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Difference between revisions of "Mesothelial cytopathology"
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Mesothelial cytopathology (view source)
Revision as of 06:00, 22 December 2015
, 06:00, 22 December 2015no edit summary
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*[[Sensitivity]] moderate for malignancy (60%).<ref name=pmid>{{Cite journal | last1 = Karoo | first1 = RO. | last2 = Lloyd | first2 = TD. | last3 = Garcea | first3 = G. | last4 = Redway | first4 = HD. | last5 = Robertson | first5 = GS. | title = How valuable is ascitic cytology in the detection and management of malignancy? | journal = Postgrad Med J | volume = 79 | issue = 931 | pages = 292-4 | month = May | year = 2003 | doi = | PMID = 12782778 }}</ref> | *[[Sensitivity]] moderate for malignancy (60%).<ref name=pmid>{{Cite journal | last1 = Karoo | first1 = RO. | last2 = Lloyd | first2 = TD. | last3 = Garcea | first3 = G. | last4 = Redway | first4 = HD. | last5 = Robertson | first5 = GS. | title = How valuable is ascitic cytology in the detection and management of malignancy? | journal = Postgrad Med J | volume = 79 | issue = 931 | pages = 292-4 | month = May | year = 2003 | doi = | PMID = 12782778 }}</ref> | ||
==Specimen types== | ===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. | ||
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This distinction is important as ''wash'' specimens may have pseudopapillae. | This distinction is important as ''wash'' specimens may have pseudopapillae. | ||
=Approach= | ===Approach=== | ||
Look for: | Look for: | ||
#Two cell populations. | #Two cell populations. | ||
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#Small cells with high [[NC ratio]]. | #Small cells with high [[NC ratio]]. | ||
==Features of malignancy== | ===Features of malignancy=== | ||
Strongly suggestive of malignancy: | Strongly suggestive of malignancy: | ||
*3-D clusters. | *3-D clusters. | ||
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*High NC ratio. | *High NC ratio. | ||
=Differential diagnosis= | ===Differential diagnosis=== | ||
*[[Adenocarcinoma]] not otherwise specified (NOS) - most common. | *[[Adenocarcinoma]] not otherwise specified (NOS) - most common. | ||
*Reactive mesothelium. | *Reactive mesothelium. | ||
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*[[Small cell carcinoma]]. | *[[Small cell carcinoma]]. | ||
===Peritoneal cavity specific=== | ====Peritoneal cavity specific==== | ||
*[[Hepatocellular carcinoma]] (HCC) may be associated with ascites... but it is rarely positive for malignant cells.<ref name=Ref_APBR679>{{Ref APBR|679}}</ref> | *[[Hepatocellular carcinoma]] (HCC) may be associated 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> | ||