Case report of large malignant pericardial effusion in a post-surgical setting of endometrial mixed carcinoma: A description of unique cytological, histological, and immunohistochemical findings

Figures

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  Figure 1.. Computed tomography, cytological findings of the pericardial effusion, and histological findings of the surgical specimen of endometrium. (a) Computed tomography on admission showed pericardial effusion (left) and a mass measuring 8 cm in size from the pericardium to the liver surface (right). (b) Cytological examination of the pericardial effusion showed the presence of atypical glandular cells with foamy cytoplasm, enlarged nuclei, fine chromatin, and distinct nucleoli (Papanicolaou staining; original magnification, 400×). (c) Psammoma body (left) and mitosis (right) were partly observed in the cytological examination of the pericardial effusion (Papanicolaou staining; original magnification, 400×). (d) The surgical specimen of endometrial carcinoma dissected 7 years earlier had been diagnosed as moderately differentiated endometrioid adenocarcinoma (G2 > G1, pT3pN1cMX, pStageIIIC) (left) (HE staining; original magnification, 40×). On retrospective evaluation of this specimen, a partly included papillary serous carcinoma-like component was identified (right) (HE staining; original magnification, 100×).

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  Figure 2.. Immunohistochemical staining of a cell block of the pericardial effusion (top line), serous carcinoma (SC)-like components (middle line), and endometrioid carcinoma (EC) components (bottom line) of the surgical specimen dissected 7 years earlier. Staining of the cell block of the pericardial effusion revealed that adenocarcinoma cells were positive for p53, p16, and IMP-3, but negative for ER. The SC-like components were positive for p53 and IMP-3 and partially positive for p16, but negative for ER. In contrast, the endometrioid carcinoma components were positive for ER but negative for p53, p16, and IMP-3.