Cytologically Yours: Unknowns: 201401: Case 2 - Revision history

Seung Park at 20:04, 16 January 2014

2014-01-16T20:04:09Z

Seung Park at 18:48, 16 January 2014

2014-01-16T18:48:26Z

Seung Park: /* Resident Questions */

2014-01-16T18:43:25Z

‎Resident Questions

Seung Park at 18:34, 16 January 2014

2014-01-16T18:34:20Z

Stephanie Simmons at 18:27, 16 January 2014

2014-01-16T18:27:52Z

Stephanie Simmons at 19:38, 15 January 2014

2014-01-15T19:38:55Z

Stephanie Simmons: Created page with "==Cytology== CytologicallyYoursUnknowns201401-01-01.jpg CytologicallyYoursUnknowns201401-01-02.jpg CytologicallyYoursUnknowns201401-01..."

2014-01-15T19:38:26Z

Created page with "==Cytology== <gallery heights="333px" widths="333px"> CytologicallyYoursUnknowns201401-01-01.jpg CytologicallyYoursUnknowns201401-01-02.jpg CytologicallyYoursUnknowns201401-01..."

New page

==Cytology==
<gallery heights="333px" widths="333px">
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@@ Line 13: / Line 13: @@
 ===Resident Questions===
-* <spoiler text="Diagnosis?">
+* <spoiler text="Diagnosis?">__NOGLOSSARY__
 * Pancreatic Endocrine Neoplasm
 ** Include Islet cell tumor and pancreatic carcinoid tumors
-** Approximately 5 percent of pancreatic neoplasms
+** Approximately 5% of pancreatic neoplasms
 ** Most commonly seen in both male and female adults between 40-60 years old but can occur at any age
 ** Small (1-5 cm) well circumscribed lesion may look cystic on imaging
@@ Line 22: / Line 22: @@
 ** Can be part of Multiple Endocrine Neoplasia-1, von Hipple-Lindau disease, Neurofibromatosis type 1, Tuberous Sclerosis Complex
 </spoiler>
-* <spoiler text="What are some of the cytologic features that lead you to the diagnosis?">
+* <spoiler text="What are some of the cytologic features that lead you to the diagnosis?">__NOGLOSSARY__
 * Cellular smear with singly dispersed uniform cells
 * Loosely cohesive or discohesive uniform cells
@@ Line 30: / Line 30: @@
 * Round/oval bland cells with salt and pepper chromatin
 </spoiler>
-* <spoiler text="Differential diagnosis?">
+* <spoiler text="Differential diagnosis?">__NOGLOSSARY__
 * Acinar cell carcinoma
 ** Clusters, acinar groups and single cells with abundant granular cytoplasm and prominent nucleoli

← Older revision		Revision as of 18:48, 16 January 2014
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		+	==Clinical History==
		+	52 year old female with a pancreatic head mass.
		+
	==Cytology==		==Cytology==
	<gallery heights="333px" widths="333px">		<gallery heights="333px" widths="333px">

@@ Line 13: / Line 13: @@
 * Pancreatic Endocrine Neoplasm
 ** Include Islet cell tumor and pancreatic carcinoid tumors
-** Approximately 5% of pancreatic neoplasms
+** Approximately 5 percent of pancreatic neoplasms
 ** Most commonly seen in both male and female adults between 40-60 years old but can occur at any age
 ** Small (1-5 cm) well circumscribed lesion may look cystic on imaging

← Older revision		Revision as of 18:34, 16 January 2014
Line 59:		Line 59:
	* Markers specific to peptide production		* Markers specific to peptide production
	</spoiler>		</spoiler>
		+
		+	{{Cytologically Yours}}
		+
		+	[[Category:Unknowns]]

← Older revision		Revision as of 18:27, 16 January 2014
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	CytologicallyYoursUnknowns201401-02-06.jpg		CytologicallyYoursUnknowns201401-02-06.jpg
	</gallery>		</gallery>
		+
		+	===Resident Questions===
		+	* <spoiler text="Diagnosis?">
		+	* Pancreatic Endocrine Neoplasm
		+	** Include Islet cell tumor and pancreatic carcinoid tumors
		+	** Approximately 5% of pancreatic neoplasms
		+	** Most commonly seen in both male and female adults between 40-60 years old but can occur at any age
		+	** Small (1-5 cm) well circumscribed lesion may look cystic on imaging
		+	** Commonly seen in the tail of the pancreas
		+	** Can be part of Multiple Endocrine Neoplasia-1, von Hipple-Lindau disease, Neurofibromatosis type 1, Tuberous Sclerosis Complex
		+	</spoiler>
		+	* <spoiler text="What are some of the cytologic features that lead you to the diagnosis?">
		+	* Cellular smear with singly dispersed uniform cells
		+	* Loosely cohesive or discohesive uniform cells
		+	* Cells are uniform, plasmacytoid with abundant finely granular cytoplasm
		+	* Background is clean
		+	* Occasional pleomorphism can be seen
		+	* Round/oval bland cells with salt and pepper chromatin
		+	</spoiler>
		+	* <spoiler text="Differential diagnosis?">
		+	* Acinar cell carcinoma
		+	** Clusters, acinar groups and single cells with abundant granular cytoplasm and prominent nucleoli
		+	** Lack salt and pepper chromatin
		+	** Positive staining for trypsin, chymotrypsin and alpha-1-antichymotrypsin
		+	** Negative for neuroendocrine markers
		+	* Solid Pseudopapillary Neoplasm
		+	** May see hyaline globules and clear cytoplasmic vacuoles
		+	** Branching papillary clusters with distinct central fibrovascular cores, but this can be seen in PEN too
		+	** Positive for vimentin, CD10, beta catenin, neuron specific enolase, CD56
		+	** Negative for keratin markers
		+	* Plasmacytoma
		+	** Look for a perinuclear hof and clock face chromatin
		+	** Positive staining for CD138
		+	** Negative for neuroendocrine markers
		+	* Islet cell hyperplasia
		+	** Difficult/ impossible to distinguish from islet cell tumor by cytology alone
		+	* Melanoma
		+	** Can see melanin pigment in the cytoplasm but not always
		+	** Melanoma cytomorphology can be quite diverse
		+	** Positive for MART-1, HMB45, MITF
		+	** Negative for neuroendocrine markers
		+	</spoiler>
		+	*<spoiler text="What ancillary studies would you order?">
		+	* Neuroendocrine markers
		+	** CD56
		+	** Synaptophysin
		+	** Chromogranin
		+	* Cytokeratin
		+	* TTF-1
		+	* Markers specific to peptide production
		+	</spoiler>

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 ==Cytology==
 <gallery heights="333px" widths="333px">
-CytologicallyYoursUnknowns201401-01-01.jpg
+CytologicallyYoursUnknowns201401-02-01.jpg
-CytologicallyYoursUnknowns201401-01-02.jpg
+CytologicallyYoursUnknowns201401-02-02.jpg
-CytologicallyYoursUnknowns201401-01-03.jpg
+CytologicallyYoursUnknowns201401-02-03.jpg
-CytologicallyYoursUnknowns201401-01-04.jpg
+CytologicallyYoursUnknowns201401-02-04.jpg
-CytologicallyYoursUnknowns201401-01-05.jpg
+CytologicallyYoursUnknowns201401-02-05.jpg
-CytologicallyYoursUnknowns201401-01-02.jpg
+CytologicallyYoursUnknowns201401-02-06.jpg
 </gallery>