Florid histiocytic reaction to oxidized cellulose masquerading as ovarian malignancy: Report of two cases.

Abstract

Bioabsorbable hemostatic agents like oxidized regenerated cellulose (ORC) are widely used in surgical practice. Rarely, adverse events due to retained ORC may occur and can pose a diagnostic dilemma. The unique tissue response to ORC may be misdiagnosed as signet ring type of adenocarcinoma. This article aims to highlight this rare phenomenon. We report two such cases involving the ovaries. Both the patients presented with ovarian cysts and tubo-ovarian adhesions 1-2 years following surgery for benign ovarian pathology. The present biopsies were featured by sheets of large cells with abundant vacuolated cytoplasm and often small peripherally displaced nuclei having "signet ring" appearance. These cells were negative for pan-cytokeratin and strongly positive for CD68, indicating the histiocytic nature of the cells. It was confirmed that in both the patients, at the time of the initial surgeries, hemostasis was ensured by packing with ORC.

• Authors: Sunitha Jacob, Sudharani Bairraju
• Journal: Indian journal of pathology & microbiology (Indian J Pathol Microbiol) 2020 Oct-Dec Vol. 63 Issue 4 Pg. 620-622 ISSN: 0974-5130 [Electronic] India
• PMID: 33154319 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antigens, CD
• Antigens, Differentiation, Myelomonocytic
• CD68 antigen, human
• Cellulose, Oxidized
• Keratins

Topics

• Adult
• Antigens, CD (genetics)
• Antigens, Differentiation, Myelomonocytic (genetics)
• Biopsy
• Cellulose, Oxidized (adverse effects)
• Diagnosis, Differential
• Female
• Histiocytosis (chemically induced, diagnosis, pathology)
• Histological Techniques
• Humans
• Keratins (genetics)
• Middle Aged
• Ovarian Neoplasms (pathology)
• Ovary (pathology, surgery)