{"id":46661,"date":"2026-02-17T22:32:38","date_gmt":"2026-02-17T14:32:38","guid":{"rendered":"https:\/\/medicine.nus.edu.sg\/pathweb\/?page_id=46661"},"modified":"2026-02-17T23:44:04","modified_gmt":"2026-02-17T15:44:04","slug":"dec2022","status":"publish","type":"page","link":"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/sscyto\/dec2022\/","title":{"rendered":"CytoPage Quiz &#8211; 2022 Dec"},"content":{"rendered":"\r\n<h2>\r\n\t\tCytoPage Quiz 2022 Dec\r\n\t<\/h2>\r\n\t<p><strong>Clinical history:<\/strong> <\/p>\r\n<p>A 50 year old lady presents with abdominal distension with large amounts of ascites. She underwent laparoscopy and cytologic images of her peritoneal washing are obtained:<\/p>\r\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2026\/02\/CQ2022.1.png\" alt=\"CQ2022.1\" itemprop=\"image\" height=\"680\" width=\"821\" title=\"CQ2022.1\" onerror=\"this.style.display='none'\"  \/>\r\n\t<p><strong>What is the diagnosis?<\/strong><\/p>\r\n<ol>\r\n<li>Acellular mucin<\/li>\r\n<li>Artefact (imposter mucin)<\/li>\r\n<li>Metastatic mucinous adenocarcinoma<\/li>\r\n<\/ol>\r\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">Answer<\/a>\r\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"-1\"><i title=\"Expand\">Expand<\/i><\/a>\r\n\t\t\t\t\t<p>&nbsp;<\/p>\r\n<p><strong>1. Artefact (imposter mucin)<\/strong><\/p>\r\n<strong><u><br \/>\r\n<\/u><u>Pitfall to the misdiagnosis of mucin on peritoneal fluid cytology<\/u><\/strong>\r\n<p>An increasing number of different peritoneal fluid collection devices are now documented to contribute to mucin-like material on the cytology smears. Suction canister liner bags from Receptal (Amsino International, USA), Lifehealthcare Serres and Vacsax have been documented as culprits so far. White flakes from the lining of the bags contribute to the artefact, which stains purple on Papanicolaou stain, with sharp to soft fibrillary edges and multiple central laminations. In contrast, true mucin is pale blue to orange on Papanicolaou stain with hazy ill-defined edges without laminations. This exogenous artefact is a close mimic to extracellular mucin in peritoneal fluid, and the awareness of this artefact is important to avoid misinterpretation.<\/p>\r\n<p><strong><u>References<\/u><\/strong><\/p>\r\n<p>Vazquez, M., &amp; Newman, M. (2019). Imposter mucin: awareness of an important cytology artefact. Pathology, 51(4), 448-449.\u00a0<a href=\"https:\/\/doi.org\/10.1016\/j.pathol.2018.12.422\">https:\/\/doi.org\/10.1016\/j.pathol.2018.12.422<\/a><\/p>\r\n<p>van der Griend, R., Lamb, D., Challis, D., Chinnock, M., &amp; Blomfield, P. (2011). A mucinous mimic: identification of a distracting artefact. Cytopathology : official journal of the British Society for Clinical Cytology, 22(2), 133-134.\u00a0<a href=\"https:\/\/doi.org\/10.1111\/j.1365-2303.2010.00809.x\">https:\/\/doi.org\/10.1111\/j.1365-2303.2010.00809.x<\/a><\/p>\r\n<p>Quinn, G., Hales, S., Hamid, B., &amp; Meara, N. (2015). Comparison of mucoid-mimic artefact with true mucin in peritoneal cytology samples. Cytopathology : official journal of the British Society for Clinical Cytology, 26(3), 194-196. https:\/\/doi.org\/10.1111\/cyt.12212<\/p>\r\n\r\n","protected":false},"excerpt":{"rendered":"<p>CytoPage Quiz 2022 Dec Clinical history: A 50 year old lady presents with abdominal distension with large amounts of ascites. She underwent laparoscopy and cytologic images of her peritoneal washing are obtained: What is the diagnosis? Acellular mucin Artefact (imposter mucin) Metastatic mucinous adenocarcinoma Answer Expand &nbsp; 1. Artefact (imposter mucin) Pitfall to the misdiagnosis [&hellip;]<\/p>\n","protected":false},"author":828,"featured_media":0,"parent":46656,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-46661","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>NUS Pathweb<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/sscyto\/dec2022\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:description\" content=\"CytoPage Quiz 2022 Dec Clinical history: A 50 year old lady presents with abdominal distension with large amounts of ascites. She underwent laparoscopy and cytologic images of her peritoneal washing are obtained: What is the diagnosis? Acellular mucin Artefact (imposter mucin) Metastatic mucinous adenocarcinoma Answer Expand &nbsp; 1. Artefact (imposter mucin) Pitfall to the misdiagnosis [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/sscyto\/dec2022\/\" \/>\n<meta property=\"og:site_name\" content=\"NUS Pathweb\" \/>\n<meta property=\"article:modified_time\" content=\"2026-02-17T15:44:04+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2026\/02\/CQ2022.1.png\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/sscyto\/dec2022\/\",\"url\":\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/sscyto\/dec2022\/\",\"name\":\"\",\"isPartOf\":{\"@id\":\"https:\/\/medicine.nus.edu.sg\/pathweb\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/sscyto\/dec2022\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/sscyto\/dec2022\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2026\/02\/CQ2022.1.png\",\"datePublished\":\"2026-02-17T14:32:38+00:00\",\"dateModified\":\"2026-02-17T15:44:04+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/sscyto\/dec2022\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/sscyto\/dec2022\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/sscyto\/dec2022\/#primaryimage\",\"url\":\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2026\/02\/CQ2022.1.png\",\"contentUrl\":\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2026\/02\/CQ2022.1.png\",\"width\":821,\"height\":680},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/sscyto\/dec2022\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/medicine.nus.edu.sg\/pathweb\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Cytopathology\",\"item\":\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Singapore Society of Cytology, CytoQuiz\",\"item\":\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/sscyto\/\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"CytoPage Quiz &#8211; 2022 Dec\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/medicine.nus.edu.sg\/pathweb\/#website\",\"url\":\"https:\/\/medicine.nus.edu.sg\/pathweb\/\",\"name\":\"NUS Pathweb\",\"description\":\"Pathology made easy\",\"publisher\":{\"@id\":\"https:\/\/medicine.nus.edu.sg\/pathweb\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/medicine.nus.edu.sg\/pathweb\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/medicine.nus.edu.sg\/pathweb\/#organization\",\"name\":\"NUS Medicine PathWeb\",\"url\":\"https:\/\/medicine.nus.edu.sg\/pathweb\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/medicine.nus.edu.sg\/pathweb\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2020\/08\/NUS-Medicine-Logo.png\",\"contentUrl\":\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2020\/08\/NUS-Medicine-Logo.png\",\"width\":300,\"height\":61,\"caption\":\"NUS Medicine PathWeb\"},\"image\":{\"@id\":\"https:\/\/medicine.nus.edu.sg\/pathweb\/#\/schema\/logo\/image\/\"},\"sameAs\":[\"https:\/\/www.instagram.com\/pathweb\/\",\"https:\/\/www.youtube.com\/channel\/UC3FweZwONWAicB72vF9P5ew\/playlists\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"NUS Pathweb","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/sscyto\/dec2022\/","og_locale":"en_US","og_type":"article","og_description":"CytoPage Quiz 2022 Dec Clinical history: A 50 year old lady presents with abdominal distension with large amounts of ascites. She underwent laparoscopy and cytologic images of her peritoneal washing are obtained: What is the diagnosis? Acellular mucin Artefact (imposter mucin) Metastatic mucinous adenocarcinoma Answer Expand &nbsp; 1. Artefact (imposter mucin) Pitfall to the misdiagnosis [&hellip;]","og_url":"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/sscyto\/dec2022\/","og_site_name":"NUS Pathweb","article_modified_time":"2026-02-17T15:44:04+00:00","og_image":[{"url":"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2026\/02\/CQ2022.1.png","type":"","width":"","height":""}],"twitter_card":"summary_large_image","twitter_misc":{"Est. reading time":"2 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/sscyto\/dec2022\/","url":"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/sscyto\/dec2022\/","name":"","isPartOf":{"@id":"https:\/\/medicine.nus.edu.sg\/pathweb\/#website"},"primaryImageOfPage":{"@id":"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/sscyto\/dec2022\/#primaryimage"},"image":{"@id":"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/sscyto\/dec2022\/#primaryimage"},"thumbnailUrl":"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2026\/02\/CQ2022.1.png","datePublished":"2026-02-17T14:32:38+00:00","dateModified":"2026-02-17T15:44:04+00:00","breadcrumb":{"@id":"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/sscyto\/dec2022\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/sscyto\/dec2022\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/sscyto\/dec2022\/#primaryimage","url":"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2026\/02\/CQ2022.1.png","contentUrl":"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2026\/02\/CQ2022.1.png","width":821,"height":680},{"@type":"BreadcrumbList","@id":"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/sscyto\/dec2022\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/medicine.nus.edu.sg\/pathweb\/"},{"@type":"ListItem","position":2,"name":"Cytopathology","item":"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/"},{"@type":"ListItem","position":3,"name":"Singapore Society of Cytology, CytoQuiz","item":"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/sscyto\/"},{"@type":"ListItem","position":4,"name":"CytoPage Quiz &#8211; 2022 Dec"}]},{"@type":"WebSite","@id":"https:\/\/medicine.nus.edu.sg\/pathweb\/#website","url":"https:\/\/medicine.nus.edu.sg\/pathweb\/","name":"NUS Pathweb","description":"Pathology made easy","publisher":{"@id":"https:\/\/medicine.nus.edu.sg\/pathweb\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/medicine.nus.edu.sg\/pathweb\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/medicine.nus.edu.sg\/pathweb\/#organization","name":"NUS Medicine PathWeb","url":"https:\/\/medicine.nus.edu.sg\/pathweb\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/medicine.nus.edu.sg\/pathweb\/#\/schema\/logo\/image\/","url":"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2020\/08\/NUS-Medicine-Logo.png","contentUrl":"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2020\/08\/NUS-Medicine-Logo.png","width":300,"height":61,"caption":"NUS Medicine PathWeb"},"image":{"@id":"https:\/\/medicine.nus.edu.sg\/pathweb\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.instagram.com\/pathweb\/","https:\/\/www.youtube.com\/channel\/UC3FweZwONWAicB72vF9P5ew\/playlists"]}]}},"_links":{"self":[{"href":"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-json\/wp\/v2\/pages\/46661"}],"collection":[{"href":"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-json\/wp\/v2\/users\/828"}],"replies":[{"embeddable":true,"href":"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-json\/wp\/v2\/comments?post=46661"}],"version-history":[{"count":7,"href":"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-json\/wp\/v2\/pages\/46661\/revisions"}],"predecessor-version":[{"id":46777,"href":"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-json\/wp\/v2\/pages\/46661\/revisions\/46777"}],"up":[{"embeddable":true,"href":"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-json\/wp\/v2\/pages\/46656"}],"wp:attachment":[{"href":"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-json\/wp\/v2\/media?parent=46661"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}