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Negative for Malignancy (NFM)

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The International System for Serous Fluid Cytopathology

Abstract

This chapter focuses on using an algorithmic approach to reporting negative findings in serous fluids, rather than providing detailed morphologic descriptions of benign entities. Specimens may be negative for malignancy (NFM) and yet be pathologic, but most serous fluids are collected to screen for primary or metastatic neoplasia. This chapter provides report examples for pathologic entities that do not represent atypical or malignant processes.

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References

  1. Light RW. Clinical practice: pleural effusion. N Engl J Med. 2002;346:1971–7.

    Article  PubMed  Google Scholar 

  2. Bibbo M, Draganova-Tacheva D, Naylor B. Pleural, peritoneal and pericardial fluids. In: Bibbo M, Wilbur DC, editors. Comprehensive Cytopathology. Philadelphia: Saunders Elsevier; 2014.

    Google Scholar 

  3. Dragoescu EA, Liu L. Pericardial fluid cytology: an analysis of 128 specimens over a 6-year period. Cancer Cytopathol. 2013;121(5):242–51.

    Article  CAS  PubMed  Google Scholar 

  4. Hsu C. Cytologic detection of malignancy in pleural effusion: a review of 5,255 samples from 3,811 patients. Diagn Cytopathol. 1987;3(1):8–12.

    Article  CAS  Google Scholar 

  5. Irani DR, Underwood RD, Johnson EH, Greenberg SD. Malignant pleural effusions. A clinical cytopathologic study. Arch Intern Med. 1987;147(6):1133–6.

    Article  CAS  PubMed  Google Scholar 

  6. Motherby H, Nadjari B, Friegel P, Kohaus J, Ramp U, Böcking A. Diagnostic accuracy of effusion cytology. Diagn Cytopathol. 1999;20(6):350–7.

    Article  CAS  PubMed  Google Scholar 

  7. Rossi ED, Bizzarro T, Schmitt F, Longatto-Filho A. The role of liquid-based cytology and ancillary techniques in pleural and pericardic effusions: an institutional experience. Cancer Cytopathol. 2015;123(4):258–66.

    Article  PubMed  Google Scholar 

  8. Mutsaers SE. The mesothelial cell. Int J Biochem Cell Biol. 2004;36(1):9–16.

    Article  CAS  PubMed  Google Scholar 

  9. Hjerpe A, Abd-Own S, Dobra K. Cytopathologic diagnosis of epithelioid and mixed-type malignant mesothelioma: ten years of clinical experience in relation to international guidelines. Arch Pathol Lab Med. 2018;142(8):893–901.

    Article  CAS  PubMed  Google Scholar 

  10. Hjerpe A, Ascoli V, Bedrossian C, et al. Guidelines for cytopathologic diagnosis of epithelioid and mixed type malignant mesothelioma. Complementary statement from the International Mesothelioma Interest Group, also endorsed by the International Academy of Cytology and the Papanicolaou Society of Cytopathology. Cytojournal. 2015;12:26.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Bedrossian CW. Diagnostic problems in serous effusions. Diagn Cytopathol. 1998;19(2):131–7.

    Article  CAS  PubMed  Google Scholar 

  12. Wu JM, Ali SZ. Significance of “signet-ring cells” seen in exfoliative and aspiration cytopathology. Diagn Cytopathol. 2010;38(6):413–8.

    PubMed  Google Scholar 

  13. Alshaikh S, Lapadat R, Atieh MK, et al. The utilization of immunostains in body fluid cytology. Cancer Cytopathol. 2020; https://doi.org/10.1002/cncy.22256.

  14. Bansal C, Tiwari V, Singh U, Srivastava A, Misra J. Cell cannibalism: a cytological study in effusion samples. J Cytol. 2011;28(2):57–60.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Sundling KE, Cibas ES. Ancillary studies in pleural, pericardial, and peritoneal effusion cytology. Cancer Cytopathol. 2018;126(Suppl8):590–8.

    Article  CAS  PubMed  Google Scholar 

  16. Yu GH, Glaser LJ, Gustafson KS. Role of ancillary techniques in fluid cytology. Acta Cytol. 2020;64(1–2):52–62.

    Article  PubMed  Google Scholar 

  17. Spieler P, Kradolfer D, Schmid U. Immunocytochemical characterization of lymphocytes in benign and malignant lymphocyte-rich serous effusions. Virchows Arch A Pathol Anat Histopathol. 1986;409(2):211–21.

    Article  CAS  PubMed  Google Scholar 

  18. Spriggs AI, Boddington MM. Absence of mesothelial cells from tuberculous pleural effusions. Thorax. 1960;15(2):169–71.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Yu GH, Vergara N, Moore EM, King RL. Use of flow cytometry in the diagnosis of lymphoproliferative disorders in fluid specimens. Diagn Cytopathol. 2014;42(8):664–70.

    Article  PubMed  Google Scholar 

  20. Walts AE, Marchevsky AM. Low cost-effectiveness of CD3/CD20 immunostains for initial triage of lymphoid-rich effusions: an evidence-based review of the utility of these stains in selecting cases for full hematopathologic workup. Diagn Cytopathol. 2012;40(7):565–9.

    Article  PubMed  Google Scholar 

  21. Kalomenidis I, Light RW. Pathogenesis of the eosinophilic pleural effusions. Curr Opin Pulm Med. 2004;10(4):289–93.

    Article  CAS  PubMed  Google Scholar 

  22. Oba Y, Abu-Salah T. The prevalence and diagnostic significance of eosinophilic pleural effusions: a meta-analysis and systematic review. Respiration. 2012;83(3):198–208.

    Article  PubMed  Google Scholar 

  23. Davies RJ, Gleeson FV. The diagnosis and management of pleural empyema. Curr Opin Pulm Med. 1998;4(3):185–90.

    CAS  PubMed  Google Scholar 

  24. Avnon LS, Abu-Shakra M, Flusser D, Heimer D, Sion-Vardy N. Pleural effusion associated with rheumatoid arthritis: what cell predominance to anticipate? Rheumatol Int. 2007;27:919–25.

    Article  CAS  PubMed  Google Scholar 

  25. Covell JL, Carry JB, Feldman PS. Peritoneal washings in ovarian tumors. Potential sources of error in cytologic diagnosis. Acta Cytol. 1985;29(3):310–6.

    CAS  PubMed  Google Scholar 

  26. Fanning J, Markuly SN, Hindman TL, et al. False positive malignant peritoneal cytology and psammoma bodies in benign gynecologic disease. J Reprod Med. 1996;41(7):504–8.

    CAS  PubMed  Google Scholar 

  27. Parwani AV, Chan TY, Ali SZ. Significance of psammoma bodies in serous cavity fluid: a cytopathologic analysis. Cancer Cytopathol. 2004;102(2):87–91.

    Article  Google Scholar 

  28. Wojcik EM, Naylor B. “Collagen balls” in peritoneal washings. Prevalence, morphology, origin and significance. Acta Cytol. 1992;36(4):466–70.

    CAS  PubMed  Google Scholar 

  29. Sidawy MK, Chandra P, Oertel YC. Detached ciliary tufts in female peritoneal washings. A common finding. Acta Cytol. 1987;31(6):841–4.

    CAS  PubMed  Google Scholar 

  30. Kuritzkes DR, Rein M, Horowitz S, et al. Detached ciliary tufts mistaken for peritoneal parasites: a warning. Rev Infect Dis. 1988;10(5):1044–7.

    Article  CAS  PubMed  Google Scholar 

  31. Butler EB, Stanbridge CM. Cytology of body cavity fluids. A colour atlas. London: Chapman and Hall; 1986.

    Google Scholar 

  32. Wahl RW. Curschmann's spirals in pleural and peritoneal fluids. Report of 12 cases. Acta Cytol. 1986;30(2):147–51.

    CAS  PubMed  Google Scholar 

  33. Naylor B. Curschmann’s spirals in pleural and peritoneal effusions. Acta Cytol. 1990;34(4):474–8.

    CAS  PubMed  Google Scholar 

  34. Naylor B. Cytological aspects of pleural, peritoneal and pericardial fluids from patients with systemic lupus erythematosus. Cytopathology. 1992;3(1):1–8.

    Article  CAS  PubMed  Google Scholar 

  35. Kaplan AI, Zakher F, Sabin S. Drug-induced lupus erythematosus with in vivo lupus erythematosus cells in pleural fluid. Chest. 1978;73(6):875–6.

    Article  CAS  PubMed  Google Scholar 

  36. Montes S, Guarda LA. Cytology of pleural effusions in rheumatoid arthritis. Diagn Cytopathol. 1988;4(1):71–3.

    Article  CAS  PubMed  Google Scholar 

  37. Boddington MM, Spriggs AI, Morton JA, Mowat AG. Cytodiagnosis of rheumatoid pleural effusions. J Clin Pathol. 1971;24(2):95–106.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Weaver KM, Novak PM, Naylor B. Vegetable cell contaminants in cytologic specimens: their resemblance to cells associated with various normal and pathologic states. Acta Cytol. 1981;25(3):210–4.

    CAS  PubMed  Google Scholar 

  39. Cherveniakov A, Tzekov C, Grigorov GE, Cherveniakov P. Acquired benign esophago-airway fistulas. Eur J Cardiothorac Surg. 1996;10(9):713–6.

    Article  CAS  PubMed  Google Scholar 

  40. Farahani SJ, Baloch Z. Are we ready to develop a tiered scheme for the effusion cytology? A comprehensive review and analysis of the literature. Diag Cytopathol. 2019;47(11):1145–59.

    Article  Google Scholar 

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Correspondence to Eva M. Wojcik .

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Wojcik, E.M., Jing, X.S., Alshaikh, S., Lobo, C. (2020). Negative for Malignancy (NFM). In: Chandra, A., Crothers, B., Kurtycz, D., Schmitt, F. (eds) The International System for Serous Fluid Cytopathology. Springer, Cham. https://doi.org/10.1007/978-3-030-53908-5_3

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  • DOI: https://doi.org/10.1007/978-3-030-53908-5_3

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-53907-8

  • Online ISBN: 978-3-030-53908-5

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