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Significance of epithelial cell clusters in pseudomyxoma peritonei
Author(s) -
Badyal R. K.,
Khairwa A.,
Rajwanshi A.,
Nijhawan R.,
Radhika S.,
Gupta N.,
Dey P.
Publication year - 2016
Publication title -
cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.512
H-Index - 48
eISSN - 1365-2303
pISSN - 0956-5507
DOI - 10.1111/cyt.12331
Subject(s) - pseudomyxoma peritonei , medicine , pathology , appendix , atypia , peritoneal fluid , cytopathology , ascitic fluid , nuclear atypia , ascites , cytology , gastroenterology , immunohistochemistry , biology , paleontology
Background Pseudomyxoma peritonei ( PMP ) is a rare clinical syndrome characterised by distension of the peritoneum by jelly‐like ascites. Cytological evaluation of peritoneal fluid is often an initial diagnostic test for possible ovarian and/or appendiceal primary tumours. Aims and objectives The present work was conducted to study the usefulness of peritoneal fluid cytomorphology in the early diagnosis of PMP and to evaluate the significance of the presence of epithelial cell ( EC ) clusters and their prognostic implications. Materials and methods We evaluated the detailed cytological features of 21 cases of PMP retrospectively. Both conventional and liquid‐based cytology smears of peritoneal fluid were reviewed, cytological features were compared with histological findings and cases were classified into disseminated peritoneal adenomucinosis ( DPAM ) and peritoneal mucinous carcinomatosis ( PMCA ). Results In our study, the common causes of PMP were primary gastrointestinal malignancies (appendix and colorectal, 57.14%), followed by primary ovarian mucinous neoplasms (28.57%) and synchronous ovarian and appendicular tumours (14.28%). Thick mucinous material was present in all cases (100%). EC s were present in 18 of 21 (85.17%) patients, with mild nuclear atypia in the majority of cases. Histiocytes, mesothelial cells and fibroblast‐like, spindle‐shaped cells with entrapped mucin were also noted in the background. The cases of PMCA showed greater numbers of EC clusters in cytology smears and these patients had recurrent episodes of PMP . Conclusion On cytomorphology, high‐grade tumours were more cellular and frequently showed EC clusters with moderate to severe atypia, prominent nucleoli and mitosis, and were more prone to PMCA .