Clinical

• specimens
  • pleural fluid
  • peritoneal fluid
  • peritoneal washing
  • pericardial fluid
• indications
  • dx
  • staging
    • ovarian
    • fallopian tube
    • pancreas
    • stomach
  • assess tx

Benign

• Normal
  • mesothelial cells in sheets
  • groups have a scalloped border (vs adenoca groups have smooth border)
  • washings
    • collagen balls
    • histiocytes
    • muscle
    • fat
    • starch granules
    • cholesterol crystals
• Inflammation
  • serositis
  • empyema
  • infection
  • eosinophilic effusion
  • lymphocytic effusion
• reactive mesothelial cells
• Pleural
  • rheumatoid pleuritis
  • lupus pleuritis
  • CHF
  • pulmonary infarction
  • esophageal rupture
• Pericardial
  • renal failure
• Peritoneal
  • cirrhosis
• Washings
  • endosalpingiosis
  • endometriosis

Atypical

Suspicious

Malignant

• lymphoma
  • primary effusion lymphoma
  • metastatic lymphoma
• plasmacytoma
• mesothelioma
• serous carcinoma
• mucinous carcinoma
• adenocarcinoma
• small cell carcinoma
• melanoma
• sarcoma
• lung cancer
  • lung adenocarcinoma
  • small cell lung cancer
• breast cancer
• GU cancer
  • kidney cancer
  • prostate cancer
  • bladder cancer
• GI cancer
  • gastric cancer
  • colon cancer
  • HCC
  • cholangiocarcinoma
  • pancreatic cancer
• pancreatic cancer
• gyn cancer
  • ovarian cancer
  • endometrial cancer
  • fallopian tube cancer
  • cervical adenocarcinoma
• other occult malignancy
• GCT

Stains

• mesothelial cells: calretinin, D2-40
• adenocarcinoma: MOC31, BerEp4