Peritoneal cytology in malignant mixed müllerian tumors of the uterus

Kanbour, Anisa; Buchsbaum, Herbert J.; Hall, Anna H.; Kanbour, Amal

doi:10.1016/0090-8258(89)90610-0

Cited by 28 publications

(14 citation statements)

References 5 publications

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“…The sarcoma cells are elongated or caudate with cyanophilic cytoplasm and large nuclei. [82] Leiomyosarcoma is the most common uterine sarcoma. They are aggressive tumors, even when confined to the uterus.…”

Section: Introductionmentioning

confidence: 99%

Abdominopelvic washings: A comprehensive review

Rodrı́guez¹,

Khalbuss²,

Austin³

et al. 2013

CytoJournal

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Intraperitoneal spread may occur with gynecological epithelial neoplasms, as well as with non-gynecological malignancies, which may result in serosal involvement with or without concomitant effusion. Therefore, washings in patients with abdominopelvic tumors represent important specimens for cytologic examination. They are primarily utilized for staging ovarian cancers, although their role has decreased in staging of endometrial and cervical carcinoma. Abdominopelvic washings can be positive in a variety of pathologic conditions, including benign conditions, borderline neoplastic tumors, locally invasive tumors, or distant metastases. In a subset of cases, washings can be diagnostically challenging due to the presence of co-existing benign cells (e.g., mesothelial hyperplasia, endosalpingiosis, or endometriosis), lesions in which there is only minimal atypia (e.g., serous borderline tumors) or scant atypical cells, and the rarity of specific tumor types (e.g., mesothelioma). Ancillary studies including immunocytochemistry and fluorescence in situ hybridization may be required in difficult cases to resolve the diagnosis. This article provides a comprehensive and contemporary review of abdominopelvic washings in the evaluation of gynecologic and non-gynecologic tumors, including primary peritoneal and mesothelial entities.

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Section: Introductionmentioning

confidence: 99%

Abdominopelvic washings: A comprehensive review

Rodrı́guez¹,

Khalbuss²,

Austin³

et al. 2013

CytoJournal

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“…Identification of malignant cells in peritoneal lavage collected at initial or second-look laparotomy/laparoscopy has prognostic and therapeutic implications for patients with ovarian and endometrial adenocarcinoma, 2-6 as well as for those with selected less common uterine malignancies such as mixed Müllerian tumors. 7,8 While the clinical significance of tumor cells in peritoneal lavages from patients with borderline ovarian tumors and cervical carcinoma has been less clearly established, [9][10][11] identification of malignant cells in the peritoneal cavity is usually equated with clinically advanced disease and elicits a recommendation for therapy in addition to hysterectomy and adnexal resection. Peritoneal lavage cytology serves as an independent indicator of tumor stage (i.e., can upstage disease) in cases of uterine cancer where tissue staging is less than FIGO IIIA…”

Section: Discussionmentioning

confidence: 99%

Optimization of the peritoneal lavage

Walts

1998

Diagn. Cytopathol.

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Review of 275 consecutive peritoneal lavages and concurrent histologic material from gynecologic operations suggested that cytologic evaluation was clinically indicated for only 60.7% of the lavages, representing 46% of the patients in the study. More than one concurrent lavage was received from 21.6% of all patients in the study, comprising 50% of patients with malignant lavages, 18.7% of patients with benign lavages, and 5.3% of patients for whom cytologic evaluation of peritoneal lavage was not clinically indicated. Malignant cells were diagnosed in 15% of the 167 lavages for which cytologic examination was clinically indicated. In this series of patients, identification of malignant cells in peritoneal lavages did not increase the tumor stage beyond that obtained solely from examination of the concurrent histologic material. There were no false‐positive cytologic diagnoses and no lavages in which neoplastic cells were misinterpreted as benign. A significant number of lavages, including several from patients with histologically confirmed peritoneal tumor, were sparsely cellular and/or excessively bloody. It is suggested that although peritoneal lavages might be collected during all gynecologic operations, only specimens from selected cases should be submitted for cytologic evaluation, and greater attention should be given to specimen collection to ensure that only well‐preserved and representative material from the peritoneum is submitted for cytologic evaluation. Diagn. Cytopathol. 1998;18:265–269. © 1998 Wiley‐Liss, Inc.

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“…23,24 The adenocarcinoma component is seen as papillary or acinar clusters with scant to moderate vacuolated cytoplasm and enlarged pleomorphic nuclei with coarse chromatin and prominent nucleoli. The sarcoma component is seen as either isolated or loose aggregates of spindle cells with scant, wispy cyanophilic cytoplasm.…”

Section: Carcinosarcoma Malignant Mixed Mullerian Tumor (Mmmt)mentioning

confidence: 99%

Pelvic Washings and the Staging of Gynecologic Cancers

Jain¹

2006

Pathology Case Reviews

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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.

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Peritoneal cytology in malignant mixed müllerian tumors of the uterus

Cited by 28 publications

References 5 publications

Abdominopelvic washings: A comprehensive review

Abdominopelvic washings: A comprehensive review

Optimization of the peritoneal lavage

Pelvic Washings and the Staging of Gynecologic Cancers

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