Oct 31, 2008

44 y/o female. FNA of thyroid. A. Unsatisfactory due to insufficient

cellularity.B. Lymphocytic thyroiditis.C. GoiterD. Indeterminate.E. Papillary carcinoma. 1

Mixture of lymphocytes and Mixture of lymphocytes and follicular cells.follicular cells.

2

Bronchoalveolar lavage.A. Unsatisfactory.B. Malignant cells present.C. PCP D. StrongyloidesE. Artifact

3

Thyroid FNAA. 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 carcinomaD. AdenoCaE. Squamous cell carcinoma

Benign ciliated bronchial cell

Pigmented macrophages are needed for an adequate sample

FNA of thyroid.A. Reactive, neg for malignancyB. GoiterC. 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 effusionA. Reactive mesothelial cellsB. AdenocarcinomaC. MesotheliomaD. 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 specimenB. Reactive cellsC. Pseudocyst contentsD. Pancreatic adenocarcinomaE. 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 scrapeA. PCPB. AcanthamoebaC. FungusD. Fuch’s corneal dystrophyE. Toxic epidermal necrolysis

Acanthamoeba has a spiky outline.

61 yo bladder wash s/p TURP.A. Benign changes. B. FungusC. Smooth muscle neoplasmD. SchistosomiasisE. High grade TCC 10

Instrumentation effect.