Can be adenocarcinoma or mesothelial cells.  We cannot tell the difference by cytology in many situation even thouth we can favor one of them.

Priniciple: You must do IHC for these kinds of cells in 腹水 if you are not 100% sure.

At least two IHC you should do are calretinin (mesothelial cells) and BerEP4 (epithelial cell).

If they are mesothelial cells, you need to look your slides and to know the clinical history more carefully to make sure they are not malignant mesothelial cells.

Priniciple: You must do IHC for these kinds of cells in 腹水 if you are not 100% sure.

At least two IHC you should do are calretinin (mesothelial cells) and BerEP4 (epithelial cell).

If they are mesothelial cells, you need to look your slides and to know the clinical history more carefully to make sure they are not malignant mesothelial cells.

cqzhao老师意见：

可能是腺癌或者间皮细胞。许多情况下在细胞学上，我们很难将二者说清楚，即使我们倾向于其中之一。

处理原则：在这种情况下，如果不是100%有把握，做免疫组化。至少两种抗体是要做的，calretinin标记间皮细胞，BerEP4标记上皮细胞。如果这些细胞是间皮细胞，那么就需要仔细观察切片并且仔细了解临床情况，以排除恶性间皮细胞。

mingfuyu老师意见：间皮细胞。

cqzhao老师意见：

 不能确定的时候就求助于免疫组化。让临床重新送一次标本不会有任何的帮助，当然如果改变处理程序，片子做的更好，那就是另外一回事了。对于这个病例来讲，不应该等着下次标本才发报告，我认为在目前的标本中就有足够的细胞供以诊断。