RESUMEN
OBJECTIVE: To determine the incidence of false positive malignant peritoneal cytology and psammoma bodies associated with benign gynecologic disorders. STUDY DESIGN: Pelvic peritoneal fluid was prospectively collected for cytologic examination from 119 women undergoing laparoscopy for benign conditions (infertility, 67; pelvic pain, 35; elective sterilization, 17). The median age was 30. No patient had laparoscopic gross cancer or histologic evidence of cancer. RESULTS: The peritoneal cytology of 2 of 119 cases (2%) contained cells with features suggestive of malignancy, and 6 of 119 cases (5%) contained psammoma bodies. Both cases of false positive peritoneal cytology and four of six with psammoma bodies were associated with endometriosis. All cases were followed for a minimum of two years, and no patient had developed cancer. CONCLUSION: Peritoneal fluid from cases of benign gynecologic disorders, especially endometriosis, can contain psammoma bodies and cells suggestive of malignancy.
Asunto(s)
Líquido Ascítico/patología , Enfermedades de los Genitales Femeninos/diagnóstico , Enfermedades de los Genitales Femeninos/patología , Neoplasias de los Genitales Femeninos/diagnóstico , Neoplasias de los Genitales Femeninos/patología , Cuerpos de Inclusión/patología , Adulto , Diagnóstico Diferencial , Endometriosis/diagnóstico , Endometriosis/patología , Reacciones Falso Positivas , Femenino , Humanos , Persona de Mediana Edad , Estudios ProspectivosRESUMEN
The peritoneal washings obtained at diagnostic laparoscopy of two women with suspected endometriosis contained cells with cytologic features of adenocarcinoma. Exploratory laparotomy, total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and pelvic washings confirmed endometriosis with no evidence of cancer. At 1.5-year and 4.0-year follow-up, respectively, cancer had not developed in either patient. The authors report what they were able to find in the literature regarding false-positive assessments of malignancy obtained by cytologic examination. They also outline steps to be taken should a diagnosis of malignancy arise in a woman with endometriosis who desires pregnancy.