Journal of Pathology and Translational Medicine

Review

The Cytopathology of Body Cavity Fluid.: Eun Kyung Hong; Korean J Cytopathol. 2008;19(2):72-85.; DOI: https://doi.org/10.3338/kjc.2008.19.2.72

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Cytologic examination of the body cavity fluid is very important because the specimens represent a significant percentage of nongynecologic samples and this cytologic examination may be the first, best or only chance for making the diagnosis of an underlying malignancy. The purposes of body cavity fluid examination are to correctly identify cancer cells and if possible, to identify the tumor types and primary sites when presented with unknown primary tumor sites. The most important basic differential diagnosis is that of benign and reactive disease vs malignant disease. Reactive mesothelial cells are a consistent population in body cavity fluid, and these are the most versatile cells in the body. Due to the specific environment of the body cavity, the exfoliated reactive mesothelial cells may show significant morphologic overlap with the morphology of cancer cells. With a focus on the differential points between reactive mesothelial cells and metastatic adenocarcinoma cells, the practical diagnostic approaches, the diagnostic clues and the pitfalls to achieve a correct diagnosis are presented in this review.

Citations

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A cytological observation of the fluid in the primo-nodes and vessels on the surfaces of mammalian internal organs
Baeckkyoung Sung, Min Su Kim, Byung-Cheon Lee, Seong-Hun Ahn, Sung-Yeoun Hwang, Kwang-Sup Soh
Biologia.2010; 65(5): 914. CrossRef

Original Articles

Immunohistochemical Expression of p53, E-cadherin, and nm23 Proteins in Metastatic Carcinoma of Neck Lymph Node and Corresponding Primary Carcinoma.: Jong Kook Kim, O Jun Kwon, Byung Heon Kim; Korean J Pathol. 2000;34(9):615-624.

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Abstract PDF: This study was carried out to evaluate the immunohistochemical expressions of p53, E-cadherin, and nm23 proteins in 114 cases of metastatic carcinoma of the neck lymph node (MTLNCA) and corresponding primary carcinoma (PRCA). The positive expressions of p53, E-cadherin, and nm23 proteins were 62.3%, 58.8% and 64.0%, respectively in PRCA, and 40.4%, 38.6%, and 43.9%, respectively in MTLNCA with significant down-regulation from PRCA to MTLNCA (p<0.05). The down-regulation was correlated with female gender, moderate and poor differentiation, and adenocarcinoma in p53 protein, female gender, respiratory and gastrointestinal carcinoma in E-cadherin protein, and female gender, respiratory carcinoma, moderate differentiation, and squamous cell carcinoma in nm23 protein (p<0.05). There was no significant relationship among expressions of p53, E-cadherin, and nm23 proteins (p<0.05). In conclusion, these results suggest that the expressions of p53, E-cadherin, and nm23 proteins seem to be down-regulated from PRCA to MTLNCA and this down-regulation may play a role in invasion and metastasis.

Metastatic Carcinoma in Lymph Nodes of Neck: Analysis of 221 Cases Diagnosed by Fine Needle Aspiration Cytology.: Duck Hwan Kim, Youn Ju Kim, Seung Eun Yang, Sung Suk Paeng, Hee Jin Chang, Jin Hee Sohn, Jung Il Suh; Korean J Cytopathol. 1995;6(1):41-47.

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Abstract PDF: Two hundreds and twenty one consecutive patients with enlarged lymph nodes of neck areas were diagnosed as metastatic carcinoma by fine needle aspiration. The metastatic carcinomas were most frequent in the supraclavicular lymph nodes(p<0.05). As a primary site, lung, stomach, upper respiratory tract and breast were common sites in descending order of frequency. In overall cytologic types, squamous cell carcinoma was the most common in males(43%) while adenocarcinoma was the most common in females(72%) (p<0.05). While carcinomas of the esophagogastro -intestinal tract showed a tendency to metastasis to the left supraclavicular lymph nodes, the metastatic carcinomas of lung and breast usually metastasized to the same side primary cancers with predilection for the supraclavicular lymph nodes. The submandibular lymph nodes were frequently involved by the carcinoma of upper and lower respiratory tract, in which squamous cell carcinoma is the most prevalent cytologic type. diagnosis by fine needle aspiration cytology is the first step in the workup of patients with nodal enlargement suspicious for malignancy, particularly in metastatic carcinoma.

Sinusoidal Involvement of Malinant Lymphoma in Lymph Nodes Simulating Metastatic Carcinoma.: Young Seak Kim, Mi Kyung Shin, In Sun Kim; Korean J Pathol. 1991;25(1):45-49.

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Abstract PDF: We present a case of this distinctive variety of malignant lymphoma, which was diagnosed in the axillary lymph nodes of a 66-year-old woman. The patient was admitted to the GS department due to palpable mass on the right axillary area for two months. A 2 x 1 cm sized mass was also palpated on the cervical area. The laboratory and radiologic findings were unremarkable. Axillary dissection was done under the impression of metastatic carcinoma from breast. Received lymph nodes were multiple and variable in size, ranging from 0.5 cm to 5.0 cm in diameter. Histologically, the lymph nodes were partly effaced and involved by nodular and diffuse infiltrations of large lymphoid cells in the subcapsular and medullary sinuses. In diffuse areas, typical starry-sky pattern was seen. Immunohistochemically, the tumor cells were negative for broad-spectrum keratin, but positive for leukocyte antigen, ML, and B cell markers, L26, and 4KB5. T cell marker. UCHL1 was negative. On staining with histiocytic marker, Mac387 antibody, the tingible-body macrophages were only positive. Interstitial plasma cells and some of the tumor cells were positive for lambda light chain. Electron microscopic study, which was done on paraffin embedded tissue showed lymphoid-type of nuclei without cellular junction suggestive for carcinoma.

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