Department of Pathology, Section of Cytology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Cancer Cytopathol. 2013 Oct;121(10):582-90. doi: 10.1002/cncy.21302. Epub 2013 May 14.
To better define the cytomorphologic spectrum of endosalpingiosis in peritoneal washings (PWs) and thereby facilitate their distinction from well differentiated serous carcinoma, the authors examined PWs from women who underwent surgery and pathologic staging of lesions other than Mullerian malignancies and correlated the findings with surgical specimens.
This was a retrospective review of medical records and PW specimens from 100 consecutive patients who had PWs coded as both "endosalpingiosis" and "negative for carcinoma" between 2002 and 2012. Thirty-eight of these patients had no gynecologic malignancies. Specimens had been prepared using cytocentrifugation and were stained using the Papanicolaou method. The cytologic findings evaluated were cell arrangement, number of cell groups per case, cellular atypia, and psammoma bodies. Smears also were assessed for paired box-8 (PAX8) immunostaining. The authors compared patients' staging biopsy findings with the findings from a review of the PWs.
PW specimens from 35 of 38 patients (92%) exhibited classic endosalpingiosis features: tubular or small branching papillary structures, some with psammoma bodies. Specimens from the 3 remaining patients displayed nonclassic features consistent with dislodged fallopian tube epithelium or endometriosis. From 2 to 20 clusters per slide and from 4 to 50 groups per case were identified. In a few cases, some cell clusters exhibited up to moderate cytologic atypia. Surgical findings included endometriosis, endosalpingiosis, both endometriosis and endosalpingiosis (12 patients; 31.6%), and a variety of unrelated pelvic lesions. All cases were PAX8-positive, confirming their Mullerian origin.
Endosalpingiosis in PWs can be diagnostically challenging. Awareness of intraoperative techniques and correlation with surgical biopsy findings are necessary to avoid a misdiagnosis of malignancy.
为了更好地定义腹膜灌洗液（PW）中内 （苗勒氏） 上皮内瘤变的细胞形态学谱，从而有助于将其与分化良好的浆液性癌区分开来，作者检查了 100 例接受手术和病理分期的除苗勒氏恶性肿瘤以外的病变的女性的 PW，并将这些发现与手术标本相关联。
这是一项回顾性病历和 PW 标本研究，纳入了 2002 年至 2012 年间被编码为“内 （苗勒氏） 上皮内瘤变”和“无癌”的 100 例连续患者的 PW。其中 38 例患者没有妇科恶性肿瘤。标本使用细胞离心沉淀法制备，并用巴氏染色法染色。评估的细胞学发现包括细胞排列、每个病例的细胞群数量、细胞异型性和砂粒体。涂片还评估了配对盒-8（PAX8）免疫染色。作者将患者的分期活检发现与 PW 回顾的发现进行了比较。
38 例患者中的 35 例（92%）的 PW 标本显示出经典的内 （苗勒氏） 上皮内瘤变特征：管状或小分支乳头状结构，一些伴有砂粒体。其余 3 例患者的标本显示出非经典特征，与脱落的输卵管上皮或子宫内膜异位症一致。每个玻片上有 2 到 20 个细胞簇，每个病例有 4 到 50 个细胞群。在少数情况下，一些细胞簇显示出高达中度的细胞学异型性。手术发现包括子宫内膜异位症、内 （苗勒氏） 上皮内瘤变、子宫内膜异位症和内 （苗勒氏） 上皮内瘤变（12 例；31.6%）以及各种无关的盆腔病变。所有病例均为 PAX8 阳性，证实了它们的苗勒氏起源。
PW 中的内 （苗勒氏） 上皮内瘤变在诊断上具有挑战性。了解术中技术并与手术活检发现相关联对于避免恶性肿瘤的误诊是必要的。
