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Diagnostic Cytopathology Dec 2016Abdominopelvic washings (APW) performed during gynecologic surgeries have become a common specimen evaluated by cytopathologists. Their role in staging of female genital... (Review)
Review
Abdominopelvic washings (APW) performed during gynecologic surgeries have become a common specimen evaluated by cytopathologists. Their role in staging of female genital tract tumors has changed significantly since they were first described, and continue to evolve. The ability of these washings to detect microscopic disease, even in the absence of gross disease, warrants the critical role that these washings play in the staging of certain female gynecologic tract tumors, allowing for optimal staging and subsequent treatment of the patient. Irrespective of the underlying pathology, the gamut of cytomorphologic findings that may be observed in APW is extensive, and ranges from benign lesions that may act as mimickers of malignancy, to both common and rare malignancies. This review discusses the changing role of APW in the staging of gynecologic tumors, and highlights the salient cytomorphologic features of these lesions, with emphasis in their correct identification, including cautionary notes to avoid over or misinterpretation. Diagn. Cytopathol. 2016;44:1039-1057. © 2016 Wiley Periodicals, Inc.
Topics: Ascitic Fluid; Carcinoma; Female; Humans; Neoplasms, Germ Cell and Embryonal; Ovarian Neoplasms; Peritoneal Lavage; Sex Cord-Gonadal Stromal Tumors; Uterine Neoplasms
PubMed: 27578056
DOI: 10.1002/dc.23569 -
Cancer Cytopathology Jul 2022The international system for reporting serous fluid cytopathology (TIS) recommends submitting at least 50-75 mL of serous fluid to decrease false-negative results....
BACKGROUND
The international system for reporting serous fluid cytopathology (TIS) recommends submitting at least 50-75 mL of serous fluid to decrease false-negative results. However, prior studies did not agree on specific volume requirements or consensus adequacy criteria. Our study aims to assess whether fluid volume affects the adequacy rate and to assess the minimum volume necessary for optimal adequacy in pleural and peritoneal fluids.
METHODS
A total of 8530 serous fluid cytology cases were identified in the laboratory information system. Differences in mean fluid volume received in the laboratory were compared using an ANOVA Games-Howell test based on TIS category. The percentage of malignant diagnoses across the volume ranges of 0 to 5 mL, 5 to 10 mL, 10 to 25 mL, 25 to 50 mL, 50 to 75 mL, 75 to 100 mL, 100 to 150 mL, 150 to 250 mL, 250 to 500 mL, 500 to 2000 mL was compared in pleural and peritoneal fluids using a chi-square test, and a SiZer analysis was performed.
RESULTS
Mean fluid volume in inadequate, atypical, and negative cases was significantly lower compared to positive cases. A SiZer analysis showed a positive relationship between the malignancy fraction of pleural and peritoneal fluids and fluid volume. The percentage of malignant diagnoses in pleural and peritoneal fluid samples increased significantly up to a volume range of 75-100 mL.
CONCLUSIONS
There is a significant relationship between fluid volume, adequacy and detection of malignancy in serous effusion cytopathology. The malignancy fraction increases with larger fluid volumes but at least 75-100 mL of fluid should be submitted for optimal diagnosis of malignancy in pleural and peritoneal fluids.
Topics: Ascitic Fluid; Cytodiagnosis; Cytological Techniques; Exudates and Transudates; Humans; Pleural Effusion; Pleural Effusion, Malignant
PubMed: 35468659
DOI: 10.1002/cncy.22577 -
Fertility and Sterility Feb 2020To demonstrate the feasibility of studying exosomes directly from peritoneal fluid, we isolated exosomes from endometriosis patient samples and from controls, and...
OBJECTIVE
To demonstrate the feasibility of studying exosomes directly from peritoneal fluid, we isolated exosomes from endometriosis patient samples and from controls, and characterized their cargo.
DESIGN
Case-control experimental study.
SETTING
Academic clinical center.
PATIENT (S)
Women with and without endometriosis who underwent laparoscopic surgery (n = 28 in total).
INTERVENTION (S)
None.
MAIN OUTCOME MEASURE (S)
Concentration of exosomes within peritoneal fluid and protein content of the isolated exosomes.
RESULT (S)
Peritoneal fluid samples were pooled according to the cycle phase and disease stage to form six experimental groups, from which the exosomes were isolated. Exosomes were successfully isolated from peritoneal fluid in all the study groups. The concentration varied with cycle phase and disease stage. Proteomic analysis showed specific proteins in the exosomes derived from endometriosis patients that were absent in the controls. Five proteins were found exclusively in the endometriosis groups: PRDX1, H2A type 2-C, ANXA2, ITIH4, and the tubulin α-chain.
CONCLUSION (S)
Exosomes are present in peritoneal fluid. The characterization of endometriosis-specific exosomes opens up new avenues for the diagnosis and investigation of endometriosis.
Topics: Adult; Annexin A2; Ascitic Fluid; Case-Control Studies; Endometriosis; Exosomes; Feasibility Studies; Female; Histones; Humans; Middle Aged; Peroxiredoxins; Proteinase Inhibitory Proteins, Secretory; Proteins; Proteomics; Tubulin; Young Adult
PubMed: 32106990
DOI: 10.1016/j.fertnstert.2019.09.032 -
Journal of Proteomics Mar 2017Epithelial ovarian cancer (EOC) is worldwide the sixth most lethal form of cancer occurring in women. More than one third of ovarian patients have ascites at the time of...
UNLABELLED
Epithelial ovarian cancer (EOC) is worldwide the sixth most lethal form of cancer occurring in women. More than one third of ovarian patients have ascites at the time of diagnosis and almost all of them have it when recurrence occurs. Although its effect on tumor cell microenvironment remains poorly understood, its presence is correlated with bad diagnosis. In previous studies, we proposed a novel glycan-based biomarker for the diagnosis of EOC, which showed an improved sensitivity and specificity at any stage of the disease and an improved discrimination between malignant and benign ovarian tumors. In this work, we report for the first time the N-glycome profiles of ascitic fluid from primary serous EOC patients and compare them with the serum N-glycomes of the same patients as well as of healthy controls. N-Glycans were digested from equivalent amount of ascites and serum from 18 EOC patients and from serum of 20 age-matched controls and measured by MALDI-TOF-MS. Ascites N-glycome showed increased antennarity, branching, sialylation and Lewis motives compared to healthy serum. In addition, a correlation was established between ascites volume and degree of sialylation.
SIGNIFICANCE
Malignant ascitic fluid is the build-up of large volumes of fluid in the peritoneal cavity secondary to cancer. At least one-third of ovarian cancer patients develop ascites, a generally voluminous fluid containing cells of tumor origin, in the course of cancer and almost all when recurrence occurs. The proteome of ascites is known to be as complex as that of serum and contains high amount of proteins shed from inflammatory cells as well as from tumor cells. Although many attempts have been made to provide molecular insight into the proteomic and peptidomic content of malignant ascites, no data about the N-glycome of the ascitic fluid fraction from cancer patients has been reported to date. In this study, the N-glycosylation profile of ascites from 20 patients suffering from epithelial ovarian cancer (EOC) was analyzed by MALDI-TOF-mass spectrometry and compared to the pathologically modified N-glycan pattern obtained from serum of the same patients as well as to the pattern of serum from healthy individuals. Significant quantitative differences were observed in the ascites of EOC patients when compared to the serum of healthy subjects. The glycome of ascites shows typical features of inflammatory conditions, what was also found in the serum of patients suffering from EOC when compared to healthy serum. In addition, a correlation was established between ascites volume and degree of sialylation, showing that the high-volume ascites contains a higher amount of sialylated structures than the low-volume ascites.
Topics: Adult; Aged; Ascitic Fluid; Biomarkers, Tumor; Female; Humans; Middle Aged; Ovarian Neoplasms; Polysaccharides; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
PubMed: 28188862
DOI: 10.1016/j.jprot.2017.02.001 -
Scientific Reports Apr 2020Bacteriophages are abundant in human biomes and therefore in human clinical samples. Although this is usually not considered, they might interfere with the recovery of...
Bacteriophages are abundant in human biomes and therefore in human clinical samples. Although this is usually not considered, they might interfere with the recovery of bacterial pathogens at two levels: 1) by propagating in the enrichment cultures used to isolate the infectious agent, causing the lysis of the bacterial host and 2) by the detection of bacterial genes inside the phage capsids that mislead the presence of the bacterial pathogen. To unravel these interferences, human samples (n = 271) were analyzed and infectious phages were observed in 11% of blood culture, 28% of serum, 45% of ascitic fluid, 14% of cerebrospinal fluid and 23% of urine samples. The genetic content of phage particles from a pool of urine and ascitic fluid samples corresponded to bacteriophages infecting different bacterial genera. In addition, many bacterial genes packaged in the phage capsids, including antibiotic resistance genes and 16S rRNA genes, were detected in the viromes. Phage interference can be minimized applying a simple procedure that reduced the content of phages up to 3 logs while maintaining the bacterial load. This method reduced the detection of phage genes avoiding the interference with molecular detection of bacteria and reduced the phage propagation in the cultures, enhancing the recovery of bacteria up to 6 logs.
Topics: Ascitic Fluid; Bacteria; Blood Culture; Capsid; Cerebrospinal Fluid; Filtration; Humans; Inoviridae; Lysogeny; Molecular Typing; Myoviridae; Podoviridae; RNA, Ribosomal, 16S; Serum; Siphoviridae; Urine
PubMed: 32317653
DOI: 10.1038/s41598-020-63432-7 -
Acta Cytologica 2023Pelvic washing and peritoneal fluid cytology specimens are used to detect peritoneal spread of malignancies. In most cases, identification of malignancy in these... (Review)
Review
BACKGROUND
Pelvic washing and peritoneal fluid cytology specimens are used to detect peritoneal spread of malignancies. In most cases, identification of malignancy in these specimens is straightforward, but benign processes may occasionally mimic neoplasia and cause diagnostic difficulty.
SUMMARY
In this article, we perform a focused review of common benign entities encountered in pelvic washing and peritoneal fluid specimens during routine practice which may cause difficulty and discuss helpful features for avoiding diagnostic pitfalls.
KEY MESSAGES
Application of strict cytomorphologic criteria, along with judicious use of ancillary studies and correlation with clinical, intraoperative, radiologic, and other pathologic findings, can help resolve most problematic cases.
Topics: Humans; Female; Ascitic Fluid; Ovarian Neoplasms; Cytodiagnosis
PubMed: 36626891
DOI: 10.1159/000528191 -
Italian Journal of Pediatrics Oct 2019Diagnosis of acute appendicitis (AA) and decisions about its treatment remain among the most common dilemmas of pediatric surgical teams. Monitoring of immune response...
BACKGROUND
Diagnosis of acute appendicitis (AA) and decisions about its treatment remain among the most common dilemmas of pediatric surgical teams. Monitoring of immune response may be of importance for this purpose. Our aim was to measure and analyze serum and peritoneal fluid cytokines, in children who had undergone surgery for suspected AA.
METHODS
Prospective investigation of serum and peritoneal fluid cytokine values was performed in 127 consecutive patients. According to the pathohistological findings, patients were divided into three groups: normal/early, uncomplicated and complicated AA. Determination of cytokine concentrations for 20 different cytokines was done using a commercial flow cytometry kit: Human Inflammation 20 plex BMS 819.
RESULTS
Statistically significant differences in serum cytokine values between pathohistological groups were found for IP-10, MIP-1α and IL-10. Preoperative cut-off values of IP-10, MIP-1α and IL-10 between groups were obtained using ROC curve analysis. Positive correlations between serum and peritoneal concentrations were recorded for most of the analyzed cytokines.
CONCLUSION
IP-10, MIP-1α and IL-10 showed potential in assessment of AA in children. Confirmatory studies with a larger number of patients are required to prove reliability of these biomarkers.
Topics: Adolescent; Appendicitis; Ascitic Fluid; Biomarkers; Child; Child, Preschool; Cytokines; Female; Humans; Male; Prospective Studies; Reproducibility of Results
PubMed: 31615548
DOI: 10.1186/s13052-019-0726-7 -
International Immunopharmacology Jul 2022Interleukin (IL) -35 induces immunotolerance by suppression of CD8 T cells during chronic infections and cancers. In the present study, we amined to investigate the role...
Interleukin (IL) -35 induces immunotolerance by suppression of CD8 T cells during chronic infections and cancers. In the present study, we amined to investigate the role of IL-35-mediated regulation of CD8 T cells in patients with liver cirrhosis. Seventy-one patients with liver cirrhosis (46 patients with untainted ascites and 25 patients with spontaneous bacterial peritonitis [SBP]) and 22 controls were enrolled. Plasma and ascitic IL-35 levels were measured using ELISA. Peripheral and ascitic CD4 and CD8 T cells were purified to investigate their functional phenotypes. IL-35-stimulated CD8 T cells were cultured with HepG2 cells in direct and indirect contact systems. Lactate dehydrogenase expression and cytokine secretion were measured to determine the cytotoxicity of CD8 T cells. Plasma IL-35 was elevated in patients with liver cirrhosis, and ascitic IL-35 levels were higher in the SBP group than in the untainted ascites group. No significant differences in transcription factor expression or cytokine production in peripheral and ascitic CD4 T cells were observed among groups. In the SBP group, ascitic CD8 T cells expressed decreased cytotoxic molecules, along with the reduced secretion of interferon-γ and tumor necrosis factor-α when compared with the untainted ascites group. IL-35 stimulation suppressed ascitic CD8 T cell cytotoxicity and cytokine production in both direct and indirect contact culture systems. This process was accompanied by decreased cytotoxic molecule expression and increased immune-checkpoint molecules in ascitic CD8 T cells. The present findings revealed that overexpression of ascitic IL-35 dampened the cytotoxicity of CD8 T cells in liver cirrhotic patients with SBP.
Topics: Ascites; Ascitic Fluid; CD8-Positive T-Lymphocytes; Humans; Interleukins; Liver Cirrhosis; Peritonitis; Tumor Necrosis Factor-alpha
PubMed: 35349961
DOI: 10.1016/j.intimp.2022.108729 -
Der Pathologe Mar 2022Body cavity fluids are among the most frequently examined samples in cytology. Cytomorphology is supplemented by additive testing. An international system of terminology... (Review)
Review
BACKGROUND
Body cavity fluids are among the most frequently examined samples in cytology. Cytomorphology is supplemented by additive testing. An international system of terminology and classification has been recently presented.
OBJECTIVES
Cytopreparation and staining techniques as well as some exemplary morphological patterns are presented. "The International System for Serous Fluid Cytopathology" (TIS) is briefly presented.
MATERIALS AND METHODS
Pleural effusion, pericardial effusion, and ascites: special technical issues, immunocytochemistry, molecular diagnostics, and reporting system issues are discussed.
RESULTS
Body cavity fluids are important samples that provide significant information. Additive testing is established for routine use. The form and structure of reports is widely divergent in practical use.
DISCUSSION
A reporting system for serous fluid cytopathology that is easily applied and recognized internationally is highly desirable. TIS is a valuable approach to this goal.
Topics: Ascitic Fluid; Body Fluids; Cytodiagnosis; Humans; Immunohistochemistry; Pathology, Molecular; Pericardial Effusion; Pleural Effusion
PubMed: 34994855
DOI: 10.1007/s00292-021-01042-4 -
Iranian Journal of Immunology : IJI Jun 2019Endometriosis is a chronic inflammatory disease with the growth of endometrial cells out of uterus and in the peritoneal cavity. T cell subsets participate in the...
BACKGROUND
Endometriosis is a chronic inflammatory disease with the growth of endometrial cells out of uterus and in the peritoneal cavity. T cell subsets participate in the establishment and progress of the disease by producing different cytokines.
OBJECTIVE
To investigate a group of cytokines related to Th1/Th2/Th17/Treg subsets within both peripheral blood and peritoneal fluid (PF) samples from infertile endometriosis women.
METHODS
Peripheral blood and PF samples were collected from 30 infertile endometriosis and 30 non-endometriosis fertile women during laparoscopy. Concentration of cytokines, including TNF-α, IFN-γ, TGF-β1, IL-4, IL-10, IL-17 and IL-23 were evaluated using ELISA method.
RESULTS
Results indicated that the concentration of IFN-γ within serum was significantly reduced in endometriosis group (p=0.001). Regarding PF cytokines, TGF-β1 was increased in endometriosis group (p=0.030). Furthermore, the ratios of IFN-γ/TGF-β1 and IL-17/IL-23 were significantly different between endometriosis and non-endometriosis women in serum samples (p<0.001 and p<0.01 respectively). The ratios of TNF-α/IL-10 and IL-17/IL-10 were also significantly different regarding PF samples between the two studied groups (p<0.04 and p<0.03 respectively). Finally, significant correlations were observed between the levels of IL-17 and IL-23, inflammatory and anti-inflammatory cytokines, in both samples and serum to PF inflammatory cytokines.
CONCLUSION
Based on the results of the present study, in women with endometriosis, the disturbance of cytokines network might gradually activate the inflammatory responses and tissue repair, resulting in endometriosis development after several years.
Topics: Adult; Ascitic Fluid; Cytokines; Endometriosis; Endometrium; Female; Humans; Infertility, Female; Middle Aged; T-Lymphocyte Subsets; Young Adult
PubMed: 31182689
DOI: 10.22034/IJI.2019.80258