Figure 1

Cytologic examination of cells in the ascitic fluid of a patient with ovarian hyperstimulation and ultrasonographic assessment of OHSS. On the left side (A,C) atypical cells can be observed among the leukocytes (Ly), red blood cells, mesothelial cells (Meso) and histiocytes (Hi). Abnormal cells contain a dark cytoplasm that, in some places, resembles a seal-ring as well as large and rough-grained nuclei with multiple nucleoli. Mitosis and polymorphonuclear (PMN) epithelial-like cells can be seen in the smear (B; magnification 200X). The cytologic diagnosis was P IV: strong suspicion of an epithelial-like, malignant ovarian tumour. On the right side, three-dimensional (X,Y,Z; three orthogonal planes) Power Doppler ultrasonographic visualization of the ovaries in a case of severe OHSS that demonstrates ominous signs of hypervascularization (static 3D image).