Intraoperative cytology of clear cell carcinoma of the ovary

Vrdoljak-Mozetič, Danijela; Stanković, Teodora; Krašević, Maja; Verša-Ostojić, Damjana; Štemberger-Papić, Snježana; Rupčić, Stanko

doi:10.1111/j.1365-2303.2006.00373.x

Cited by 20 publications

(34 citation statements)

References 11 publications

(26 reference statements)

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“…It is recognized that the accurate intraoperative diagnosis of ovarian clear cell carcinomas can be particularly problematic because these tumors exhibit a wide variety of histological patterns that can mimic other primary and secondary ovarian tumors. 28 It has been suggested that cytological preparations may be particularly helpful in the diagnosis of these tumors, notably in highlighting their characteristic hyaline stroma, 29,30 but this feature was not seen in all of the cases in this study. Not surprisingly, rare ovarian tumors also caused greater difficulty in the intraoperative setting and these sometimes elicited a nonspecific or differential diagnosis.…”

Section: Discussionmentioning

confidence: 44%

Value of cytology in the intraoperative assessment of ovarian tumors

Stewart

Brennan

Koay

et al. 2010

Cancer Cytopathology

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BACKGROUND:Intraoperative pathological assessment is frequently requested in patients with suspected ovarian neoplasia so that optimal surgical management can be performed. In this study the accuracy of intraoperative cytology has been assessed and the results compared with frozen section diagnosis.METHODS:The study comprised 402 ovarian tumors that were submitted for intraoperative assessment in which both cytology preparations, usually scrape smears, and conventional frozen sections were examined. Each technique was evaluated independently, although the diagnosis transmitted to the surgeon was based upon the combination of the clinical, macroscopic, histological, and cytological information. The results were compared with the final pathological diagnosis in each case and cases with discordant diagnoses were reviewed.RESULTS:There were 226 benign lesions, 35 borderline epithelial neoplasms, and 141 malignant tumors according to the final pathological diagnosis. All benign lesions were accurately categorized using both frozen section and cytology. Thirty (86%) of the borderline tumors and 137 (97%) of the malignant tumors were accurately identified on frozen section, whereas the corresponding results for cytology were 23 (66%) and 131 (93%), respectively. There were no false‐positive diagnoses with either technique and the overall accuracy was 97.8%. Cytological evaluation provided better morphologic detail, permitted wider tumor sampling, and directed appropriate ancillary investigations in some cases.CONCLUSIONS:Overall, frozen section was more accurate than smear preparations in this series. However, cytology has a complementary role in the intraoperative assessment of ovarian neoplasia and provides a more specific diagnosis in some cases. Cancer (Cancer Cytopathol) 2010. © 2010 American Cancer Society.

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Section: Discussionmentioning

confidence: 44%

Value of cytology in the intraoperative assessment of ovarian tumors

Stewart

Brennan

Koay

et al. 2010

Cancer Cytopathology

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“…Finally, the extracellular hyaline material evident on the smear preparations would be an unusual finding in most ovarian epithelial neoplasms with the possible exception of clear cell carcinoma. 23,24 In our experience, the intraoperative diagnosis of ovarian clear cell carcinoma can present particular difficulty, 25 but the neoplastic cells generally are large, and cytologic material from clear cell carcinomas usually demonstrates 3-dimensional Braspberry[ bodies, a glycogen-rich background, and high-grade nuclei, features that were not identified in the current case. Anecdotally, however, we have also encountered metachromatic hyalinelike material in intraoperative cytologic preparations from other rare epithelial tumors including cases of corded and hyaline endometrioid adenocarcinoma and adenoid cysticlike carcinoma of the ovary.…”

Section: Discussioncontrasting

confidence: 50%

An Ovarian Tumor With Small Cell Pattern at Intraoperative Assessment

Stewart¹,

Kee²,

Ruba³

2010

Pathology Case Reviews

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Gynecological oncologists frequently request intraoperative assessment of ovarian or adnexal masses because the provisional pathological diagnosis is used to guide surgical management. Frozen section has been used most widely in this context, but, as in other anatomic sites, this technique has well-recognized limitations. Cytologic preparations such as scrape smears or imprints can be made easily from tumor specimens and without the requirement of expert technical assistance. They offer the potential for wider tumor sampling and optimize cellular detail without artifacts related to tissue freezing. The case presented herein illustrates the complementary value of cytologic preparations as an adjunct to diagnosis in the interpretation of an ovarian tumor exhibiting a small cell morphologic pattern.

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“…Interestingly, recent cytological studies have also emphasized the diagnostic value of hyaline stromal change in CCC because this has distinctive metachromatic appearances in air-dried preparations. Therefore, cytology smears or imprints may be a useful adjunct to frozensection diagnosis in the intraoperative assessment of CCC and other ovarian tumors (36,37).…”

Section: Clear Cell Carcinoma Of the Ovarymentioning

confidence: 99%

Intraoperative Assessment of Clear Cell Carcinoma of the Ovary

Stewart

Brennan

Hammond

et al. 2008

International Journal of Gynecological Pathology

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Frozen section is a reliable technique in gynecologic pathology and is widely used to guide intraoperative management in patients presenting with ovarian masses. However, there are limited data regarding the diagnostic accuracy of frozen section in specific subtypes of ovarian neoplasia. Our impression that primary clear cell carcinoma (CCC) causes disproportionate diagnostic difficulty led us to review the intraoperative and final histopathologic reports from a consecutive series of 44 CCC that were subject to frozen-section assessment and to compare the results with a similar number of primary serous and endometrioid carcinomas. The original intraoperative slides from those CCC with discordant diagnoses were also reviewed. Review of the diagnostic reports showed that CCC was less frequently specifically identified than serous or endometrioid carcinomas on frozen section (44% cases compared with 55% and 65%, respectively), although the differences were not statistically significant. Difficulties in distinguishing primary ovarian carcinoma from tumors metastatic to the ovary occurred in a minority of cases of all histologic subtypes, but was slightly more frequent in CCC. Two CCC were misdiagnosed as borderline epithelial tumors and 1 case as a dysgerminoma. Review of the frozen-section slides from the CCC with discrepant intraoperative diagnoses showed features suggestive or indicative of the correct diagnosis in 7 (39%) of 18 cases.

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Intraoperative cytology of clear cell carcinoma of the ovary

Abstract: Using cytological analysis of imprint and scraping samples of ovarian tumours it is possible to make a precise intraoperative cytological diagnosis in most cases of CCC of the ovary.

Cited by 20 publications

References 11 publications

Value of cytology in the intraoperative assessment of ovarian tumors

Value of cytology in the intraoperative assessment of ovarian tumors

An Ovarian Tumor With Small Cell Pattern at Intraoperative Assessment

Intraoperative Assessment of Clear Cell Carcinoma of the Ovary

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