CASE N°26 – Ovarian carcinoma with psammoma bodies in ascites

Clinical History:

Age: 44

Sex: female

Abdominal echography: Presence of a few centimeter lymph node near the aorta and in the context of mesentery.
In the pelvis voluminous swelling structure, with liquid and solid component, with a maximum diameter of about 72 mm, suspect for adnexal pathology. Cysts are recognized in the context of the liver parenchyma. No alterations of the spleen, pancreas, adrenals and kidneys, neither iliac lymphadenopathy.

Cytological Images:

Cytological speciemen: Ascites

Image 1

Image 2

Image 3

Image 4

Image 5

Cytological Report:

Presence of numerous aggregates of malignant epithelial cells, sometimes with abundant cytoplasmic vacuoles and occasionally sourranding psammoma bodies. Reactive mesothelial cells and bloody material.
Positive for malignancy.


Images 2,3 psammoma bodies.
Images 4 epithelial malignant cells.
Images 5 reactive mesothelial cells.
Note the difference between images 4 & 5; diagnostic clue to differentiate mesothelial from epithelial cell are intercellular spaces between mesothelial cells. To diagnose malignancy, obviously look for the atypical nuclei, be aware that mesothelioma and epithelial carcinoma frequently share the same nuclear atipia.

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