[Cytologic diagnosis of metastases of stomach cancer during laparoscopy]

The detection of gastric carcinoma metastases to the peritoneum necessitates the development of a specific treatment strategy. The present paper reviews the results of analyses of ascitic fluid and impressions obtained in laparoscopy from 42 patients. Eighty-one investigations have been carried out. Malignant cells have been detected in 93.1% of impressions and in 50% of ascites. Three types of mesothelial cells are described, all of them present both in the impressions and in the fluid. Type I cells are more incident in proliferation of the mesothelial cells. They are often similar to adenocarcinoma cells as regards their chromatin structure, hyperchromatism, eccentric position of the nucleus, and cytoplasmic basophilia. In distinction from the adenocarcinoma cells, the mesothelial cells are monomorphous and are much smaller. Type I mesothelial cells differ from signet ring cell carcinoma in the following: nuclear hyperchromatism in mesothelial cells is combined with cytoplasmic basophilia, whereas in signet ring cells a colorless vacuole occupies the whole of the cytoplasm in case of a hyperchromatic eccentric nucleus.