Cytology of effusions in the coelom cavities

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Authors: Jaroslava Dušková
Authors place of work: Ústav patologie 1. LF UK a VFN, Praha
Published in the journal: Čes.-slov. Patol., 63, 2018, No. 4, p. 175-189
Category: Přehledový článek

Summary

oelom cavities (pleura, pericardium, peritoneum, tunica vaginalis testis) lined with mesothelial lining derived from the mesoderm, represent a frequent place of propagation of pathological processes both from the neighbourhood and primary. These are most often manifested by effusion, whose cytological examination contributes significantly to the diagnosis. Each larger amount of fluid in the coelom spaces is pathological. The primary task is, as a rule, the identification of tumour cells, more often of metastatic origin (with decreasing frequency (adenocarcinomas, melanoma, sarcomas) than primary (mesothelioma, primary lymphomas of coelom cavities). The differentiation of carcinoma or other tumour populations from mesothelial cells often requires, following careful morphological evaluation, the indication of complementary methods of staining, immunocytochemistry (in haematological malignancies, preferably in combination with flow cytometry) or methods of molecular pathology. Standardization is not yet advanced in this diagnostic area, however there is a consensus for a panel to distinguish between carcinoma and mesothelioma. Diagnosis is always generated via a summation of features. A good outcome requires adequate control of all three phases of the diagnostic process and a clear and unambiguous diagnosis, or differential diagnosis, formulation.

Keywords:

cytology of effusions – body cavity fluids – coelom cavities – carcinoma – reactive mesothelial cells – mesothelioma

Zdroje

1. Lee KF, Olak J. Anatomy and physiology of the pleural space. Chest Surg Clin N Am 1994; 4(3): 391-403.

2. Collins P. Embryogenesis. Cell populations at the start of organogenesis. In: Standring S, editor. Gray’s anatomy: the anatomical basis of clinical practice. Forty-first edition. ed. New York: Elsevier Limited; 2016: 29.

3. Wigley C. Integrating cells into tissues. In: Standring S, editor. Gray’s anatomy: the anatomical basis of clinical practice. Forty-first edition. ed. New York: Elsevier Limited; 2016: 192.

4. Parsons L, Taymor ML. Carcinoma of the breast metastatic to the peritoneum as a source of positive vaginal smears. Am J Obstet Gynecol 1953; 66(1): 194-196.

5. Ng AB, Teeple D, Lindner EA, Reagan JW. The cellular manifestations of extrauterine cancer. Acta Cytol 1974; 18(2): 108-117.

6. Herrick SE, Mutsaers SE. Mesothelial progenitor cells and their potential in tissue engineering. Int J Biochem Cell Biol 2004; 36(4): 621-642.

7. Mutsaers SE, Prele CM, Pengelly S, Herrick SE. Mesothelial cells and peritoneal homeostasis. Fertil Steril 2016; 106(5): 1018-24.

8. Mutsaers SE, Wilkosz S. Structure and function of mesothelial cells. Cancer Treat Res 2007; 134: 1-19.

9. DeMay RM. The art and science of cytopathology. Chicago: ASCP Press; 1995. 2 bd.: 258.

10. Ishihara T, Ferrans VJ, Jones M, Boyce SW, Kawanami O, Roberts WC. Histologic and ultrastructural features of normal human parietal pericardium. Am J Cardiol 1980; 46(5): 744-753.

11. Michailova KN, Usunoff KG. Serosal membranes (pleura, pericardium, peritoneum). Normal structure, development and experimental pathology. Adv Anat Embryol Cell Biol 2006; 183: 1-144.

12. Bolen JW, Hammar SP, McNutt MA. Reactive and neoplastic serosal tissue. A light-microscopic, ultrastructural, and immunocytochemical study. Am J Surg Pathol 1986; 10(1): 34-47.

13. Wang ZB, Li M, Li JC. Recent advances in the research of lymphatic stomata. Anat Rec 2010; 293(5): 754-761.

14. Li J. Ultrastructural study on the pleural stomata in human. Funct Dev Morphol 1993; 3(4): 277-280.

15. Li J, Jiang B. A scanning electron microscopic study on three-dimensional organization of human diaphragmatic lymphatics. Funct Dev Morphol 1993; 3(2): 129-132.

16. Bedrossian CWM. Malignant Effusions: A Multimodal Approach to Cytologic Diagnosis. New York: Igaku-Shoin Medical Publishers, Inc.; 1994: 1.

17. Noppen M, De Waele M, Li R, Gucht KV, D’Haese J, Gerlo E, et al. Volume and cellular content of normal pleural fluid in humans examined by pleural lavage. Am J Respir Crit Care Med 2000; 162(3 Pt 1): 1023-1026.

18. Zocchi L. Physiology and pathophysiology of pleural fluid turnover. Eur Respir J 2002; 20(6): 1545-1558.

19. Mutsaers SE, Prele CM, Lansley SM, Herrick SE. The origin of regenerating mesothelium: a historical perspective. Int J Artif Organs 2007; 30(6): 484-494.

20. Miranda EA. Marie-Francois Xavier Bichat. In: Clinical anatomy associates 2013; A moment in history series Medical terminology daily. https://clinanat.com/mtd/314-marie-francois-xavier-bichat.

21. Bjonness-Jacobsen EC, Eriksen AK, Hagen VN, Ostbye KM, Witterso A, Pedersen MK, et al. The effect of the small amount of formaldehyde in the SurePath liquid when establishing protocols for immunocytochemistry. Cytojournal 2016; 13: 27.

22. Silverman JF, Nance K, Phillips B, Norris HT. The use of immunoperoxidase panels for the cytologic diagnosis of malignancy in serous effusions. Diagn Cytopathol 1987; 3(2): 134-140.

23. Redard M, Vassilakos P, Weintraub J. A simple method for estrogen receptor antigen preservation in cytologic specimens containing breast carcinoma cells. Diagn Cytopathol 1989; 5(2): 188-193.

24. Frisman DM, McCarthy WF, Schleiff P, Buckner SB, Nocito JD, Jr., O’Leary TJ. Immunocytochemistry in the differential diagnosis of effusions: use of logistic regression to select a panel of antibodies to distinguish adenocarcinomas from mesothelial proliferations. Mod Pathol 1993; 6(2): 179-184.

25. Grefte JM, de Wilde PC, Salet-van de Pol MR, Tomassen M, Raaymakers-van Geloof WL, Bulten J. Improved identification of malignant cells in serous effusions using a small, robust panel of antibodies on paraffin-embedded cell suspensions. Acta Cytol 2008; 52(1): 35-44.

26. Murugan P, Siddaraju N, Habeebullah S, Basu D. Immunohistochemical distinction between mesothelial and adenocarcinoma cells in serous effusions: a combination panel-based approach with a brief review of the literature. Indian J Pathol Microbiol 2009; 52(2): 175-181.

27. Westfall DE, Fan X, Marchevsky AM. Evidence-based guidelines to optimize the selection of antibody panels in cytopathology: pleural effusions with malignant epithelioid cells. Diagn Cytopathol 2010; 38(1): 9-14.

28. Arora R, Agarwal S, Mathur SR, Verma K, Iyer VK, Aron M. Utility of a limited panel of calretinin and Ber-EP4 immunocytochemistry on cytospin preparation of serous effusions: A cost-effective measure in resource-limited settings. Cytojournal 2011; 8: 14.

29. Facchetti F, Lonardi S, Gentili F, Bercich L, Falchetti M, Tardanico R, et al. Claudin 4 identifies a wide spectrum of epithelial neoplasms and represents a very useful marker for carcinoma versus mesothelioma diagnosis in pleural and peritoneal biopsies and effusions. Virchows Arch 2007; 451(3): 669-680.

30. Davidson B, Smith Y, Nesland JM, Kaern J, Reich R, Trope CG. Defining a prognostic marker panel for patients with ovarian serous carcinoma effusion. Hum Pathol 2013; 44(11): 2449-2460.

31. Shield PW, Papadimos DJ, Walsh MD. GATA3: a promising marker for metastatic breast carcinoma in serous effusion specimens. Cancer Cytopathol 2014; 122(4): 307-312.

32. Kim NI, Kim GE, Lee JS. Diagnostic Usefulness of Claudin-3 and Claudin-4 for Immunocytochemical Differentiation between Metastatic Adenocarcinoma Cells and Reactive Mesothelial Cells in Effusion Cell Blocks. Acta Cytol 2016; 60(3): 232-239.

33. Hjerpe A, Ascoli V, Bedrossian CW, Boon ME, Creaney J, Davidson B, et al. Guidelines for the Cytopathologic Diagnosis of Epithelioid and Mixed-Type Malignant Mesothelioma: a secondary publication. Cytopathology 2015; 26(3): 142-156.

34. Capkova L, Koubkova L, Kodet R. Expression of carbonic anhydrase IX (CAIX) in malignant mesothelioma. An immunohistochemical and immunocytochemical study. Neoplasma 2014; 61(2): 161-169.

35. Travis WD, Brambilla, E., Burke, A.P., Marx, A., Nicholson, A. G. WHO Classification of Tumours of the Lung, Pleura, Thymus and Heart. Fourth edition. 4th ed. Lyon: IARC; 2015:160.

36. Light RW, Macgregor MI, Luchsinger PC, Ball WC, Jr. Pleural effusions: the diagnostic separation of transudates and exudates. Ann Intern Med 1972; 77(4): 507-513.

37. Moltyaner Y, Miletin MS, Grossman RF. Transudative pleural effusions: false reassurance against malignancy. Chest 2000; 118(3): 885.

38. Ryu JS, Ryu ST, Kim YS, Cho JH, Lee HL. What is the clinical significance of transudative malignant pleural effusion? Korean J Intern Med 2003; 18(4): 230-233.

39. Johnson L, Fakih HA, Daouk S, Saleem S, Ataya A. Transudative pleural effusion of malignant etiology: Rare but real. Respir Med Case Rep 2017; 20:188-191.

40. Augoulea A, Lambrinoudaki I, Christodoulakos G. Thoracic endometriosis syndrome. Respiration 2008; 75(1):113-119.

41. Lignitz E, Gillner E, May D. Complications of resuscitative measures with special regard to liver damage. Prakt Anaesth 1977; 12(6):523-526.

42. Rubecz I, Nemeth G, Fintics K, Gasztonyi V, Lukacs Z, Sipos J. Subscapular liver hematoma and liver hemorrhage in neonatal age. Orv Hetil 1990; 131(37):2037-2042.

43. Liu J, Yao C, Xu B, Shen W, Zhou C, Duan X, et al. Clinical analysis of 2 cases with chylothorax due to primary lymphatic dysplasia and review of literature. Zhonghua Er Ke Za Zhi 2014; 52(5): 362-367.

44. Hillerdal G. Chylothorax and pseudochylothorax. Eur Respir J 1997; 10(5): 1157-1162.

45. Hauser H, Mischinger HJ, Beham A, Berger A, Cerwenka H, Razmara J, et al. Cystic retroperitoneal lymphangiomas in adults. Eur J Surg Oncol 1997; 23(4): 322-326.

46. Kohler C, Tozzi R, Klemm P, Schneider A. Laparoscopic paraaortic left-sided transperitoneal infrarenal lymphadenectomy in patients with gynecologic malignancies: technique and results. Gynecol Oncol 2003; 91(1): 139-148.

47. Mizushima Y, Yoshida Y, Inoue A, Sugiyama S, Hamazaki T, Kobayashi M. Chylopericardium following right thoracotomy for lung cancer. Tumori 1996; 82(3): 264-5.

48. Akashi H, Tayama K, Ishihara K, Tanaka A, Fujino T, Okazaki T, et al. Isolated primary chylopericardium. Jpn Circ J 1999; 63(1): 59-60.

49. Pongprot Y, Silvilairat S, Cheuratanapong S, Woragidpoonpol S, Sittiwangkul R, Phornphutkul C. Isolated primary chylopericardium: a case report. J Med Assoc Thai 2003; 86(4): 361-364.

50. Yuksel M, Yildizeli B, Zonuzi F, Batirel HF. Isolated primary chylopericardium. Eur J Cardiothorac Surg 1997; 12(2): 319-321.

51. Goodman ZD, Gupta PK, Frost JK, Erozan YS. Cytodiagnosis of viral infections in body cavity fluids. Acta Cytol 1979; 23(3): 204-208.

52. Iuchi K, Aozasa K, Yamamoto S, Mori T, Tajima K, Minato K, et al. Non-Hodgkin’s lymphoma of the pleural cavity developing from long-standing pyothorax. Summary of clinical and pathological findings in thirty-seven cases. Jpn J Clin Oncol 1989; 19(3): 249-257.

53. O’Donovan M, Silva I, Uhlmann V, Bermingham N, Luttich K, Martin C, et al. Expression profile of human herpesvirus 8 (HHV-8) in pyothorax associated lymphoma and in effusion lymphoma. Mol Pathol 2001; 54(2): 80-85.

54. Loddenkemper C, Hoecht S, Anagnostopoulos I, Heine B, Stoltenburg-Didinger G, Stein H. A 62-year-old man with chronic pyothorax. Brain Pathol 2005; 15(4): 371-373.

55. Cobb CJ, Wynn J, Cobb SR, Duane GB. Cytologic findings in an effusion caused by rupture of a benign cystic teratoma of the mediastinum into a serous cavity. Acta Cytol 1985; 29(6): 1015-1020.

56. Wu PS, Lai CR. Ovarian immature teratoma with gliomatosis peritonei and pleural glial implant: a case report. Int J Surg Pathol 2015; 23(4): 336-338.

57. Rempen A. Laparoscopic removal of dermoid cysts. Geburtshilfe Frauenheilkd 1993; 53(10): 700-704.

58. Pothula V, Matseoane S, Godfrey H. Gonadotropin-producing benign cystic teratoma simulating a ruptured ectopic pregnancy. J Natl Med Assoc 1994; 86(3): 221-222.

59. Achtari C, Genolet PM, Bouzourene H, De Grandi P. Chemical peritonitis after iatrogenic rupture of a dermoid cyst of the ovary treated by coelioscopy. Apropos of a case and review of the literature. Gynakol Geburtshilfliche Rundsch 1998; 38(3): 146-150.

60. Kim D, Cho HC, Park JW, Lee WA, Kim YM, Chung PS, et al. Struma ovarii and peritoneal strumosis with thyrotoxicosis. Thyroid 2009; 19(3): 305-308.

61. Murtaza B, Saeed S, Sharif MA, Malik IB, Mahmood A. Ruptured ovarian teratoma presenting as peritonitis. J Coll Physicians Surg Pak 2009; 19(1): 59-61.

62. Ashton PR, Hollingsworth AS, Jr., Johnston WW. The cytopathology of metastatic breast cancer. Acta Cytol 1975; 19(1): 1-6.

63. Domagala W, Woyke S. Transmission and scanning electron microscopic studies of cells in effusions. Acta Cytol 1975; 19(3): 214-224.

64. Ferenczy A. Cytology of metastases of rare tumors in the pleura. Arch Geschwulstforsch 1978; 48(5): 380-386.

65. Ansari MQ, Dawson DB, Nador R, Rutherford C, Schneider NR, Latimer MJ, et al. Primary body cavity-based AIDS-related lymphomas. Am J Clin Pathol 1996; 105(2): 221-229.

66. Jones D, Weinberg DS, Pinkus GS, Renshaw AA. Cytologic diagnosis of primary serous lymphoma. Am J Clin Pathol 1996; 106(3): 359-364.

67. Said W, Chien K, Takeuchi S, Tasaka T, Asou H, Cho SK, et al. Kaposi’s sarcoma-associated herpesvirus (KSHV or HHV8) in primary effusion lymphoma: ultrastructural demonstration of herpesvirus in lymphoma cells. Blood 1996; 87(12): 4937-4943.

68. Dunphy CH, Collins B, Ramos R, Grosso LE. Secondary pleural involvement by an AIDS-related anaplastic large cell (CD30+) lymphoma simulating metastatic adenocarcinoma. Diagn Cytopathol 1998; 18(2): 113-117.

69. Wakely PE, Jr., Menezes G, Nuovo GJ. Primary effusion lymphoma: cytopathologic diagnosis using in situ molecular genetic analysis for human herpesvirus 8. Mod Pathol 2002; 15(9): 944-950.

70. Das DK. Serous effusions in malignant lymphomas: a review. Diagn Cytopathol 2006; 34(5): 335-347.

71. Rossi ED, Bizzarro T, Schmitt F, Longatto-Filho A. The role of liquid-based cytology and ancillary techniques in pleural and pericardic effusions: an institutional experience. Cancer Cytopathol 2015; 123(4): 258-266.

72. Yu GH, Vergara N, Moore EM, King RL. Use of flow cytometry in the diagnosis of lymphoproliferative disorders in fluid specimens. Diagn Cytopathol 2014; 42(8): 664-670.

73. Bode-Lesniewska B. Flow Cytometry and Effusions in Lymphoproliferative Processes and Other Hematologic Neoplasias. Acta Cytol 2016; 60(4): 354-364.

74. Antoniadou F, Dimitrakopoulou A, Voutsinas PM, Vrettou K, Vlahadami I, Voulgarelis M, et al. Monomorphic epitheliotropic intestinal T-cell lymphoma in pleural effusion: A case report. Diagn Cytopathol 2017; 45(11): 1050-1054.

75. Wang HY, Wang L. Diagnostic pitfall: primary effusion lymphoma with rare cytokeratin immunoreactivity. Blood 2016; 127(24): 3102.

76. Sharif K, Alton H, Clarke J, Desai M, Morland B, Parikh D. Paediatric thoracic tumours presenting as empyema. Pediatr Surg Int 2006; 22(12): 1009-1014.

77. Armstrong GR, Raafat F, Ingram L, Mann JR. Malignant peritoneal mesothelioma in childhood. Arch Pathol Lab Med 1988; 112(11): 1159-1162.

78. Gong YS, Rong YT, Han WC, Zhang YC. Peripheral lymphadenopathy as the initial manifestation of malignant mesothelioma in a child. Hum Pathol 2013; 44(4): 664-669.

79. Latief KH, Somers JM, Hewitt M. High-resolution ultrasound in the diagnosis of childhood malignant peritoneal mesothelioma. Pediatr Radiol 1998; 28(3): 173.

80. Goyal M, Swanson KF, Konez O, Patel D, Vyas PK. Malignant pleural mesothelioma in a 13-year-old girl. Pediatr Radiol 2000; 30(11): 776-778.

81. Stojsic Z, Jankovic R, Jovanovic B, Vujovic D, Vucinic B, Bacetic D. Benign cystic mesothelioma of the peritoneum in a male child. J Pediatr Surg 2012; 47(10): e45-9.

82. Antman KH. Clinical presentation and natural history of benign and malignant mesothelioma. Semin Oncol 1981; 8(3): 313-320.

83. Hjerpe A, Ascoli V, Bedrossian C, Boon M, Creaney J, Davidson B, et al. Guidelines for cytopathologic diagnosis of epithelioid and mixed type malignant mesothelioma. Complementary statement from the International Mesothelioma Interest Group, also endorsed by the International Academy of Cytology and the Papanicolaou Society of Cytopathology. Cytojournal 2015; 12: 26.

84. Husain AN, Colby TV, Ordonez NG, Allen TC, Attanoos RL, Beasley MB, et al. Guidelines for Pathologic Diagnosis of Malignant Mesothelioma 2017 Update of the Consensus Statement From the International Mesothelioma Interest Group. Arch Pathol Lab Med 2018; 142(1): 89-108.