemic infiltrate associated with thoracoabdominal disease and surgery in infants.

Surgical procedures and diseases in childhood involving damage to or obstruction of the thoracic duct and related lymphatic channels can cause pleural effusions that are often chylous and can be massive. The morphology of fluid cytology in these cases can prompt a mistaken diagnosis of a hematolymphoid malignancy. We describe 6 infants, aged 3 days to 5 months, in whom thoracoabdominal disease and/or surgical procedures interfered with lymphatic drainage of the thorax and pleural space.

Detection of neuroblastoma in the bone marrow: biopsy versus aspiration.

Purpose: Multiple studies have emphasized the higher yield of detection of metastatic neuroblastoma (MNb) by bone marrow biopsy (BMB) than by bone marrow aspiration (BMA). Because the need for BMA has been questioned, the yield of both procedures was investigated at diagnosis and during the course of disease.

Methods: For morphologic and immunohistochemical detection of MNb, 289 specimens obtained by BMA and BMB from 57 children with neuroblastoma were reviewed.

Transient erythroblastopenia of childhood associated with human herpesvirus type 6, variant B.

Transient erythroblastopenia of childhood (TEC) is a disorder of young children ages 3 months to 4 years that is characterized by anemia associated with reticulOcytopenia and decreased red blood cell precursors in the bone marrow aspirate (BMA). A viral cause has been suspected for TEC. Bone marrow aspirate-derived DNA from 14 children with anemia or another hematologic disorder, including two children with TEC, were analyzed by polymerase chain reaction for human herpesvirus type 6 (HHV-6) DNA and human parvovirus B19 DNA.

Tumorlike clusters of immature cells in cerebrospinal fluid of infants.

Cerebrospinal fluid (CSF) samples from four infants 3 days to 4 months of age with a history of prematurity or birth trauma were found to contain clusters of immature cells. These cells were arranged in groups or syncytia, sometimes with nuclear molding, and were cytologically characterized by scant basophilic cytoplasm, nuclei with fine nuclear chromatin, and small nucleoli. The picture simulated the appearance of metastatic tumor admixed with hemosiderin-laden macrophages, erythrocytes, and leukocytes.