{"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":"2026-09-08T13:52:21","modified_gmt":"2026-09-08T05:52:21","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":"\n<h2>\n\t\t\tCytoPage Quiz 2022 December\t<\/h2>\n\t<p><strong>Clinical history:<\/strong> <\/p>\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>\n<figure itemscope itemtype=\"https:\/\/schema.org\/ImageObject\">\n\t\t\t\t\t<img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2026\/02\/CQ2022.1.png\" alt=\"CQ2022.1\" height=\"680\" width=\"821\" title=\"CQ2022.1\" onerror=\"this.style.display='none'\" loading=\"lazy\" \/>\n\t<\/figure>\n\t<p><strong>What is the diagnosis?<\/strong><\/p>\n<ol>\n<li>Acellular mucin<\/li>\n<li>Artefact (imposter mucin)<\/li>\n<li>Metastatic mucinous adenocarcinoma<\/li>\n<\/ol>\n\t<a role=\"heading\" aria-level=\"2\"><button id=\"fl-accordion--button-0\" aria-controls=\"fl-accordion--content-0\" aria-expanded=\"true\" type=\"button\">Answer<i data-label-icon=\"fas fa-angle-down\" data-active-icon=\"fas fa-minus\">Collapse<\/i><\/button><\/a><p>&nbsp;<\/p>\n<p><strong>1. Artefact (imposter mucin)<\/strong><\/p>\n<strong><u><br \/>\n<\/u><u>Pitfall to the misdiagnosis of mucin on peritoneal fluid cytology<\/u><\/strong>\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>\n<p><strong><u>References<\/u><\/strong><\/p>\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>\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>\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>\n\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/\" target=\"_blank\" rel=\"noopener\">Cytopathology Home(opens in new tab)<\/a><a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/cytopreparation\/\" target=\"_blank\" rel=\"noopener\">Cytopreparation(opens in new tab)<\/a><a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/quick-approaches-cases\/\" target=\"_blank\" rel=\"noopener\">Quick Approaches and Cases(opens in new tab)<\/a><a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/cyto-mystery-cases\/\" target=\"_blank\" rel=\"noopener\">Mystery cases(opens in new tab)<\/a><a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/picture-atlas\/\" target=\"_blank\" rel=\"noopener\">Picture Atlas(opens in new tab)<\/a><a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/sscyto\/\" target=\"_blank\" rel=\"noopener\">SSC Cytoquiz(opens in new tab)<\/a><a href=\"https:\/\/www.youtube.com\/playlist?list=PL2TaQ3CT3zlCdQ4ntNg3pE93krOQSrBGt\" target=\"_blank\" rel=\"noopener\">Talking cases(opens in new tab)<\/a>\n\n","protected":false},"excerpt":{"rendered":"<p>CytoPage Quiz 2022 December 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 AnswerCollapse &nbsp; 1. Artefact (imposter mucin) Pitfall to the misdiagnosis of [&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 v28.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\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 December Clinical history: A 50 year old lady presents with abdominal distension with large amounts of ascites. 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