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Image Number 58 - Peritoneal cavity, ascites, adenocarcinoma

This cytology specimen represents cells that have been aspirated along with ascitic fluid. Ascites is accumulated fluid in the peritoneal cavity. Ascites may arise from a number of causes, such as portal hypertension, any inflammatory process in the cavity, and the presence of cancer. The volume of ascitic fluid can be quite large. Notice that the cells in this slide are seen as a tissue fragment, which is suggestive of an adenocarcinoma. More importantly, the cells are malignant. The diagnosis of malignancy is made particularly from nuclear characteristics: extreme pleomorphism; variation in size; prominent, irregular and multiple nucleoli; variations in thickness of the nuclear membrane; and clearing and clumping of the chromatin. Arrow 1 indicates the nuclear membrane of one nucleus and arrow 2 highlights the most prominent of the many nucleoli in this cell.

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