Sudha A, Fatima A

Pseudomyxoma peritonei is defined as peritoneal involvement by a mucinous neoplasm accompanied by collections of intraabdominal mucus (mucinous ascites). Cytologic examination of ascitic fluid, which is usually a thick and gelatinous material may appear to be devoid of cells except for an occasional macrophage. However, if enough fluid is examined, it is possible to find tumor cells with varying cytologic appearances ranging from benign mucinous epithelium to poorly differentiated adenocarcinoma based on the histology of the primary neoplasm. We studied ascitic fluid in a patient whose main complaint was rapidly increasing ascites unresponsive to antituberculous treatment. There were whorls of signet ring cells in a background of abundant mucin. A diagnosis of pseudomyxoma peritonei was followed by a peritoneal biopsy which confirmed a signet ring cell carcinoma. Colonoscopy and subsequent biopsy of caecal ulcer revealed primary tumor in the caecum.

Key words: ascitic fluid, psuedomyxoma, signet ring cell carcinoma