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Müllerian inclusions in peritoneal washings. Potential source of error in cytologic diagnosis
Abstract:
Müllerian inclusions in peritoneal washings from female patients may be mistaken for adenocarcinoma. Such findings were studied in the peritoneal washing cytology specimens from eight cases. The inclusions usually presented as tubular or papillary structures, often forming a single layer of epithelium surrounding psammoma bodies. The cells forming these structures often displayed some degree of atypia. Recognition of this entity in peritoneal fluids is important to avoid a misdiagnosis of disseminated cancer. A general outline is proposed for interpreting such findings in peritoneal washings, based on the cytomorphology of these structures as well as the microscopic features of the primary neoplasms.
Insights
Müllerian inclusions in peritoneal washings can mimic cancer. Recognizing these benign structures, often with psammoma bodies and atypical cells, is crucial to prevent misdiagnosis of adenocarcinoma in cytology specimens.
Area of Science:
- Gynecologic Pathology
- Cytopathology
- Surgical Pathology
Background:
- Müllerian inclusions in peritoneal washings are rare findings.
- These inclusions can be morphologically similar to adenocarcinoma, posing a diagnostic challenge.
- Accurate differentiation is vital to avoid misdiagnosis and unnecessary treatment.
Purpose of the Study:
- To describe the cytomorphology of Müllerian inclusions in peritoneal washings.
- To differentiate Müllerian inclusions from adenocarcinoma in peritoneal fluid cytology.
- To propose an interpretive guideline for these findings.
Main Methods:
- Retrospective review of eight cases with Müllerian inclusions in peritoneal washings.
- Analysis of cytomorphologic features, including architectural patterns and cellular atypia.
- Correlation with primary neoplasms and clinical follow-up.
Main Results:
- Müllerian inclusions presented as tubular or papillary structures.
- Epithelial lining often formed a single layer surrounding psammoma bodies.
- Cells exhibited varying degrees of atypia, mimicking malignancy.
- Eight cases were analyzed, highlighting key diagnostic features.
Conclusions:
- Müllerian inclusions are a potential pitfall in peritoneal washing cytology.
- Recognition of specific features like psammoma bodies and architectural patterns aids in correct diagnosis.
- A systematic approach based on cytomorphology and primary neoplasm features is recommended for accurate interpretation.