Cytohistologic correlation in malignant peritoneal washings. Analysis of 75 malignant fluids.

Abstract

To determine the value of peritoneal washing (PW) cytology alone in upstaging carcinomas of the female genital tract (FGT). The histologic reports and slides of surgically resected FGT carcinomas related to 75 malignant PWs were reviewed. For inclusion in the study, no ascites was present. The cases consisted of 28 primary and 4 metastatic ovarian tumors, 9 peritoneal "serous implants" from second-look laparotomy, 3 metastatic peritoneal carcinomas, 1 primary peritoneal serous carcinoma, and 19 endometrial, 6 cervical and 5 tubal carcinomas. Cytologic examination alone was responsible for the upstaging of 0-75% of carcinomas, depending on tumor origin. Malignant cells were seen in 97% (73/75) of the cytologic smears and in 51% (28/75) of the cell blocks prepared from the PWs. The clinical value of PW cytology lies in the upstaging of 63% of borderline ovarian tumors, 50% of primary ovarian malignancies of nonserous type and 11% of endometrial adenocarcinomas. PW cytology is not recommended for primary carcinomas of the cervix, fallopian tube or peritoneum or for ovarian carcinoma of serous and metastatic types. Furthermore, PW cell blocks were less sensitive than cytocentrifuged smears and contributed only a single additional malignant PW.