Qap (Anatomical Pathology) 

QAP Peer Review

AP188
Case History: F/49 Abdominal distension due to ascites. On laparotomy there were numerous peritoneal depositis and omental cake. Ovaries were not enlarged.
Intended diagnosis: Primary peritoneal serous adenocarcinoma. Contributed by:JKCC
Code Diagnosis Comment Score
anonymous Papillary serous adenocarcinoma (100%), metastatic or primary peritoneal To look for primary tumour in female genital tract and other sites.  100
anonymous Extraovarian peritoneal serous papillary carcinoma, EPSPC Immunostaining for Calretinin to rule out malignant mesothelioma  100
anonymous Primary peritoneal serous carcinoma. Need to confirm the absence of tumour in ovaries (despite normal in size) and endometrium.  100
anonymous Primary peritoneal serous adenocarcinoma Immunostaining for WT-1 (positive).  100
anonymous Papillary serous carcinoma(consistent with primary peritoneum type). 100% To exclude a primary in the ovary and endometrium clinically. Mesothelioma is a valid though remote differential. Clinical correlation is prudent. Although there is significant immnohistochemical overlap between papillary serous carcinoma and mesothelioma, mesothelioma is more likely to be CEA-, BerEP4-, calretinin+, thrombomodulin+, CK5/6+.  100
anonymous Serous papillary carcinoma. (100%) To look for primary, e.g. status of uterus and cervix. If none, could be primary peritoneal serous carcinoma. Do CA125, WT1 and S100 protein to help to confirm. Do calretinin to exclude mesothelioma.  100
anonymous Primary peritoneal serous adenocarcinoma 100% nil  100
anonymous Serous adenocarcinoma (100%) Since the ovaries are normal and upon exclusion of primary from the uterine cavity, primary peritoneal origin has to be considered.  100
anonymous Malignant peritoneal tumor: Peritoneal serous papillary carcinoma? Malignant mesothelioma? Metastatic adenocarcinoma? nil  90
anonymous Infiltration by ADENOCARCINOMA (please see comment) (100%) The histologic features are consistent with serous carcinoma. Metastatic serous carcinoma of female genital tract and other primary sites like gastrointestinal tract and pancreas need to be excluded. Primary peritoneal serous carcinoma is also a possibility. Please correlate with clinical and operative findings.  100
anonymous High-grade serous adenocarcinoma 100% CA125, WT1, CK7/20 for serous phenotype (CA125+ WT1+ CK7+ CK20-) Histological assessment of ovaries to determine primary ovarian vs peritoneal tumour Further blocks to exclude carcinosarcomatous foci (MMMT)  100
anonymous Serous adenocarcinoma Either primary peritoneal or metastasis from genital tract. Likely to be primary if both ovaries are grossly normal.  100
anonymous Adenocarcinomatous deposits 50% Mesothelioma 50% nil  40
anonymous Primary peritoneal serous adenocarcinoma. Probability: 100% nil  100
anonymous Serous adenocarcinoma 100% Correlate with clinical findings to determine whether primary peritoneal or metastatic adenocarcinoma  100
anonymous serous adenocarcinoma (100%) Correlate with clinical findings for peritoneal or endometrial primary.  100