Diagnostic value of hair shafts and squamous cells in peritoneal washing cytology

OBJECTIVE: Little attention has been given to hair shafts and squamous cell s in peritoneal fluid. To investigate their diagnostic value in peritoneal washing specimens, we reviewed peritoneal washing cytology preparations fi om 83 cases of ovarian tumors. STUDY DESIGN: We reviewed peritoneal washing specimens and histologic secti ons of 86 cases of ovarian tumors and tumorous conditions, including 22 ter atomas, 16 serous adenocarcinomas, 10 clear cell adenocarcinomas, 9 endomet rioid adenocarcinomas, 5 cases of endometriosis, 4 mucinous adenomas, 3 ser ous cystade-nocarcinomas and 17 other tumors. RESULTS: We observed both squamous cells and hair shafts surrounded by infl ammatory cells in 5 of the 22 cases of ovarian teratoma. Rupture of an ovar ian teratoma was clinically and histologically found in one of the five cas es. Hair shafts were not observed in the other tumors or in nonneoplastic c onditions. The diameter of hair shafts in peritoneal washing specimens rang ed from 10 to 28.8 mu m (average, 16.6), and such hair shafts were present within an ovarian teratoma examined histologically. The diameter of hair sh afts from six normal adults who were examined as controls ranged from 61.5 to 118.6 mu m (average, 89.4). CONCLUSION: Hair shafts and squamous cells surrounded by inflammatory cells in peritoneal washing specimens are a diagnostic clue to ovarian teratoma and can be observed even when rupture of the tumor is not detected clinical ly or microscopically.