Cytologically Yours: CoW: 20140213 - Revision history

Stephanie Simmons at 22:22, 4 March 2014

2014-03-04T22:22:05Z

Stephanie Simmons at 22:18, 4 March 2014

2014-03-04T22:18:51Z

Stephanie Simmons at 22:16, 4 March 2014

2014-03-04T22:16:19Z

Stephanie Simmons at 22:14, 4 March 2014

2014-03-04T22:14:48Z

Stephanie Simmons at 22:11, 4 March 2014

2014-03-04T22:11:51Z

Stephanie Simmons: Created page with "== Clinical Summary == The patient is a 66yo old male presenting with jaundice. === Past Medical History === * History of prostate cancer 5 years ago. * Hyperlipidemia * Chr..."

2014-03-04T22:02:10Z

Created page with "== Clinical Summary == The patient is a 66yo old male presenting with jaundice. === Past Medical History === * History of prostate cancer 5 years ago. * Hyperlipidemia * Chr..."

New page

== Clinical Summary ==
The patient is a 66yo old male presenting with jaundice.

=== Past Medical History ===
* History of prostate cancer 5 years ago.
* Hyperlipidemia
* Chronic back pain

=== Past Surgical History ===
* Prostatectomy (2009)
* Thyroidectomy (2004)

==Ultrasound==
* Ultrasound of head of pancreas shows a 43mm x 23mm ill defined mass.

===Clinical Plan===
The differential diagnosis included pancreatic adenocarcinoma and metastatic prostate cancer.

==Pathology==

===Cytology===
<gallery heights="250px" widths="250px">
CytologicallyYoursCoW20140213Cytology1.jpg|10x magnification of large cohesive groups of cells.
CytologicallyYoursCoW20140213Cytology2.jpg|40x magnification showing atypical cells with large irregular nuclei.
CytologicallyYoursCoW20140213Cytology3.jpg|20x magnification showing atypical cells with large irregular nuclei.
CytologicallyYoursCoW20140213Cytology4.jpg|40x magnification showing large, markedly pleomorphic cells.
CytologicallyYoursCoW20140213Cytology5.jpg|40x magnification of malignant cell groups.
CytologicallyYoursCoW20140213Cytology6.jpg|60x magnification of malignant cells. Macronucleoli are easily identified.
</gallery>

====Resident Questions====
* <spoiler text="The radiologic differential diagnosis was between osteosarcoma and Ewing sarcma. What would be a possible diagnostic pitfall?"> The confusion between osteosarcoma and Ewing may occur with the small cell variant of osteosarcoma. </spoiler>

<div class="usermessage mw-customtoggle-diagnosis" style="cursor:pointer">Click here to toggle the diagnosis and discussion.</div>
<div class="mw-collapsible mw-collapsed" id="mw-customcollapsible-diagnosis">
<div class="mw-collapsible-content">

==Final Diagnosis==
===Cytology===
* '''High grade sarcoma, favor osteosarcoma'''.

===Biopsy===
<gallery heights="250px" widths="250px">
CytologicallyYoursCoW20140206Biopsy1.jpg|20x magnification of bone biopsy showing sclerotic bone.

</gallery>

===Biopsy Diagnosis===
* '''Conventional high grade sarcoma, sclerotic type'''.

===Discussion===
The experience of FNA of osteosarcoma is mainly with conventional high-grade intramedullary sarcoma and to the rare high-grade surface osteosarcoma. Smears usually contain dissociated neoplastic cells and cell clusters.

</div></div>

{{Cytologically Yours}}

[[Category:Case Reports]]

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 </gallery>
-CK7 Negative
+* CK7 Negative
-CA19.9 Negative
+* CA19.9 Negative
-PSA Positive
+* PSA Positive
 ===Discussion===
-Metastatic prostate carcinoma to the pancreas is rare.
+Metastatic prostate carcinoma to the pancreas is rare; however, long term survival of prostate cancer may increase the incidence. Renal cell carcinoma is the most metastatic pancreatic tumor.
 </div></div>

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 ====Resident Questions====
 * <spoiler text="What was the initial diagnosis on rapid interpretation?"> Adenocarcinoma.   </spoiler>
@@ Line 43: / Line 50: @@
 ===Biopsy Diagnosis===

@@ Line 31: / Line 31: @@
 ====Resident Questions====
-* <spoiler text="What is your initial diagnosis?"> This was initially called adenocarcinoma on rapid diagnosis during the endoscopic ultrasound guided procedure. </spoiler>
+* <spoiler text="What was the initial diagnosis on rapid interpretation?"> Adenocarcinoma.   </spoiler>
 <div class="usermessage mw-customtoggle-diagnosis" style="cursor:pointer">Click here to toggle the diagnosis and discussion.</div>
@@ Line 48: / Line 43: @@
+===Cell Block===
 </gallery>

@@ Line 31: / Line 31: @@
 ====Resident Questions====
-* <spoiler text="The radiologic differential diagnosis was between osteosarcoma and Ewing sarcma. What would be a possible diagnostic pitfall?"> The confusion between osteosarcoma and Ewing may occur with the small cell variant of osteosarcoma.   </spoiler>
+* <spoiler text="What is your initial diagnosis?"> This was initially called adenocarcinoma on rapid diagnosis during the endoscopic ultrasound guided procedure. </spoiler>
 <div class="usermessage mw-customtoggle-diagnosis" style="cursor:pointer">Click here to toggle the diagnosis and discussion.</div>
@@ Line 40: / Line 45: @@
 ==Final Diagnosis==
 ===Cytology===
-* '''High grade sarcoma, favor osteosarcoma'''.
+* '''Metastatic prostate carcinoma'''.
 </gallery>