Laparoscopic aspiration cytology in rheumatoid ascites: A case report

Luis E. De Las Casas, Angel M. Morales, Darius A. Boman, Alan H. Tyroch, Jesus E. Calleros-Macias, Roberto Miranda

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: To the best of our knowledge, there are currently no recorded cytologic features of any effusion from rheumatoid peritonitis showing cytologic findings linked to rheumatoid pleural disease, although rheumatoid nodules have been described in the peritoneum. Case: A 75-year-old man with long-standing, poorly controlled rheumatoid arthritis was seen in our hospital after a motor vehicle collision. Computed tomography showed free fluid in the abdominal cavity. Laparoscopic examination revealed a large amount of nonhemorrhagic ascitic fluid and no traumatic intraabdominal injuries. Abdominal and peritoneal surfaces appeared completely normal. The ascitic fluid was aspirated through the laparoscope and sent for cytologic examination. Cytospin preparations revealed histiocytes and loosely cohesive clusters of small cytologically bland epithelioid cells amid acute inflammatory cells and granular necrotic debris. Cell block material displayed transected fibroconnective tissue fragments lined by hyperplastic mesothelium with squamous metaplasia. Immunohistochemical studies revealed that the mesothelial cells were positive for calretinin, cytokeratin 5/6, and p63. Conclusion: The ascites was attributed to peritoneal disease from rheumatoid arthritis, based on the cytologic findings, immunoprofile, exclusion of other possible causes (i.e., cirrhosis, nephrotic syndrome, protein-losing enteropathy, or drugs), and patient's clinical setting.

Original languageEnglish (US)
Pages (from-to)1123-1126
Number of pages4
JournalActa Cytologica
Volume54
Issue number6
DOIs
StatePublished - Jan 1 2010

Fingerprint

Ascites
Cell Biology
Ascitic Fluid
Rheumatoid Arthritis
Peritoneal Diseases
Keratin-6
Rheumatoid Nodule
Keratin-5
Protein-Losing Enteropathies
Pleural Diseases
Laparoscopes
Calbindin 2
Epithelioid Cells
Histiocytes
Abdominal Cavity
Peritoneum
Metaplasia
Nephrotic Syndrome
Motor Vehicles
Peritonitis

Keywords

  • Ascites
  • Cytology
  • Rheumatoid arthritis
  • Rheumatoid ascites

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

Cite this

De Las Casas, L. E., Morales, A. M., Boman, D. A., Tyroch, A. H., Calleros-Macias, J. E., & Miranda, R. (2010). Laparoscopic aspiration cytology in rheumatoid ascites: A case report. Acta Cytologica, 54(6), 1123-1126. https://doi.org/10.1159/000325255

Laparoscopic aspiration cytology in rheumatoid ascites : A case report. / De Las Casas, Luis E.; Morales, Angel M.; Boman, Darius A.; Tyroch, Alan H.; Calleros-Macias, Jesus E.; Miranda, Roberto.

In: Acta Cytologica, Vol. 54, No. 6, 01.01.2010, p. 1123-1126.

Research output: Contribution to journalArticle

De Las Casas, LE, Morales, AM, Boman, DA, Tyroch, AH, Calleros-Macias, JE & Miranda, R 2010, 'Laparoscopic aspiration cytology in rheumatoid ascites: A case report', Acta Cytologica, vol. 54, no. 6, pp. 1123-1126. https://doi.org/10.1159/000325255
De Las Casas LE, Morales AM, Boman DA, Tyroch AH, Calleros-Macias JE, Miranda R. Laparoscopic aspiration cytology in rheumatoid ascites: A case report. Acta Cytologica. 2010 Jan 1;54(6):1123-1126. https://doi.org/10.1159/000325255
De Las Casas, Luis E. ; Morales, Angel M. ; Boman, Darius A. ; Tyroch, Alan H. ; Calleros-Macias, Jesus E. ; Miranda, Roberto. / Laparoscopic aspiration cytology in rheumatoid ascites : A case report. In: Acta Cytologica. 2010 ; Vol. 54, No. 6. pp. 1123-1126.
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