—  SPECIALTY CONFERENCE  — Cytopathology Wednesday, March 21 , 2012, 7:30 PM Convention Centre 301-305 Click the button above to add this event to your Itinerary Planner... Moderator: PAUL WAKELY The Ohio State Univ/Medicine Columbus, OH Disclosure: In accordance with ACCME guidelines regarding disclosure, the USCAP policy requires that faculty members who have a significant financial or other relationship with a commercial company, entity, or service (which will be discussed in this Symposium) must disclose this to attendees. The Academy also requires that speakers disclose any products that are not labeled for the use under discussion. The speakers listed below have indicated they have nothing to disclose. Panelists: Lester J. Layfield, University of Utah, Salt Lake City, UT Jan F. Silverman, West Penn Allegheny Gen Hosp, Pittsburgh, PA Dina R. Mody, The Methodist Hospital, Houston, TX David Chhieng, Yale University School of Medicine, New Haven, CT Clinical histories are displayed below. For the fastest viewing of virtual slides, click: under each thumbnail image below. You must have Aperio ImageScope installed on your PC. If you do not already have Aperio ImageScope, Windows users with administrator privileges may download and install a free version in order to view USCAP Virtual Slides. Click the icon on the right to get your free copy:   Or, click on slide thumbnail images to view each slide in a Web-based slide viewer, which is somewhat slower. If you have any difficulties viewing these slides, email or call George Clay at +1.724.449.1137. Case 1 Submitted by: Lester Layfield - University of Utah, Salt Lake City, UT Clinical Summary: The patient is a 43 year old Iraqi American with a history of hypertension and hemophilia with Factor VIII deficiency. He has received numerous blood transfusions to help control his hemophilia. The patient is HIV positive secondary to multiple blood transfusions and also is known to be Hepatitis C positive. In May of 2009, the patient presented to Orthopedic Oncology Clinic with a large (20 cm) right thigh and hip mass. The mass was initially believed to be a massive hematoma based on his known history of hemophilia. Imaging studies including CT and MRI were equivocal for a neoplasm and a fine-needle aspiration was obtained. The FNA revealed rare atypical cells admixed with a large amount of blood. The patient underwent drainage and debulking of the suspected hematoma. Histologic evaluation of the specimen resulted in a diagnosis of malignancy. Following this diagnosis, the mass was resected. The patient was placed on chemotherapy and followed with CT examinations of the leg to detect possible recurrence as well as chest x-rays every three months. In October of 2011, multiple pulmonary nodules were detected as was an adrenal mass. Fine-needle aspiration of the adrenal mass was performed which yielded the material submitted for review. Case 1 - Figure 1 Diff Quik x 200 Case 1 - Figure 2 Diff Quik x 200 Case 1 - Figure 3 Diff Quik x 400 Case 1 - Figure 4 H&E x 200 Case 1 - Figure 5 Diff Quik x 400 Case 1 - Figure 6 Diff Quik x 600 Case 1 - Figure 7 Diff Quik x 1000 Case 1 - Figure 8 Diff Quik x 400 Case 1 - Figure 9 Diff Quik x 1000 Case 1 - Figure 10 Diff Quik x 1000 Case 1 - Figure 11 Diff Quik x 1000 Case 1 - Figure 12 Diff Quik x 1000 Case 2 Submitted by: Jan Silverman - West Penn Allegheny Gen Hosp, Pittsburgh, PA Clinical Summary: 80 y/o African-American male with history of CLL/SLL underwent FNA new 8 cm. left inguinal mass Case 2 - Figure 1 DQ10x Case 2 - Figure 2 DQ10x-2 Case 2 - Figure 3 DQ20x-1 Case 2 - Figure 4 DQ20x-2 Case 2 - Figure 5 DQ40x Case 2 - Figure 6 PAP10x Case 2 - Figure 7 PAP20x-1 Case 2 - Figure 8 PAP20x-2 Case 2 - Figure 9 PAP40x-2 Case 3 Submitted by: Dina R. Mody - The Methodist Hospital, Houston, TX Clinical Summary: 39 YR old hispanic male who was working in his garage and suddenly developed hemoptysis. Rushed to local emergency room. Found to have a "patch" of pneumonia on chest films. Was transfered to tertiary care center due to deterioration of condition. Pertinent Laboratory Data: Patient admitted to ICU. Condition worsening. BAL (Bronchioloalveolar lavage) performed. HIV status is unknown at time of reciept of BAL in laboratory but was subsequently found to be negative Case 3 - Figure 1 Case 3 - Figure 2 Case 3 - Figure 3 Case 3 - Figure 4 Case 3 - Figure 5 GMS Case 3 - Figure 6 GMS Case 3 - Figure 7 Gram Case 4 Submitted by: David Chhieng - Yale University School of Medicine, New Haven, CT Clinical Summary: A 66 year old man was found to have an incidental thyroid nodule on ultrasound examination. He had no other symptoms. He had history of head and neck irradiation exposure in childhood. There was no other significant medical or surgical history or pertinent family history except for a left facial hemanigoma. On physical examination, a small nodule was palpable in the isthmus of the thyroid gland. The patient had no palpable lymphadenopathy. Thyroid function tests were within normal limits. Thyroid ultrasound revealed a well-circumscribed hypoechoic nodule, measuring 1.5 cm, in the right isthmus. There were also several smaller nodules scattered in both the left and right lobes of the thyroid gland. The patient underwent an ultrasound guided fine needle aspiration biopsy of the isthmic nodule. Case 4 - Figure 1 Case 4 - Figure 2 Case 4 - Figure 3 Case 4 - Figure 4 Case 4 - Figure 5 Case 4 - Figure 6 Case 4 - Figure 7 Case 4 - Figure 8 Handouts for all Specialty Conferences will be accessible via the "Educational Materials" section on the homepage the morning after each respective conference. Printed copies of the handout will not be available at the meeting.