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cytology_cases_Jan_20_09_v2

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					January 20, 2009
    28 y/o female. Thin Prep.
    A. Atypical glandular cells (AGUS)
    B. HSIL
    C. Tubal metaplasia
    D. Benign endometrial cells
1   E. Adenocarcinoma
The cells are
hyperchromatic and
overlapping; however
cilia is present. Tubal
metaplasia of
endocervical cells can
often be confused for
HSIL/AGUS, but cilia
denotes a benign
process.




                          28 y/o female. Thin Prep.
                          A. Atypical glandular cells (AGUS)
                          B. HSIL
                          C. Tubal metaplasia
                          D. Benign endometrial cells
 1                        E. Adenocarcinoma
33 y/o female. Thin Prep Pap. Based
   on the cells shown above, what is
   the appropriate management for
   the patient?
A. Repeat cytology in 6 months
B. HPV molecular testing
C. Repeat cytology in 1 year
D. Colposcopy
E. Observation
                                       2
33 y/o female. Thin Prep Pap. Based
   on the cells shown above, what is
                                       All high grade
   the appropriate management for
                                       lesions (HSIL) go
   the patient?
                                       straight to
A. Repeat cytology in 6 months
                                       colposcopy.
B. HPV molecular testing
C. Repeat cytology in 1 year
D. Colposcopy
E. Observation
                                                       2
18 y/o female. Thin Prep Pap.
Based on the cells shown, what is
the appropriate management for
the patient?

A.   Repeat cytology in 6 months
B.   HPV molecular testing
C.   Repeat cytology in 1 year
D.   Colposcopy
E.   Observation




                                   3
                                  18 y/o female. Thin Prep Pap.
                                  Based on the cells shown, what is
                                  the appropriate management for
                                  the patient?

                                  A.   Repeat cytology in 6 months
                                  B.   HPV molecular testing
                                  C.   Repeat cytology in 1 year
                                  D.   Colposcopy
                                  E.   Observation
For adolescents (20 years and
younger), the new guidelines
recommend repeat cytology at 12
months for both ASCUS and LSIL




                                                                     3
45 y/o female. FNA of thyroid.
A. Reactive, neg for malignancy
B. Goiter
C. Indeterminate for malignancy.
D. Papillary carcinoma.
E. Hashimoto’s thyroiditis
                                   4
                                   Cluster of lymphocytes and
                                   dispersed lymphs in the
                                   background




    Oncocytes




45 y/o female. FNA of thyroid.
A. Reactive, neg for malignancy
B. Goiter
C. Indeterminate for malignancy.
D. Papillary carcinoma.
E. Hashimoto’s thyroiditis
                                                                4
    54 y/o female. Thin Prep pap.
    A. HSIL
    B. Adenocarcinoma
    C. Benign endocervical cells
    D. Benign endometrial cells
5   E. Squamous cell carcinoma
Glandular cells with large
pleomorphic nuclei and
prominent nucleoli. Can
appreciate some
overlapping/architectural
disorder.




                             54 y/o female. Thin Prep pap.
                             A. HSIL
                             B. Adenocarcinoma
                             C. Benign endocervical cells
                             D. Benign endometrial cells
5                            E. Squamous cell carcinoma
    23 y/o female. Thin Prep pap.
    A. ASCUS
    B. Squamous metaplasia
    C. HSIL
    D. Endocervical cells
    E. LSIL




6
    23 y/o female. Thin Prep pap.
    A. ASCUS
    B. Squamous metaplasia
    C. HSIL
    D. Endocervical cells
    E. LSIL




6
    FNA of salivary gland mass. PAP
       stain
    A. Pleomorphic adenoma
    B. Mucoepidermoid carcinoma
    C. Normal salivary gland
    D. Adenoid cystic carcioma
7   E. Myoepithelioma
        Myoepithelial cells
        embedded in stroma




    Chondromyxoid stroma is
    present here. In this case, it is
    lacking the typical “fibrillary”
    appearance.

           FNA of salivary gland mass. PAP
              stain
           A. Pleomorphic adenoma
           B. Mucoepidermoid carcinoma
           C. Normal salivary gland
           D. Adenoid cystic carcioma
7          E. Myoepithelioma
55 yo female. Breast mass. FNA
A. Benign ductal cells
B. Fibroadenoma
C. Apocrine metaplasia
D. Breast carcinoma
E. Phyllodes tumor               8
                                 Disorderly sheets of
                                 crowded cells. Cells are
                                 pleomorphic, nuclear
                                 enlargement, coarse
                                 chromatin and prominent
                                 nucleoli.




55 yo female. Breast mass. FNA
A. Benign ductal cells
B. Fibroadenoma
C. Apocrine metaplasia
D. Breast carcinoma
E. Phyllodes tumor                                          8
75 yo female with idiopathic
   fibrosis. BAL
A. Candida
B. Aspergillus species
C. Pneumocystis
D. CMV
E. Amoeba




                               9
75 yo female with idiopathic
   fibrosis. BAL
A. Candida
B. Aspergillus species
C. Pneumocystis
D. CMV
E. Amoeba




     Just to prove you can see
     fungus on Pap stain. If only
     the boards were this easy…




                                9
44 yo female with liver lesion.
   FNA
A. Positive – c/w hepatocellular
   carcinoma
B. Positive – c/w melanoma met
C. Positive – c/w colon cancer met
D. Benign liver cells
E. Benign bile duct cells




                                     10
44 yo female with liver lesion.
   FNA
A. Positive – c/w hepatocellular
   carcinoma
B. Positive – c/w melanoma met
C. Positive – c/w colon cancer met
D. Benign liver cells
E. Benign bile duct cells




                                     10

				
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posted:8/10/2012
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