cytopathology conference 11/17/05 - case 1
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Cytopathology Conference 11/17/05 - Case 1TRANSCRIPT
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Cytopathology Cytopathology Conference: A Few Conference: A Few Interesting CasesInteresting Cases
November 17, 2005November 17, 2005
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Case #4Case #4
Cervicovaginal thinprep from a Cervicovaginal thinprep from a 55-year-old female.55-year-old female.
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Diagnosis?Diagnosis?
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Endocervical Endocervical AdenocarcinomaAdenocarcinoma
in Situ (AIS)in Situ (AIS)
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Adenocarcinoma in SituAdenocarcinoma in Situ GroupsGroups
Very crowdedVery crowded
Stratified stripsStratified strips
RosettesRosettes
Conventional slides: “feathering”Conventional slides: “feathering”
Liquid-based slides: “knucklesLiquid-based slides: “knuckles””
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Adenocarcinoma in SituAdenocarcinoma in Situ NucleiNuclei
High N/C ratioHigh N/C ratio
Oval to elongated or regularOval to elongated or regular
Marked hyperchromasiaMarked hyperchromasia
Coarse chromatinCoarse chromatin
Nucleoli typically inconspicuousNucleoli typically inconspicuous
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Adenocarcinoma in SituAdenocarcinoma in Situ
No diathesisNo diathesis
Frequently associated with Frequently associated with squamous lesionssquamous lesions
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Case #4Case #4
64-year-old female with 64-year-old female with a history of a left breast a history of a left breast mass.mass.
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Diagnosis?Diagnosis?
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Mucinous Neoplasm or Mucinous Neoplasm or LesionLesion
Suspicious for mucinous carcinomaSuspicious for mucinous carcinoma Differential includes mucocele-like lesionDifferential includes mucocele-like lesion
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Mucocele with an associated Intraductal Papilloma
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Papilloma: Benign Features
• Well developed fibrovascular core – Arborizing fronds
– Club-like fronds can have adenomatous component
• Two Cell types– Myoepithelial cell variably distinctive but
always present
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Differential
• Colloid Carcinoma– Irregular groups of cells
– More single intact cells
– Abnormal nuclei
– Older patients
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Comparison: Colloid Carcinoma
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Comparison: Colloid Carcinoma
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Colloid Carcinoma
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Case #5Case #5
55-year-old male with an FNA 55-year-old male with an FNA from a right inguinal lymph from a right inguinal lymph node.node.
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Diagnosis?Diagnosis?
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High-grade mostly necrotic High-grade mostly necrotic malignant neoplasmmalignant neoplasm
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ImmunohistochemistryImmunohistochemistry
Vimentin: Vimentin: PositivePositive
Pan-Keratin, CK7, CK20, LCA, Pan-Keratin, CK7, CK20, LCA, CD20, CD3 and c-kit: negative CD20, CD3 and c-kit: negative
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Final DiagnosisFinal Diagnosis
High-grade mostly necrotic High-grade mostly necrotic malignant neoplasmmalignant neoplasm