Background: The prognostic significance of positive peritoneal cytology in endometrial cancer remains unsettled. We previously classified malignant cell clusters on peritoneal smears into two morphologic types and found that those with irregular edges, so-called “scalloped clusters”, were associated with peritoneal seeding or a poor clinical outcome. We have also reported on the use of postoperative peritoneal washings to investigate residual malignant cells in the peritoneal cavity. Case: A 56-year-old woman underwent surgery for endometrial cancer (grade 1 endometrioid adenocarcinoma). At operation, positive peritoneal cytology was found without obvious peritoneal seeding, so a tube for cytologic studies was inserted when closing the abdomen. Washings were obtained via the tube at 7 days and 14 days after surgery, and both sets of washings were also positive for malignant cells. All three peritoneal smears showed scalloped clusters. These findings strongly suggested the presence of occult metastasis in the peritoneal cavity that had been overlooked at operation. Despite adjuvant therapy, the patient developed intraperitonal recurrence 8 months after surgery. Conclusion: Postoperative peritoneal washings and morphologic analysis of positive peritoneal smears are useful to determine the malignant potential of endometrial cancer with positive peritoneal cytology.
We report a case of cutaneous metastasis of prostate cancer, A 73-year-old man had a nodular lesion in a chest tumor. Aspiration cytology showed a cribriform pattern of tumor cells with oval and round nuclei and fine granular chromatin. Histologically, the tumor consisted of various-sized glands and cribriform structures. Immunohistochemical staining for prostate-specific antigen was positive in tumor cells and confirmed in transrectal biopsy of the prostate. When aspiration cytology is used in cutaneous tumors, prostate cancer should be considered as a differential diagnosis.
A 78-year-old male reporting cough and hemoptysis was found in chest radiography to have multiple hazy nodular shadows in both lungs but computed tomography and ultrasonography did not indicate a primary lesion in other organs. He died 12 days later. Autopsy showed multiple blood-tinged tumors in the lung but not in other organs. Cytology imprinted from 1 pulmonary tumor showed atypical cells occasionally forming small clusters and lumen-like structures. Nuclei were irregular and byperchromatic with large nucleoli. Some tumor cells showed erythrophagia in the marginal cytoplasm. Immunohistochemically, tumor cells were positive for factor VIII and CD31, lading to a diagnosis of angiosarcoma. Cytologically. it was difficult, but possible to diagnose angiosarcoma by erythrophagia.