—  SPECIALTY CONFERENCE  — Cytopathology Wednesday, March 24, 2010, 7:30 PM Salon 3 Click the button above to add this event to your Itinerary Planner... Diagnostic Challenges in Cytopathology - The Case I'll Remember for the Rest of My Life Moderator: EVA WOJCIK Loyola University Medical Center Maywood, IL 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: BARBARA ANN CENTENO, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL CLAIRE W. MICHAEL, University of Michigan, Ann Arbor, MI EDMUND S. CIBAS, Brigham & Women's Hospital, Boston, MA SAVITRI KRISHNAMURTHYO, MD Anderson Cancer Center, Houston, TX GLADWYN LEIMAN, Fletcher Allen Health Care, University of Vermont, Burlington, VT 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: Barbara Ann Centeno, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL Clinical Summary: The patient was a 49 year old female who was found to have a hard, irregular, mobile mass in her right breast that had recently increased to 4.5 cm in size. Mammogram showed an oval mass with well-circumscribed borders and coarse, heterogenous calcifcations in the subareolar region of the right breast. She had experienced a fall two-three months prior which injured the right breast. Her past medical history was significant for invasive cervical cancer treated with chemotherapy and radiation 6 years prior to the discovery of this mass. A fine needle aspiration was performed using palpation. Case 1 - Slide 1 Click to view with ImageScope Click to view with a Web-Based Viewer Case 2 Submitted by: Claire W. Michael, University of Michigan, Ann Arbor, MI Clinical Summary: Thocacocentesis fluid submitted from a 63 years old man presenting with recurrent effusion. Chest x-ray and CT Scan with and without contrast showed large left pleural effusion. the lungs were clear and no pleural thickening or nodularities were noted. Case 2 - Slide 1 Click to view with ImageScope Click to view with a Web-Based Viewer Case 3 Submitted by: Edmund S. Cibas, Brigham & Women's Hospital, Boston, MA Clinical Summary: 31 year old man with longstanding juvenile rheumatoid arthritis and chronic renal failure. Now with diffuse enlargement of the thyroid. Thyroid FNA (all images: Papanicolaou-stained smear). Case 3 - Figure 1 Case 3 - Figure 2 Case 3 - Figure 3 Case 3 - Figure 4 Case 3 - Figure 5 Case 3 - Figure 6 Case 3 - Figure 7 Case 4 Submitted by: Savitri Krishnamurthy, MD Anderson Cancer Center, Houston, TX Clinical Summary: An 85 year old gentleman with chief complaints of left sided chest pain and breathlessness of gradual onset. In addition, he also gave the history of weight loss (17lb), anorexia and dyschezia. He had been a 50 pack a year cigarette smoker in the past. He underwent carolid endarterectomy, hernia repair, and removal of small skin lesions in the past. Chest X-ray revealed a right lower lobe lung mass measuring 3.0cm in maximum dimension. Subsequently, CT scan showed in addition a 2.5cm right adrenal mass. The patient was referred for further evaluation of the lung and adrenal mass. Fine needle aspiration (FNA) of the adrenal mass was performed. Direct smears of FNA of the adrenal mass are provided. 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 Case 4 - Figure 9 PANCYTOKERATIN Case 4 - Figure 10 MELAN-A Case 4 - Figure 11 S-100 Case 4 - Figure 12 INHIBIN Case 4 - Figure 13 S-100 Case 5 Submitted by: Gladwyn Leiman, Fletcher Allen Health Care, University of Vermont, Burlington, VT Clinical Summary: 57 year old man with 4cm heterogeneous mass in the tail of the pancreas; FNA performed under endoscopic ultrasound guidance. Case 5 - Figure 1 Case 5 - Figure 2 Case 5 - Figure 3 Case 5 - Figure 4 Case 5 - Figure 5 Case 5 - Figure 6 Case 5 - Figure 7 Case 5 - Figure 8 Case 5 - Figure 9 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.