Cytopathology Challenge! Weekly Cases

October 1st 2007

66 year old female. BALA. Oral contaminantB. Squamous metaplasiaC. Inflammatory change/reactiveD. Suspicious for tumorE. Squamous Cell CA

54 year old female with liver transplantBAL for respiratory distress/infiltrates.A. DirofilariaB. StrongyloidesC. EnterobiusD. TrichurisE. Ascaris

23 year old female. ThinPrep pap.A. ReactiveB. ASCUSC. LSILD. HSILE. Squamous metaplasia

78 year old male. BAL. A. Pulmonary macrophagesB. AtypicalC. SuspiciousD. Positive for tumorE. Reactive

38 year old female. ThinPrep PapA. Squamous metaplasiaB. Reactive endocervical cellsC. ASCUSD. LSILE. HSIL

57 year old female. Ovarian mass. Pelvicwashing in OR.A. Reactive mesothelial cellB. LymphomaC. HistiocyteD. Consistent with Ovarian CAE. Artifact

45 year old female. Corneal scrape GMSA. HistoplasmosisB. HistoplasmosisC. PCPD. CandidaE. Acanthameba

72 year old female. Common bile duct brushingA. ReactiveB. AtypicalC. SuspiciousD. PositiveE. Epithelial Cell Abnormality

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

26 year old female.ThinPrep Pap.A. Squamous metaplasiaB. Reactive endocervical cellsC. Atrophic changesD. ASCUSE. LSIL

Answers1. Squamous cell Ca

• Large tumor cell with features of squamous cell

2. Strongyloides• Coolest case of the week!

3. LSIL• Koilocytes

4. Positive for tumor• Non-small cell lung CA – probably squamous again.

5. HSIL• NC ratio is increased, not koilocytes.

6. Consistent with ovarian cancer• Tumor cell in peritoneal washing – used for staging purposes.

7. Candida• Budding yeast

8. 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

9. Papillary thyroid tumor. Correct answer is “E”• Check out Rosai page 535….

10. Squamous metaplasia• Normal finding