Week of September 29, 2008

24 year old female. ThinPrep pap A.Lactobacillus B.Gonorrhea C.Trichomonas D.Bacterial Vaginosis E.Artifact 1

24 year old female. ThinPrep pap D. Bacterial Vaginosis – coccobacilli cover the squamous cells. Also called “Clue cells” 1

2 43 year old male. FNA of neck mass A.Nematode worm B.Rhabdomyosarcoma C.Normal muscle D.Squamous cell carcinoma E.Colloid

2 43 year old male. FNA of neck mass C. Normal muscle – strips/chunks of muscle with peripherally placed nuclei and striations

3 57 year old male. Urine cytology A.Reactive urothelial cells B.High grade TCC C.Low grade TCC D.Squamous cell carcinoma E.Polyoma virus

3 57 year old male. Urine cytology E. Polyoma virus – enlarged cell with smudgy intranuclear inclusion. Do not mistake for High grade TCC!

4 62 year old female. Peritoneal fluid A.Positive for tumor - Adenocarcinoma B.Reactive mesothelial cells C.Atypical D.Positive for tumor – Lymphoma E.Benign lymphocytic effusion

4 62 year old female. Pleural fluid A.Positive for tumor - Adenocarcinoma “ Cannonball” group of epithelial cells with large nuclei and distinct cell borders. Pleomorphism and irregular nuclear membranes are seen. Patient had history of breast cancer.

5 53 year old female. Pleural fluid A. Positive for tumor - Adenocarcinoma B. Reactive mesothelial cells C. Atypical D. Positive for tumor – Lymphoma E. Benign lymphocytic effusion

5 53 year old female. Pleural fluid A. Positive for tumor – Adenocarcinoma Large pleomorphic single cells with secretory vacuoles c/w adenoca. Signet rings forms are noted. Pt also has history of breast cancer. Don’t miss single malignant cells in effusions!

6 36 year old female. Thyroid FNA A.Goiter B.Indeterminate C.Positive for tumor – papillary thyroid carcinoma D.Positive for tumor – follicular carcinoma E.Hurthle cell neoplasm

6 36 year old female. Thyroid FNA B. Indeterminate – multiple microfollicles with no colloid in the background. This is suspicious for a potential follicular neoplasm. On cytology we call this indeterminate because we cannot determine whether this is a follicular adenoma or a follicular carcinoma (for which you need to see either capsular +/or vascular invasion on histo)

7 60 year old male s/p bilateral lung transplant. BAL A.Aspergillus B.Candida C.PCP D.Mucor E.Fusarium

7 60 year old male s/p bilateral lung transplant. BAL A.Aspergillus – septated hyphae with 45 degree branching

8 29 year old female. ThinPrep pap A.Reactive B.Endocervical cells C.ASC-US D.LSIL E.HSIL

8 29 year old female. ThinPrep pap D. LSIL – enlarged nuclei with koilocytic change. Also have binucleates

9 63 year old male. FNA of lung A. Adenocarcinoma B. Squamous cell carcinoma C. Small cell carcinoma D. BAC E. Reactive lymphocytes

9 63 year old male. FNA of lung C. Small cell carcinoma – note the molding

10 26 year old female. ThinPrep pap A.LSIL B.HSIL C.Endometrial cells D.Squamous cell carcinoma E.Tubal metaplasia

10 26 year old female. ThinPrep pap B. HSIL