[369] Does Cytological Examination of Ovarian Cyst Fluids Obtained during Oophorectomy Add Useful Information?

Cherif Garady, Scott L Boerner. University Health Network, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada

Background: Ovarian cyst fluid obtained during oophorectomy is frequently submitted for cytological examination. However, the value of cytologic examination of this sample is unclear, given that the ovarian lesion is undergoing excision and histologic examination. The aim of this study was to determine the accuracy of cytologic examination of the ovarian cyst fluid obtained during oophorectomy.
Design: A 10-year retrospective review was performed on ovarian cyst fluids obtained during oophorectomy. The fluid samples had been received fresh as a routine clinical sample and processed into a single ThinPrep slide. Cell blocks and ancillary studies were performed on selected cases at the discretion of the examining pathologist. Retrospectively, the cytology reports were reviewed and the cytologic diagnoses were categorized as benign, suspicious, unclassified neoplasm, malignant and non-diagnostic (cyst contents and insufficient cellularity). Histologic diagnoses on the excised ovarian lesion were categorized into benign, suspicious or malignant (including borderline tumors).
Results: 114 ovarian cyst fluids obtained during oophorectomy were identified from 112 patients. The mean patient age was 52 years (median: 49.5, range: 20 to 86 years). The mean cyst fluid volume was 49 mL (range 1 to 1000 mL). The results of the cytology and histology interpretations are presented in Table 1.

Table 1. Comparison of Cytology Classification of Ovarian Cyst Fluid and Histologic Classification.
 Histologic Classification of Ovarian Lesion 
Cytology ClassificationBenignMalignantSuspiciousTotal
Benign257032
Unclassified Neoplasm88016
Suspicious28111
Malignant022022
Non-Diagnostic285033
Total63501114


Excluding the one suspicious histologic diagnosis and including all abnormal cytologic diagnosis (neoplasm, suspicious and malignant) as one category, the sensitivity, specificity, positive and negative predictive values, were 56.3%, 84.4%, 79.2% and 39.7%, respectively.
Conclusions: Malignant diagnoses from cytologic examination of the ovarian cyst fluid obtained during oophorectomy is highly accurate. However, the high rate of non-diagnostic samples, inaccuracies of benign diagnoses and large number of equivocal cytologic diagnoses render cytologic examination of cyst fluid obtained during oophorectomy of little value.
Category: Cytopathology

Monday, March 4, 2013 1:00 PM

Poster Session II # 89, Monday Afternoon

 

Close Window