Objective: To investigate the cytomorphological and immunocytochemical features of tumor cells in the ascites of ovarian plasmacytoma (SOC). Methods: Specimens of serous cavity effusions were collected from 61 tumor patients admitted to the Affiliated Wuxi People's Hospital of Nanjing Medical University from January 2015 to July 2021, including ascites from 32 SOC, 10 gastrointestinal adenocarcinomas, 5 pancreatic ductal adenocarcinomas, 6 lung adenocarcinomas, 4 benign mesothelial hyperplasia and 1 malignant mesothelioma patients, pleural effusions from 2 malignant mesothelioma patients and pericardial effusion from 1 malignant mesothelioma. Serous cavity effusion samples of all patients were collected, conventional smears were made through centrifugation, and cell paraffin blocks were made through centrifugation of remaining effusion samples. Conventional HE staining and immunocytochemical staining were applied to observe and summarize cytomorphological characteristics and immunocytochemical characteristics. The levels of serum tumor markers carbohydrate antigen 125 (CA125), carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) were detected. Results: Of the 32 SOC patients, 5 had low-grade serous ovarian carcinoma (LGSOC) and 27 had high-grade serous ovarian carcinoma (HGSOC). 29 (90.6%) SOC patients had elevated serum CA125, but the difference was not statistically significant between them and patients with non-ovarian primary lesions included in the study (P>0.05); The serum CEA was positive in 9 patients with gastrointestinal adenocarcinoma and 5 patients with lung adenocarcinoma, and the positive rate was higher than that in SOC patients (P<0.001); The serum CA19-9 was positive in 5 patients with gastrointestinal adenocarcinoma and 5 patients with pancreatic ductal adenocarcinoma, and the positive rate was higher than that in SOC patients (P<0.05). The serum CA125, CEA and CA19-9 were within the normal range in 4 patients with benign mesothelial hyperplasia. LGSOC tumor cells were less heterogeneous and aggregated into small clusters or papillary pattern, and psammoma bodies could be observed in some LGSOC cases. The background cells were fewer and lymphocytes were predominant; the papillary structure was more obvious after making cell wax blocks. HGSOC tumor cells were highly heterogeneous, with significantly enlarged nuclei and varying sizes, which could be more than 3-fold different, and nucleoli and nuclear schizophrenia could be observed in some cases; tumor cells were mostly clustered into nested clusters, papillae and prune shapes; there were more background cells, mainly histiocytes. Immunocytochemical staining showed that AE1/AE3, CK7, PAX-8, CA125, and WT1 were diffusely positively expressed in 32 SOC cases. P53 was focally positive in all 5 LGSOCs, diffusely positive in 23 HGSOCs, and negative in the other 4 HGSOCs. Most of adenocarcinomas of the gastrointestinal tract and lung had a history of surgery, and tumor cells of pancreatic ductal adenocarcinoma tend to form small cell nests. Immunocytochemistry can assist in the differential diagnosis of mesothelial-derived lesions with characteristic "open window" phenomenon. Conclusion: Combining the clinical manifestations of the patient, the morphological characteristics of the cells in the smear and cell block of the ascites can provide important clues for the diagnosis of SOC, and the immunocytochemical tests can further improve the accuracy of the diagnosis.
Female ; Humans ; Carcinoembryonic Antigen ; Ascites ; CA-19-9 Antigen ; Mesothelioma, Malignant/diagnosis* ; Hyperplasia ; Adenocarcinoma/pathology* ; Cystadenocarcinoma, Serous/diagnosis* ; Biomarkers, Tumor ; Carcinoma, Ovarian Epithelial ; Diagnosis, Differential ; Ovarian Neoplasms/pathology* ; Carbohydrates

OBJECTIVE: Ovarian needle aspiration and biopsy (ONAB) may be employed for pretreatment diagnosis of ovarian malignancies or intraoperatively to facilitate removal of ovarian masses. However, there is reluctance to utilize this procedure due to potential cyst rupture or seeding of malignant cells. The objective of this study was to examine the efficacy of ONAB over a 13-year period at our institution. METHODS: Between 2000 and 2013, all ONAB specimens were identified from the Queen's Medical Center Pathology Department database. All cytologic specimens were reviewed and correlated with histopathologic findings. A retrospective chart review was conducted to retrieve data on clinical course and treatment. RESULTS: This study identified 144 cases of ovarian masses sampled by aspiration or needle biopsy between 2000 and 2013. Ninety-two (64%) cases had corresponding histopathology, 84 (91%) of which were obtained concomitantly. On histology, 12 (13%) cases were malignant and 80 (87%) benign. Three false negative cases were noted; 2 serous borderline tumors and 1 mucinous cystadenocarcinoma. These were sampling errors; no diagnostic tumor cells were present in the aspirates. Sensitivity and specificity of ONAB in the detection of malignancy were 75% and 100%, respectively. The positive and negative predictive values were 100% and 96%, respectively. CONCLUSION: ONAB represents a valuable tool in the diagnosis of malignancy and treatment of ovarian masses. In our study, it was highly specific, with excellent positive and negative predictive value.
Biopsy ; Biopsy, Needle ; Cystadenocarcinoma, Mucinous ; Diagnosis* ; Needles* ; Ovarian Neoplasms ; Pathology ; Retrospective Studies ; Rupture ; Selection Bias ; Sensitivity and Specificity

No abstract available.
Bile Duct Neoplasms/*diagnosis/pathology ; Cystadenocarcinoma/*diagnosis/pathology ; Diagnostic Errors ; Humans ; Liver/pathology ; Liver Abscess/diagnosis ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Tomography, X-Ray Computed

OBJECTIVETo analyze the clinicopathological characteristics and the factors affecting the prognosis of intrahepatic biliary cystadenocarcinoma (IBC).

METHODSForty-six patients with histologically confirmed IBC from January, 2000 to April, 2014 were included. The clinical characteristics of the patients with IBC were compared with those of 58 patients with intrahepatic biliary cystadenoma (IBCA). Kaplan-Meier analysis was used to identify the factors affecting the prognosis of IBC.

RESULTSThe 46 patients with IBC included 15 men and 31 women with a mean age of 57.0 ± 10.5 years. Compared with the patients with IBCA, IBC patients had an older mean age (57.0 ± 10.7 vs 44.3 ± 15.3 years, P=0.03) and a greater proportion of male patients (15/46 vs 8/58, P=0.02). The differential diagnosis between IBC and IBCA was difficult on the basis of preoperative laboratory and imaging findings. The median overall survival of IBC patients was 56 months with 1-, 3-, and 5-year survival rates of 85.9%, 65.2%, and 47.7%, respectively. Gender, surgical approach, tumor growth pattern and distant metastasis were all significant prognostic factors for the overall survival of the patients.

CONCLUSIONIBC is a rare cystic lesion occurring primarily in middle-aged men. Complete resection is recommended for curative treatment and close follow-up is essential especially for male patients and patients with tumors exhibiting an invasive growth.

Adult ; Aged ; Bile Duct Neoplasms ; pathology ; Bile Ducts, Intrahepatic ; pathology ; Cystadenocarcinoma ; pathology ; Diagnosis, Differential ; Diagnostic Imaging ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Prognosis ; Retrospective Studies

A pulmonary mucinous cystadenocarcinoma is an extremely rare tumor that is considered to be a cystic variant of mucin-producing lung adenocarcinoma. We present a case of pulmonary mucinous cystadenocarcinoma in a 54-year-old woman. Chest CT scans showed a 4.3-cm-sized, lobulated, well-defined, and homogeneous mass in the right middle lobe with peripheral stippled calcifications that demonstrated low-attenuation with no enhancement after contrast administration; 18F-fluorodeoxyglucose (FDG) PET/CT demonstrated mild heterogeneous FDG uptake. The mass was diagnosed as adenocarcinoma with mucin production by transbronchial lung biopsy. Right middle lobectomy was performed, and the pathologic examination disclosed a pulmonary mucinous cystadenocarcinoma.
Cystadenocarcinoma, Mucinous/pathology/*radiography/surgery ; Diagnosis, Differential ; Female ; Fluorodeoxyglucose F18/diagnostic use ; Humans ; Lung Neoplasms/pathology/*radiography/surgery ; Middle Aged ; Positron-Emission Tomography and Computed Tomography ; Radiopharmaceuticals/diagnostic use ; Tomography, X-Ray Computed/*methods

Adenocarcinoma, Clear Cell ; metabolism ; pathology ; Adenocarcinoma, Mucinous ; metabolism ; pathology ; Carcinoma, Endometrioid ; metabolism ; pathology ; Carcinoma, Transitional Cell ; metabolism ; pathology ; Cystadenocarcinoma, Serous ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Humans ; Neoplasms, Glandular and Epithelial ; classification ; metabolism ; pathology ; Ovarian Neoplasms ; classification ; metabolism ; pathology ; Tumor Suppressor Protein p53 ; metabolism ; WT1 Proteins ; metabolism

Adenocarcinoma, Clear Cell ; diagnosis ; metabolism ; pathology ; Adenocarcinoma, Mucinous ; diagnosis ; metabolism ; pathology ; Biomarkers, Tumor ; metabolism ; Carcinoma, Endometrioid ; diagnosis ; metabolism ; pathology ; Cystadenocarcinoma, Serous ; diagnosis ; metabolism ; pathology ; Diagnosis, Differential ; Endometrial Neoplasms ; diagnosis ; metabolism ; pathology ; Female ; Humans ; Immunohistochemistry ; Uterine Cervical Neoplasms ; diagnosis ; metabolism ; pathology

Cyclin-Dependent Kinase Inhibitor p16 ; metabolism ; Cystadenocarcinoma, Serous ; metabolism ; pathology ; Diagnosis, Differential ; Endometrial Neoplasms ; metabolism ; pathology ; Female ; Humans ; Precancerous Conditions ; metabolism ; pathology ; RNA-Binding Proteins ; metabolism ; Tumor Suppressor Protein p53 ; metabolism

OBJECTIVE: To determine whether or not detailed cystic feature analysis on CT scans can assist in the differential diagnosis of pancreatic ductal adenocarcinoma (PDAC) from serous cystadenoma (SCN), mucinous cystadenoma (MCN), and a pseudocyst. MATERIALS AND METHODS: This study received Institutional Review Board approval and informed patient consent was waived. Electronic radiology and pathology databases were searched to identify patients with PDAC (n = 19), SCN (n = 26), MCN (n = 20) and a pseudocyst (n = 23) who underwent pancreatic CT imaging. The number, size, location, and contents of cysts, and the contour of the lesions were reviewed, in addition to the wall thickness, enhancement patterns, and other signs of pancreatic and peripancreatic involvement. Diagnosis was based on lesion resection (n = 82) or on a combination of cytological findings, biochemical markers, and tumor markers (n = 6). Fisher's exact test was used to analyze the results. RESULTS: A combination of the CT findings including irregular contour, multiple cysts, mural nodes, and localized thickening, had a relatively high sensitivity (74%) and specificity (75%) for differentiating PDAC from SCN, MCN, and pseudocysts (p < 0.05). Other CT findings such as location, greatest dimension, or the presence of calcification were not significantly different. CONCLUSION: The CT findings for PDAC are non-specific, but perhaps helpful for differentiation. PDAC should be included in the general differential diagnosis of pancreatic cystic neoplasms.
Adenocarcinoma/pathology/*radiography ; Adolescent ; Adult ; Aged ; Cystadenocarcinoma, Serous/pathology/*radiography ; Cystadenoma, Mucinous/pathology/*radiography ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Pancreatic Neoplasms/pathology/*radiography ; Retrospective Studies ; Sensitivity and Specificity ; *Tomography, X-Ray Computed ; Tumor Markers, Biological/analysis

OBJECTIVE: We wanted to evaluate the diagnostic value of serum CA-125 concentration, when used in combination with the preoperative contrast-enhanced CT results, to differentiate borderline ovarian tumors (BOTs) from stage I malignant epithelial ovarian tumors (MEOTs). MATERIALS AND METHODS: Ninety-eight masses (46 BOTs and 52 stage I MEOTs) from 87 consecutive patients (49 with BOTs and 38 with stage I MEOTs) who had undergone preoperative contrast-enhanced computed tomography (CT) and surgical staging were evaluated retrospectively and independently by two radiologists. The preoperative serum CA-125 concentration was measured in all patients. The utility of analyzing serum CA-125 concentration in combination with the CT results was evaluated by receiver operating characteristic (ROC) curve analysis. RESULTS: An irregular tumor surface and lymphadenopathy were predictive of a MEOT. ROC analysis showed that the combination of CT data and the serum CA-125 level resulted in a higher diagnostic performance than did using the CT alone for differentiating BOTs from MEOTs. The areas under the curves (AUCs) without and with the use of the serum CA-125 level data were 0.67 (95% confidence interval [CI]: 0.57-0.77) and 0.78 (95% CI: 0.68-0.85), respectively, for reader 1 (p = 0.029) and 0.71 (95% CI: 0.61-0.80) and 0.81 (95% CI: 0.72-0.89), respectively, for reader 2 (p = 0.009). CONCLUSION: The serum CA-125 concentration is of additional diagnostic value when used in conjunction with the CT imaging results for differentiating BOTs from MEOTs.
Adenocarcinoma, Mucinous/*blood/pathology/*radiography ; Adolescent ; Adult ; Aged ; Biological Markers/blood ; CA-125 Antigen/*blood ; Contrast Media/diagnostic use ; Cystadenocarcinoma, Serous/*blood/pathology/*radiography ; Diagnosis, Differential ; Female ; Humans ; Middle Aged ; Neoplasm Staging ; Ovarian Neoplasms/*blood/pathology/*radiography ; Predictive Value of Tests ; ROC Curve ; Retrospective Studies