False positive malignant peritoneal cytology and psammoma bodies in benign gynecologic disease.

OBJECTIVE: To determine the incidence of false positive malignant peritoneal cytology and psammoma bodies associated with benign gynecologic disorders. STUDY DESIGN: Pelvic peritoneal fluid was prospectively collected for cytologic examination from 119 women undergoing laparoscopy for benign conditions (infertility, 67; pelvic pain, 35; elective sterilization, 17). The median age was 30. No patient had laparoscopic gross cancer or histologic evidence of cancer. RESULTS: The peritoneal cytology of 2 of 119 cases (2%) contained cells with features suggestive of malignancy, and 6 of 119 cases (5%) contained psammoma bodies. Both cases of false positive peritoneal cytology and four of six with psammoma bodies were associated with endometriosis. All cases were followed for a minimum of two years, and no patient had developed cancer. CONCLUSION: Peritoneal fluid from cases of benign gynecologic disorders, especially endometriosis, can contain psammoma bodies and cells suggestive of malignancy.

False-positive malignant peritoneal cytology associated with pelvic endometriosis.

The peritoneal washings obtained at diagnostic laparoscopy of two women with suspected endometriosis contained cells with cytologic features of adenocarcinoma. Exploratory laparotomy, total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and pelvic washings confirmed endometriosis with no evidence of cancer. At 1.5-year and 4.0-year follow-up, respectively, cancer had not developed in either patient. The authors report what they were able to find in the literature regarding false-positive assessments of malignancy obtained by cytologic examination. They also outline steps to be taken should a diagnosis of malignancy arise in a woman with endometriosis who desires pregnancy.