Cytology Weekly Cases

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Cytopathology Challenge Weekly Cases
Week of March 30, 2009
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• 17 year old female. Conventional pap
• Endocervical adenocarcinoma in situ
• Benign endometrial cells
• Viral changes consistent with Herpes
• Alternaria
• Trichimonas

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17 year old female. Conventional pap C. Viral
changes consistent with Herpes This picture
is slightly out of focus however, you can still
see the molding and margination of the nuclei c/w
herpes
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4

• 69 year old male. FNA of Lung
• Granuloma
• Non-small cell carcinoma
• Small cell carcinoma
• Reactive bronchial cells
• Lymphoma

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69 year old male. FNA of Lung B. Non-small cell
carcinoma The cluster is cohesive with large
pleomorphic cells. The cells are overlapping and
disorganized.
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57 year old male. Urine cytology A. Polyoma
virus B. Reactive urothelial cells C. High grade
TCC D. Metastatic prostate carcinoma E. This
picture is horribleI cant tell.
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57 year old male. Urine cytology C. High grade
TCC -- Though this picture is horrible (much
like the pictures on the test), you can tell this
is high grade TCC. The cells are enlarged
(compared to the polys) with irregular nuclear
membranes, eccentric nuclei and dark/irregularly
distributed chromatin.
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• 67 year old male. History of prostate carcinoma
  and squamous cell carcinoma of the lung. Now
  presents with bone pain. FNA of bone lesion
• Positive for tumor - Adenocarcinoma
• Positive for tumor - SCC
• Plasma cell neoplasm
• Positive for tumor Lymphoma
• Positive for tumor - melanoma

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Pap
Diff Quick
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• 67 year old male. History of prostate carcinoma
  and squamous cell carcinoma of the lung. Now
  presents with bone pain. FNA of bone lesion
• Positive for tumor Adenocarcinoma
• The cells are cohesive with vague formation
  of acinar structures (seen in DQ). The
  monomorphic appearance of the cells along with
  the prominent nuclei favors prostate
  adenocarcinoma. Melanoma is in the differential
  however, melanoma cells are usually more
  discohesive. Immunostains can always be done to
  help with the diagnosis.

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Pap
Diff Quick
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34 year old female. Thin Prep Pap A. LSIL B.
Squamous metaplasia C. Benign endocervical
cells D. HSIL E. AIS
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34 year old female. Thin Prep Pap D. HSIL
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60 year old male. BAL A. Aspergillus B.
Blastomycosis C. PCP D. A and B E. A and C
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60 year old male. BAL E. A and C This is a
case of Aspergillus and PCP together.
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• 51 year old female with extensive bilateral lung
  infiltrates. A BAL shows numerous amorphous
  globules as seen here. What stain should be
  ordered to confirm the diagnosis?
• Silver stain (GMS)
• PAS
• Iron stain
• Oil Red O
• Reticulin

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PAP
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51 year old female with extensive bilateral lung
infiltrates. A BAL shows numerous amorphous
globules as seen here. What stain should be
ordered to confirm the diagnosis? B. PAS PAS
will confirm the diagnosis of Pulmonary Alveolar
Proteinosis.
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PAS
Surgical
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41 year old female with newly developed breast
mass. Breast FNA A. Positive for breast
carcinoma B. Phyllodes tumor C. Fibroadenoma D.
Consistent with breast cyst E. Reactive ductal
cells
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41 year old female with newly developed breast
mass. Breast FNA C. Fibroadenoma
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• 29 year old female. ThinPrep pap
• Reactive
• Squamous metaplasia
• ASC-US
• LSIL
• HSIL

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29 year old female. ThinPrep pap D. LSIL
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