The International System for Reporting Serous Fluid Cytopathology survey data reveal substantial variability in the reporting and utilization of pelvic washing and peritoneal fluid specimens among pathologists and gynecologic oncologists.

Introduction: Pelvic and peritoneal washings (PW) are often taken during gynecologic resections when the presence of a neoplastic process is known or suspected. A positive PW may upstage a patient and/or impact a patient's prognosis and treatment. Two surveys were created to inform The International System for Serous Fluid Cytology, a standardized reporting system, regarding the practice and utilization of PW cytology.

Materials and methods: Pathologists and cytotechnologists (n = 475) responded to a survey which examined their reporting preferences. Gynecologic oncologists (GONC) (n = 168) answered a separate survey which examined how they utilized PW specimens.

Results: Most pathologists/cytotechnologists felt that bland-appearing epithelial cells of unknown origin should be classified as benign. Most favored reporting psammomatous calcification without associated epithelial cells as benign (64.1%), whereas 8.6% did not report this finding at all, 20.5% would report as atypical, and 6.8% would report as suspicious of a neoplasm. Most GONCs (63.9%) routinely obtained PW specimens during endometrial cancer staging; of those, 53% reported that a positive cytology result could change their management. Sixty-six percent of GONCs indicated that they treat indeterminate PW results as negative. Others indicated that an indeterminate PW may result in review of slides with the pathologist, counseling the patient, and/or closer observation. Most GONCs did not find utility in the reporting of psammomatous calcifications, presence of mucin, atypical cells favored to be benign, endometrial cells, or iatrogenic material.

Conclusions: Substantial variability exists among pathologists in how PW specimens are reported, as well as how gynecologic oncologists utilize these specimens.