Ascitic fluid cholesterol level

Last revised by Daniel J Bell on 28 Jan 2021

Citation, DOI, disclosures and article data

Citation:

Iqbal S, Bell D, Knipe H, Ascitic fluid cholesterol level. Reference article, Radiopaedia.org (Accessed on 25 Apr 2024) https://radiopaedia.org/articles/85948

DOI:

Permalink:

https://radiopaedia.org/articles/85948

rID:

85948

Article created:

15 Jan 2021, Subhan Iqbal

Disclosures:

At the time the article was created Subhan Iqbal had no recorded disclosures.

View Subhan Iqbal's current disclosures

Last revised:

28 Jan 2021, Daniel J Bell ◉

Disclosures:

At the time the article was last revised Daniel J Bell had no recorded disclosures.

View Daniel J Bell's current disclosures

Revisions:

5 times, by 3 contributors - see full revision history and disclosures

Systems:

Gastrointestinal, Hepatobiliary

Sections:

Pathology

Tags:

ascites, cases

Synonyms:

Ascitic cholesterol level
Ascites cholesterol level

Ascitic fluid cholesterol level estimation is a simple and precise test for differentiating malignant ascites from non-malignant (cirrhotic) ascites ^5-9.

Pathology

Ascites is the abnormal collection of fluid within the peritoneal cavity. Malignant ascites comprises ~10% and is usually secondary to hepatic, endometrial, colorectal, lung, or breast malignancy ^3-5. The distinction between malignant and non-malignant ascites is crucial for additional therapeutic and diagnostic procedures ^4.5.

The cholesterol level of malignant ascitic fluid is higher, ranging from 70-90 mg/dL, than that of non-malignant ascitic fluid, usually 29-35 mg/dL ^1,3,9,11. In tubercular ascites, the mean level of ascites cholesterol was found to be up to 35 mg/dL ⁸.

Ascitic cholesterol level is also used for differentiating between non-portal hypertensive ascites and in mixed non-portal hypertensive ascites. Therefore, this is a simple measure that may be used in patients with new-onset ascites ³.

References

1. Garg R, Garg SA, Garg AS, Garg BK, Garg CA, Garg GR, Garg CL, Garg. Ascitic fluid cholesterol in differential diagnosis of ascites. (1993) The Journal of the Association of Physicians of India. doi: - Pubmed
2. Du L, Du ZS, Du HX, Du SY, Du. Editorial: ascitic cholesterol - is it superior to serum-ascites albumin gradient? Authors' reply. (2019) Alimentary pharmacology & therapeutics. doi:10.1111/apt.15105 - Pubmed
3. Du L, Du ZS, Du LZ, Du XT, Du BT, Du XD, Du WX, Du LJ, Du XK, Du YJ, Du HX, Du SY, Du. Ascitic cholesterol is superior to serum-ascites albumin gradient in the detection of non-portal hypertensive ascites and the diagnosis of mixed ascites. (2019) Alimentary pharmacology & therapeutics. doi:10.1111/apt.15042 - Pubmed
3. Barbare J, Barbare DG, Barbare DJ, Barbare PJ, Barbare VW, Barbare LJ, Barbare CJ, Barbare. [Concentration of lipids in ascitic fluid and the concentration gradient of albumin in blood and ascites: diagnostic significance]. (1989) Annales de gastroenterologie et d'hepatologie. doi: - Pubmed
4. Zhu H, Shen Y, Deng K, Liu X, Zhao Y, Liu T, Huang Y. Diagnostic accuracy of ascitic cholesterol concentration for malignant ascites: a meta-analysis. (2015) International journal of clinical and experimental medicine. 8 (10): 18494-9. Pubmed
5. Patel S, Patel SM, Patel. Editorial: ascitic cholesterol-is it superior to serum-ascites albumin gradient?. (2019) Alimentary pharmacology & therapeutics. doi:10.1111/apt.15078 - Pubmed
6. Sood A, Sood GR, Sood KR, Sood CR, Sood AS, Sood GR, Sood BK, Sood. Ascitic fluid cholesterol in malignant and tubercular ascites. (1995) The Journal of the Association of Physicians of India. doi: - Pubmed
7. Barbare J, Barbare DG, Barbare DJ, Barbare PJ, Barbare VW, Barbare LJ, Barbare CJ, Barbare. [Concentration of lipids in ascitic fluid and the concentration gradient of albumin in blood and ascites: diagnostic significance]. (1989) Annales de gastroenterologie et d'hepatologie. doi: - Pubmed
7. Rana S, Rana BS, Rana KR, Rana. Usefulness of ascitic fluid cholesterol as a marker for malignant ascites. (2005) Medical science monitor : international medical journal of experimental and clinical research. doi: - Pubmed
8. Prabhu M, Prabhu GR, Prabhu SW, Prabhu. Diagnostic Utility of Serum Ascites Lipid and Protein Gradients in Differentiation of Ascites. (2019) International journal of hepatology. doi:10.1155/2019/8546010 - Pubmed
9. Garg R, Garg SA, Garg AS, Garg BK, Garg CA, Garg GR, Garg CL, Garg. Ascitic fluid cholesterol in differential diagnosis of ascites. (1993) The Journal of the Association of Physicians of India. doi: - Pubmed
10. Khan F, Khan. Ascites in the state of Qatar: aetiology and diagnostic value of ascitic fluid analysis. (2007) Singapore medical journal. doi: - Pubmed
11. Sartori M, Andorno S, Gambaro M, Leone F, Molinari GL, Pontiroli L, Aglietta M. Diagnostic paracentesis. A two-step approach. Ital J Gastroenterol. 1996 Feb-Mar;28(2):81-5. PMID: 8781999.