Occurrence of intercellular spaces (windows) in metastatic adenocarcinoma in serous fluids: A cytomorphologic, histochemical, and ultrastructural study

Yu, Gordon H.; Sack, Martha J.; Baloch, Zubair W.; DeFrias, Denise V. S.; Gupta, Prabodh K.

doi:10.1002/(sici)1097-0339(199903)20:3<115::aid-dc1>3.0.co;2-3

Cited by 13 publications

(3 citation statements)

References 10 publications

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“…For example, intercellular spaces (windows), commonly seen in cellular aggregates of mesothelial cells, also can be identified in 13% of cases of metastatic adenocarcinoma. 28 Therefore, ancillary studies often are performed to assist in the differential diagnosis. Electron microscopy has been used for differentiating mesothelial cells from adenocarcinoma by demonstrating long, thin, "bushy" microvilli in the mesothelial cells.…”

Section: Discussionmentioning

confidence: 99%

Use of a Panel of Markers in the Differential Diagnosis of Adenocarcinoma and Reactive Mesothelial Cells in Fluid Cytology

Jhala

Shultz

et al. 2001

Am J Clin Pathol

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The relevance of 8 contemporary classification and grading systems for ductal carcinoma in situ (DCIS) of the breast was examined in 100 tumors by comparing DCIS grade with grade of the concurrent infiltrating ductal carcinoma (IDC). Besides tumor size and nodal status, the immunohistochemical parameters in both lesions were compared, including estrogen receptor, progesterone receptor, c-erbB-2 protein, E-cadherin, vimentin, Ki-67 (MIB1), and p27. Nuclear grading of DCIS alone or in combination with architectural pattern and necrosis showed the best correlation with grade of the invasive component. There also was a positive correlation between every biologic marker expressed in DCIS and in the concurrent IDC, supporting a clonal relationship. Biologic markers varied between the different grades of DCIS. DCIS is heterogeneous, and the progression of DCIS to IDC may be from low-grade DCIS to low-grade IDC and high-grade DCIS to high-grade IDC. This concept is different from the conventional model held for intraepithelial neoplasia in the cervix, vulva, vagina, and skin, in which there is increasing severity of in situ atypia (dysplasia) before the development of stromal invasion.

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Section: Discussionmentioning

confidence: 99%

Use of a Panel of Markers in the Differential Diagnosis of Adenocarcinoma and Reactive Mesothelial Cells in Fluid Cytology

Jhala

Shultz

et al. 2001

Am J Clin Pathol

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“…Less common, but fairly specific, is the finding of small orangiophilic squamous‐like cells. Recently the specificity of the ‘window’ effect so characteristic of benign and malignant mesothelial cells has been challenged 29 ; however, as a common quantitative characteristic it remains useful. There is no single or set of morphological criteria that are entirely specific for mesothelioma, yet there are common patterns that often permit us to confidently assert the diagnosis.…”

Section: Serous Effusions: Key Morphological Findings and Their Signimentioning

confidence: 99%

Invited review The cytology of malignant mesothelioma

Whitaker

2000

Cytopathology

126

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“…On the other hand, adenocarcinoma cells may resemble reactive mesothelial cells, leading to false-negative interpretations. Some well-differentiated and low-grade adenocarcinomas show features such as intercellular spaces resembling ‘mesothelial windows’ [see Figures 2c , 3 ], [ 9 ] hyperchromasia, high nucleocytoplasmic ratios, anisokaryosis, etc., overlapping with reactive mesothelial cells.…”

Section: Cytopathologymentioning

confidence: 99%

Metastatic Carcinoma in Effusions

Shidham¹

2022

Cytojournal

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Serous cavity may be involved by any neoplasm, including very rare examples of involvement by central nervous system tumors leading to a malignant effusion. The serous cavity lining is rich in lymphatics with lymphatic lacunae opening directly through narrow gaps (stoma) in the lining. Carcinomas mainly metastasize to serosa via the lymphatic vessels, which may be blocked leading to effusion. Primary carcinomas of organs such as lung, intestines, liver, ovary, etc., lined by serosal membranes may spread by direct extension, resulting in malignant effusions. As standard of practice, unless specified, cytopathologic examination of serous effusions implies detection of malignant cells. As compared to a surgical biopsy from a small focal area of an extensive serosal surface, effusion fluid from respective cavity exfoliates the cells from the entire serosal surface with minimal chance of sampling artifact. Because of this, effusion fluid cytology generally provides a higher diagnostic yield as compared to biopsy of the serous lining, as demonstrated by some studies. However, various challenges related to effusion fluid cytology makes the interpretation of effusion fluid cytology a field with potential misinterpretations, especially for those without proper experience or training. Developing and following a methodical approach is important for appropriate cytologic examination of effusion fluids. Proper approach may achieve definitive interpretation even without ancillary tests. However, lack of appropriate approach and processing may introduce a significant variation in interpretation due to combination of well-recognized diagnostic pitfalls, which may lead to lower reproducibility and even serious misinterpretations. Current review discusses in brief appropriate approach to processing and evaluating effusion fluid cytology for metastatic carcinoma. At general level, this is comparable to that of other specimens; however, it is critical to modify with reference to the limitations associated with effusion cytology.

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Occurrence of intercellular spaces (windows) in metastatic adenocarcinoma in serous fluids: A cytomorphologic, histochemical, and ultrastructural study

Cited by 13 publications

References 10 publications

Use of a Panel of Markers in the Differential Diagnosis of Adenocarcinoma and Reactive Mesothelial Cells in Fluid Cytology

Use of a Panel of Markers in the Differential Diagnosis of Adenocarcinoma and Reactive Mesothelial Cells in Fluid Cytology

Invited review The cytology of malignant mesothelioma

Metastatic Carcinoma in Effusions

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