Open AccessSerous cavity metastasis: Evaluation of unknown primary
Author(s) -
Nirag Jhala,
Aileen Arriola,
Liron Pantanowitz
Publication year - 2022
Publication title -
cyto journal/cytojournal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.371
H-Index - 27
eISSN - 0974-5963
pISSN - 1742-6413
DOI - 10.25259/cmas_02_11_2021
Subject(s) - pathology , malignancy , medicine , signet ring cell , serous fluid , metastasis , population , mesothelial cell , psammoma body , giant cell , cancer , adenocarcinoma , immunohistochemistry , environmental health
Malignant effusions can occur in patients with neoplasia. Once a metastatic diagnosis is confirmed, the primary site of origin of malignancy needs to be ascertained. This task can be challenging without a prior history of malignancy. In some patients their effusion may be the initial presentation of an underlying malignancy. Metastases usually present with a dual population of mesothelial and malignant cells. Combining cytomorphologic examination with ancillary testing such as immunocytochemistry can help identify the origin of the foreign malignant cell population. Helpful architectural clues include a single cell pattern, solid cell ball pattern, single file arrangement, papillary formation, psammoma bodies and background mucin. Useful cellular features include the presence of signet ring cells, small cells, pleomorphic and multinucleated giant cells, squamous cells, spindle cells and pigmentation. Rarely, despite an extensive work-up the primary site of origin for a malignant effusion may remain unresolved. This review article will be incorporated finally as one of the chapters in CMAS (CytoJournal Monograph/Atlas Series) #2. It is modified slightly from the chapter by the initial authors in the first edition of Cytopathologic Diagnosis of Serous Fluids.