Cytology Weekly Cases

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Cytopathology Challenge Weekly Cases
Week of September 29, 2008
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• 24 year old female. ThinPrep pap
• Lactobacillus
• Gonorrhea
• Trichomonas
• Bacterial Vaginosis
• Artifact

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3
24 year old female. ThinPrep pap D. Bacterial
Vaginosis coccobacilli cover the squamous
cells. Also called Clue cells
1
4

• 43 year old male. FNA of neck mass
• Nematode worm
• Rhabdomyosarcoma
• Normal muscle
• Squamous cell carcinoma
• Colloid

2
5
43 year old male. FNA of neck mass C. Normal
muscle strips/chunks of muscle with
peripherally placed nuclei and striations
2
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• 57 year old male. Urine cytology
• Reactive urothelial cells
• High grade TCC
• Low grade TCC
• Squamous cell carcinoma
• Polyoma virus

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57 year old male. Urine cytology E. Polyoma
virus enlarged cell with smudgy intranuclear
inclusion. Do not mistake for High grade TCC!
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8

• 62 year old female. Peritoneal fluid
• Positive for tumor - Adenocarcinoma
• Reactive mesothelial cells
• Atypical
• Positive for tumor Lymphoma
• Benign lymphocytic effusion

4
9

• 62 year old female. Pleural fluid
• Positive for tumor - Adenocarcinoma
• Cannonball group of epithelial cells with
  large nuclei and distinct cell borders.
  Pleomorphism and irregular nuclear membranes are
  seen. Patient had history of breast cancer.

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10
53 year old female. Pleural fluid A. Positive
for tumor - Adenocarcinoma B. Reactive
mesothelial cells C. Atypical D. Positive for
tumor Lymphoma E. Benign lymphocytic effusion
5
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53 year old female. Pleural fluid A. Positive
for tumor Adenocarcinoma Large pleomorphic
single cells with secretory vacuoles c/w
adenoca. Signet rings forms are noted. Pt
also has history of breast cancer. Dont
miss single malignant cells in
effusions!
5
12

• 36 year old female. Thyroid FNA
• Goiter
• Indeterminate
• Positive for tumor papillary thyroid carcinoma
• Positive for tumor follicular carcinoma
• Hurthle cell neoplasm

6
13
36 year old female. Thyroid FNA B.
Indeterminate multiple microfollicles with no
colloid in the background. This is suspicious
for a potential follicular neoplasm. On cytology
we call this indeterminate because we cannot
determine whether this is a follicular adenoma or
a follicular carcinoma (for which you need to see
either capsular /or vascular invasion on histo)
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14

• 60 year old male s/p bilateral lung transplant.
  BAL
• Aspergillus
• Candida
• PCP
• Mucor
• Fusarium

7
15

• 60 year old male s/p bilateral lung transplant.
  BAL
• Aspergillus septated hyphae with 45 degree
  branching

7
16

• 29 year old female. ThinPrep pap
• Reactive
• Endocervical cells
• ASC-US
• LSIL
• HSIL

8
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29 year old female. ThinPrep pap D. LSIL
enlarged nuclei with koilocytic change. Also
have binucleates
8
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63 year old male. FNA of lung A.
Adenocarcinoma B. Squamous cell carcinoma C.
Small cell carcinoma D. BAC E. Reactive
lymphocytes
9
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63 year old male. FNA of lung C. Small cell
carcinoma note the molding
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• 26 year old female. ThinPrep pap
• LSIL
• HSIL
• Endometrial cells
• Squamous cell carcinoma
• Tubal metaplasia

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26 year old female. ThinPrep pap B. HSIL
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