Oct 31, 2008. 44 y/o female. FNA of thyroid. A.Unsatisfactory due to insufficient cellularity. B.Lymphocytic thyroiditis. C.Goiter D.Indeterminate. E.Papillary.

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Oct 31, 2008

44 y/o female. FNA of thyroid. A.Unsatisfactory due to insufficient cellularity. B.Lymphocytic thyroiditis. C.Goiter D.Indeterminate. E.Papillary carcinoma. 1 Mixture of lymphocytes and follicular cells.

2 Bronchoalveolar lavage. A.Unsatisfactory. B.Malignant cells present. C.PCP D.Strongyloides E.Artifact

3 Thyroid FNA A.Colloid with cholesterol crystals. B.Indeterminate. C.Papillary carcinoma. D.Anaplastic carcinoma. E.Metastatic carcinoma. Large rectangular cholesterol crystals commonly seen in goiter

4 FNA of thigh mass. A.Negative for malignancy. B.Sq. cell carcinoma. C.AdenoCa. D.Sarcoma. E.Abscess. Some of the malignant cells are splindled. Others are large and hyperchromatic.

5 Bronchoalveolar lavage. A.Unsatisfatory. B.Negative for malignancy. C.Small cell carcinoma D.AdenoCa E.Squamous cell carcinoma Benign ciliated bronchial cell Pigmented macrophages are needed for an adequate sample

FNA of thyroid. A.Reactive, neg for malignancy B.Goiter C.Indeterminate for malignancy. D.Papillary carcinoma. E.Follicular carcinoma. 6 Intranuclear inclusion This papillary structure viewed at high power demonstrates cells with high N/C ratios, hyperchromasia, and intranuclear inclusions.

7 54 yo female with pleural effusion A.Reactive mesothelial cells B.Adenocarcinoma C.Mesothelioma D.Melanoma E.Lymphoma This “cannon ball” of tumor cells is characteristic for breast carcinoma in pleural fluid. Other adenocarcinomas may form large proliferation spheres as well. Adenoca’s have smooth community borders, whereas mesotheliomas tend to have a more knobby outline.

8 FNA of pancreatic mass. A.Unsatisfactory specimen B.Reactive cells C.Pseudocyst contents D.Pancreatic adenocarcinoma E.Amebiasis Compare the malignant cells to the reactive ductal cells arranged in a orderly honeycomb pattern. The malignant cells are less cohesive. Did you notice the tumor diathesis in the background?

9 GMS of corneal scrape A. PCP B. Acanthamoeba C. Fungus D. Fuch’s corneal dystrophy E. Toxic epidermal necrolysis Acanthamoeba has a spiky outline.

61 yo bladder wash s/p TURP. A.Benign changes. B.Fungus C.Smooth muscle neoplasm D.Schistosomiasis E.High grade TCC 10 Instrumentation effect.