Interesting Case Presentation Written by: Neil Blackwell This case was provided by: GynaePath – Douglass Hanly Moir Pathology, Sydney, Australia.

Slides:



Advertisements
Similar presentations
July 21, year old female. Thin prep pap A) Reactive endocervical cells B) HSIL C) LSIL D) Squamous metaplasia E) ASCUS 1.
Advertisements

An 80-year-old female presented with an ulcerated nodule on the left cheek. An excision was performed.
Welcome Glandular workshop 29 th May Glandular Cytology in the BD SurePath® Liquid-based Pap Test Advanced Customer Training And Education BD Diagnostics,
SURGICAL APPROACH TO GYNAECOLOGICAL CANCERS
Cytology Training Program: Gyn Cytology Revision Exercise by Tony Chan
Week of March 30, year old female. Conventional pap A.Endocervical adenocarcinoma in situ B.Benign endometrial cells C.Viral changes consistent.
Hologic Proprietary © 2012 ThinPrep ® Pap Test Diagnostic Challenges and Differential Diagnoses.
Abnormal Vaginal Bleeding in a 56 year old Max Brinsmead PhD FRANZCOG May 2015.
A significant increase in the incidence of endometrial cancer. This increased incidence of endometrial cancer has been widely interpreted to be a result.
ThinPrep® General Cytology Lecture Series
Management of Gynaecological Cancers. Gynaecological Cancers in NSW 1180 new cases in % of all new cancer diagnoses Crude incidence rate 35.3 per.
Case Study 63: Cancer of the Female Breast
Section 2 Atypia.
MHD II Laboratory Session Cytology APRIL 24, 2014.
FNA of breast Slide session The 6th Arab-British School of Pathology
MRS PC, 63YO WOMAN  Initially presented with chronic RIF pain  Found to have cholelithiasis, underwent a laparoscopic cholecystectomy  On the laparoscopy,
Endometrial Carcinoma
Tumors of Cervix.
The Breast Clinic Index case Year 2 Michaelmas term.
Female Genital Tract Lab Dr. Nisreen Abu Shahin Assistant Professor of Pathology University of Jordan.
Neoplasia p.1 SYLLABUS: RBP(Robbins Basic Pathology) Chapter: Neoplasia Definitions Nomenclature Characteristics of benign and malignant neoplasms Epidemiology.
August 1st, year old female. ThinPrep pap A.Trichomonas B.Lactobacillus C.Atrophy D.Bacterial vaginosis E.Artifact 1.
Diagnostic Challenge Pathology for Neurosurgery & Neurology Residents Department of Pathology University of Oklahoma Health Sciences Center, Oklahoma City,
Lananh Nguyen, M.D. Division of Neuropathology University of Pittsburgh Medical Center 15-year-old boy presenting with back pain and skull lesion.
‘Let’s get it right - Referral for suspected Cancer’
April 2014 Dr J King Dr K Syred.  90% mesotheliomas are linked to asbestos exposure  May be eligible for compensation  3 yr survival rate 8%  Subtype.
17 th century microscopes In The Name of God PARISA REZAEI,M.D.,AP.CP.
Diagnostics. HEMATOLOGY Laboratory Work-Up NormalJune 23, 2010Remarks WBC4-11 x 10­ 9 /L8.08 x 10­ 9 /LNORMAL RBC4-6 x 10­ 9 /L4.82 x 10­ 9 /LNORMAL.
Diagnostic Challenge Pathology for Neurosurgery & Neurology Residents Department of Pathology University of Oklahoma Health Sciences Center, Oklahoma City,
Male Genital Tract 1, Case 3 A 72-year-old man presents with back pain. On physical exam there is tenderness over the lower spine. Neurologic exam is normal.
NEOPLASIA CASES. CASE 1 A 20 year old female presented with a round mobile breast lump. She has no family history of breast cancer Question : What test.
Diagnostic Challenge Pathology for Neurosurgery & Neurology Residents Department of Pathology University of Oklahoma Health Sciences Center, Oklahoma City,
Respiratory practical II
March 13, y/o female. FNA of thyroid. 1 Hashimoto’s thyroiditis Lymphocytes mixed with follicular cells.
KCP 784 경희대학교병원 병리과 박재영. Clinical History  F/54  20여 일간 지속된 폐경 후 질 출혈을 주소로 내원  2010년 자궁경부 생검에서 Mild dysplasia (CIN 1) 진단  이 후 추적 검사(Pap smear)에서 특이.
Cytology of Body Fluid Pleural peritoneal pericardial
KCP-771 ( 제출자 ) 원자력병원 R3 허일영. History  71 세 여자환자  6 개월 전부터 운동시 호흡곤란  2 주일 전부터 호흡곤란이 악화  흉부단순촬영에서 오른쪽 폐에 흉수와 무기폐.
KCP-760 ( 토 의 자 ) 원 자 력 병 원 전공의 허일영. Male / 75 Chief complaint: Chest pain on exertion for 6 months Chest CT: Pleural effusion with diffuse pleural thickening.
KCP 750 경북대학교병원 병리학교실 R3 김미선. History 63 세 여자환자 8 년전에 왼쪽 골반 통증으로 내원 -> 흉부전산화단층 촬영 : 양측 폐에 10 개정 도의 작은 결절 작년에 오른쪽 어깨와 등의 통증으로 내원 -> 흉부전산화단층 촬영에서 양측 폐의.
KCP 797 강남세브란스병원박혜성. 33/M, Cervical lymphadenopathy: R/O TB, R/O nonspecific lymphadenopathy R/O TB, R/O nonspecific lymphadenopathy.
KCP-786 KCP-786 서울대학교 병원 전공의 백해운. History 59 세 (Gravida5, Para2) 2007 년 HPV18(+) 이후 자궁질 도말검사를 수 차례 받음 Op Hx : 2011 년 담낭결석, 2010 년 복압 요실금 기타 특이사항 없음 2012.
KCP792 79/ 여자, 자궁경부 / 흉수 성균관의대 병리학교실 강북삼성병원 병리과 채승완.
An otherwise healthy 76 year-old man with h/o prostate cancer and renal cell carcinoma (s/p TURP and nephrectomy) was seen as part of his routine follow-up.
KCP 748 (P ) 고려대학교 구로병원 서울대학교 병원 R4 김효진 대한세포병리학회 4 월 월례집담회.
References:1. Georgiannos SN, et al/.Secondary neoplasms of the breast: a survey of the 20 th Century. Cancer 2001: 92 (9): Case Presentation:
case report Title: uterine mass Master: Dr.Mahzooni Resident: Dr.Soleimani 92/7/6.
KCP 788 가톨릭중앙의료원 전공의 서성욱. Clinical History F/39 특이 병력 없음 건강검진시 부인과 이상소견 자궁경부 세포학검사 후 원추절제술 및 자궁 절제술 시행 슬라이드는 자궁경부 액상도말표본.
KCP 791 삼성서울병원 전공의 신유주. Patient history F/58 On chemotherapy (due to breast cancer) Carotid doppler ultrasound (follow up) –Thyroid nodule Ultrasonography.
KCP-780 울산대학교 서울아산병원 전공의 노진. Patient History 72/M 경부 종괴 양측 갑상선 –2.0cm, 1.5cm 석회화를 동반한 저음영의 종괴 – 다양한 크기의 여러 결절 양측 경부 level Ⅲ, Ⅳ, Ⅴ 림프절 비대.
Advanced Ovarian Dysgerminoma infiltrating both ovaries and uterus in a 7-year-old girl: a case report Hyseni N.S.1, Llullaku S.2, Jashari H.1, Zahiti.
Brain imaging prior to lung cancer resection
KCP-815 서울대학교 병원 전공의 최은오.
KCP 794 인하대병원 전공의 최창환.
Medullary Thyroid Carcinoma
CT-guided FNAB of intra-abdominal desmoplastic small round cell tumor (DSRCT): A case report with presentation of cytologic and immunocytochemical features.
Male and Female Reproductive Health Concerns
History 58 year-old female presented with back pain and right toe numbness. Her past medical history was significant for hypertension, glaucoma and.
Primary Urethral Clear-Cell Adenocarcinoma
Chapter 14 Hepatic Tumors, Malignant 1
Case Study 44 Julia Kofler, M.D..
Acta Cytologica 2015;59: DOI: /
GEMSTONE Educational Case Summary
Cytological changes in abnormal conditions
Case Study 41 Henry Armah, M.D., M.Phil..
Acta Cytologica 2014;58: DOI: /
FNAC for Diagnosis - the very basic for ALL –
GEMSTONE Educational Case Summary
Extraosseous Ewing sarcoma arising in a chronically lymphedematous limb  David John Tobias McArdle, BA (Hons), MPsych (Clin Neuro), MBBS, Louise Nott,
Peter Kulesza, Isam A. Eltoum  Clinical Gastroenterology and Hepatology 
(A–C) Electron microscopic images obtained from two different cases, (A) a cluster of large malignant cells with cytoplasmic mucin vacuoles consistent.
Presentation transcript:

Interesting Case Presentation Written by: Neil Blackwell This case was provided by: GynaePath – Douglass Hanly Moir Pathology, Sydney, Australia.

Patient History 37-year-old female Reporting abdominal discomfort and bloating LMP 2 weeks ago Normal appearing cervix Conventional Pap smear and ThinPrep ® Pap Test collected 2

Conventional Slide 3 Blood and inflammation 10x

ThinPrep ® Pap Test 4 Hyperchromatic crowded groups 10x

5 ThinPrep ® Pap Test 3-Dimensional groups 40x

ThinPrep ® Pap Test 6 Eccentrically placed nuclei 40x

ThinPrep ® Pap Test 7 Papillary-like projections 40x

ThinPrep ® Pap Test 8 Finely granular cytoplasm 40x

ThinPrep ® Pap Test 9 Cytoplasmic vacuolization 40x

ThinPrep ® Pap Test 10 Granular chromatin 40x

ThinPrep ® Pap Test 11 Variation in nuclear shape & size 40x

ThinPrep Pap Test 12 Background clingy diathesis 40x

ThinPrep ® Pap Test 13 Prominent nucleoli and scalloped edges 40x

Ancillary testing from the Vial 14 Residual material: Agar cell bock from ThinPrep vial H&E section 14 Immunocytochemistry Panel

Cell Block from the ThinPrep ® Vial 15

Immunocytochemistry CA Membranous staining

Final Cytology Diagnosis Adenocarcinoma Strong membranous staining of the tumour cells are suggestive of a tumour –Ovarian (most likely) –Biliary duct and breast (can not be excluded) –Clinical and Radiological correlation is recommended Cell block and Immunohistochemical stains Positive: CA125 CK7, CK19 Negative: PAX8, CK20, p53, p16, ER & PR, AMACR, NAPSIN A, HNF 1B, CDX 2,GATA3, P63 The cell block shows multiple groups and clusters of malignant cells with high nuclear to cytoplasmic ratio, pleomorphic nuclei and prominent nucleoli The features are consistent with an adenocarcinoma 17

Patient follow up 18 Investigative tests were ordered for lower pelvic discomfort, abdominal distention and Sister Mary Joseph’s nodule: Pelvis U/S - Showed an ascites CT Scan Referral to a Gynaecologist Treatment: Radical hysterectomy - Stage IV High Grade Ovarian Ca Rectosigmoid resection Peritonectomy Chemotherapy 1. Example of Sister Mary Joseph’s nodule 1 ADS Rev. 001