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Slide Seminar 16 - Diagnostic Cytopathology: Something for Everyone
Wednesday, September 20, 2006 08:00 - 12:00
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Moderator:
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Dr. Celeste N. Powers
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Disclosure:
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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 Slide Seminar) must disclose this to attendees. The Academy also requires that speakers disclose any products that are not labeled for the use under discussion. Faculty members for this Slide Seminar have indicated they have no disclosures to make.
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Clinical histories are displayed below.
Click on the case numbers to display the text and references for each case.
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- Normal Vaginal Smear of a Neovagina
Submitted by: Dr. Ed Cibas
Vaginal smear. A 35-year-old presents s/p hysterectomy.
Case 1 - Slide 1
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- Metastatic Gastric Adenocarcinoma, of Signet-ring Type
Submitted by: Dr. Terrence Colgan
Peritoneal fluid. This 30-year-old woman presented to the Emergency Department with a 4-week history of abdominal pain and a history of fullness in the upper abdomen, culminating in an increase in abdominal girth in the last few days. She had otherwise been well. A CT scan of the abdomen revealed a right ovarian mass of 12 cm, a left ovarian mass of 4 cm, massive ascites and omental thickening consistent with metastatic disease. A serum ß-HCG was negative, but a serum a-fetoprotein was increased to 160 mcg/L (normal <10). A paracentesis of the abdomen was performed.
Case 2 - Slide 1
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- Surprises in Scalp Aspirations
Submitted by: Dr. Gladwyn Leiman
FNA of scalp. A 45-year-old man, HIV positive for 10 years, on HAART for 7 years, complained of "feeling funky" for a month. He described a vague vertical headache and was found to have 2 adjacent scalp masses, vaguely outlined, on the vertex of the scalp. They were superficial, rubbery in consistency, and non-tender. The patient was non-febrile. An FNA of the scalp mass was performed.
Case 3 - Slide 1
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Case 3 - Slide 2
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- Small Blue Cells in a Postmenopausal Pap Test
Submitted by: Dr. Máire Duggan
Pap Test. A 69-year-old woman had a routine Pap test. Past history, system review and physical examination was unremarkable.
Case 4 - Slide 1
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- Fungal Infection: Pseudallescheria Boydii
Submitted by: Dr. Ritu Nayar
Bronchioloalveolar lavage. A 62-year-old female presented with decreased appetite, weight loss and left pleuritic chest pain. A lavage was performed.
Case 5 - Slide 1
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- Mixed Papillary, Insular, and Anaplastic Carcinoma of the Thyroid
Submitted by: Dr. Ed Cibas
FNA of thyroid. A 64-year-old woman presents with a hard right thyroid mass.
Case 6 - Slide 1
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- LBC (ThinPrep®) Increased Sensitivity in the Detection of Glandular Lesions
Submitted by: Dr. Terrence Colgan
Pap test. A 44-year-old woman was referred for colposcopy and management of an abnormal Pap smear. The patient subsequently underwent a loop electro-excisional procedure (LEEP). Four months later she returned for a follow-up visit and this ThinprepTM was taken.
Case 7 - Slide 1
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- Pemphigus Vulgaris Presenting with Genital Ulceration, with Cervical Cytology
Submitted by: Dr. Gladwyn Leiman
Pap test. A 43-year-old female with a 1-month history of dyspareunia and an offensive vaginal discharge. The cervix appeared inflamed and hemorrhagic; a Pap smear was taken.
Case 8 - Slide 1
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- Lung FNA: Well Differentiated Fetal Adenocarcinoma
Submitted by: Dr. Máire Duggan
FNA of lung. A 25-year-old woman presented with a 3 to 4 day history of pleuritic type chest pain, shortness of breath, fever and chills. The patient had a six-year history of chronic bronchitis, attributed to her 1 pack a day, 10-year smoking habit. Her family medical history was remarkable for premenopausal breast cancer in her grandmother, five maternal grand aunts, and her mother. At presentation, the patient was noted to be in mild respiratory distress. Examination revealed reduced air entry and breath sounds in the right lower lobe. A pleural effusion was also detected. Chest X ray confirmed the presence of a right-sided pleural effusion with consolidation of the right lower lobe. A large, 10 cm mass was also identified in the same lobe. The patient was initially treated with antibiotics and right-sided chest tube to drain the effusion. Nine days later she underwent CT guided FNA of the mass using a #20 Chiba needle.
Case 9 - Slide 1
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Case 9 - Slide 2
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Case 9 - Slide 3
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- Renal Cell Carcinoma, Papillary (Chromophil) RCC
Submitted by: Dr. Ritu Nayar
FNA biopsy of lymph node. A 77-year-old male who presented with hematuria and enlarged retroperitoneal lymph node, which was aspirated.
Case 10 - Slide 1
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