Diagnosis of primary site of tumour origin using immunohistochemistry on cell block in cases of malignant ascitic fluid

This chapter covers cancer of unknown primary site (CUP), and includes information on epidemiology, molecular biology, pathology, and multidisciplinary management of clinicopathological subsets. Previously, these tumours were diagnosed and treated based on clinical presentation, light microscopy and clinical intuition. Today, the majority of cancers of unknown primary site are becoming less unknown, more accurately classified, and appropriately treated by the use of multiplex or genome-wide expression profiling platforms. These techniques allow for precise and correct knowledge of the true tumour origin, leading to more rational and effective treatment. However, there also may be genetic signatures that are primary-independent, pro-metastatic, and possibly CUP-specific.

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Cancer of unknown primary site

Oxford Textbook of Oncology ◽

10.1093/med/9780199656103.003.0059_update_002 ◽

2016 ◽

pp. 965-974

Author(s):

Nicholas Pavlidis ◽

George Pentheroudakis

Keyword(s):

Expression Profiling ◽

Cancer Of Unknown Primary ◽

Primary Site ◽

Unknown Primary ◽

Unknown Primary Site ◽

Clinical Intuition ◽

Genome Wide ◽

Genetic Signatures ◽

Genome Wide Expression ◽

Tumour Origin

This chapter covers cancer of unknown primary site (CUP), and includes information on epidemiology, molecular biology, pathology, and multidisciplinary management of clinicopathological subsets. Previously, these tumours were diagnosed and treated based on clinical presentation, light microscopy and clinical intuition. Today, the majority of cancers of unknown primary site are becoming less unknown, more accurately classified, and appropriately treated by the use of multiplex or genome-wide expression profiling platforms. These techniques allow for precise and correct knowledge of the true tumour origin, leading to more rational and effective treatment. However, there also may be genetic signatures that are primary-independent, pro-metastatic, and possibly CUP-specific.

Download Full-text

Cancer of unknown primary site

Oxford Textbook of Oncology ◽

10.1093/med/9780199656103.003.0059_update_001 ◽

2016 ◽

pp. 965-974

Author(s):

Nicholas Pavlidis ◽

George Pentheroudakis

Keyword(s):

Expression Profiling ◽

Cancer Of Unknown Primary ◽

Primary Site ◽

Unknown Primary ◽

Unknown Primary Site ◽

Clinical Intuition ◽

Genome Wide ◽

Genetic Signatures ◽

Genome Wide Expression ◽

Tumour Origin

This chapter covers cancer of unknown primary site (CUP), and includes information on epidemiology, molecular biology, pathology, and multidisciplinary management of clinicopathological subsets. Previously, these tumours were diagnosed and treated based on clinical presentation, light microscopy and clinical intuition. Today, the majority of cancers of unknown primary site are becoming less unknown, more accurately classified, and appropriately treated by the use of multiplex or genome-wide expression profiling platforms. These techniques allow for precise and correct knowledge of the true tumour origin, leading to more rational and effective treatment. However, there also may be genetic signatures that are primary-independent, pro-metastatic, and possibly CUP-specific.

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Study of Ascitic Fluid by Liquid Based Cytology and Its Comparision with Conventional Cytosmears and Cell Block Preprations

Annals of International medical and Dental Research ◽

10.21276/aimdr.2016.2.6.pt4 ◽

2016 ◽

Vol 2 (6) ◽

Author(s):

Rishu Mittal ◽

Kundal Ramesh ◽

Singh harpal ◽

Deepika Gupta ◽

Bhavleen Kaur ◽

...

Keyword(s):

Ascitic Fluid ◽

Cell Block ◽

Liquid Based Cytology

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ASCITIC FLUID CYTOLOGY IN SUSPECTED MALIGNANT EFFUSIONS WITH SPECIAL EMPHASIS ON CELL BLOCK PREPARATION

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2015/1511 ◽

2015 ◽

Vol 4 (60) ◽

pp. 10488-10493

Author(s):

Saswati Pal ◽

Dulali Murmu ◽

Bidyut Krishna Goswami

Keyword(s):

Ascitic Fluid ◽

Cell Block ◽

Malignant Effusions ◽

Fluid Cytology

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Efficacy of ascitic fluid cell block for diagnosing primary ovarian, peritoneal, and tubal cancer in patients with peritoneal carcinomatosis with ascites

Gynecologic Oncology ◽

10.1016/j.ygyno.2020.02.004 ◽

2020 ◽

Vol 157 (2) ◽

pp. 398-404

Author(s):

Takashi Uehara ◽

Hiroshi Yoshida ◽

Mei Fukuhara ◽

Masayuki Yoshida ◽

Noriko Motoi ◽

...

Keyword(s):

Peritoneal Carcinomatosis ◽

Ascitic Fluid ◽

Cell Block ◽

Tubal Cancer ◽

Fluid Cell

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Morphologic and Immunocytochemical Features of High-Grade Serous Carcinoma of Ovary in Ascitic Fluid Effusion and Fine-Needle Aspiration Cytology

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqaa028 ◽

2020 ◽

Vol 154 (1) ◽

pp. 103-114

Author(s):

Akriti Bansal ◽

Radhika Srinivasan ◽

Manish Rohilla ◽

Archana Sundaram ◽

Bhavana Rai ◽

...

Keyword(s):

Ascitic Fluid ◽

Fine Needle Aspiration ◽

Needle Aspiration ◽

Serous Carcinoma ◽

High Grade ◽

Cell Block ◽

Ovarian Mass ◽

Fine Needle ◽

Response To Chemotherapy ◽

Needle Aspiration Cytology

Abstract Objectives High-grade serous carcinoma (HGSC) is the most common ovarian malignancy. The role of cytopathology in obtaining tissue diagnosis before institution of neoadjuvant chemotherapy (NACT) was evaluated. Methods All histopathology-proven HGSC specimens between 2015 and 2018 with prior cytopathologic diagnosis by ascitic fluid evaluation or fine-needle aspiration (FNA) of ovarian mass were reviewed with cell block immunocytochemistry for CK7, CK20, PAX8, WT1, and p53. Results Of 288 cases of HGSC, pre-NACT cytology diagnosis was established in 32% (93/288), with specific HGSC diagnoses made on ascitic fluid in 88% (82/93) and by ovarian mass FNA in 12% (11/93). The ascitic fluid showed moderate/high cellularity with papillary clusters in 76% (71/93) cases. Cell block immunocytochemistry showed tumor cells positive for CK7, PAX8, and WT1. p53 showed mutant or null-type positivity in 65% (33/51) and 33% (17/51) of cases, respectively, with 100% concordance with subsequent histopathology specimens. Poor/intermediate response to chemotherapy was shown in 75% of cases. Conclusions Combined assessment of cytomorphology, cell block histomorphology, and ancillary immunohistochemical testing, including PAX8, WT1, and p53, allows for specific pre-NACT diagnoses of HGSC in ascitic fluid and ovarian FNA cytology. This practice allows for initiation of chemotherapy and diminution of disease burden prior to definitive surgical therapy.

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