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Cytologically Yours: Unknowns: 201310: Case 2 - Revision history
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Seung Park: 1 revision
2014-01-09T19:29:25Z
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<p><b>New page</b></p><div>==Clinical History==<br />
55 year old male with a right upper lobe lung mass and mediastinal adenopathy.<br />
The patient is a smoker.<br />
<br />
==Cytology==<br />
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<br />
===Resident Questions===<br />
* <spoiler text="Diagnosis?"><br />
*Small Cell Carcinoma<br />
**12-18% of all lung cancers<br />
**Age range 32-79 years<br />
**Males &gt; Females<br />
**Association with smoking <br />
</spoiler><br />
* <spoiler text="Are these tumors resectable?"><br />
Most are metastatic at diagnosis, therefore not resectable.<br />
</spoiler><br />
* <spoiler text="Name 3 markers you could use to confirm the diagnosis."> <br />
* CD56<br />
* Synaptophysin<br />
* Chromogranin<br />
* Neuron Specific Enolase (NSE)<br />
* Pancytokeratin (dot like staining)<br />
* Thyroid Transcription Factor-1 (TTF-1)<br />
</spoiler><br />
<br />
==Additional Teaching Points==<br />
===Differential Diagnosis===<br />
* Follicular bronchitis<br />
** Polymorphic lymphocytic population<br />
** Follicular centers<br />
** Tingible body macrophages<br />
** Plasma cells<br />
* Reactive bronchial cells<br />
** Round/cuboidal (en face) columnar (on profile)<br />
** Smooth nuclear membranes<br />
** Fine granular chromatin<br />
** No nuclear molding<br />
* Carcinoid<br />
** Cells will be in loosely cohesive groups or in tissue fragments, in cords, nests, ribbons, or acinar pattern<br />
** Cells will be uniform small round with round/oeal smooth nuclear membrane<br />
** Salt and pepper chromatin<br />
** +/- Nucleoli<br />
** No molding<br />
** + Neuroendocrine markers, + Cytokeratin, + CEA<br />
* Large Neuroendocrine Carcinoma<br />
** Isolated cells or loosely cohesive groups<br />
** Variable cell size and cytoplasm<br />
** High N/C<br />
** Round nuclei<br />
** Coarsely granular cytoplasm <br />
** Frequent nucleoli<br />
** Nuclear molding<br />
<br />
{{Cytologically Yours}}<br />
<br />
[[Category:Unknowns]]<br />
[[Category:Respiratory]]</div>
Seung Park