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Cancer of Other Origin

  • Ben Davidson
  • Claire Michael
  • Pınar Fırat
Chapter

Abstract

The peritoneal, pleural, and pericardial cavities may be the site of metastasis from practically any malignant tumor, including carcinomas, sarcomas, melanoma, hematological tumors, and pediatric cancers other than the aforementioned entities. The differential diagnosis is critically dependent on the age and gender of the patient, which are in turn likely to impact the choice of immunohistochemistry panels and molecular analyses performed. In adults, carcinomas predominate, and those not originating from the lung, ovary, or breast (discussed in other chapters) are discussed in this chapter, with the main focus on gastrointestinal primaries. Additionally discussed are carcinomas of other origin, including non-ovarian female genital tract cancers and carcinomas of the urothelial tract and the head and neck region. Non-epithelial cancers, including melanoma, sarcomas, and childhood cancers, are additionally discussed. The combination of morphology, immunohistochemistry, and, when mandated, molecular analysis allows for a conclusive diagnosis in the majority of cases.

Keywords

Gastrointestinal carcinoma Germ cell tumor Sarcoma Childhood cancer Immunohistochemistry 

References

  1. 1.
    Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65:87–108.PubMedPubMedCentralCrossRefGoogle Scholar
  2. 2.
    Ajani JA, Lee J, Sano T, Janjigian YY, Fan D, Song S. Gastric adenocarcinoma. Nat Rev Dis Primers. 2017;3:17036.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Maeda H, Kobayashi M, Sakamoto J. Evaluation and treatment of malignant ascites secondary to gastric cancer. World J Gastroenterol. 2015;21:10936–47.PubMedPubMedCentralCrossRefGoogle Scholar
  4. 4.
    Bozzetti C, Negri FV, Lagrasta CA, Crafa P, Bassano C, Tamagnini I, Gardini G, Nizzoli R, Leonardi F, Gasparro D, Camisa R, Cavalli S, Silini EM, Ardizzoni A. Comparison of HER2 status in primary and paired metastatic sites of gastric carcinoma. Br J Cancer. 2011;104:1372–6.PubMedPubMedCentralCrossRefGoogle Scholar
  5. 5.
    Wong DD, de Boer WB, Platten MA, Jo VY, Cibas ES, Kumarasinghe MP. HER2 testing in malignant effusions of metastatic gastric carcinoma: is it feasible? Diagn Cytopathol. 2015;43:80–5.PubMedPubMedCentralCrossRefGoogle Scholar
  6. 6.
    Spieler P, Gloor F. Identification of types and primary sites of malignant tumors by examination of exfoliated tumor cells in serous fluids. Comparison with the diagnostic accuracy on small histologic biopsies. Acta Cytol. 1985;29:753–67.PubMedPubMedCentralGoogle Scholar
  7. 7.
    Chiaravalli M, Reni M, O’Reilly EM. Pancreatic ductal adenocarcinoma: State-of-the-art 2017 and new therapeutic strategies. Cancer Treat Rev. 2017;60:32–43.PubMedPubMedCentralCrossRefGoogle Scholar
  8. 8.
    Conroy T, Bachet JB, Ayav A, Huguet F, Lambert A, Caramella C, Maréchal R, Van Laethem JL, Ducreux M. Current standards and new innovative approaches for treatment of pancreatic cancer. Eur J Cancer. 2016;57:10–22.PubMedPubMedCentralCrossRefGoogle Scholar
  9. 9.
    Das KK, Early D. Pancreatic cancer screening. Curr Treat Options Gastroenterol. 2017;15:562–75.PubMedCrossRefPubMedCentralGoogle Scholar
  10. 10.
    Kamisawa T, Wood LD, Itoi T, Takaori K. Pancreatic cancer. Lancet. 2016;388:73–85.PubMedPubMedCentralCrossRefGoogle Scholar
  11. 11.
    DeWitt J, Yu M, Al-Haddad MA, Sherman S, McHenry L, Leblanc JK. Survival in patients with pancreatic cancer after the diagnosis of malignant ascites or liver metastases by EUS-FNA. Gastrointest Endosc. 2010;71:260–5.PubMedPubMedCentralCrossRefGoogle Scholar
  12. 12.
    Zervos EE, Osborne D, Boe BA, Luzardo G, Goldin SB, Rosemurgy AS. Prognostic significance of new onset ascites in patients with pancreatic cancer. World J Surg Oncol. 2006;4:16.PubMedPubMedCentralCrossRefGoogle Scholar
  13. 13.
    Nakata B, Nishino H, Ogawa Y, Yokomatsu H, Kawasaki F, Kosaka K, Wada T, Suto R, Montani A, Hirakawa K. Prognostic predictive value of endoscopic ultrasound findings for invasive ductal carcinomas of pancreatic head. Pancreas. 2005;30:200–5.PubMedPubMedCentralCrossRefGoogle Scholar
  14. 14.
    Hicks AM, Chou J, Capanu M, Lowery MA, Yu KH, O’Reilly EM. Pancreas adenocarcinoma: ascites, clinical manifestations, and management implications. Clin Colorectal Cancer. 2016;15(4):360–8.PubMedPubMedCentralCrossRefGoogle Scholar
  15. 15.
    Shukuya T, Yasui H, Boku N, Onozawa Y, Fukutomi A, Yamazaki K, Taku K, Kojima T, Machida N. Weekly Paclitaxel after failure of gemcitabine in pancreatic cancer patients with malignant ascites: a retrospective study. Jpn J Clin Oncol. 2010;40:1135–8.PubMedPubMedCentralCrossRefGoogle Scholar
  16. 16.
    Yonemori K, Okusaka T, Ueno H, Morizane C, Takesako Y, Ikeda M. FP therapy for controlling malignant ascites in advanced pancreatic cancer patients. Hepato-Gastroenterology. 2007;54:2383–6.PubMedPubMedCentralGoogle Scholar
  17. 17.
    Warshaw AL. Implications of peritoneal cytology for staging of early pancreatic cancer. Am J Surg. 1991;161:26–9. Discussion 29–30PubMedPubMedCentralCrossRefGoogle Scholar
  18. 18.
    Lei S, Kini J, Kim K, Howard JM. Pancreatic cancer. Cytologic study of peritoneal washings. Arch Surg. 1994;129:639–42.PubMedCrossRefPubMedCentralGoogle Scholar
  19. 19.
    Di Bonito L, Dudine S, Falconieri G. Cytopathology of exocrine pancreatic carcinoma in effusions. Acta Cytol. 1991;35:311–4.PubMedPubMedCentralGoogle Scholar
  20. 20.
    Dienstmann R, Vermeulen L, Guinney J, Kopetz S, Tejpar S, Tabernero J. Consensus molecular subtypes and the evolution of precision medicine in colorectal cancer. Nat Rev Cancer. 2017;17:79–92.PubMedPubMedCentralCrossRefGoogle Scholar
  21. 21.
    DeMay RM, editor. The art & science of cytopathology. Chicago: ASCP Press; 1996. p. 257–325.Google Scholar
  22. 22.
    Ronnett BM, Zahn CM, Kurman RJ, Kass ME, Sugarbaker PH, Shmookler BM. Disseminated peritoneal adenomucinosis and peritoneal mucinous carcinomatosis. A clinicopathologic analysis of 109 cases with emphasis on distinguishing pathologic features, site of origin, prognosis, and relationship to “pseudomyxoma peritonei”. Am J Surg Pathol. 1995;19:1390–408.PubMedCrossRefPubMedCentralGoogle Scholar
  23. 23.
    Bradley RF, Stewart JH 4th, Russell GB, Levine EA, Geisinger KR. Pseudomyxoma peritonei of appendiceal origin: a clinicopathologic analysis of 101 patients uniformly treated at a single institution, with literature review. Am J Surg Pathol. 2006;30:551–9.PubMedCrossRefPubMedCentralGoogle Scholar
  24. 24.
    Carr NJ, Cecil TD, Mohamed F, Sobin LH, Sugarbaker PH, González-Moreno S, Taflampas P, Chapman S, Moran BJ, Peritoneal Surface Oncology Group International. A consensus for classification and pathologic reporting of pseudomyxoma peritonei and associated appendiceal neoplasia: the results of the Peritoneal Surface Oncology Group International (PSOGI) modified Delphi process. Am J Surg Pathol. 2016;40:14–26.PubMedCrossRefPubMedCentralGoogle Scholar
  25. 25.
    Jackson SL, Fleming RA, Loggie BW, Geisinger KR. Gelatinous ascites: a cytohistologic study of pseudomyxoma peritonei in 67 patients. Mod Pathol. 2001;14:664–71.PubMedCrossRefPubMedCentralGoogle Scholar
  26. 26.
    Badyal RK, Khairwa A, Rajwanshi A, Nijhawan R, Radhika S, Gupta N, Dey P. Significance of epithelial cell clusters in pseudomyxoma peritonei. Cytopathology. 2016;27:418–26.PubMedCrossRefPubMedCentralGoogle Scholar
  27. 27.
    Wojcik EM, Selvaggi SM. Goblet-cell carcinoid tumor in peritoneal fluid: a case report. Diagn Cytopathol. 1991;7:155–7.PubMedCrossRefPubMedCentralGoogle Scholar
  28. 28.
    Kobayashi TK, Ueda M, Nishino T, Tamagaki T, Watanabe S, Kushima R. Malignant pleural effusions due to adeno-endocrine-cell carcinoma of the appendix: a case report. Diagn Cytopathol. 1997;16:522–5.PubMedCrossRefPubMedCentralGoogle Scholar
  29. 29.
    Zafar S, Chen H, Sun W, Das K. Cytology of metastatic appendiceal goblet cell carcinoid in pleural effusion fluid: a case report. Diagn Cytopathol. 2008;36:894–8.PubMedCrossRefPubMedCentralGoogle Scholar
  30. 30.
    Gupta A, Patel T, Dargar P, Shah M. Metastatic appendiceal goblet cell carcinoid masquerading as mucinous adenocarcinoma in effusion cytology: a diagnostic pitfall. J Cytol. 2013;30:136–8.PubMedPubMedCentralCrossRefGoogle Scholar
  31. 31.
    Tonooka A, Oda K, Hayashi M, Sakazume K, Tanaka H, Kaburaki KH, Uekusa T. Cytological findings of appendiceal mixed adenoneuroendocrine carcinoma in pleural effusion: morphological changes evident after metastasis. Diagn Cytopathol. 2015;43:577–80.PubMedCrossRefPubMedCentralGoogle Scholar
  32. 32.
    Cameron SE, Alsharif M, McKeon D, Pambuccian SE. Cytology of metastatic thymic well-differentiated neuroendocrine carcinoma (thymic carcinoid) in pleural fluid: report of a case. Diagn Cytopathol. 2008;36:333–7.PubMedCrossRefPubMedCentralGoogle Scholar
  33. 33.
    Vasseur B, Cadiot G, Zins M, Fléjou JF, Belghiti J, Marmuse JP, Vilgrain V, Bernades P, Mignon M, Ruszniewski P. Peritoneal carcinomatosis in patients with digestive endocrine tumors. Cancer. 1996;78:1686–92.PubMedCrossRefPubMedCentralGoogle Scholar
  34. 34.
    Forner A, Llovet JM, Bruix J. Hepatocellular carcinoma. Lancet. 2012;379:1245–55.PubMedPubMedCentralCrossRefGoogle Scholar
  35. 35.
    Thrall MJ, Giampoli EJ. Routine review of ascites fluid from patients with cirrhosis or hepatocellular carcinoma is a low-yield procedure: an observational study. Cytojournal. 2009;6:16.PubMedPubMedCentralCrossRefGoogle Scholar
  36. 36.
    Falconieri G, Zanconati F, Colautti I, Dudine S, Bonifacio-Gori D, Di Bonito L. Effusion cytology of hepatocellular carcinoma. Acta Cytol. 1995;39:893–7.PubMedPubMedCentralGoogle Scholar
  37. 37.
    Colli A, Cocciolo M, Riva C, Marcassoli L, Pirola M, Di Gregorio P, Buccino G. Ascitic fluid analysis in hepatocellular carcinoma. Cancer. 1993;72:677–82.PubMedPubMedCentralCrossRefGoogle Scholar
  38. 38.
    Morishita Y, Etori F, Sawada K, Kachi H, Yamada T, Kawamori T, Tanaka T. Sarcomatous hepatocellular carcinoma with malignant ascites. A report of two cases. Acta Cytol. 1998;42:759–64.PubMedCrossRefPubMedCentralGoogle Scholar
  39. 39.
    Lagergren J, Smyth E, Cunningham D, Lagergren P. Oesophageal cancer. Lancet. 2017;390:2383–96.CrossRefGoogle Scholar
  40. 40.
    Ozyurtkan MO, Balci AE, Cakmak M. Predictors of mortality within three months in the patients with malignant pleural effusion. Eur J Intern Med. 2010;21:30–4.PubMedPubMedCentralCrossRefGoogle Scholar
  41. 41.
    Renshaw AA, Nappi D, Sugarbaker DJ, Swanson S. Effusion cytology of esophageal carcinoma. Cancer. 1997;81:365–72.PubMedCrossRefPubMedCentralGoogle Scholar
  42. 42.
    Gamez RG, Jessurun J, Berger MJ, Pambuccian SE. Cytology of metastatic cervical squamous cell carcinoma in pleural fluid: report of a case confirmed by human papillomavirus typing. Diagn Cytopathol. 2009;37:381–7.PubMedPubMedCentralCrossRefGoogle Scholar
  43. 43.
    Semczuk A, Skomra D, Rybojad P, Jeczeń R, Rechberger T. Endometrial carcinoma with pleural metastasis: a case report. Acta Cytol. 2006;50:697–700.PubMedCrossRefPubMedCentralGoogle Scholar
  44. 44.
    Kogan J, Golzman B, Turkot S, Ben-Dor D, Charkowsky T, Oren S. Malignant pericardial effusion and cardiac tamponade as a late complication of endometrial carcinoma. Eur J Intern Med. 2004;15:318–20.PubMedCrossRefPubMedCentralGoogle Scholar
  45. 45.
    Jamshed A, Khafaga Y, El-Husseiny G, Gray AJ, Manji M. Pericardial metastasis in carcinoma of the uterine cervix. Gynecol Oncol. 1996;61:451–3.PubMedCrossRefPubMedCentralGoogle Scholar
  46. 46.
    Santala M, Puistola U, Kauppila A. Endometrial adenocarcinoma complicated by malignant pericardial effusion. Gynecol Oncol. 1995;56:444–5.PubMedCrossRefPubMedCentralGoogle Scholar
  47. 47.
    Rieke JW, Kapp DS. Successful management of malignant pericardial effusion in metastatic squamous cell carcinoma of the uterine cervix. Gynecol Oncol. 1988;31:338–51.PubMedCrossRefPubMedCentralGoogle Scholar
  48. 48.
    Hayashi Y, Iwasaka T, Hachisuga T, Kishikawa T, Ikeda N, Sugimori H. Malignant pericardial effusion in endometrial adenocarcinoma. Gynecol Oncol. 1988;29:234–9.PubMedCrossRefPubMedCentralGoogle Scholar
  49. 49.
    Arville B, Al Diffalha S, Mehrotra S. Cervical squamous cell carcinoma metastatic to pericardial fluid--large cell balls masquerade as adenocarcinoma. Diagn Cytopathol. 2015;43:912–5.PubMedCrossRefPubMedCentralGoogle Scholar
  50. 50.
    Ikoma S, Nicolas M, Jagirdar J, Policarpio-Nicolas ML. Chondrosarcoma-like metastasis from a poorly differentiated uterine cervical squamous cellcarcinoma. A unique morphology and diagnostic pitfall in cytology. Diagn Cytopathol. 2017;45:750–3.PubMedCrossRefPubMedCentralGoogle Scholar
  51. 51.
    Huang CC, Michael CW. Cytomorphological features of metastatic squamous cell carcinoma in serous effusions. Cytopathology. 2014;25:112–9.PubMedPubMedCentralCrossRefGoogle Scholar
  52. 52.
    Silver SA, Devouassoux-Shisheboran M, Mezzetti TP, Tavassoli FA. Mesonephric adenocarcinomas of the uterine cervix: a study of 11 cases with immunohistochemical findings. Am J Surg Pathol. 2001;25:379–87.PubMedCrossRefPubMedCentralGoogle Scholar
  53. 53.
    Khunamornpong S, Siriaunkgul S, Suprasert P. Cytology of small-cell carcinoma of the uterine cervix in serous effusion: a report on two cases. Diagn Cytopathol. 2001;24:253–5.PubMedPubMedCentralCrossRefGoogle Scholar
  54. 54.
    Atahan S, Ekinci C, Içli F, Erdoğan N. Cytology of clear cell carcinoma of the female genital tract in fine needle aspirates and ascites. Acta Cytol. 2000;44:1005–9.PubMedCrossRefPubMedCentralGoogle Scholar
  55. 55.
    Zhou C, Gilks CB, Hayes M, Clement PB. Papillary serous carcinoma of the uterine cervix: a clinicopathologic study of 17 cases. Am J Surg Pathol. 1998;22:113–20.PubMedCrossRefPubMedCentralGoogle Scholar
  56. 56.
    Johnston WW. The malignant pleural effusion. A review of cytopathologic diagnoses of 584 specimens from 472 consecutive patients. Cancer. 1985;56:905–9.PubMedPubMedCentralCrossRefGoogle Scholar
  57. 57.
    McGrath SM, Rana DN, Lynch M, Desai M. Metastatic transitional cell carcinoma causing a unilateral pleural effusion: a case report. Acta Cytol. 2008;52:351–3.PubMedCrossRefPubMedCentralGoogle Scholar
  58. 58.
    Renshaw AA, Madge R, Granter SR. Intracytoplasmic eosinophilic inclusions (Melamed-Wolinska bodies). Association with metastatic transitional cell carcinoma in pleural fluid. Acta Cytol. 1997;41:995–8.PubMedCrossRefPubMedCentralGoogle Scholar
  59. 59.
    Fabozzi SJ, Newton JR Jr, Moriarty RP, Schellhammer PF. Malignant pericardial effusion as initial solitary site of metastasis from transitional cell carcinoma of the bladder. Urology. 1995;45:320–2.PubMedCrossRefPubMedCentralGoogle Scholar
  60. 60.
    Xiao GQ. Cytomorphology of urothelial carcinomatous peritoneal effusion. Cytopathology. 2008;19:131–3.PubMedCrossRefPubMedCentralGoogle Scholar
  61. 61.
    Kim SS, Choi YD, Nam JH, Kwon DD, Juhng SW, Choi C. Cytologic features of primary signet ring cell carcinoma of the bladder: a case report. Acta Cytol. 2009;53:309–12.PubMedCrossRefPubMedCentralGoogle Scholar
  62. 62.
    Cimino-Mathews A, Ali SZ. Metastatic urothelial carcinoma with signet ring features: Cytomorphologic findings in abdominal paracentesis. Diagn Cytopathol. 2011;39:132–4.PubMedCrossRefPubMedCentralGoogle Scholar
  63. 63.
    Islam N, Ahmedani MY. Renal carcinoma presenting as cardiac tamponade: a case report and review of literature. Int J Cardiol. 1998;64:207–11.PubMedCrossRefPubMedCentralGoogle Scholar
  64. 64.
    Peck JR, Hitchcock CL, Maguire S, Dickerson J, Bush C. Isolated cardiac metastasis from plasmacytoid urothelial carcinoma of the bladder. Exp Hematol Oncol. 2012;1:16.PubMedPubMedCentralCrossRefGoogle Scholar
  65. 65.
    Katsuya Y, Fukusumi M, Morita S, Ibe T, Wakuda K, Mouri A, Hamamoto Y, Yamada K, Kamimura M. Pseudomesotheliomatous carcinoma due to pleural metastasis from renal pelvic cancer. Intern Med. 2014;53:871–4.PubMedCrossRefPubMedCentralGoogle Scholar
  66. 66.
    Huang CC, Attele A, Michael CW. Cytomorphologic features of metastatic urothelial carcinoma in serous effusions. Diagn Cytopathol. 2013;41:569–74.PubMedCrossRefPubMedCentralGoogle Scholar
  67. 67.
    Mai KT, Roustan Delatour NL, Assiri A, Al-Maghrabi H. Secondary prostatic adenocarcinoma: a cytopathological study of 50 cases. Diagn Cytopathol. 2007;35:91–5.PubMedCrossRefPubMedCentralGoogle Scholar
  68. 68.
    Renshaw AA, Nappi D, Cibas ES. Cytology of metastatic adenocarcinoma of the prostate in pleural effusions. Diagn Cytopathol. 1996;15:103–7.PubMedCrossRefPubMedCentralGoogle Scholar
  69. 69.
    Saif MW, Figg WD, Hewitt S, Brosky K, Reed E, Dahut W. Malignant ascites as only manifestation of metastatic prostate cancer. Prostate Cancer Prostatic Dis. 1999;2:290–3.PubMedCrossRefPubMedCentralGoogle Scholar
  70. 70.
    Saif MW. Malignant ascites associated with carcinoma of the prostate. J Appl Res. 2005;5:305–11.PubMedPubMedCentralGoogle Scholar
  71. 71.
    Catton PA, Hartwick RW, Srigley JR. Prostate cancer presenting with malignant ascites: signet-ring cell variant of prostatic adenocarcinoma. Urology. 1992;39:495–7.PubMedCrossRefPubMedCentralGoogle Scholar
  72. 72.
    Brimo F, Epstein JI. Immunohistochemical pitfalls in prostate pathology. Hum Pathol. 2012;43:313–24.PubMedCrossRefPubMedCentralGoogle Scholar
  73. 73.
    Sears D, Hajdu SI. The cytologic diagnosis of malignant neoplasms in pleural and peritoneal effusions. Acta Cytol. 1987;31:85–97.PubMedPubMedCentralGoogle Scholar
  74. 74.
    Renshaw AA, Comiter CV, Nappi D, Granter SR. Effusion cytology of renal cell carcinoma. Cancer. 1998;84:148–52.PubMedCrossRefPubMedCentralGoogle Scholar
  75. 75.
    Gupta R, Mathur SR, Iyer VK, Kumar AS, Seth A. Cytomorphologic consideration in malignant ascites with renal cell carcinoma: a report of two cases. Cytojournal. 2010;7:4.PubMedPubMedCentralCrossRefGoogle Scholar
  76. 76.
    Teresa P, Maria Grazia Z, Doriana M, Irene P, Michele S. Malignant effusion of chromophobe renal-cell carcinoma: cytological and immunohistochemical findings. Diagn Cytopathol. 2012;40:56–61.PubMedCrossRefPubMedCentralGoogle Scholar
  77. 77.
    Davion S, Rohan S, Nayar R, Kulesza P. Metastatic chromophobe renal cell carcinoma in pleural fluid cytology: review of literature and report of a case. Diagn Cytopathol. 2012 Sep;40(9):826–9.PubMedCrossRefPubMedCentralGoogle Scholar
  78. 78.
    Ellis CL, Burroughs F, Michael CW, Li QK. Cytology of metastatic renal medullary carcinoma in pleural effusion: a study of two cases. Diagn Cytopathol. 2009;37:843–8.PubMedCrossRefPubMedCentralGoogle Scholar
  79. 79.
    Caraway NP, Wojcik EM, Katz RL, Ro JY, Ordóñez NG. Cytologic findings of collecting duct carcinoma of the kidney. Diagn Cytopathol. 1995;13:304–9.PubMedCrossRefPubMedCentralGoogle Scholar
  80. 80.
    Drut R. Malignant rhabdoid tumor of the kidney diagnosed by fine-needle aspiration cytology. Diagn Cytopathol. 1990;6:124–6.PubMedCrossRefPubMedCentralGoogle Scholar
  81. 81.
    Chute DJ, Kong CS, Stelow EB. Immunohistochemistry for the detection of renal cell carcinoma in effusion cytology. Diagn Cytopathol. 2011;39:118–23.PubMedCrossRefPubMedCentralGoogle Scholar
  82. 82.
    Knoepp SM, Kunju LP, Roh MH. Utility of PAX8 and PAX2 immunohistochemistry in the identification of renal cell carcinoma in diagnostic cytology. Diagn Cytopathol. 2012;40:667–72.PubMedCrossRefPubMedCentralGoogle Scholar
  83. 83.
    Waters L, Crumley S, Truong L, Mody D, Coffey D. PAX2 and PAX8: useful markers for metastatic effusions. Acta Cytol. 2014;58:60–6.PubMedCrossRefPubMedCentralGoogle Scholar
  84. 84.
    Wiseman W, Michael CW, Roh MH. Diagnostic utility of PAX8 and PAX2 immunohistochemistry in the identification of metastatic Müllerian carcinoma in effusions. Diagn Cytopathol. 2011;39:651–6.PubMedPubMedCentralCrossRefGoogle Scholar
  85. 85.
    Tong GX, Devaraj K, Hamele-Bena D, Yu WM, Turk A, Chen X, Wright JD, Greenebaum E. Pax8: a marker for carcinoma of Müllerian origin in serous effusions. Diagn Cytopathol. 2011;39:567–74.PubMedPubMedCentralCrossRefGoogle Scholar
  86. 86.
    Hajdu SI, Nolan MA. Exfoliative cytology of malignant germ cell tumors. Acta Cytol. 1975;19:255–60.PubMedPubMedCentralGoogle Scholar
  87. 87.
    Geisinger KR, Hajdu SI, Helson L. Exfoliative cytology of nonlymphoreticular neoplasms in children. Acta Cytol. 1984;28:16–28.PubMedPubMedCentralGoogle Scholar
  88. 88.
    Wong JW, Pitlik D, Abdul-Karim FW. Cytology of pleural, peritoneal and pericardial fluids in children. A 40-year summary. Acta Cytol. 1997;41:467–73.PubMedPubMedCentralCrossRefGoogle Scholar
  89. 89.
    Kashimura M, Tsukamoto N, Matsuyama T, Kashimura Y, Sugimori H, Taki I. Cytologic findings of ascites from patients with ovarian dysgerminoma. Acta Cytol. 1983;27:59–62.PubMedPubMedCentralGoogle Scholar
  90. 90.
    Roncalli M, Gribaudi G, Simoncelli D, Servida E. Cytology of yolk-sac tumor of the ovary in ascitic fluid. Report of a case. Acta Cytol. 1988;32:113–6.PubMedPubMedCentralGoogle Scholar
  91. 91.
    Selvaggi SM. Cytologic features of malignant ovarian monodermal teratoma with an ependymal component in peritoneal washings. Int J Gynecol Pathol. 1992;11:299–303.PubMedPubMedCentralCrossRefGoogle Scholar
  92. 92.
    Valente PT, Schantz HD, Edmonds PR, Hanjani P. Peritoneal cytology of uncommon ovarian tumors. Diagn Cytopathol. 1992;8:98–106.PubMedPubMedCentralCrossRefGoogle Scholar
  93. 93.
    Selvaggi SM, Guidos BJ. Immature teratoma of the ovary on fluid cytology. Diagn Cytopathol. 2001;25:411–4.PubMedPubMedCentralCrossRefGoogle Scholar
  94. 94.
    Abe T, Shinohara N, Harabayashi T, Tsuchiya K, Suzuki S, Itoh T, Seki T, Togashi M, Nonomura K, Koyanagi T. Peritoneal carcinomatosis in refractory seminoma. Int J Urol. 2004;11:184–6.PubMedCrossRefPubMedCentralGoogle Scholar
  95. 95.
    Ikeda K, Tate G, Suzuki T, Mitsuya T. Cytomorphologic features of immature ovarian teratoma in peritoneal effusion: a case report. Diagn Cytopathol. 2005;33:39–42.PubMedPubMedCentralCrossRefGoogle Scholar
  96. 96.
    Murugan P, Siddaraju N, Sridhar E, Soundararaghavan J, Habeebullah S. Unusual ovarian malignancies in ascitic fluid: a report of 2 cases. Acta Cytol. 2010;54:611–7.PubMedPubMedCentralCrossRefGoogle Scholar
  97. 97.
    Izban KF, Candel AG, Hsi ED, Selvaggi SM. Metastatic melanoma of the vulva identified by peritoneal fluid cytology. Diagn Cytopathol. 1999;20:152–5.PubMedCrossRefPubMedCentralGoogle Scholar
  98. 98.
    Baniak N, Podberezin M, Kanthan SC, Kanthan R. Primary pulmonary/pleural melanoma in a 13 year-old presenting as pleural effusion. Pathol Res Pract. 2017;213:161–4.PubMedCrossRefPubMedCentralGoogle Scholar
  99. 99.
    Longatto Filho A, de Carvalho LV, Santos Gda C, Oyafuso MS, Lombardo V, Bortolan J, Neves JI. Cytologic diagnosis of melanoma in serous effusions. A morphologic and immunocytochemical study. Acta Cytol. 1995;39:481–4.PubMedPubMedCentralGoogle Scholar
  100. 100.
    Beaty MW, Fetsch P, Wilder AM, Marincola F, Abati A. Effusion cytology of malignant melanoma. A morphologic and immunocytochemical analysis including application of the MART-1 antibody. Cancer. 1997;81:57–63.PubMedCrossRefPubMedCentralGoogle Scholar
  101. 101.
    Ikeda K, Tate G, Iezumi K, Suzuki T, Kitamura T, Mitsuya T. Effusion cytomorphology and immunocytochemistry of malignant melanoma: five cases of melanotic melanoma and one case of amelanotic melanoma. Diagn Cytopathol. 2009;37:516–21.PubMedCrossRefPubMedCentralGoogle Scholar
  102. 102.
    Niemann TH, Thomas PA. Melanoma with signet-ring cells in a peritoneal effusion. Diagn Cytopathol. 1995;12:241–4.PubMedCrossRefPubMedCentralGoogle Scholar
  103. 103.
    Pinto MM. An immunoperoxidase study of S-100 protein in neoplastic cells in serous effusions. Use as a marker for melanoma. Acta Cytol. 1986;30:240–4.PubMedPubMedCentralGoogle Scholar
  104. 104.
    Conner JR, Cibas ES, Hornick JL, Qian X. Wilms tumor 1/cytokeratin dual-color immunostaining reveals distinctive staining patterns in metastatic melanoma, metastatic carcinoma, and mesothelial cells in pleural fluids: an effective first-line test for the workup of malignant effusions. Cancer Cytopathol. 2014;122:586–95.PubMedCrossRefPubMedCentralGoogle Scholar
  105. 105.
    Watson CW, Friedman KJ. Cytology of metastatic neuroendocrine (Merkel-cell) carcinoma in pleural fluid. A case report. Acta Cytol. 1985;29:397–402.PubMedPubMedCentralGoogle Scholar
  106. 106.
    Payne MM, Rader AE, McCarthy DM, Rodgers WH. Merkel cell carcinoma in a malignant pleural effusion: case report. Cytojournal. 2004;1:5.PubMedPubMedCentralCrossRefGoogle Scholar
  107. 107.
    Policarpio-Nicolas ML, Avery DL, Hartley T. Merkel cell carcinoma presenting as malignant ascites: A case report and review of literature. Cytojournal. 2015;12:19.PubMedPubMedCentralCrossRefGoogle Scholar
  108. 108.
    Cohen I, Loberant N, King E, Herskovits M, Sweed Y, Jerushalmi J. Rhabdomyosarcoma in a child with massive pleural effusion: cytological diagnosis from pleural fluid. Diagn Cytopathol. 1999;21:125–8.PubMedCrossRefPubMedCentralGoogle Scholar
  109. 109.
    Abadi MA, Zakowski MF. Cytologic features of sarcomas in fluids. Cancer. 1998;84:71–6.PubMedCrossRefPubMedCentralGoogle Scholar
  110. 110.
    Longatto-Filho A, Bisi H, Bortolan J, Granja NV, Lombardo V. Cytologic diagnosis of metastatic sarcoma in effusions. Acta Cytol. 2003;47:317–8.PubMedPubMedCentralGoogle Scholar
  111. 111.
    Ikeda K, Tsuta K. Effusion cytomorphology of small round cell tumors. J Cytol. 2016;33:85–92.PubMedPubMedCentralCrossRefGoogle Scholar
  112. 112.
    Ahmed AA, Andraws N, Almutairi AM, Saied HM, Elbagir-Mohamed AM. Cytologic and immunophenotypic features of malignant cells in pediatric body fluids. Acta Cytol. 2015;59:332–8.PubMedCrossRefPubMedCentralGoogle Scholar
  113. 113.
    Allsbrook WC Jr, Stead NW, Pantazis CG, Houston JH, Crosby JH. Embryonal rhabdomyosarcoma in ascitic fluid. Immunocytochemical and DNA flow cytometric study. Arch Pathol Lab Med. 1986;110:847–9.PubMedPubMedCentralGoogle Scholar
  114. 114.
    Thompson KS, Jensen JD, Bhoopalam N, Reyes CV. Pleural effusion cytology of embryonal rhabdomyosarcoma. Diagn Cytopathol. 1997;16:270–3.PubMedCrossRefPubMedCentralGoogle Scholar
  115. 115.
    Cribbs RK, Shehata BM, Ricketts RR. Primary ovarian rhabdomyosarcoma in children. Pediatr Surg Int. 2008;24:593–5.PubMedCrossRefPubMedCentralGoogle Scholar
  116. 116.
    Yao JC, Wang WC, Tseng HH, Hwang WS. Primary rhabdomyosarcoma of the prostate. Diagnosis by needle biopsy and immunocytochemistry. Acta Cytol. 1988;32:509–12.PubMedPubMedCentralGoogle Scholar
  117. 117.
    Ohi S. Characterization, anticancer drug susceptibility and atRA-induced growth inhibition of a novel cell line (HUMEMS) established from pleural effusion of alveolar rhabdomyosarcoma of breast tissue. Hum Cell. 2007;20:39–51.PubMedCrossRefPubMedCentralGoogle Scholar
  118. 118.
    Kaw YT, Cramer HM. Cytologic diagnosis of rhabdomyosarcoma in a patient with germ cell tumor. A case report. Acta Cytol. 1995;39:249–51.PubMedPubMedCentralGoogle Scholar
  119. 119.
    Alderman MA, Thomas DG, Roh MH. Diagnostic evaluation of metastatic rhabdomyosarcoma in effusion specimens. Diagn Cytopathol. 2013;41:955–9.PubMedCrossRefPubMedCentralGoogle Scholar
  120. 120.
    Bhattacharya B, Sariya D, Reddy VB, Kluskens L, Gould VE, Gattuso P. Application of adjunct techniques in cytologic material in the diagnosis of rhabdomyosarcoma: case report and review of the literature. Diagn Cytopathol. 2002;26:384–6.PubMedCrossRefPubMedCentralGoogle Scholar
  121. 121.
    Thiryayi SA, Rana DN, Roulson J, Crosbie P, Woodhead M, Eyden BP, Hasleton PS. Diagnosis of alveolar rhabdomyosarcoma in effusion cytology: a diagnostic pitfall. Cytopathology. 2010;21:273–5.PubMedCrossRefPubMedCentralGoogle Scholar
  122. 122.
    Theunissen P, Cremers M, van der Meer S, Bot F, Bras J. Cytologic diagnosis of rhabdomyosarcoma in a child with a pleural effusion. A case report. Acta Cytol. 2004;48:249–53.PubMedCrossRefPubMedCentralGoogle Scholar
  123. 123.
    Yuregir OO, Sahin FI, Avci Z, Yilmaz Z, Celasun B, Sarialioglu F. Multiple chromosome abnormalities in the pleural fluid of a patient with recurrent Ewing sarcoma. Pediatr Hematol Oncol. 2009;26:267–72.PubMedCrossRefPubMedCentralGoogle Scholar
  124. 124.
    Schiavo R, Tullio C, La Grotteria M, Andreotti IC, Scarpati B, Romiti L, Bozzi F, Pedrazzoli P, Establishment SS. characterization of a new Ewing’s sarcoma cell line from a malignant pleural effusion. Anticancer Res. 2007;27:3273–8.PubMedPubMedCentralGoogle Scholar
  125. 125.
    Nishio J, Iwasaki H, Ishiguro M, Ohjimi Y, Fujita C, Yanai F, Nibu K, Mitsudome A, Kaneko Y, Kikuchi M. Establishment and characterization of a novel human desmoplastic small round cell tumor cell line, JN-DSRCT-1. Lab Investig. 2002;82:1175–82.PubMedPubMedCentralCrossRefGoogle Scholar
  126. 126.
    Hallman JR, Geisinger KR. Cytology of fluids from pleural, peritoneal and pericardial cavities in children. A comprehensive survey. Acta Cytol. 1994;38:209–17.PubMedPubMedCentralGoogle Scholar
  127. 127.
    Hattori Y, Yoshida A, Sasaki N, Shibuki Y, Tamura K, Tsuta K. Desmoplastic small round cell tumor with sphere-like clusters mimicking adenocarcinoma. Diagn Cytopathol. 2015;43:214–7.PubMedCrossRefPubMedCentralGoogle Scholar
  128. 128.
    Zhu H, McMeekin EM, Sturgis CD. Desmoplastic small round cell tumor, a “Floating Island” pattern in pleural fluid cytology: a case report and review of the literature. Case Rep Pathol. 2015;2015:676894.PubMedPubMedCentralGoogle Scholar
  129. 129.
    Berry GJ, Anderson CJ, Pitts WC, Neitzel GF, Weiss LM. Cytology of angiosarcoma in effusions. Acta Cytol. 1991;35:538–42.PubMedPubMedCentralGoogle Scholar
  130. 130.
    Boucher LD, Swanson PE, Stanley MW, Silverman JF, Raab SS, Geisinger KR. Cytology of angiosarcoma. Findings in fourteen fine-needle aspiration biopsy specimens and one pleural fluid specimen. Am J Clin Pathol. 2000;114:210–9.PubMedCrossRefPubMedCentralGoogle Scholar
  131. 131.
    Davidson B, Abeler VM. Primary ovarian angiosarcoma presenting as malignant cells in ascites: case report and review of the literature. Diagn Cytopathol. 2005;32:307–9.PubMedPubMedCentralCrossRefGoogle Scholar
  132. 132.
    Shin OR, Cho U, Chang E, Seo KJ. Metastatic pleural angiosarcoma: a diagnostic pitfall might be overcome by morphologic clues and clinical correlation. Diagn Cytopathol. 2015;43:669–72.PubMedCrossRefPubMedCentralGoogle Scholar
  133. 133.
    Antic T, Staerkel G. Mediastinal epithelioid hemangioendothelioma metastatic to lymph nodes and pleural fluid: report of a case. Diagn Cytopathol. 2010;38:113–6.PubMedPubMedCentralGoogle Scholar
  134. 134.
    Buggage RR, Soudi N, Olson JL, Busseniers AE. Epithelioid hemangioendothelioma of the lung: pleural effusion cytology, ultrastructure, and brief literature review. Diagn Cytopathol. 1995;13:54–60.PubMedCrossRefPubMedCentralGoogle Scholar
  135. 135.
    Enbom ET, Abasolo PA, Dixon JR, Nikolaenko LM, French SW, Duane GB. Cytomorphological features of epithelioid hemangioendothelioma in ascitic fluid with radiological, clinical and histopathological correlations. Acta Cytol. 2014;58:211–6.PubMedCrossRefPubMedCentralGoogle Scholar
  136. 136.
    Sayah M, VandenBussche C, Maleki Z. Epithelioid hemangioendothelioma in pleural effusion. Diagn Cytopathol. 2015;43:751–5.PubMedCrossRefPubMedCentralGoogle Scholar
  137. 137.
    Wengerkievicz AC, Corá AP, de Almeida LP, Duarte NJ, Siqueira SA, Antonangelo L. Neoplastic ascites in osteosarcoma: a case report. Acta Cytol. 2010;54:845–8.PubMedPubMedCentralGoogle Scholar
  138. 138.
    Geisinger KR, Naylor B, Beals TF, Cytopathology NPM. including transmission and scanning electron microscopy, of pleomorphic liposarcomas in pleural fluids. Acta Cytol. 1980;24:435–41.PubMedPubMedCentralGoogle Scholar
  139. 139.
    Dagli AF, Pehlivan S, Ozercan MR. Pleural liposarcoma mimicking carcinoma in pleural effusion cytology: a case report. Acta Cytol. 2010;54:601–4.PubMedCrossRefPubMedCentralGoogle Scholar
  140. 140.
    Kudo N, Ogose A, Hotta T, Kawashima H, Gu W, Umezu H, Toyama T, Endo N. Establishment of novel human dedifferentiated chondrosarcoma cell line with osteoblastic differentiation. Virchows Arch. 2007;451:691–9.PubMedPubMedCentralCrossRefGoogle Scholar
  141. 141.
    Ikemoto S, Sugimura K, Yoshida N, Nakatani T. Chondrosarcoma of the urinary bladder and establishment of a human chondrosarcoma cell line (OCUU-6). Hum Cell. 2004;17:93–6.PubMedPubMedCentralCrossRefGoogle Scholar
  142. 142.
    Chen KT. Effusion cytology of metastatic extraskeletal myxoid chondrosarcoma. Diagn Cytopathol. 2003;28:222–3.PubMedCrossRefPubMedCentralGoogle Scholar
  143. 143.
    Tsuchido K, Yamada M, Satou T, Otsuki Y, Shimizu S, Kobayashi H. Cytology of sclerosing epithelioid fibrosarcoma in pleural effusion. Diagn Cytopathol. 2010;38:748–53.PubMedPubMedCentralGoogle Scholar
  144. 144.
    Hagiwara Y, Nakamura K, Taguchi M, Ashiwa A, Nishioka C, Kono T, Matsuzaki N, Yuba Y. Myxofibrosarcoma of the heart: a case report with positive pleural effusion cytology. Diagn Cytopathol. 2016;44:1112–6.PubMedCrossRefPubMedCentralGoogle Scholar
  145. 145.
    Nguyen GK, Jeannot A. Cytology of synovial sarcoma metastases in pleural fluid. Acta Cytol. 1982;26:517–20.PubMedPubMedCentralGoogle Scholar
  146. 146.
    Sonobe H, Manabe Y, Furihata M, Iwata J, Oka T, Ohtsuki Y, Mizobuchi H, Yamamoto H, Kumano O, Abe S. Establishment and characterization of a new human synovial sarcoma cell line, HS-SY-II. Lab Investig. 1992;67:498–505.PubMedPubMedCentralGoogle Scholar
  147. 147.
    Ng WK, Lui PC, Ma L. Peritoneal washing cytology findings of disseminated myxoid leiomyosarcoma of uterus: report of a case with emphasis on possible differential diagnosis. Diagn Cytopathol. 2002;27:47–52.PubMedCrossRefPubMedCentralGoogle Scholar
  148. 148.
    Awasthi A, Gupta N, Srinivasan R, Nijhawan R, Rajwanshi A. Cytopathological spectrum of unusual malignant pleural effusions at a tertiary care centre in north India. Cytopathology. 2007;18:28–32.PubMedCrossRefPubMedCentralGoogle Scholar
  149. 149.
    Knapik J, Yachnis AT, Ripley D, Biegel JA, Rathor S, Hardt NS, Talerman A, Wilkinson EJ. Aggressive uterine sarcoma with rhabdoid features: diagnosis by peritoneal fluid cytology and absence of INI1 gene mutation. Hum Pathol. 2001;32:884–6.PubMedCrossRefPubMedCentralGoogle Scholar
  150. 150.
    Hirakawa E, Kobayashi S, Miki H, Haba R, Saoo K, Yamakawa K, Ohkura I, Kira Y. Ascitic fluid cytology of adenosarcoma of the ovary: a case report. Diagn Cytopathol. 2001;24:343–6.PubMedPubMedCentralCrossRefGoogle Scholar
  151. 151.
    Keller JM, Listrom MB, Hart JB, Olson NJ, Jordan SW. Cytologic detection of penile malignant melanoma of soft parts in pleural effusion using monoclonal antibody HMB-45. Acta Cytol. 1990;34:393–6.PubMedPubMedCentralGoogle Scholar
  152. 152.
    Jaffer S, Woodruff JM. Cytology of melanotic schwannoma in a fine needle aspirate and pleural fluid. A case report. Acta Cytol. 2000;44:1095–100.PubMedCrossRefPubMedCentralGoogle Scholar
  153. 153.
    Lee JC, Wu JM, Liau JY, Huang HY, Lo CY, Jan IS, Hornick JL, Qian X. Cytopathologic features of epithelioid inflammatory myofibroblastic sarcoma with correlation of histopathology, immunohistochemistry, and molecular cytogenetic analysis. Cancer Cytopathol. 2015;123:495–504.PubMedCrossRefPubMedCentralGoogle Scholar
  154. 154.
    Motoyama T, Watanabe H. Ascitic fluid cytologic features of a malignant mixed mesodermal tumor of the ovary. Acta Cytol. 1987;31:63–7.PubMedPubMedCentralGoogle Scholar
  155. 155.
    Farr GH, Hajdu SI. Exfoliative cytology of metastatic neuroblastoma. Acta Cytol. 1972;16:203–6.PubMedPubMedCentralGoogle Scholar
  156. 156.
    Baliga M, Holmquist N, Warrier RP. Alteration of Wilms’ tumor staging by cytologic detection of malignant cells in chylous ascites. Diagn Cytopathol. 1995;12:357–9.PubMedCrossRefPubMedCentralGoogle Scholar
  157. 157.
    Vernon AN, Sheeler LR, Biscotti CV, Stoller JK. Pleural effusion resulting from metastatic papillary carcinoma of the thyroid. Chest. 1992;101:1448–50.PubMedCrossRefPubMedCentralGoogle Scholar
  158. 158.
    Vassilopoulou-Sellin R, Sneige N. Pleural effusion in patients with differentiated papillary thyroid cancer. South Med J. 1994;87:1111–6.PubMedCrossRefPubMedCentralGoogle Scholar
  159. 159.
    Hyman MP. Papillary and undifferentiated thyroid carcinoma presenting as a metastatic papillary serous effusion. A case report. Acta Cytol. 1979;23:483–6.PubMedPubMedCentralGoogle Scholar
  160. 160.
    Siddaraju N, Viswanathan VK, Saka VK, Basu D, Shanmugham C. Fine needle aspiration of follicular variant of papillary thyroid carcinoma presenting with pleural effusion: a case report. Acta Cytol. 2007;51:911–5.PubMedCrossRefPubMedCentralGoogle Scholar
  161. 161.
    Hsu KF, Hsieh CB, Duh QY, Chien CF, Li HS, Shih ML. Hürthle cell carcinoma of the thyroid with contralateral malignant pleural effusion. Onkologie. 2009;32:47–9.PubMedPubMedCentralGoogle Scholar
  162. 162.
    Rosa M. Cytological features of medullary thyroid carcinoma in ascitic effusion. Diagn Cytopathol. 2017;45:1030–2.PubMedCrossRefGoogle Scholar
  163. 163.
    Geisinger KR, Steffee CH, McGee RS, Woodruff RD, Buss DH. The cytomorphologic features of sclerosing mucoepidermoid carcinoma of the thyroid gland with eosinophilia. Am J Clin Pathol. 1998;109:294–301.PubMedCrossRefGoogle Scholar
  164. 164.
    Olson MT, Nuransoy A, Ali SZ. Malignant pleural effusion resulting from metastasis of thyroid primaries: a cytomorphological analysis. Acta Cytol. 2013;57:177–83.PubMedCrossRefPubMedCentralGoogle Scholar
  165. 165.
    Lew M, Pang JC, Roh MH, Jing X. Cytologic Features and Immunocytochemical Profiles of Malignant Effusions with Metastatic Papillary Thyroid Carcinoma: A Case Series from a Single Institution. Acta Cytol. 2015;59:412–7.PubMedCrossRefPubMedCentralGoogle Scholar
  166. 166.
    Vyas M, Harigopal M. Metastatic thyroid carcinoma presenting as malignant pleural effusion: a cytologic review of 5 cases. Diagn Cytopathol. 2016;44:1085–9.PubMedCrossRefPubMedCentralGoogle Scholar
  167. 167.
    Seok JY, Lee KG. Cytologic features of metastatic lymphoepithelial carcinoma in pleural fluid: a case report. Acta Cytol. 2009;53:215–8.PubMedCrossRefPubMedCentralGoogle Scholar
  168. 168.
    Florentine BD, Fink T, Avidan S, Braslavsky D, Raza A, Cobb CJ. Extra-salivary gland presentations of adenoid cystic carcinoma: a report of three cases. Diagn Cytopathol. 2006;34:491–4.PubMedCrossRefPubMedCentralGoogle Scholar
  169. 169.
    Benchetritt M, Butori C, Long E, Ilie M, Ferrari E, Hofman P. Pericardial effusion as primary manifestation of metastatic cutaneous adenoid cystic carcinoma: diagnostic cytopathology from an exfoliative sample. Diagn Cytopathol. 2008;36:351–4.PubMedCrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of PathologyThe Norwegian Radium Hospital, Oslo University HospitalOsloNorway
  2. 2.Faculty of MedicineInstitute of Clinical Medicine, University of OsloOsloNorway
  3. 3.UH Cleveland Medical CenterCase Western Reserve UniversityClevelandUSA
  4. 4.Department of PathologySchool of Medicine, Koc UniversityIstanbulTurkey
  5. 5.[Previously] Department of PathologyIstanbul Faculty of Medicine, Istanbul UniversityIstanbulTurkey

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