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Cytopathology Challenge! Weekly Cases

Cytopathology Challenge! Weekly Cases. September 1 st , 2008. 34 year old female, FNA of parotid Benign salivary gland tissue Pleomorphic adenoma Warthin’s tumor Adenoid cystic carcinoma Acinic cell carcinoma. 1. 34 year old female, FNA of parotid Benign salivary gland tissue

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Cytopathology Challenge! Weekly Cases

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  1. Cytopathology Challenge! Weekly Cases September 1st, 2008

  2. 34 year old female, FNA of parotid • Benign salivary gland tissue • Pleomorphic adenoma • Warthin’s tumor • Adenoid cystic carcinoma • Acinic cell carcinoma 1

  3. 34 year old female, FNA of parotid • Benign salivary gland tissue • Pleomorphic adenoma • Warthin’s tumor • Adenoid cystic carcinoma • Acinic cell carcinoma • Serous cells with granular cytoplasm resembling normal acinic cell, but unlike the distinct “bunches of grapes” arrangement of benign acinic cells intermixed with ductal cells, this FNA shows only sheets of acinic cells. 1

  4. FNA of submandibular saliv gland • Benign salivary gland tissue • Pleomorphic adenoma • Warthin’s tumor • Adenoid cystic carcinoma • Acinic cell carcinoma 2

  5. FNA of submandibular saliv gland • Benign salivary gland tissue • Pleomorphic adenoma • Warthin’s tumor • Adenoid cystic carcinoma • Hyaline spherical globules of varying size with surrounding basaloid cells • Acinic cell carcinoma 2

  6. 45 year old female. FNA of thyroid • Colloid • Hyperplastic nodule • Follicular adenoma • Papillary thyroid carcinoma • Hashimoto’s thyroiditis 3

  7. 45 year old female. FNA of thyroid • Colloid • This is another photogenic representation of colloid. • Hyperplastic nodule • Follicular adenoma • Papillary thyroid carcinoma • Hashimoto’s thyroiditis 3

  8. 49 year old female. FNA of parotid • Benign salivary gland • Warthin’s tumor • Pleomorphic adenoma • Mucoepidermoid carcinoma • Adenoid cystic carcinoma 4

  9. 49 year old female. FNA of parotid • Benign salivary gland • Warthin’s tumor • Pleomorphic adenoma • Mucoepidermoid carcinoma • Squamous cells (black arrow), intermediate cells (green), and mucin secreting cells (yellow). • Adenoid cystic carcinoma 4

  10. Lung FNA • Granulomas • Hamartoma • AdenoCa • SCC • Small cell carcinoma 5

  11. Lung FNA • Granulomas • Hamartoma • AdenoCa • SCC • Small cell carcinoma 5

  12. 29 year old female. Peritoneal lavage. • Amebiasis • Reactive mesothelial cells • Lymphoma • Adenocarcinoma • Metastatic papillary thyroid carcinoma 6

  13. 29 year old female. Peritoneal lavage. • Amebiasis • Reactive mesothelial cells • “Daisy cells” are normal mesothelial cells with multiple deep nuclear indentations. Apparently, this type of cell is only seen in peritoneal mesothelial cells. • Lymphoma • Adenocarcinoma • Metastatic papillary thyroid carcinoma 6

  14. 35 year old female, FNA of parotid • Benign salivary gland tissue • Pleomorphic adenoma • Warthin’s tumor • Adenoid cystic carcinoma • Acinic cell carcinoma 7

  15. 35 year old female, FNA of parotid • Benign salivary gland tissue • Pleomorphic adenoma • Poorly cohesive epithelial-like cells associated with fibromyxoid stroma. • Warthin’s tumor • Adenoid cystic carcinoma • Acinic cell carcinoma 7

  16. 69 year old male. FNA of neck mass • Negative for malignancy • Reactive lymphoid hyperplasia • Metastatic squamous cell ca • Metastatic melanoma • Amebic abscess 8

  17. 69 year old male. FNA of neck mass • Negative for malignancy • Reactive lymphoid hyperplasia • Metastatic squamous cell ca • Metastatic melanoma • Amebic abscess 8

  18. BAL A. Candida B. Aspergillus C. PCP D. Amebiasis E. Scedosporium 9

  19. BAL • A. Candida • B. Aspergillus • C. PCP • D. Amebiasis • Scedosporium • If you picked this one all I can say is WOW! 9

  20. 63 year old male. FNA of parotid • Non diagnostic FNA • Reactive lymph node in parotid gland • Warthin’s tumor • Acinic cell carcinoma • Mucoepidermoid carcinoma 10

  21. 63 year old male. FNA of parotid • Non diagnostic FNA • Reactive lymph node in parotid gland • Warthin’s tumor • Also called “papillary cystadenoma lymphomatosum papilliferum.” Lymphocytes and oncocytic cells. • Acinic cell carcinoma • Mucoepidermoid carcinoma 10

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