Case 1 - Click here for Text and References
Submitted by: Susan J. Maygarden
A 21 year old college student presented with jaw pain, fullness under the left angle of the jaw, diminished hearing in the left ear, trismus and 15 pound weight loss. This initially was felt to represent unilateral otitis media, but when myringotomy was unsuccessful an MRI scan was obtained, which showed a large parapharyngeal mass displacing the left tonsil medially and extending to the skull base. Transoral fine needle aspiration was performed. The images are from Diff-Quik and Pap stained direct smears and H&E stained cell block from the aspiration.
Case 2 - Click here for Text and References
Submitted by: Diane D. Davey
A 69 year old man with a history of non-small cell lung carcinoma 8 years prior presents with a 2 month history of worsening shortness of breath, fatigue, weight loss, cough, and wheezing. He had been treated with both chemotherapy and radiation and continued to smoke 1/2 pack per day. A work-up revealed a large pleural effusion, plus intense right lung and pleural uptake on a PET scan. A pleural effusion was submitted to cytology for evaluation.
Pertinent Laboratory Data:
Pleural fluid WBC: 1069/µL; pleural fluid RBC: 3700/µL; pleural fluid protein: 4.6 g/dL Complete blood count showed Hematocrit 42%, WBC 14,000/µL, platelets 179,000/µL
Case 3 - Click here for Text and References
Submitted by: Tarik Elsheikh
59 year old man presented with a tumor of the left parotid gland, which has been growing in size. The tumor was noted to be in the deep lobe of parotid.
An ultrasound-guided FNA was performed. A single LBC (ThinPrep) slide was prepared.
Case 4 - Click here for Text and References
Submitted by: Zubair W. Baloch
24-year-old woman presented with a large neck mass involving thyroid and right lateral neck. According to the patient this mass originally started as a small nodule and has rapidly increased to the present size of 4.5 cm over the course of 6 months. She had a thyroid ultrasound which demonstrated right thyroid mass associated with right cervical adenopathy; indirect laryngoscopy showed extrinsic compression of trachea from right anterior aspect. Patient underwent CT neck, which showed a 4.5 cm mass centered on the right lobe of the thyroid gland, narrowing and displacing the trachea. Patient also had a PET/CT which showed an intensely FDG avid mass centered on the right lobe of the thyroid, narrowing and displacing the trachea with multiple FDG avid right cervical lymph nodes extending into the thoracic inlet.