What is the best diagnosis for the following pelvic washing from a 45 year old female?
Pelvic washing from a 45-year-old patient.
Benign mesothelial cells
Signet ring cell carcinoma
Metastatic lobular carcinoma
Metastatic mucinous carcinoma
Show Answer and Explanations
Benign mesothelial cells — Correct answer
Correct. Benign mesothelial cells may have vacuoles. They can be distinguished from signet ring carcinoma by their round nuclei with smooth nuclear borders.
Signet ring cell carcinoma
Incorrect. In signet ring cell carcinoma, the vacuoles compress the nucleus to the side. In addition, the nuclei are hyperchromatic and irregular.
Metastatic lobular carcinoma
Incorrect. In lobular carcinoma, abnormal nuclear features are present along with intracytoplasmic vacuoles.
Metastatic mucinous carcinoma
Incorrect. Well differentiated mucinous tumors retain their columnar shape and poorly differentiated tumors show obvious cytologic atypia. Background macrophages are also present.
Summary
Summary: Mesothelial cells have variable morphology. Although they can have intracytoplasmic vacuoles, nuclei are not compressed and have benign features.
