Malignant Ascites of Unknown Primary - A Diagnostic Dilemma

Supreet Kaur Kalra; Amarjit Singh; Babita Rani; Gaurav Pawar; Ashwini Mahajan

Volume : VII, Issue : I, January - 2018

Malignant Ascites of Unknown Primary - A Diagnostic Dilemma

Supreet Kaur Kalra, Amarjit Singh, Babita Rani, Gaurav Pawar, Ashwini Mahajan

Abstract :

Malignant ascites indicates the presence of malignant cells in the peritoneal cavity and is a grave prognostic sign with poor survival of the patient. Peritoneal carcinomatosis accounts for approximately 10% of all cases of ascites. Tumors causing carcinomatosis are more commonly secondary peritoneal surface malignancies which include: ovarian, colorectal, pancreatic and uterine; extra–abdominal tumors originating from lymphoma, lung and east; and a small number of unknown primary tumors. The diagnostic accuracy of Exfoliative Effusion cytology is still a challenging task for cytopathologists. The diagnosis of metastases from carcinomas of unknown primary site (CUP) in serous effusions is distinctly difficult. We report an unusual case of a sixty year female who presented with ascites with no history of any known primary malignancy. The characteristic Indian file arrangement of the cells seen in the stained smears prepared from ascitic fluid raised the possibility of Lobular carcinoma east which on subsequent detection of the lump east, FNAC and histopathological examination was proved. Immunohistochemistry was applied as an adjunct to the cytological diagnosis which is otherwise a gold standard to the confirmation of diagnosis in malignant effusions. The aim of this case report is to highlight the diagnostic accuracy of conventional effusion cytology and to ing awareness of carcinoma east among females, physicians and surgeons.