Surgical restaging by laparoscopy (peritonoscopy) and histopathologic findings showing different patterns of peritoneal involvement following prior systemic chemotherapy. (A,B) Exophytic peritoneal metastases approximately 1 cm in diameter showing multiple capillary loops. Histologic evaluation demonstrates numerous blood vessels surrounded by tumor cells. (C,D) Small 1 mm sized peritoneal metastases that are subperitoneal on histologic evaluation. (E,F) Multiple metastases about 1 cm in diameter that are growing deep to the peritoneal surface and coalescing to form plaques. Histologic evaluation demonstrates that these lesions are relatively avascular and contain significant amounts of peritumoral fibrosis. (Reprinted with permission from Cytokine, Cellular & Molecular Therapy).