Background: Evaluation of peritoneal fluid cytology, either from ascitic fluids or as a result of peritoneal washings, is a fundamental aspect in the evaluation of women presenting with clinically concerning or histologically confirmed gynecologic neoplasms. Summary: Ascitic fluid samples are often the initial and only source of diagnostic material in women presenting with gynecologic malignancies, and important therapeutic decisions will result from the information provided in the cytology report. On the other hand, cytologic evaluation of peritoneal washing specimens obtained during surgical excision of a presumed gynecologic neoplasm provides crucial information to the clinical team regarding tumor staging, often with significant therapeutic implications. While recognition of high-grade tumors in either of these samples is generally straightforward, low-grade tumors and unusual neoplasms can prove to be more difficult to recognize, differentiate from benign mimics, and correctly diagnose, particularly in low-cellularity specimens. Even with high-grade tumors, a mere diagnosis of “positive for malignancy” in diagnostic ascitic fluid specimens might not suffice to guide clinical management, and the use of ancillary techniques to further and more definitively characterize the lesional cells is required. Key Messages: This review will focus on the clinically relevant issues surrounding interpretation of peritoneal fluid cytology specimens in the setting of gynecologic neoplasms, making emphasis on the salient cytomorphologic and immunocytochemical features of the various neoplastic processes, in an attempt to provide a practical yet effective guide on how to best evaluate, diagnose, and report these samples.

1.
Creasman WT, Rutledge F. The prognostic value of peritoneal cytology in gynecologic malignant disease. Am J Obstet Gynecol. 1971;110(6):773–81.
2.
Mathew S, Erozan YS. Significance of peritoneal washings in gynecologic oncology. The experience with 901 intraoperative washings at an academic medical center. Arch Pathol Lab Med. 1997;121(6):604–6.
3.
Prat J. Ovarian, fallopian tube and peritoneal cancer staging: rationale and explanation of new FIGO staging 2013. Best Pract Res Clin Obstet Gynaecol. 2015;29(6):858–69.
4.
Hou Y, Bruehl FK, McHugh KE, Reynolds JP. Primary tumor types and origins in positive abdominopelvic washing cytology, a single institution experience. J Am Soc Cytopathol. 2020;9(2):89–94.
5.
Koh WJ, Abu-Rustum NR, Bean S, Bradley K, Campos SM, Cho KR, et al. Uterine neoplasms, version 1.2018, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2018;16(2):170–99.
6.
Garg G, Gao F, Wright JD, Hagemann AR, Mutch DG, Powell MA. Positive peritoneal cytology is an independent risk-factor in early stage endometrial cancer. Gynecol Oncol. 2013;128(1):77–82.
7.
Fader AN, Java J, Tenney M, Ricci S, Gunderson CC, Temkin SM, et al. Impact of histology and surgical approach on survival among women with early-stage, high-grade uterine cancer: an NRG Oncology/Gynecologic Oncology Group ancillary analysis. Gynecol Oncol. 2016;143(3):460–5.
8.
Seagle BLL, Alexander AL, Lantsman T, Shahabi S. Prognosis and treatment of positive peritoneal cytology in early endometrial cancer: matched cohort analyses from the National Cancer Database. Am J Obstet Gynecol. 2018;218(3):329.e1–329.e15.
9.
Wang L, Li L, Wu M, Lang J. The prognostic role of peritoneal cytology in stage IA endometrial endometrioid carcinomas. Curr Probl Cancer. 2020;44(2):100514.
10.
Pinto D, Chandra A, Crothers BA, Kurtycz DFI, Schmitt F. The international system for reporting serous fluid cytopathology-diagnostic categories and clinical management. J Am Soc Cytopathol. 2020;9(6):469–77.
11.
Shield P. Peritoneal washing cytology. Cytopathology. 2004;15(3):131–41.
12.
Mutsaers SE. The mesothelial cell. Int J Biochem Cell Biol. 2004;36(1):9–16.
13.
Rodriguez EF, Monaco SE, Khalbuss W, Austin RM, Pantanowitz L. Abdominopelvic washings: a comprehensive review. Cytojournal. 2013;10:7.
14.
Shidham VB, Layfield LJ. Immunocytochemistry of effusion fluids: introduction to SCIP approach. Cytojournal. 2022;19:3.
15.
Barnetson RJ, Burnett RA, Downie I, Harper CM, Roberts F. Immunohistochemical analysis of peritoneal mesothelioma and primary and secondary serous carcinoma of the peritoneum: antibodies to estrogen and progesterone receptors are useful. Am J Clin Pathol. 2006;125(1):67–76.
16.
Ordonez NG. Value of estrogen and progesterone receptor immunostaining in distinguishing between peritoneal mesotheliomas and serous carcinomas. Hum Pathol. 2005;36(11):1163–7.
17.
Chapel DB, Husain AN, Krausz T, McGregor SM. PAX8 expression in a subset of malignant peritoneal mesotheliomas and benign mesothelium has diagnostic implications in the differential diagnosis of ovarian serous carcinoma. Am J Surg Pathol. 2017;41(12):1675–82.
18.
Rajendran S, McCluggage WG. WT1 positive ovarian endometrioid tumors: observations from consult cases and strategies for distinguishing from serous neoplasms. Int J Gynecol Pathol. 2022;41(2):191–202.
19.
Al-Hussaini M, Stockman A, Foster H, McCluggage WG. WT-1 assists in distinguishing ovarian from uterine serous carcinoma and in distinguishing between serous and endometrioid ovarian carcinoma. Histopathology. 2004;44(2):109–15.
20.
Kurman RJ, Carcangiu ML, Herrington CS, Young RH. WHO classification of tumours of female reproductive organs. 5th ed. Lyon: International Agency for Research on Cancer; 2020.
21.
Schulte JJ, Lastra RR. Abdominopelvic washings in gynecologic pathology: a comprehensive review. Diagn Cytopathol. 2016;44(12):1039–57.
22.
Sood T, Handa U, Mohan H, Goel P. Evaluation of aspiration cytology of ovarian masses with histopathological correlation. Cytopathology. 2010;21(3):176–85.
23.
Seidman JD, Soslow RA, Vang R, Berman JJ, Stoler MH, Sherman ME, et al. Borderline ovarian tumors: diverse contemporary viewpoints on terminology and diagnostic criteria with illustrative images. Hum Pathol. 2004;35(8):918–33.
24.
Sneige N, Thomison JB, Malpica A, Gong Y, Ensor J, Silva EG. Peritoneal washing cytologic analysis of ovarian serous tumors of low malignant potential to detect peritoneal implants and predict clinical outcome. Cancer Cytopathol. 2012;120(4):238–44.
25.
Cheng L, Wolf NG, Rose PG, Rodriguez M, Abdul-Karim FW. Peritoneal washing cytology of ovarian tumors of low malignant potential: correlation with surface ovarian involvement and peritoneal implants. Acta Cytol. 1998;42(5):1091–4.
26.
Fadare O, Mariappan MR, Wang S, Hileeto D, McAlpine J, Rimm DL. The histologic subtype of ovarian tumors affects the detection rate by pelvic washings. Cancer. 2004;102(3):150–6.
27.
Kurman RJ, Shih IM. The origin and pathogenesis of epithelial ovarian cancer: a proposed unifying theory. Am J Surg Pathol. 2010;34(3):433–43.
28.
Hunter SM, Anglesio MS, Ryland GL, Sharma R, Chiew YE, Rowley SM, et al. Molecular profiling of low grade serous ovarian tumours identifies novel candidate driver genes. Oncotarget. 2015;6(35):37663–77.
29.
Gilks CB, Bell DA, Scully RE. Serous psammocarcinoma of the ovary and peritoneum. Int J Gynecol Pathol. 1990;9(2):110–21.
30.
Weir MM, Bell DA, Young RH. Grade 1 peritoneal serous carcinomas: a report of 14 cases and comparison with 7 peritoneal serous psammocarcinomas and 19 peritoneal serous borderline tumors. Am J Surg Pathol. 1998;22(7):849–62.
31.
Kobel M, Piskorz AM, Lee S, Lui S, LePage C, Marass F, et al. Optimized p53 immunohistochemistry is an accurate predictor of TP53 mutation in ovarian carcinoma. J Pathol Clin Res. 2016;2(4):247–58.
32.
Kaspar HG, Crum CP. The utility of immunohistochemistry in the differential diagnosis of gynecologic disorders. Arch Pathol Lab Med. 2015;139(1):39–54.
33.
McEachron J, Baqir AW, Zhou N, Jabbar A, Gupta R, Levitan D, et al. Evaluation of the incidence and clinical significance of WT-1 expression in uterine serous carcinoma. Gynecol Oncol Rep. 2022;39:100918.
34.
Hart WR. Mucinous tumors of the ovary: a review. Int J Gynecol Pathol. 2005;24(1):4–25.
35.
Stewart CJR, Brennan BA, Koay E, Naran A, Ruba S. Value of cytology in the intraoperative assessment of ovarian tumors: a review of 402 cases and comparison with frozen section diagnosis. Cancer Cytopathol. 2010;118(3):127–36.
36.
Shimada M, Kigawa J, Ohishi Y, Yasuda M, Suzuki M, Hiura M, et al. Clinicopathological characteristics of mucinous adenocarcinoma of the ovary. Gynecol Oncol. 2009;113(3):331–4.
37.
Cobb LP, Gershenson DM. Treatment of rare epithelial ovarian tumors. Hematol Oncol Clin North Am. 2018;32(6):1011–24.
38.
Seidman JD, Kurman RJ, Ronnett BM. Primary and metastatic mucinous adenocarcinomas in the ovaries: incidence in routine practice with a new approach to improve intraoperative diagnosis. Am J Surg Pathol. 2003;27(7):985–93.
39.
Yemelyanova AV, Vang R, Judson K, Wu LSF, Ronnett BM. Distinction of primary and metastatic mucinous tumors involving the ovary: analysis of size and laterality data by primary site with reevaluation of an algorithm for tumor classification. Am J Surg Pathol. 2008;32(1):128–38.
40.
Kajiyama H, Suzuki S, Utsumi F, Yoshikawa N, Nishino K, Ikeda Y, et al. Comparison of long-term oncologic outcomes between metastatic ovarian carcinoma originating from gastrointestinal organs and advanced mucinous ovarian carcinoma. Int J Clin Oncol. 2019;24(8):950–6.
41.
Leen SLS, Singh N. Pathology of primary and metastatic mucinous ovarian neoplasms. J Clin Pathol. 2012;65(7):591–5.
42.
Lee KR, Young RH. The distinction between primary and metastatic mucinous carcinomas of the ovary: gross and histologic findings in 50 cases. Am J Surg Pathol. 2003;27(3):281–92.
43.
Moh M, Krings G, Ates D, Aysal A, Kim GE, Rabban JT. SATB2 expression distinguishes ovarian metastases of colorectal and appendiceal origin from primary ovarian tumors of mucinous or endometrioid type. Am J Surg Pathol. 2016;40(3):419–32.
44.
McCluggage WG. Immunohistochemistry in the distinction between primary and metastatic ovarian mucinous neoplasms. J Clin Pathol. 2012;65(7):596–600.
45.
Bassiouny D, Ismiil N, Dube V, Han G, Cesari M, Lu FI, et al. Comprehensive clinicopathologic and updated immunohistochemical characterization of primary ovarian mucinous carcinoma. Int J Surg Pathol. 2018;26(4):306–17.
46.
Rutgers JL, Scully RE. Ovarian mullerian mucinous papillary cystadenomas of borderline malignancy. A clinicopathologic analysis. Cancer. 1988;61(2):340–8.
47.
Rodriguez IM, Irving JA, Prat J. Endocervical-like mucinous borderline tumors of the ovary: a clinicopathologic analysis of 31 cases. Am J Surg Pathol. 2004;28(10):1311–8.
48.
Taylor J, McCluggage WG. Ovarian seromucinous carcinoma: report of a series of a newly categorized and uncommon neoplasm. Am J Surg Pathol. 2015;39(7):983–92.
49.
Shappell HW, Riopel MA, Smith Sehdev AE, Ronnett BM, Kurman RJ. Diagnostic criteria and behavior of ovarian seromucinous (endocervical-type mucinous and mixed cell-type) tumors: atypical proliferative (borderline) tumors, intraepithelial, microinvasive, and invasive carcinomas. Am J Surg Pathol. 2002;26(12):1529–41.
50.
Dube V, Roy M, Plante M, Renaud MC, Tetu B. Mucinous ovarian tumors of Mullerian-type: an analysis of 17 cases including borderline tumors and intraepithelial, microinvasive, and invasive carcinomas. Int J Gynecol Pathol. 2005;24(2):138–46.
51.
Hayashi H, Taniguchi S, Kurihara S, Hachisuga K, Fukuda S, Inada C, et al. Pelvic recurrence of an ovarian seromucinous borderline tumor detected by vaginal cytology: a case report and review of the literature. Diagn Cytopathol. 2016;44(11):912–6.
52.
Kai K, Hashiguchi M, Kurihara M, Tanaka Y, Kitamura S, Nakamura M, et al. Cytological appearances of ovarian seromucinous borderline tumor in ascites: presentation of 2 cases. Acta Cytol. 2021;65(5):440–7.
53.
Vang R, Gown AM, Barry TS, Wheeler DT, Ronnett BM. Ovarian atypical proliferative (borderline) mucinous tumors: gastrointestinal and seromucinous (endocervical-like) types are immunophenotypically distinctive. Int J Gynecol Pathol. 2006;25(1):83–9.
54.
Yasunaga M, Ohishi Y, Oda Y, Misumi M, Iwasa A, Kurihara S, et al. Immunohistochemical characterization of mullerian mucinous borderline tumors: possible histogenetic link with serous borderline tumors and low-grade endometrioid tumors. Hum Pathol. 2009;40(7):965–74.
55.
Alexandrova E, Pecoraro G, Sellitto A, Melone V, Ferravante C, Rocco T, et al. An overview of candidate therapeutic target genes in ovarian cancer. Cancers. 2020;12(6):1470.
56.
Anglesio MS, Yong PJ. Endometriosis-associated ovarian cancers. Clin Obstet Gynecol. 2017;60(4):711–27.
57.
Leskela S, Romero I, Cristobal E, Perez-Mies B, Rosa-Rosa JM, Gutierrez-Pecharroman A, et al. Mismatch repair deficiency in ovarian carcinoma: frequency, causes, and consequences. Am J Surg Pathol. 2020;44(5):649–56.
58.
Matias-Guiu X, Stewart CJR. Endometriosis-associated ovarian neoplasia. Pathology. 2018;50(2):190–204.
59.
Bennett JA, Pesci A, Morales-Oyarvide V, Da Silva A, Nardi V, Oliva E. Incidence of mismatch repair protein deficiency and associated clinicopathologic features in a cohort of 104 ovarian endometrioid carcinomas. Am J Surg Pathol. 2019;43(2):235–43.
60.
Odashima H, Yoshioka H, Minami K, Miyakawa K, Horie K, Norimatsu Y, et al. Morphometrical differences among endometrial endometrioid carcinoma grade 1, grade 3, and serous carcinoma in endometrial liquid-based cytology preparations. Acta Cytol. 2022;66(6):524–31.
61.
Acs G, Pasha T, Zhang PJ. WT1 is differentially expressed in serous, endometrioid, clear cell, and mucinous carcinomas of the peritoneum, fallopian tube, ovary, and endometrium. Int J Gynecol Pathol. 2004;23(2):110–8.
62.
Okuda T, Otsuka J, Sekizawa A, Saito H, Makino R, Kushima M, et al. p53 mutations and overexpression affect prognosis of ovarian endometrioid cancer but not clear cell cancer. Gynecol Oncol. 2003;88(3):318–25.
63.
Fraune C, Rosebrock J, Simon R, Hube-Magg C, Makrypidi-Fraune G, Kluth M, et al. High homogeneity of MMR deficiency in ovarian cancer. Gynecol Oncol. 2020;156(3):669–75.
64.
Wu R, Hendrix-Lucas N, Kuick R, Zhai Y, Schwartz DR, Akyol A, et al. Mouse model of human ovarian endometrioid adenocarcinoma based on somatic defects in the Wnt/beta-catenin and PI3K/Pten signaling pathways. Cancer Cell. 2007;11(4):321–33.
65.
McConechy MK, Ding J, Senz J, Yang W, Melnyk N, Tone AA, et al. Ovarian and endometrial endometrioid carcinomas have distinct CTNNB1 and PTEN mutation profiles. Mod Pathol. 2014;27(1):128–34.
66.
Lee KR, Tavassoli FA, Prat J, Dietel M, Gersell DJ, Karseladze AI, et al. Surface epithelial-stromal tumours. In: Tavassoli FA, Devilee P, editors. World Health Organization classification of tumors: pathology and genetics of the breast and female genital organs. Lyon: IARC Press; 2003. p. 117–45.
67.
Bell DA, Scully RE. Benign and borderline clear cell adenofibromas of the ovary. Cancer. 1985;56(12):2922–31.
68.
Damiani D, Suciu V, Genestie C, Vielh P. Cytomorphology of ovarian clear cell carcinomas in peritoneal effusions. Cytopathology. 2016;27(6):427–32.
69.
Naka M, Ohishi Y, Kaku T, Watanabe S, Tamiya S, Ookubo F, et al. Identification of intranuclear inclusions is useful for the cytological diagnosis of ovarian clear cell carcinoma. Diagn Cytopathol. 2015;43(11):879–84.
70.
Vrdoljak-Mozetic D, Stanković T, Krasević M, Versa-Ostojić D, Stemberger-Papić S, Rupcić S. Intraoperative cytology of clear cell carcinoma of the ovary. Cytopathology. 2006;17(6):390–5.
71.
Mikami Y, Hata S, Melamed J, Moriya T, Manabe T. Basement membrane material in ovarian clear cell carcinoma: correlation with growth pattern and nuclear grade. Int J Gynecol Pathol. 1999;18(1):52–7.
72.
DeLair D, Oliva E, Kobel M, Macias A, Gilks CB, Soslow RA. Morphologic spectrum of immunohistochemically characterized clear cell carcinoma of the ovary: a study of 155 cases. Am J Surg Pathol. 2011;35(1):36–44.
73.
Parra-Herran C, Bassiouny D, Lerner-Ellis J, Olkhov-Mitsel E, Ismiil N, Hogen L, et al. p53, mismatch repair protein, and POLE abnormalities in ovarian clear cell carcinoma: an outcome-based clinicopathologic analysis. Am J Surg Pathol. 2019;43(12):1591–9.
74.
Kobel M, Luo L, Grevers X, Lee S, Brooks-Wilson A, Gilks CB, et al. Ovarian carcinoma histotype: strengths and limitations of integrating morphology with immunohistochemical predictions. Int J Gynecol Pathol. 2019;38(4):353–62.
75.
Wiegand KC, Shah SP, Al-Agha OM, Zhao Y, Tse K, Zeng T, et al. ARID1A mutations in endometriosis-associated ovarian carcinomas. N Engl J Med. 2010;363(16):1532–43.
76.
Friedlander ML, Russell K, Millis S, Gatalica Z, Bender R, Voss A. Molecular profiling of clear cell ovarian cancers: identifying potential treatment targets for clinical trials. Int J Gynecol Cancer. 2016;26(4):648–54.
77.
Wang YK, Bashashati A, Anglesio MS, Cochrane DR, Grewal DS, Ha G, et al. Genomic consequences of aberrant DNA repair mechanisms stratify ovarian cancer histotypes. Nat Genet. 2017;49(6):856–65.
78.
Kato N, Motoyama T. Ascitic fluid cytology of a malignant mixed Mullerian tumor of the peritoneum: a report of two cases with special reference to p53 status. Diagn Cytopathol. 2009;37(4):281–5.
79.
Kadoch C, Crabtree GR. Mammalian SWI/SNF chromatin remodeling complexes and cancer: mechanistic insights gained from human genomics. Sci Adv. 2015;1(5):e1500447.
80.
Witkowski L, Carrot-Zhang J, Albrecht S, Fahiminiya S, Hamel N, Tomiak E, et al. Germline and somatic SMARCA4 mutations characterize small cell carcinoma of the ovary, hypercalcemic type. Nat Genet. 2014;46(5):438–43.
81.
Chaudet K, Kem M, Lerwill M, Young RH, Mino-Kenudson M, Agaimy A, et al. SWI/SNF protein and claudin-4 expression in anaplastic carcinomas arising in mucinous tumours of the ovary and retroperitoneum. Histopathology. 2020;77(2):231–9.
82.
McCluggage WG, Stewart CJR. SWI/SNF-deficient malignancies of the female genital tract. Semin Diagn Pathol. 2021;38(3):199–211.
83.
Kolin DL, Dong F, Baltay M, Lindeman N, MacConaill L, Nucci MR, et al. SMARCA4-deficient undifferentiated uterine sarcoma (malignant rhabdoid tumor of the uterus): a clinicopathologic entity distinct from undifferentiated carcinoma. Mod Pathol. 2018;31(9):1442–56.
84.
Young RH, Oliva E, Scully RE. Small cell carcinoma of the ovary, hypercalcemic type. A clinicopathological analysis of 150 cases. Am J Surg Pathol. 1994;18(11):1102–16.
85.
Fulciniti F, Barizzi J, Migliora P, Papadia A, Mazzucchelli L. Cytologic presentation of ovarian large cell carcinoma with rhabdoid features detected on peritoneal washing. Report of one case with cyto-histologic correlation and previously undescribed inactivating SMARCA-4 mutations. Diagn Cytopathol. 2022;50(3):E95–E99.
86.
Trichia HJ, Tziakou P, Papatheodorou DC, Lekka J. Cytological features of the large cell variant of small cell ovarian carcinoma in young patients with hypercalcemia: histological findings and review of the literature. Acta Cytol. 2017;61(6):462–8.
87.
Witkowski L, Goudie C, Foulkes WD, McCluggage WG. Small-cell carcinoma of the ovary of hypercalcemic type (malignant rhabdoid tumor of the ovary): a review with recent developments on pathogenesis. Surg Pathol Clin. 2016;9(2):215–26.
88.
Gupta R, Mathur SR, Arora VK, Sharma SG. Cytologic features of extragonadal germ cell tumors: a study of 88 cases with aspiration cytology. Cancer. 2008;114(6):504–11.
89.
Black JD, Roque DM, Pasternak MC, Buza N, Rutherford TJ, Schwartz PE, et al. A series of malignant ovarian cancers arising from within a mature cystic teratoma: a single institution experience. Int J Gynecol Cancer. 2015;25(5):792–7.
90.
Wheeler L, Westhoff GL, O'Keefe MC, Kong CS, Karam A. Adenocarcinoma with breast/adnexal and upper gastrointestinal differentiation arising in an ovarian mature cystic teratoma: a case report and review of the literature. Int J Gynecol Pathol. 2016;35(1):72–7.
91.
Vang R, Gown AM, Zhao C, Barry TS, Isacson C, Richardson MS, et al. Ovarian mucinous tumors associated with mature cystic teratomas: morphologic and immunohistochemical analysis identifies a subset of potential teratomatous origin that shares features of lower gastrointestinal tract mucinous tumors more commonly encountered as secondary tumors in the ovary. Am J Surg Pathol. 2007;31(6):854–69.
92.
Mandai M, Konishi I, Koshiyama M, Komatsu T, Yamamoto S, Nanbu K, et al. Ascitic positive cytology and intraperitoneal metastasis in ovarian dysgerminoma. J Obstet Gynaecol Res. 1996;22(1):89–94.
93.
Valente PT, Schantz HD, Edmonds PR, Hanjani P. Peritoneal cytology of uncommon ovarian tumors. Diagn Cytopathol. 1992;8(2):98–106.
94.
Hees K, de Jonge JP, von Kortzfleisch DH. Dysgerminoma of the ovary. Cytologic, histologic and electron microscopic study of a case. Acta Cytol. 1991;35(3):341–4.
95.
McCluggage WG. Ovarian neoplasms composed of small round cells: a review. Adv Anat Pathol. 2004;11(6):288–96.
96.
Euscher ED. Germ cell tumors of the female genital tract. Surg Pathol Clin. 2019;12(2):621–49.
97.
Akhtar M, al Dayel F. Is it feasible to diagnose germ-cell tumors by fine-needle aspiration biopsy? Diagn Cytopathol. 1997;16(1):72–7.
98.
Bandyopadhyay A, Chakraborty J, Chowdhury AR, Bhattacharya A, Bhattachrya P, Chowdhury M. Fine needle aspiration cytology of ovarian tumors with histological correlation. J Cytol. 2012;29(1):35–40.
99.
Murugan P, Siddaraju N, Sridhar E, Soundararaghavan J, Habeebullah S. Unusual ovarian malignancies in ascitic fluid: a report of 2 cases. Acta Cytol. 2010;54(4):611–7.
100.
Afroz N, Khan N, Chana RS. Cytodiagnosis of yolk sac tumor. Indian J Pediatr. 2004;71(10):939–42.
101.
Mizrak B, Ekinci C. Cytologic diagnosis of yolk sac tumor. A report of seven cases. Acta Cytol. 1995;39(5):936–40.
102.
Nogales FF, Quinonez E, Lopez-Marin L, Dulcey I, Preda O. A diagnostic immunohistochemical panel for yolk sac (primitive endodermal) tumours based on an immunohistochemical comparison with the human yolk sac. Histopathology. 2014;65(1):51–9.
103.
Dallenbach P, Bonnefoi H, Pelte MF, Vlastos G. Yolk sac tumours of the ovary: an update. Eur J Surg Oncol. 2006;32(10):1063–75.
104.
Lau SK, Weiss LM, Chu PG. D2-40 immunohistochemistry in the differential diagnosis of seminoma and embryonal carcinoma: a comparative immunohistochemical study with KIT (CD117) and CD30. Mod Pathol. 2007;20(3):320–5.
105.
Cheng L, Zhang S, Talerman A, Roth LM. Morphologic, immunohistochemical, and fluorescence in situ hybridization study of ovarian embryonal carcinoma with comparison to solid variant of yolk sac tumor and immature teratoma. Hum Pathol. 2010;41(5):716–23.
106.
Ikeda K, Tate G, Suzuki T, Mitsuya T. Cytomorphologic features of immature ovarian teratoma in peritoneal effusion: a case report. Diagn Cytopathol. 2005;33(1):39–42.
107.
Selvaggi SM, Guidos BJ. Immature teratoma of the ovary on fluid cytology. Diagn Cytopathol. 2001;25(6):411–4.
108.
Fuller PJ, Leung D, Chu S. Genetics and genomics of ovarian sex cord-stromal tumors. Clin Genet. 2017;91(2):285–91.
109.
Schumer ST, Cannistra SA. Granulosa cell tumor of the ovary. J Clin Oncol. 2003;21(6):1180–9.
110.
Atilgan AO, Tepeoglu M, Ozen O, Bilezikci B. Peritoneal washing cytology in an adult granulosa cell tumor: a case report and review of literature. J Cytol. 2013;30(1):74–7.
111.
Edmund LN, Salama AM, Murali R. Cytologic features of sex cord-stromal tumors in women. Cancer Cytopathol. 2022;130(1):55–71.
112.
Gupta N, Rajwanshi A, Dey P, Suri V. Adult granulosa cell tumor presenting as metastases to the pleural and peritoneal cavity. Diagn Cytopathol. 2012;40(10):912–5.
113.
Kavuri S, Kulkarni R, Reid-Nicholson M. Granulosa cell tumor of the ovary: cytologic findings. Acta Cytol. 2010;54(4):551–9.
114.
Lal A, Bourtsos EP, Nayar R, DeFrias DV. Cytologic features of granulosa cell tumors in fluids and fine needle aspiration specimens. Acta Cytol. 2004;48(3):315–20.
115.
Deavers MT, Malpica A, Ordonez NG, Silva EG. Ovarian steroid cell tumors: an immunohistochemical study including a comparison of calretinin with inhibin. Int J Gynecol Pathol. 2003;22(2):162–7.
116.
Kommoss S, Gilks CB, Penzel R, Herpel E, Mackenzie R, Huntsman D, et al. A current perspective on the pathological assessment of FOXL2 in adult-type granulosa cell tumours of the ovary. Histopathology. 2014;64(3):380–8.
117.
Young RH, Dickersin GR, Scully RE. Juvenile granulosa cell tumor of the ovary. A clinicopathological analysis of 125 cases. Am J Surg Pathol. 1984;8(8):575–96.
118.
Wu H, Pangas SA, Eldin KW, Patel KR, Hicks J, Dietrich JE, et al. Juvenile granulosa cell tumor of the ovary: a clinicopathologic study. J Pediatr Adolesc Gynecol. 2017;30(1):138–43.
119.
Baillard P, Genestie C, Croce S, Descotes F, Rouleau E, Treilleux I, et al. Rare DICER1 and absent FOXL2 mutations characterize ovarian juvenile granulosa cell tumors. Am J Surg Pathol. 2021;45(2):223–9.
120.
Bessiere L, Todeschini AL, Auguste A, Sarnacki S, Flatters D, Legois B, et al. A hot-spot of in-frame duplications activates the oncoprotein AKT1 in juvenile granulosa cell tumors. EBioMedicine. 2015;2(5):421–31.
121.
Kalfa N, Ecochard A, Patte C, Duvillard P, Audran F, Pienkowski C, et al. Activating mutations of the stimulatory g protein in juvenile ovarian granulosa cell tumors: a new prognostic factor? J Clin Endocrinol Metab. 2006;91(5):1842–7.
122.
Rietveld L, Nieboer TE, Kluivers KB, Schreuder HWB, Bulten J, Massuger LFAG. First case of juvenile granulosa cell tumor in an adult with Ollier disease. Int J Gynecol Pathol. 2009;28(5):464–7.
123.
Karnezis AN, Wang Y, Keul J, Tessier-Cloutier B, Magrill J, Kommoss S, et al. DICER1 and FOXL2 mutation status correlates with clinicopathologic features in ovarian sertoli-leydig cell tumors. Am J Surg Pathol. 2019;43(5):628–38.
124.
Hayes MC, Scully RE. Ovarian steroid cell tumors (not otherwise specified). A clinicopathological analysis of 63 cases. Am J Surg Pathol. 1987;11(11):835–45.
125.
Tebeu PM, Popowski GY, Verkooijen HM, Casals J, Ludicke F, Zeciri G, et al. Impact of peritoneal cytology on survival of endometrial cancer patients treated with surgery and radiotherapy. Br J Cancer. 2003;89(11):2023–6.
126.
Kasamatsu T, Onda T, Katsumata N, Sawada M, Yamada T, Tsunematsu R, et al. Prognostic significance of positive peritoneal cytology in endometrial carcinoma confined to the uterus. Br J Cancer. 2003;88(2):245–50.
127.
Fadare O, Mariappan MR, Hileeto D, Wang S, McAlpine JN, Rimm DL. Upstaging based solely on positive peritoneal washing does not affect outcome in endometrial cancer. Mod Pathol. 2005;18(5):673–80.
128.
Milosevic MF, Dembo AJ, Thomas GM. The clinical significance of malignant peritoneal cytology in stage I endometrial carcinoma. Int J Gynecol Cancer. 1992;2(5):225–35.
129.
Pecorelli S. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynaecol Obstet. 2009;105(2):103–4.
130.
Saga Y, Imai M, Jobo T, Kuramoto H, Takahashi K, Konno R, et al. Is peritoneal cytology a prognostic factor of endometrial cancer confined to the uterus? Gynecol Oncol. 2006;103(1):277–80.
131.
Wethington SL, Barrena Medel NI, Wright JD, Herzog TJ. Prognostic significance and treatment implications of positive peritoneal cytology in endometrial adenocarcinoma: unraveling a mystery. Gynecol Oncol. 2009;115(1):18–25.
132.
Corey L, Fucinari J, Elshaikh M, Schultz D, Musallam R, Zaiem F, et al. Impact of positive cytology in uterine serous carcinoma: a reassessment. Gynecol Oncol Rep. 2021;37:100830.
133.
Shiozaki T, Tabata T, Yamada T, Yamamoto Y, Yamawaki T, Ikeda T. Does positive peritoneal cytology not affect the prognosis for stage I uterine endometrial cancer?: the remaining controversy and review of the literature. Int J Gynecol Cancer. 2014;24(3):549–55.
134.
Matsuo K, Yabuno A, Hom MS, Shida M, Kakuda M, Adachi S, et al. Significance of abnormal peritoneal cytology on survival of women with stage I-II endometrioid endometrial cancer. Gynecol Oncol. 2018;149(2):301–9.
135.
Matsuo K, Nusbaum DJ, Matsuzaki S, Chang EJ, Roman LD, Wright JD, et al. Malignant peritoneal cytology and increased mortality risk in stage I non-endometrioid endometrial cancer. Gynecol Oncol. 2020;159(1):43–51.
136.
Scott SA, van der Zanden C, Cai E, McGahan CE, Kwon JS. Prognostic significance of peritoneal cytology in low-intermediate risk endometrial cancer. Gynecol Oncol. 2017;145(2):262–8.
137.
Kuzel D, Toth D, Kobilkova J, Dohnalova A. Peritoneal washing cytology on fluid hysteroscopy and after curettage in women with endometrial carcinoma. Acta Cytol. 2001;45(6):931–5.
138.
Sonoda Y, Zerbe M, Smith A, Lin O, Barakat RR, Hoskins WJ. High incidence of positive peritoneal cytology in low-risk endometrial cancer treated by laparoscopically assisted vaginal hysterectomy. Gynecol Oncol. 2001;80(3):378–82.
139.
Lim S, Kim HS, Lee KB, Yoo CW, Park SY, Seo SS. Does the use of a uterine manipulator with an intrauterine balloon in total laparoscopic hysterectomy facilitate tumor cell spillage into the peritoneal cavity in patients with endometrial cancer? Int J Gynecol Cancer. 2008;18(5):1145–9.
140.
Eltabbakh GH, Mount SL. Laparoscopic surgery does not increase the positive peritoneal cytology among women with endometrial carcinoma. Gynecol Oncol. 2006;100(2):361–4.
141.
Hopkins MR, Richmond AM, Cheng G, Davidson S, Spillman MA, Sheeder J, et al. Lymphovascular space invasion in robotic surgery for endometrial cancer. JSLS. 2014;18(3):e2014.00021.
142.
Kitahara S, Walsh C, Frumovitz M, Malpica A, Silva EG. Vascular pseudoinvasion in laparoscopic hysterectomy specimens for endometrial carcinoma: a grossing artifact? Am J Surg Pathol. 2009;33(2):298–303.
143.
Krizova A, Clarke BA, Bernardini MQ, James S, Kalloger SE, Boerner SL, et al. Histologic artifacts in abdominal, vaginal, laparoscopic, and robotic hysterectomy specimens: a blinded, retrospective review. Am J Surg Pathol. 2011;35(1):115–26.
144.
Logani S, Herdman AV, Little JV, Moller KA. Vascular “pseudo invasion” in laparoscopic hysterectomy specimens: a diagnostic pitfall. Am J Surg Pathol. 2008;32(4):560–5.
145.
Folkins AK, Nevadunsky NS, Saleemuddin A, Jarboe EA, Muto MG, Feltmate CM, et al. Evaluation of vascular space involvement in endometrial adenocarcinomas: laparoscopic vs abdominal hysterectomies. Mod Pathol. 2010;23(8):1073–9.
146.
Momeni M, Kolev V, Cardenas-Goicoechea J, Getrajdman J, Fishman D, Chuang L, et al. Does the type of surgery for early-stage endometrial cancer affect the rate of reported lymphovascular space invasion in final pathology specimens? Am J Obstet Gynecol. 2013;208(1):71 e1–6.
147.
Kanbour AI, Buchsbaum HJ, Hall A, Kanbour AI. Peritoneal cytology in malignant mixed mullerian tumors of the uterus. Gynecol Oncol. 1989;33(1):91–5.
148.
Ricci S, Stone RL, Fader AN. Uterine leiomyosarcoma: epidemiology, contemporary treatment strategies and the impact of uterine morcellation. Gynecol Oncol. 2017;145(1):208–16.
149.
Matsuo K, Matsuzaki S, Nusbaum DJ, Ki S, Chang EJ, Klar M, et al. Significance of malignant peritoneal cytology on survival of women with uterine sarcoma. Ann Surg Oncol. 2021;28(3):1740–8.
150.
Suh DS, Kim YH, Yun KY, Lee NK, Choi KU, Kim KH, et al. An unusual case of pedunculated subserosal leiomyosarcoma of the uterus mimicking ovarian carcinoma. J Ovarian Res. 2016;9:2.
151.
Boșoteanu M, Vodă RI, Așchie M, Bosoteanu LA, Bălțătescu GI. Morphological and ancillary features of uterine leiomyosarcoma: case report. Clin Pathol. 2022;15:2632010X221105224.
152.
Lee CH, Turbin DA, Sung YCV, Espinosa I, Montgomery K, van de Rijn M. A panel of antibodies to determine site of origin and malignancy in smooth muscle tumors. Mod Pathol. 2009;22(12):1519–31.
153.
Schaefer IM, Hornick JL, Sholl LM, Quade BJ, Nucci MR, Parra-Herran C. Abnormal p53 and p16 staining patterns distinguish uterine leiomyosarcoma from inflammatory myofibroblastic tumour. Histopathology. 2017;70(7):1138–46.
154.
Albores-Saavedra J, Dorantes-Heredia R, Chable-Montero F, Chanona-Vilchis J, Perez-Montiel D, Lino-Silva LS, et al. Endometrial stromal sarcomas: immunoprofile with emphasis on HMB45 reactivity. Am J Clin Pathol. 2014;141(6):850–5.
155.
Koontz JI, Soreng AL, Nucci M, Kuo FC, Pauwels P, van Den Berghe H, et al. Frequent fusion of the JAZF1 and JJAZ1 genes in endometrial stromal tumors. Proc Natl Acad Sci U S A. 2001;98(11):6348–53.
156.
Lee CH, Ou WB, Marino-Enriquez A, Zhu M, Mayeda M, Wang Y, et al. 14-3-3 fusion oncogenes in high-grade endometrial stromal sarcoma. Proc Natl Acad Sci U S A. 2012;109(3):929–34.
157.
Hoang LN, Aneja A, Conlon N, Delair DF, Middha S, Benayed R, et al. Novel high-grade endometrial stromal sarcoma: a morphologic mimicker of myxoid leiomyosarcoma. Am J Surg Pathol. 2017;41(1):12–24.
158.
Marino-Enriquez A, Lauria A, Przybyl J, Ng TL, Kowalewska M, Debiec-Rychter M, et al. BCOR internal tandem duplication in high-grade uterine sarcomas. Am J Surg Pathol. 2018;42(3):335–41.
159.
Zou Y, Turashvili G, Soslow RA, Park KJ, Croce S, McCluggage WG, et al. High-grade transformation of low-grade endometrial stromal sarcomas lacking YWHAE and BCOR genetic abnormalities. Mod Pathol. 2020;33(9):1861–70.
160.
Anastasiadis P, Sivridis E, Koutlaki N, Tamiolakis D, Galazios G, Tsikouras P. The significance of rapid intraoperative cytology in the evaluation of intraperitoneal and retroperitoneal spread of cervical cancer. Gynecol Oncol. 2002;84(1):102–9.
161.
Trelford JD, Kinney W, Vogt P. Positive peritoneal cytology in stage I carcinoma of the cervix. Acta Cytol. 1995;39(2):177–9.
162.
Estape R, Angioli R, Wagman F, Madrigal M, Janicek M, Ganjei-Azar P, et al. Significance of intraperitoneal cytology in patients undergoing radical hysterectomy. Gynecol Oncol. 1998;68(2):169–71.
163.
Benedetti Panici P, Perniola G, Tomao F, Fischetti M, Savone D, Di Donato V, et al. An update of laparoscopy in cervical cancer staging: is it a useful procedure? Oncology. 2013;85(3):160–5.
164.
Ditto A, Martinelli F, Carcangiu M, Lorusso D, Raspagliesi F. Peritoneal cytology as prognostic factor in cervical cancer. Diagn Cytopathol. 2015;43(9):705–9.
165.
Roberts WS, Bryson SC, Cavanagh D, Roberts VC, Lyman GH. Peritoneal cytology and invasive carcinoma of the cervix. Gynecol Oncol. 1986;24(3):331–6.
166.
Imachi M, Tsukamoto N, Matsuyama T, Nakano H. Peritoneal cytology in patients with carcinoma of the uterine cervix. Gynecol Oncol. 1987;26(2):202–7.
167.
Kashimura M, Sugihara K, Toki N, Matsuura Y, Kawagoe T, Kamura T, et al. The significance of peritoneal cytology in uterine cervix and endometrial cancer. Gynecol Oncol. 1997;67(3):285–90.
168.
Takeshima N, Katase K, Hirai Y, Yamawaki T, Yamauchi K, Hasumi K. Prognostic value of peritoneal cytology in patients with carcinoma of the uterine cervix. Gynecol Oncol. 1997;64(1):136–40.
169.
Attipoe MF, Sturgis CD. Small cell carcinoma of the uterine cervix in a pregnant patient diagnosed with liquid based cytology and cell block immunocytochemistry. Case Rep Pathol. 2014;2014:971464.
170.
Reich O, Pickel H, Purstner P. Exfoliative cytology of invasive neuroendocrine small cell carcinoma in a cervical cytologic smear. A case report. Acta Cytol. 1996;40(5):980–4.
171.
Haldar K, Giamougiannis P, Crawford R. Utility of peritoneal lavage cytology during laparoscopic salpingo-oophorectomy: a retrospective analysis. BJOG. 2011;118(1):28–33.
172.
Colgan TJ, Murphy J, Cole DE, Narod S, Rosen B. Occult carcinoma in prophylactic oophorectomy specimens: prevalence and association with BRCA germline mutation status. Am J Surg Pathol. 2001;25(10):1283–9.
173.
Rebbeck TR, Lynch HT, Neuhausen SL, Narod SA, Van't Veer L, Garber JE, et al. Prophylactic oophorectomy in carriers of BRCA1 or BRCA2 mutations. N Engl J Med. 2002;346(21):1616–22.
174.
Carcangiu ML, Radice P, Manoukian S, Spatti G, Gobbo M, Pensotti V, et al. Atypical epithelial proliferation in fallopian tubes in prophylactic salpingo-oophorectomy specimens from BRCA1 and BRCA2 germline mutation carriers. Int J Gynecol Pathol. 2004;23(1):35–40.
175.
Carcangiu ML, Peissel B, Pasini B, Spatti G, Radice P, Manoukian S. Incidental carcinomas in prophylactic specimens in BRCA1 and BRCA2 germ-line mutation carriers, with emphasis on fallopian tube lesions: report of 6 cases and review of the literature. Am J Surg Pathol. 2006;30(10):1222–30.
176.
Steenbeek MP, van Bommel MHD, Bulten J, Hulsmann JA, Bogaerts J, Garcia C, et al. Risk of peritoneal carcinomatosis after risk-reducing salpingo-oophorectomy: a systematic review and individual patient data meta-analysis. J Clin Oncol. 2022;40(17):1879–91.
177.
Manchanda R, Drapkin R, Jacobs I, Menon U. The role of peritoneal cytology at risk-reducing salpingo-oophorectomy (RRSO) in women at increased risk of familial ovarian/tubal cancer. Gynecol Oncol. 2012;124(2):185–91.
178.
Vaysse C, Touboul C, Filleron T, Mery E, Jouve E, Leguevaque P, et al. Early stage (IA-IB) primary carcinoma of the fallopian tube: case-control comparison to adenocarcinoma of the ovary. J Gynecol Oncol. 2011;22(1):9–17.
179.
Landon G, Stewart J, Deavers M, Lu K, Sneige N. Peritoneal washing cytology in patients with BRCA1 or BRCA2 mutations undergoing risk-reducing salpingo-oophorectomies: a 10-year experience and reappraisal of its clinical utility. Gynecol Oncol. 2012;125(3):683–6.
You do not currently have access to this content.