Objectives: Cytologic specimens are routinely collected as part of gynecologic oncology surgery. Consultation cases often include cytology specimens. Outside diagnosis was compared to consultation diagnosis for cytopathology specimens that were part of larger oncologic cases. Study Design: Gynecologic pathology consultation cases containing pelvic washing (PW) material were queried. Cases had major discordance if the diagnosis changed from negative to positive or vice versa, and minor discordance if an atypical diagnosis was changed to positive or negative or vice versa. Results: Of 237 cases, 9 showed major discordance (4%), 29 showed minor discordance (12%) and the remaining 199 no discordance (84%). The 9 major discordance cases involved PWs from cases that were performed for ovarian pathology. Treatment would have changed in only 2 of the cases with major discordance. Of the minor discordance cases, 21/29 (72%) involved PW from ovarian cases and 8/29 (28%) were PW from uterine cases. Conclusions: Only a few cases showed major or minor discordance, and of those that were discordant, most involved ovarian specimens. Major discordance between original and consulting diagnoses would have changed treatment in only 2 cases.

Keywords:
Gynecologic pathology, Pelvic washing specimens, Peritoneal fluid
1.
Keettel WC, Elkins HG: Experience with radioactive colloidal gold in the treatment of ovarian carcinoma. Am J Obstet Gynecol 1956;71:553-568.
2.
Creasman WT, Rutledge F: The prognostic value of peritoneal cytology in gynecologic malignant disease. Am J Obstet Gynecol 1971;110:773-781.
3.
Ravinsky E: Cytology of peritoneal washings in gynecologic patients. Diagnostic criteria and pitfalls. Acta Cytol 1986;30:8-16.
4.
Yoshimura S, Scully RE, Taft PD, et al: Peritoneal fluid cytology in patients with ovarian cancer. Gynecol Oncol 1984;17:161-167.
5.
Lewin SN, Herzog TJ, Barrena Medel NI, Deutsch I, Burke WM, Sun X, et al: Comparative performance of the 2009 International Federation of Gynecology and Obstetrics' staging system for uterine corpus cancer. Obstet Gynecol 2010;116:1141-1149.
6.
Heintz AP, Odicino F, Maisonneuve P, Quinn MA, Benedet JL, Creasman WT, et al: Carcinoma of the ovary. FIGO 26th Annual Report on the Results of Treatment in Gynecological Cancer. Int J Gynaecol Obstet 2006;95:S161-S192.
7.
Kronz JD, Westra WH, Epstein JI: Mandatory second opinion surgical pathology at a large referral hospital. Cancer 1999;86:2426-2435.
8.
Abt AB, Abt LG, Olt GJ: The effect of interinstitution anatomic pathology consultation on patient care. Arch Pathol Lab Med 1995;119:514-517.
9.
National Comprehensive Cancer Network: Epithelial Ovarian Cancer/Fallopian Tube Cancer/Primary Peritoneal Cancer v1. http://www.nccn.org/professionals/physician_gls/pdf/ovarian.pdf (accessed 2015).
10.
Rodriguez EF, Monaco SE, Khalbuss W, Austin RM, Pantanowitz L: Abdominopelvic washings: a comprehensive review. Cytojournal 2013;10:7.
11.
Altaras MM, Aviram R, Cohen I, Cordoba M, Weiss E, Beyth Y: Primary peritoneal papillary serous adenocarcinoma: clinical and management aspects. Gyn Oncol 1990;40:230-236.
12.
Zuna RE: Diagnostic pathology of peritoneal washing; in Shidham VB, Atkinson B (eds): Cytopathologic Diagnosis of Serous Fluids, ed 1. London, Elsevier, 2007, pp 91-105.
13.
De May R: The Art and Science of Cytopathology, vol 1, ed 2. Chicago, American Society of Clinical Pathology Press, 2012.
14.
Ali SZ, Cibas ES: Serous Cavity and Cerebrospinal Fluid Cytopathology. New York, Springer, 2012.
15.
Pisharodi LR, Bedrossian CW: Cytopathology of serous neoplasia of the ovary and the peritoneum: differential diagnosis from mesothelial proliferations. Diagn Cytopathol 1996;15:292-295.
16.
Arora R, Agarwal S, Mathur SR, Verma K, Iyer VK, Aron M: Utility of a limited panel of calretinin and Ber-EP4 immunocytochemistry on cytospin preparation of serous effusions: a cost-effective measure in resource-limited settings. Cytojournal 2011;8:14.
17.
Politi E, Kandaraki C, Apostolopoulou C, Kyritsi T, Koutselini H: Immunocytochemical panel for distinguishing between carcinoma and reactive mesothelial cells in body cavity fluids. Diagn Cytopathol 2005;32:151-155.
18.
Kundu UR, Krishnamurthy S: Use of the monoclonal antibody MOC‐31 as an immunomarker for detecting metastatic adenocarcinoma in effusion cytology. Cancer Cytopathol 2011;119:272-278.
© 2016 S. Karger AG, Basel
2016
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.