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Optimization of the peritoneal lavage
1Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA.
Diagnostic Cytopathology
|April 29, 1998
Summary
Cytologic evaluation of peritoneal lavage is clinically indicated for selected gynecologic surgery patients. Careful specimen collection is crucial for accurate diagnosis of malignancy in peritoneal fluid.
Area of Science:
- Gynecologic Oncology
- Cytopathology
- Surgical Pathology
Background:
- Peritoneal lavage is a common procedure during gynecologic operations.
- Cytologic evaluation of peritoneal fluid aids in diagnosing malignancy.
- The clinical utility and optimal application of peritoneal lavage cytology require further investigation.
Purpose of the Study:
- To assess the clinical indications for cytologic evaluation of peritoneal lavages in gynecologic surgery.
- To determine the diagnostic yield of peritoneal lavage cytology for malignancy.
- To evaluate the impact of peritoneal lavage cytology on tumor staging.
Main Methods:
- Retrospective review of 275 consecutive peritoneal lavages and concurrent histologic material.
- Analysis of cytologic findings in relation to clinical indications and histologic diagnoses.
- Assessment of specimen quality, including cellularity and blood contamination.
Main Results:
- Cytologic evaluation was clinically indicated for 60.7% of lavages (46% of patients).
- Malignant cells were diagnosed in 15% of indicated lavages.
- Peritoneal lavage cytology did not alter tumor staging compared to concurrent histology; no false-positive diagnoses were reported.
Conclusions:
- Selective submission of peritoneal lavage specimens for cytologic evaluation is recommended.
- Improved attention to specimen collection is necessary to ensure diagnostic quality.
- Peritoneal lavage cytology can be a valuable tool when applied judiciously in selected gynecologic oncology cases.