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Pelvic Washings and the Staging of Gynecologic Cancers

Jain, Reena MD

doi: 10.1097/01.pcr.0000204642.96147.07
Case Review

Pelvic or peritoneal washing cytology (PWC) is a most useful indicator of subclinical peritoneal spread of ovarian cancer and thus provides valuable staging and prognostic information, particularly for nonserous ovarian carcinomas. However, PWC's role in endometrial cancer staging is less clear. Detection of malignant cells in peritoneal washings relies upon identification of nonmesothelial cells and their arrangement. While high-grade carcinoma can be easily identified, a number of benign conditions like reactive mesothelial cells, endosalpingiosis, and endometriosis may mimic serous borderline tumors and low-grade serous carcinomas. The presence in these benign conditions of ciliated cells and absence of single atypical cells, marked nuclear atypia, mitotic activity, or two distinct cell populations should help to avoid errors. In addition, close correlation with clinical history and the results of current or prior surgical specimens should help clinch the diagnosis. Additional techniques like cell blocks and ancillary studies can facilitate an accurate diagnosis.

From the Department of Pathology, Virginia Commonwealth University, Richmond, Virginia.

Reprints: Reena Jain, MD, Department of Anatomic Pathology, Virginia Commonwealth University, 1200 East Marshall Street, PO Box 980662, Richmond, VA 23298. E-mail: rjain@vcu.edu.

© 2006 Lippincott Williams & Wilkins, Inc.