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Marshall M, Elishaev E, Khader S. The diagnostic accuracy and prognostic implication of pelvic and peritoneal fluid cytology specimens in ovarian clear cell carcinoma. J Am Soc Cytopathol 2024; 13:53-58. [PMID: 37865568 DOI: 10.1016/j.jasc.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/11/2023] [Accepted: 09/11/2023] [Indexed: 10/23/2023]
Abstract
INTRODUCTION Ovarian clear cell carcinoma (OCCC) is a rare subtype of ovarian epithelial carcinoma. Patients with low-stage disease have an excellent prognosis, while the prognosis for those with high-stage disease is poor. Neoplastic cells in abdominopelvic washings upstages the patient to at least FIGO 1C3. Positive cytology confers a worse prognosis when compared to similar stage patients with negative cytology. This study aims to investigate the diagnostic performance of abdominopelvic fluid cytology specimens in cases with pure OCCC and reaffirm the importance of accurate cytologic detection and its impact on patient prognosis. MATERIALS AND METHODS The laboratory information system was queried to identify all patients treated for ovarian clear cell carcinoma at our institution over a period of 20 years with a companion abdominopelvic fluid cytology specimen at the time of surgical resection. Cases were sorted by the FIGO stage of the corresponding oophorectomy specimen. Cytology results, patient demographics, fluid volume, immunohistochemical results, and follow-up data were recorded. RESULTS A total of 143 cases were identified. The overall detection rate was 38%, with 54 of 143 cases positive for malignancy. Cytologic detection rates increased as FIGO stages increased. Fifty percent of stage 1C cases were upstaged on cytology alone. Ascites fluids performed better among stage 1 cases compared to pelvic wash specimens (77% detection rate versus 23%). Stage 1 patients with positive cytology trended towards a worse prognosis compared to those with negative cytology. CONCLUSIONS Positive cytology in low stage cases of OCCC has significant prognostic and therapeutic implications. Our large cohort further underscores the importance of accurate cytologic detection and subsequent staging in this setting.
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Affiliation(s)
- Mason Marshall
- Department of Pathology, Cytopathology Center of Excellence, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
| | - Esther Elishaev
- Department of Pathology, Cytopathology Center of Excellence, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Samer Khader
- Department of Pathology, Cytopathology Center of Excellence, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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Sawada M, Oishi T, Nonaka M, Hikino K, Ookawa M, Iida Y, Hosokawa M, Komatsu H, Kudoh A, Sato S, Taniguchi F. Malignant Pericardial Tamponade Secondary to Ovarian Clear Cell Carcinoma. Yonago Acta Med 2023; 66:459-462. [PMID: 38028261 PMCID: PMC10674060 DOI: 10.33160/yam.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 09/19/2023] [Indexed: 12/01/2023]
Abstract
Malignant pericardial effusion is an uncommon metastatic manifestation of ovarian carcinoma. Few cases of ovarian serous carcinoma have been previously reported. Ovarian clear cell carcinoma is the second most common histologic subtype in East Asian countries and is a relatively rare in Western countries. Here, we report the case of cardiac tamponade secondary to Ovarian clear cell carcinoma. A 46-year-old woman with recurrent Ovarian clear cell carcinoma presented with worsening cough, palpitations, and shortness of breath during chemotherapy. Chest radiography and computed tomography confirmed a pleural effusion with cardiac tamponade. The patient underwent pericardial fenestration and drainage for cardiac tamponade. Pericardial fluid cytology showed malignant cells forming papillary and ball-like clusters with irregular stacking. The cells had a mirror ball-like appearance and collagenous stroma, in which a homogenous hyaline core was observed in the center of most tumor cell clusters. Based on these findings, a diagnosis of Ovarian clear cell carcinoma metastasis was made. She received palliative care and died 5 months after the operation without recurrent cardiac tamponade. This case suggests that cytological findings from pericardial effusion are useful in diagnosing Ovarian clear cell carcinoma metastasis.
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Affiliation(s)
- Mayumi Sawada
- Division of Gynecology, Department of Obstetrics and Gynecology, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan and
| | - Tetsuro Oishi
- Department of Obstetrics and Gynecology, Matsue City Hospital, Matsue 690-8509, Japan and
| | - Michiko Nonaka
- Department of Obstetrics and Gynecology, Tottori Prefectural Central Hospital, Tottori 680-0901, Japan
| | - Kohei Hikino
- Division of Gynecology, Department of Obstetrics and Gynecology, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan and
| | - Masayo Ookawa
- Division of Gynecology, Department of Obstetrics and Gynecology, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan and
| | - Yuki Iida
- Division of Gynecology, Department of Obstetrics and Gynecology, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan and
| | - Masayo Hosokawa
- Division of Gynecology, Department of Obstetrics and Gynecology, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan and
| | - Hiroaki Komatsu
- Division of Gynecology, Department of Obstetrics and Gynecology, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan and
| | - Akiko Kudoh
- Division of Gynecology, Department of Obstetrics and Gynecology, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan and
| | - Shinya Sato
- Division of Gynecology, Department of Obstetrics and Gynecology, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan and
| | - Fuminori Taniguchi
- Division of Gynecology, Department of Obstetrics and Gynecology, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan and
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Erdogan-Durmus S, Yulek O, Erdem Z. Diagnosis of lung adenocarcinoma with clear cell features in pleural effusion: Cytomorphologic features, immunocytochemical studies, and differential diagnosis. J Cytol 2022; 39:134-136. [PMID: 36277803 PMCID: PMC9585815 DOI: 10.4103/joc.joc_48_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 08/03/2022] [Indexed: 11/10/2022] Open
Abstract
Clear cell adenocarcinoma (CCA) of the lungs is no longer referred to as a subtype in recent classifications of lung adenocarcinoma. Like signet ring features, clear cell features are regarded as cytological features rather than histological subtypes. Additionally, in serous fluids, adenocarcinoma metastasis with clear cell features is a diagnostic challenging entity due to other tumors that come to mindfirst during the differential diagnosis. Here we report a case, diagnosed as CCA of lung metastasis in pleural fluid and evaluated its differential diagnosis.
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Iwahashi H, Miyamoto M, Minabe S, Hada T, Sakamoto T, Ishibashi H, Kakimoto S, Matsuura H, Suzuki R, Matsukuma S, Tsuda H, Takano M. Diagnostic efficacy of ascites cell block for ovarian clear cell carcinoma. Diagn Cytopathol 2021; 49:735-742. [PMID: 33675673 DOI: 10.1002/dc.24734] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 02/16/2021] [Accepted: 02/25/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Ascites cytology is important for determining the stage and treatment methods for ovarian clear cell carcinoma (CCC) as defined by the 2014 International Federation of Obstetrics and Gynecology classification. METHODS Patients with CCC who underwent surgery at our hospital between January 2012 and December 2019 and who received cytodiagnosis of their ascites using Papanicolaou (Pap) and May-Grünwald-Giemsa (MGG) staining, and cell block methods were identified. The cell block technique was performed using hematoxylin-eosin (H&E) staining and immunohistochemical staining for hepatocyte nuclear factor-1β (HNF-1β), estrogen receptor (ER), progesterone receptor (PR), and Wilms tumor-1 (WT-1). Cancer cells of CCC were defined as tumor cells that were positive for HNF-1β and negative for ER, PR, and WT-1. The diagnostic accuracy of ascites cytology using Pap and MGG staining and cell block methods was examined. RESULTS Based on cytological data, our study included 17 patients: seven (41.1%) with malignant (MAL) ascites, eight (47.1%) with negative for malignancy (NFM), and two (11.8%) with atypia of undetermined significance (AUS) because of a few atypical cells based on Pap and MGG staining. Malignant cells diagnosed by cell blocks were detected in 7/7 patients with MAL ascites based on PAP and MGG staining, 2/8 (25.0%) patients with NFM, and 1/2 (50%) patients with AUS. CONCLUSION These findings show that the cell block method combined with the immunohistochemical investigation may be useful for increasing the diagnostic accuracy of malignant cells in CCC.
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Affiliation(s)
- Hideki Iwahashi
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Morikazu Miyamoto
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Shinya Minabe
- Department of Laboratory Medicine, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Taira Hada
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Takahiro Sakamoto
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Hiroki Ishibashi
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Soichiro Kakimoto
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Hiroko Matsuura
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Rie Suzuki
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Susumu Matsukuma
- Department of Laboratory Medicine, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Hitoshi Tsuda
- Department of Basic Pathology, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Masashi Takano
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, Tokorozawa, Japan
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Abstract
Effusion cytology plays multiple roles in the management of benign and malignant disease, from primary diagnosis to tissue allocation for ancillary diagnostic studies and biomarker testing of therapeutic targets. This article summarizes recent advances in pleural effusion cytology, with a focus on the practical application of immunohistochemical markers, cytogenetic techniques, flow cytometry, and molecular techniques for the diagnosis and management of primary and secondary neoplasms of the pleura.
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Affiliation(s)
- Christin M Lepus
- Department of Pathology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA
| | - Marina Vivero
- Department of Pathology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
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Shintaku M, Dohi M, Yamamoto Y, Nagai A, Higuchi T. Ovarian clear cell carcinoma with plasma cell-rich inflammatory stroma. Diagn Cytopathol 2016; 45:128-132. [DOI: 10.1002/dc.23609] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 08/09/2016] [Accepted: 08/30/2016] [Indexed: 11/10/2022]
Affiliation(s)
- Masayuki Shintaku
- Department of Pathology; Shiga Medical Center for Adults; Moriyama Shiga 524-8524 Japan
| | - Makoto Dohi
- Department of Pathology; Shiga Medical Center for Adults; Moriyama Shiga 524-8524 Japan
| | - Yoshihiro Yamamoto
- Department of Pathology; Shiga Medical Center for Adults; Moriyama Shiga 524-8524 Japan
| | - Aya Nagai
- Department of Gynecology; Shiga Medical Center for Adults; Moriyama Shiga 524-8524 Japan
| | - Toshihiro Higuchi
- Department of Gynecology; Shiga Medical Center for Adults; Moriyama Shiga 524-8524 Japan
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