By measuring ascites fluid cholesterol and lactate dehydrogenase, it is possible to distinguish malignant ascites from ascites due to cirrhosis or hepatocellular carcinoma. Malignant ascites involves peritoneal metastases from ovarian, endometrial, cervical, breast, or gastrointestinal carcinomas and from malignant lymphoma. Hepatocellular carcinoma frequently arises in cirrhotic livers and usually does not cause a malignant ascites.

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