Cellules grumelées: old terminology revisited. Regarding the cytologic diagnosis of chronic lymphocytic leukemia and well-differentiated lymphocytic lymphoma in pleural effusions.

Distinguishing chronic lymphocytic leukemia (CLL) or well-differentiated lymphocytic lymphoma (WDLL) from a benign chronic inflammatory process involving the serous cavities is often a difficult task for the cytopathologist faced with a lymphocyte-rich effusion fluid. Spriggs and Boddington decribed characteristic heavy chromatin clumping (cellules grumelées) of the lymphocytic nuclei in effusions as diagnostic of chronic lymphocytic leukemia. A study of 23 cases of lymphocyte-rich pleural effusions in our laboratory showed that, while this cytomorphologic feature is a function of cytopreparatory technique and fixation, it was observed only in cases of CLL or WDLL and not in benign inflammatory processes.