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Difference between revisions of "Mesothelial cytopathology"
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An introduction to cytopathology is in the ''[[cytopathology]]'' article. | An introduction to cytopathology is in the ''[[cytopathology]]'' article. | ||
= | =Specimen types= | ||
*'''Wash''', e.g. ''peritoneal wash'': expect sheets of (benign squamous) cells. | *'''Wash''', e.g. ''peritoneal wash'': expect sheets of (benign squamous) cells. | ||
*'''Spontaneous''', e.g. ''pleural fluid'': usually no large sheets. | *'''Spontaneous''', e.g. ''pleural fluid'': usually no large sheets. | ||
Note: | |||
This distinction is important as ''wash'' specimens may have pseudopapillae. | |||
=Approach= | |||
Look for: | Look for: | ||
#Two cell populations. | #Two cell populations. | ||
| Line 26: | Line 28: | ||
#Small cells with high [[NC ratio]]. | #Small cells with high [[NC ratio]]. | ||
===Main DDx | |||
==Malignancy== | |||
Strongly suggestive of malignancy: | |||
*3-D clusters. | |||
*Large clusters. | |||
*Highly cellularity. | |||
*Irregular nucleoli. | |||
*Group pleomorphism. | |||
May be suggestive: | |||
*High NC ratio. | |||
=Main DDx= | |||
*Mesothelium. | *Mesothelium. | ||
*Other. | *Other. | ||
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*[[HCC]] may be assoc. with ascites... but it is rarely positive for malignant cells.<ref name=Ref_APBR679>{{Ref APBR|679}}</ref> | *[[HCC]] may be assoc. with ascites... but it is rarely positive for malignant cells.<ref name=Ref_APBR679>{{Ref APBR|679}}</ref> | ||
**HCC in ascites fluid is super rare -- ''I haven't seen a case''.<ref>SB. 8 January 2010.</ref> | **HCC in ascites fluid is super rare -- ''I haven't seen a case''.<ref>SB. 8 January 2010.</ref> | ||
=Normal mesothelium= | =Normal mesothelium= | ||