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Original Articles
- BRCA1/2-stratified immune profiling of treatment-naive high-grade serous ovarian cancer ascites identifies a Treg-enriched ascitic immune phenotype
- Megha Sharma, Bhavneet Kaur, Bhavana Rai, Man Updesh Singh Sachdeva, Amit Raj Sharma, Parikshaa Gupta, Upasana Gautam, Rashmi Bagga, Radhika Srinivasan
- J Pathol Transl Med. 2026;60(5):558-571. Published online September 11, 2026
- DOI: https://doi.org/10.4132/jptm.2026.07.27
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Supplementary Material - Background
Malignant ascites is a common presentation in advanced high-grade serous ovarian carcinoma (HGSOC), yet its immune composition and genetic correlates remain poorly defined. This study explored the immune microenvironment of ascitic fluid in ovarian carcinoma and its association with BRCA mutation status, chemotherapy response, and survival. Methods: Ascitic fluid from 133 patients (33 non-malignant controls, 31 non-ovarian carcinoma, and 69 HGSOC cases) was analyzed using multiparameter flow cytometry to quantify lymphocyte and macrophage subsets, and programmed cell death 1/programmed cell death ligand 1 immune-checkpoint marker expression. Targeted sequencing of TP53 and BRCA1/2 was performed in HGSOC, and findings were correlated to immune parameters, chemotherapy response, progression-free and overall survival. Results: Ovarian carcinoma ascites, compared with non-malignant effusions, showed increased CD3+ and CD8+ T-cell frequencies, higher regulatory T cell (Treg)–associated populations, and reduced CD19+CD20+ B-cell levels. Targeted sequencing identified TP53 mutations in 97.4% and BRCA1/2 mutations in 35.9% of sequenced HGSOC cases. BRCA-wild-type cases showed significantly lower CD4+ T-cell and B-cell levels, higher Treg levels, and shorter progression-free and overall survival than BRCA1/2-mutated cases. Higher CD3+ and CD8+ T-cell levels were associated with poor chemotherapy response. In exploratory multivariable Cox models, BRCA-wild-type status remained significantly associated with poorer overall survival, whereas immune-cell groups were not independently significant. Conclusions: HGSOC ascites showed a Treg-enriched immune profile, with relatively higher Treg levels in BRCA-wild-type cases. BRCA-wild-type status was associated with poorer outcomes, while the evaluated immune-cell subsets were not independently prognostic in exploratory analysis. Ascitic fluid-based immune and molecular profiling may provide prognostic information worthy of validation in larger independent cohorts.
- Cytologic Features and Distribution of Primary site of Malignant Cells in Body Fluids.
- Kyoung Ho Kim, Kwang Gil Lee
- Korean J Pathol. 1990;24(4):456-464.
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- Many articles concerning the accuracy of diagnosis of malignant tumor cells in body fluids have appeared in the literature, but few authors have attempted to describe the characteristics of these cells to determine the site of the primary tumor as they relate to tumors of specific primary sites. This paper presents the results of a retrospective study on malignant body cavity effusions of which the primary site was established on the basis of either biopsy or surgical resection of the primary neoplasm during the period of 6 years beginning from January 1983 to December 1988. The results obtained are summarized as follows: 1) The 143 fluid specimens from 129 patients were composed of 51 cases of pleural, 69 of peritoneal, and 9 of pericardial origin. 2) Adenocarcinoma was the most frequent type of malignant effusions (78.3%). The most common primary site was the lung (50%) in pleural fluid and stomach (55.2%) in ascites. 3) The results of this study show that the primary site of tumor cells can be identified in the body fluid of accurate cytomorphologic criteria are used. Identification of the primary site of an effusion would be improved by the consideration of clinical information
Case Reports
- Cytologic Features of Endodermal Sinus Tumor of Ovary in the Ascitic Fluid: Report of a Cases.
- Eun Sun Jeong, Young Shin Kim, Chang Suk Kang, Sang In Shim
- J Pathol Transl Med. 1995;6(2):204-208.
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- The cytologic findings of endodermal sinus tumor of the ovary are reported. The cytologic preperations were obtained from ascitic specimens. The findings on Papanicolaou-stained smears included a clean background and poorly preserved atypical cells loosely arranged in irregular or papillary groups. At high magnification, the cells had ill-defined and microvacuolated cytoplasms, with an increased nuclear-cytoplasmic ratio and prominent nucleoli. Hyaline globules characteristic of the alpha-fetoprotein (AFP)-synthesizing cells of endodermal sinus tumor were observed within the cells with periodic-acid-Schiff (PAS) stain. The presence of PAS - positive hyaline globules can be regarded, therefore, as a diagnostic clue to endodermal sinus tumor in an appropriate clinical setting and in the presence of AFP production. The cytologic findings in a cell block is important, in addition to smears, to obtain more diagnostic clues. A preliminary cytomorphologic diagnosis of this highly malignant tumor is valuable as a guide in planning further immunocytochemical and serologic studies.
- Cytologic Features of Infiltrating Lobular Carcinoma of the Breast in Ascitic Fluid: A Case Report.
- Mi Kyung Lee, Kwang Gil Lee
- J Pathol Transl Med. 1996;7(1):75-78.
- 2,318 View
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Abstract
- We experienced a case of infiltrating lobular carcinoma of the breast in the ascitic fluid. The patient was a 49 year-old woman who presented with a palable mass of 3 months duration in the left upper quadrant of the abdomen and abdominal distension. Five years ago, she had undergone left radical mastectomy with chemotherapy and radiotherapy for infiltrating lobular carcinoma of the breast. The ascitic fluid smears revealed singly scattered small round to elliptical cells, many of which were arranged in characteristic indian-file patterns consisting of 3 to 5 cells. The tumor cells had scanty cytoplasm, rare cytoplasmic vacuoles and marked chromatin clumping with small, but prominent nucleoli.
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