Challenges in cyto-diagnosis: a report of 2 interesting cases of pseudomyxoma peritonei

Diffuse intra-abdominal gelatinous or mucinous ascites is commonly known as pseudomyxoma peritonei (PMP). It is a clinical entity rather than a histological diagnosis and usually results from peritoneal dissemination of mucus producing neoplasms most frequently from the appendix and rarely other GIT tumours. Since ascites may be the first symptom, cytologists may face diagnostic challenges in mucinous ascites. We present two cases of mucinous ascites in elderly females, in which thick, sticky, gelatinous fluid was received for cytological examination. After correlation of cytological examination findings with clinical and radiological features, diagnosis of disseminated peritoneal adenomucinosis was made which was later confirmed by fluid cell block with IHC studies.