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Figure 2: Cytosmears from the centrifuged deposit of pleural fluid (left side) demonstrating markedly increased cellularity comprising of monotonous population of intermediate to large sized atypical cells with increased nuclear to cytoplasmic ratio, nuclei showing irregular membrane contour, dense chromatin and one to two conspicuous nucleoli; consistent with a malignant effusion (a) (May Grunewald Giemsa stain, ×400). On cellblock immunohistochemistry these atypical cells were strongly and diffusely positive for leukocyte common antigen (b), CD 30 (Golgi zone, c), epithelial membrane antigen (d), but negative for anaplastic lymphoma kinase 1(ALK1) consistent with a diagnosis of ALK1 negative anaplastic large-cell lymphoma (Peroxidase-antiperoxidase, ×400). Left supraclavicular lymph node biopsy, 1½ month later, confirmed the present diagnosis (histopathological features not represented)

Figure 2: Cytosmears from the centrifuged deposit of pleural fluid (left side) demonstrating markedly increased cellularity comprising of monotonous population of intermediate to large sized atypical cells with increased nuclear to cytoplasmic ratio, nuclei showing irregular membrane contour, dense chromatin and one to two conspicuous nucleoli; consistent with a malignant effusion (a) (May Grunewald Giemsa stain, ×400). On cellblock immunohistochemistry these atypical cells were strongly and diffusely positive for leukocyte common antigen (b), CD 30 (Golgi zone, c), epithelial membrane antigen (d), but negative for anaplastic lymphoma kinase 1(ALK1) consistent with a diagnosis of ALK1 negative anaplastic large-cell lymphoma (Peroxidase-antiperoxidase, ×400). Left supraclavicular lymph node biopsy, 1½ month later, confirmed the present diagnosis (histopathological features not represented)