Pelvic Washings and the Staging of Gynecologic Cancers

Abstract

Pelvic or peritoneal washing cytology (PWC) is a most useful indicator of subclinical peritoneal spread of ovarian cancer and thus provides valuable staging and prognostic information, particularly for nonserous ovarian carcinomas. However, PWC's role in endometrial cancer staging is less clear. Detection of malignant cells in peritoneal washings relies upon identification of nonmesothelial cells and their arrangement. While high-grade carcinoma can be easily identified, a number of benign conditions like reactive mesothelial cells, endosalpingiosis, and endometriosis may mimic serous borderline tumors and low-grade serous carcinomas. The presence in these benign conditions of ciliated cells and absence of single atypical cells, marked nuclear atypia, mitotic activity, or two distinct cell populations should help to avoid errors. In addition, close correlation with clinical history and the results of current or prior surgical specimens should help clinch the diagnosis. Additional techniques like cell blocks and ancillary studies can facilitate an accurate diagnosis.

Malignant Mesothelioma in Body Fluids - with Special Reference to Differential Diagnosis from Metastatic Adenocarcinoma -

“…9 In the cases of pleural or pericardial involvement, MA from lung is the main differential diagnosis, while peritoneal involvement should be distinguished from MA of gynecologic or gastrointestinal origin. 10,11 Clinically, body cavity effusions might occasionally be an initial presentation, 12 and body cavity fluid cytology is commonly submitted without sufficient information of the possibility of other malignancies, which limits cytologic diagnosis. Nevertheless, careful cytomorphologic examination has been regarded as a reliable and accurate method, 13 although overall sensitivity of body fluid cytology has been variably reported.…”