Cytopathology Challenge! Weekly Cases

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Cytopathology Challenge! Weekly Cases

• October 1st 2007

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• 66 year old female. BAL
• Oral contaminant
• Squamous metaplasia
• Inflammatory change/reactive
• Suspicious for tumor
• Squamous Cell CA

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• 54 year old female with liver transplant
• BAL for respiratory distress/infiltrates.
• Dirofilaria
• Strongyloides
• Enterobius
• Trichuris
• Ascaris

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• 23 year old female. ThinPrep pap.
• Reactive
• ASCUS
• LSIL
• HSIL
• Squamous metaplasia

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• 78 year old male. BAL.
• Pulmonary macrophages
• Atypical
• Suspicious
• Positive for tumor
• Reactive

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• 38 year old female. ThinPrep Pap
• Squamous metaplasia
• Reactive endocervical cells
• ASCUS
• LSIL
• HSIL

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• 57 year old female. Ovarian mass. Pelvic
• washing in OR.
• Reactive mesothelial cell
• Lymphoma
• Histiocyte
• Consistent with Ovarian CA
• Artifact

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• 45 year old female.
• Corneal scrape GMS
• Histoplasmosis
• Histoplasmosis
• PCP
• Candida
• Acanthameba

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• 72 year old female.
• Common bile duct brushing
• Reactive
• Atypical
• Suspicious
• Positive
• Epithelial Cell Abnormality

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• 38 year old female with thyroid nodule.
• FNA Pap stain.
• RET/PTC2 is the most common mutation
• RET/PTC1 is the least common mutation
• RET/PTC rearrangements are specific to this tumor
• These tumors are CK7-/CK20
• The proto-oncogene for this tumor is on 10q11.2

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• 26 year old female.
• ThinPrep Pap.
• Squamous metaplasia
• Reactive endocervical cells
• Atrophic changes
• ASCUS
• LSIL

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Answers

• Squamous cell Ca
• Large tumor cell with features of squamous cell
• Strongyloides
• Coolest case of the week!
• LSIL
• Koilocytes
• Positive for tumor
• Non-small cell lung CA probably squamous again.
• HSIL
• NC ratio is increased, not koilocytes.
• Consistent with ovarian cancer
• Tumor cell in peritoneal washing used for
  staging purposes.
• Candida
• Budding yeast
• Positive for tumor
• Likely an adenocarcinoma, I put an image of some
  Normal reactive epithelium from the case in the
  image in the bottom right corner for comparison
  to the tumor in the rest of the images
• Papillary thyroid tumor. Correct answer is E
• Check out Rosai page 535.
• Squamous metaplasia