Curschmann's spirals in pleural and peritoneal fluids. Report of 12 cases

A limited prospective study of 334 peritoneal and pleural fluids demonstrated Curschmann's spirals in 12 specimens, a prevalence of 1 in 28 cases. Nine of these 12 specimens were peritoneal washings, 2 specimens were pleural fluids, and 1 specimen was a peritoneal dialysis fluid. The fluids came from nine women and three men. Both pleural fluids were from men (one with a history of lung adenocarcinoma and one with probable collagen vascular disease). The peritoneal dialysis fluid was from a man with renal failure. Seven of the nine women with peritoneal washing specimens had gynecologic cancer; only one had evidence of serosal involvement by neoplasm at the time of the peritoneal washing. Tissue, including serosal surfaces, was available for examination in 10 of the 12 cases. The study indicates that Curschmann's spirals are a relatively common finding in peritoneal and pleural fluids, particularly in peritoneal washings. Mucin-producing epithelium or involvement of serosa by malignant neoplasm is not necessary for the phenomenon to take place. The feature common to all the cases in which tissue was available for review was the presence of myxoid degenerative changes of the serosal and subserosal fibrous connective tissue.