Peritoneal washing cytology of disseminated low grade endometrial stromal sarcoma: a case report.
BACKGROUND
Low grade endometrial stromal sarcoma (LESS) with dissemination is rare, and its cytomorphology has not been well described. Recently, we experienced a case of LESS with peritoneal dissemination that was confirmed by peritoneal washing cytology and histology.


METHODS
A 51-year-old woman was admitted for evaluation of vaginal bleeding. Uterine ultrasonography revealed a diffisely thickened endomyometrium with a vaguely circumscribed nodular mass-like lesion measuring 7.4 cm in the largest dimension. Under the impression of adenomyosis, an exploratory laparotomy was performed. On examination of the abdominal cavity, multiple tiny, grayish nodular excrescences firmly attached to the peritoneal wall and the serosal surface of the small bowel and uterus were noted. A total hysterectomy with bilateral salpingo-oophorectomy and peritoneal fluid sampling were performed. The peritoneal fluid smear demonstrated several loosely packed clusters of monotonous cells showing round to oval nuclei, rare small nucleoli and scanty cytoplasm. CD10 immunostaining revealed cytoplasmic positivity in these cells, but reactive mesothelial cells showed a negative reaction. Histologic examination of the uterus revealed the typical histologic findings of LESS.


CONCLUSIONS
Cytopathologic diagnosis of disseminated LESS is not always easy. Immunocytochemical staining for CD10 can be helpful.
Lim
Beom Jin
BJ
Department of Pathology, Chungnam National University College of Medicine, Chung-go, Daejeon, Korea.
Choi
Song Yi
SY
Kang
Dae Young
DY
Suh
Kwang Sun
KS
D001202:Ascitic Fluid / Q000276:immunology / Q000473:pathology*; D003951:Diagnostic Errors / Q000517:prevention & control; D016889:Endometrial Neoplasms / Q000276:immunology / Q000473:pathology* / Q000601:surgery; D004715:Endometriosis / Q000473:pathology; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007150:Immunohistochemistry; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D015260:Neprilysin / Q000032:analysis; D010052:Ovariectomy; D010533:Peritoneal Lavage; D011237:Predictive Value of Tests; D018203:Sarcoma, Endometrial Stromal / Q000276:immunology / Q000473:pathology* / Q000601:surgery
D015260:Neprilysin