Diagnostic Cytology SeminarNovember 6, 2006

Sheraton CentreToronto, Ontario, Canada

Moderator: Celeste N. Powers, M.D., Ph.D.Panelists: Terence Colgan, M.D.

Tarik M. Elsheikh, M.D.Jennifer A. Brainard, M.D.

Michael Facik, M.P.A., CT(ASCP)

CASE 1 ANSWER

Thyroidectomy:Thyroidectomy:Papillary Thyroid Carcinoma, oxyphilic typePapillary Thyroid Carcinoma, oxyphilic type

FNA Dx:FNA Dx:Cystic lesion, suspicious for papillary caCystic lesion, suspicious for papillary ca

CASE 2 ANSWER

Nephrectomy:Nephrectomy:Renal Cell Carcinoma, mixed clear and granular Renal Cell Carcinoma, mixed clear and granular

cell types, Fuhrman Grade III, multifocalcell types, Fuhrman Grade III, multifocal

FNA DX:FNA DX:Metastatic Renal Cell CarcinomaMetastatic Renal Cell Carcinoma

CASE 3 ANSWER

BAL Dx:BAL Dx:Acute InflammationAcute InflammationInfectious Process,Infectious Process,NocardiaNocardia spp. spp.(negative for AFB, PCP)(negative for AFB, PCP)

CASE 4 ANSWER

Hysterectomy:Hysterectomy:

Adenocarcinoma,Adenocarcinoma,endometrioid type with focal squamous differentiation, endometrioid type with focal squamous differentiation,

FIGO II arising in an endometrial polyp without FIGO II arising in an endometrial polyp without myometrial invasionmyometrial invasion

Cx Cytology: Cx Cytology:

AGUS, Carcinoma not excludedAGUS, Carcinoma not excluded

Endometrial Biopsy:Endometrial Biopsy:

Endometrioid carcinoma, FIGO IIEndometrioid carcinoma, FIGO II

CASE 5 ANSWER

FNA Dx:FNA Dx:Malignant cells present consistent with Malignant cells present consistent with

adenosquamous carcinomaadenosquamous carcinoma

Patient lost to follow up.Patient lost to follow up.

CASE 6 ANSWER

Lymph Node Biopsy Dx:Lymph Node Biopsy Dx:Rosai-Dorfman’s Dz (Sinus histiocytosis Rosai-Dorfman’s Dz (Sinus histiocytosis

with massive lymphadenopathy)with massive lymphadenopathy)

FNA Dx:FNA Dx:

Rosai-Dorfman’s DzRosai-Dorfman’s Dz (Sinus histiocytosis (Sinus histiocytosis with massive lymphadenopathy)with massive lymphadenopathy)

CASE 7 ANSWER

Cervical Biopsy:Cervical Biopsy:Carcinosarcoma (Malignant mixed Carcinosarcoma (Malignant mixed

mesodermal tumor)mesodermal tumor)

Cx Cytology:Cx Cytology:NILMNILM

Squamous metaplasia, CervicitisSquamous metaplasia, Cervicitis

CASE 8 ANSWER

Parotidectomy:Parotidectomy:Acinic Cell CarcinomaAcinic Cell Carcinoma

FNA Dx:FNA Dx:Salivary Gland neoplasm, cytologically benign, Salivary Gland neoplasm, cytologically benign,

favor monomorphic adenomafavor monomorphic adenoma