Cytology of Pleural, Pericardial and Peritoneal Cavity Effusions - Effusions - Metastatic Gastrointestinal Malignancy

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Figure 93
Peritoneal effusion: Gastric adenocarcinoma. Cells with malignant features are present as a distinct population. Some may exhibit nuclear displacement by a large secretory vacuole, a “signet ring” cell. Origin from one part of the GI tract over another cannot be easily ascertained. 60x

Figure 94
Peritoneal effusion: Cell block, gastric adenocarcinoma. The cell block contains cells with similar malignant features as those seen in the ThinPrep slide of the effusion. 40x

Figure 95
Peritoneal effusion: Poorly differentiated gastric carcinoma. Malignant cells stand out easily from the benign cells in the background. 20x

Figure 96
Peritoneal effusion: Poorly differentiated gastric carcinoma. The enlarged, eccentric nuclei exhibit irregular nuclear membranes and prominent nucleoli. 60x

Figure 97
Peritoneal effusion: Gastric carcinoma. Malignant peritoneal effusion in a case of metastatic gastric carcinoma. A loose cluster of malignant cells with pleomorphic nuclei and multiple mitotic figures. 60x

Figure 98
Pleural effusion: Gastric carcinoma. 40x

Figure 99
Pleural effusion: Gastric carcinoma. 60x

Fig 98-99: Pleural effusion: Gastric carcinoma.
Malignant glandular cells arranged in a dense, rounded cluster. Note that the surface cells maintain cell polarity with apical cytoplasm. The nuclei are irregular with prominent nucleoli.

Figure 100
Abdominal wash: Colon adenocarcinoma. 20x

Figure 101
Abdominal wash: Colon adenocarcinoma. 40x

Figure 102
Abdominal wash: Colon adenocarcinoma. 60x

Fig 101-102: Abdominal wash: Colon adenocarcinoma.
Abdominal washings showing malignant glandular cells. This case is from a patient with colon carcinoma. The papillary clusters of cells show obvious features of an adenocarcinoma, but no distinct clues as to the origin of the tumor.

Figure 103
Peritoneal effusion: Hepatocellular carcinoma. 20x

Figure 104
Peritoneal effusion: Hepatocellular carcinoma. 60x

Figure 105
Peritoneal effusion: Hepatocellular carcinoma. 60x

Fig 103-105: Peritoneal effusion:Hepatocellular carcinoma.
Hepatoma may shed malignant cells into the peritoneal effusion. The cells exhibit granular cytoplasm and centrally placed, abnormal nuclei. Distinction from adenocarcinoma may be difficult.

Figure 106
Peritoneal effusion: Cholangiocarcinoma. 20x

Figure 107
Peritoneal effusion: Cholangiocarcinoma. 40x

Figure 108
Peritoneal effusion: Cholangiocarcinoma. 60x

Fig 106-108: Peritoneal effusion: Cholangiocarcinoma.
Cholangiocarcinoma, either from an intra-hepatic source or from an extra-hepatic biliary tree, may look like adenocarcinoma from elsewhere in the GI tract. By exclusion of other sources through endoscopy, ultrasonography and/orCT imaging, the location may be determined.

Figure 109
Peritoneal wash: Suspicious for pancreatic carcinoma. 60x

Figure 110
Peritoneal wash: Suspicious for pancreatic carcinoma. 60x

Figure 111
Peritoneal effusion: Pancreatic carcinoma. 20x

Figure 112
Peritoneal effusion: Pancreatic carcinoma. 40x

Figure 113
Peritoneal effusion: Pancreatic carcinoma. 60x