Cytomorphology of ovarian clear cell carcinomas in peritoneal effusions

Our plain-English summary of Cytomorphology of ovarian clear cell carcinomas in peritoneal effusions, by D. Damiani, V. Suciu, C. Genestie, et al (Cytopathology, 2016).

The study

• Authors: D. Damiani, V. Suciu, C. Genestie, P. Vielh
• Journal: Cytopathology
• Published: 2016;27(6):427-432
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Objective: To investigate and describe the cytomorphology of malignant effusions from ovarian clear cell carcinomas (OCCC).

Methods: Five cases of malignant peritoneal effusions from OCCC histologically confirmed were analysed and compared.

Results: Among the malignant peritoneal effusions exhibiting clear cell features, a characteristic feature of OCCC was the presence of large deposits of a hyaline matrix. This matrix may be typically arranged either in 'raspberry bodies' or 'globule-like' structures. Other rare neoplasms composed of clear cells must be considered in the differential diagnosis such as yolk sac tumour of the ovary, clear cell subtype of endometrial carcinoma and, less frequently, malignant peritoneal mesothelioma as well as metastatic renal cell carcinoma.

Conclusions: Ovarian clear cell carcinomas have distinct morphological features that are helpful in making a cytological diagnosis of this entity. The role of cytological examination in ovarian neoplasms is of paramount importance, as stated by The International Federation of Gynecology and Obstetrics (FIGO) recommendations.

© 2016 John Wiley & Sons Ltd.

In plain English

This article is not about asbestos. It is a case series from the Gustave Roussy Comprehensive Cancer Center in Villejuif, France, describing how ovarian clear cell carcinoma looks under the microscope in fluid from the abdomen (peritoneal effusions). The authors searched their department's database for 2005 to 2015 and studied five such cases. One patient gave two samples: one from the early effusion and one taken when the cancer recurred. A sixth case, an endometrial clear cell carcinoma, was used for comparison. The tumour cells had finely granular or vacuolated cytoplasm, and hobnail cells were recorded in every sample, though scant in the recurrence sample. The authors noted a characteristic matrix of large, glassy-looking stroma. It took two forms: 'raspberry bodies', with stroma at the centre, and large round 'globule-like' structures. In the recurrence sample, the globule-like structures increased in number. The authors concluded that their study, though based on a limited number of cases, focused on the most reliable features for diagnosing this cancer and avoiding common pitfalls. Malignant mesothelioma appears only in their discussion of tumours that can look similar.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case series: a review of microscope (cytology) slides from five cases of malignant peritoneal effusions caused by ovarian clear cell carcinoma
• Who was studied: Five patients with ovarian clear cell carcinoma confirmed by tissue examination, found in the database of the Biopathology Department, Gustave Roussy Comprehensive Cancer Center (Villejuif, France), 2005 to 2015. One patient had two sequential samples: one from the early effusion and one at recurrence. A sixth specimen, an endometrial clear cell carcinoma, was used for comparison.
• Main results:
  • In the five ovarian clear cell carcinoma cases, the tumour cells had finely granular or vacuolated cytoplasm, and some cells had the 'hobnail' appearance.
  • Hobnail cells were recorded as present in every sample in the summary table, and as scant in the recurrence sample (2bis).
  • A characteristic matrix was seen in these cases: large fragments of abundant stroma with a hyalinised (glassy, shapeless) appearance.
  • The matrix took two main forms: a 'raspberry body', with stroma at the centre, and a large round 'globule-like' pattern.
  • In the one patient with two samples, the sample taken at recurrence showed fewer raspberry bodies and more globule-like structures than the earlier sample.
  • In the comparison case of endometrial clear cell carcinoma, matrix was scant and sat at the centre of papillae, mixed with high-grade endometrioid tumour cells.
• The authors' conclusion: The authors concluded that their study focused on the most reliable cytological features for correctly diagnosing ovarian clear cell carcinoma and avoiding the commonest pitfalls in malignant peritoneal effusions.
• Limitations the authors state:
  • The study was based on a limited number of cases.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Ovarian cancer.

Medical terms in this study, explained in our Lexicon: Carcinoma, Neoplasm, Differential Diagnosis, Peritoneal Mesothelioma.

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