Cytopathology Challenge! Weekly Cases

September 24th 2007

63 year old male with liver transplantBAL for pulmonary infiltratesA. PCPB. CandidaC. BlastomycosisD. HistoplasmosisE. Coccidiomycosis

25 year old femaleThinPrep Pap

A. Reactive/InfectiousB. ASCUSC. LSILD. HSILE. AGC

22 year old femaleThinPrep Pap

A. Reactive/InfectiousB. ASCUSC. LSILD. HSILE. AGC

66 year old female withPancreatic Cancer. Pleuralfluid cytospin

A. Reactive MesothelialsB. Viral effectC. AtypicalD. SuspiciousE. Positive for tumor

25 year old femaleThinPrep Pap

A. Reactive/infectiousB. ASCUSC. LSILD. HSILE. AGC

47 year old femalewith lung transplant.BAL Silver stain

A. AspergillusB. PenicilliumC. Mucormycosis D. Actinomycetoma E. Artifact

58 year old male withlung mass. BAL.

A. Pulmonary MacrophagesB. Reactive Endobronchial cellsC. Bronchioloalveolar carcinomaD. Viral Effect (CMV)E. Adenocarcinoma

67 year old femalewith axillary lymphadenopathy,breast mass, lung mass, liverMass. Lymph node FNA cell block.

A. Metastatic breast CAB. Metastatic lung CAC. Metastatic hepatocellular CAD. Metastatic leiomyosarcomaE. Fibrotic lymph node

71 year old male.Bladder Washing

A. Normal/reactiveB. Low Grade TCCC. High grade TCCD. Metastatic tumor E. Artifact

71 year old femalePancreatic mass.FNA cell block

A. ReactiveB. Atypical C. SuspiciousD. Positive for tumorE. Indeterminate

Answers1. Histoplasmosis

• Organisms inside macrophage, culture positive

2. LSIL• Koilocytes!

3. Infectious• Trichomonas (hiding next to PMN!)

4. Positive for tumor• Metastatic Pancreatic Cancer

5. Infectious• Yep, it’s trich again!

6. Artifact

7. Reactive Endobronchial cells• See the cilia…..

8. Metastatic leiomyosarcoma• Spindle cells. Immunos were helpful, but no other choice listed is morphologically feasible

9. Normal• Normal urothelium with an umbrella cell

10. Positive for tumor• Adenocarcinoma