Cytologically Yours: CoW: 20140227: Difference between revisions
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===Biopsy=== | ===Biopsy=== | ||
<gallery heights="250px" widths="250px"> | <gallery heights="250px" widths="250px"> | ||
CytologicallyYoursCoW20140227Biopsy1.jpg|20x magnification of pleomorphic nuclei and lipoblasts. | |||
CytologicallyYoursCoW20140227Biopsy2.jpg|40x magnification of pleomorphic nuclei and lipoblasts. | |||
</gallery> | </gallery> | ||
Latest revision as of 18:10, 4 March 2014
Clinical Summary
The patient is a 74 year old female with a history of sarcoma of the right thigh and a new lung mass.
Past Medical History
- Sarcoma of thigh (3 years prior)
- Osteoarthritis
Past Surgical History
- Previous excision of thigh sarcoma.
- Hysterectomy
Radiology
- CT showed a right upper lobe low density nodule measuring 3.0 x 2.6 cm which is abutting the pleural surface.
Clinical Plan
The patient was scheduled for an endobronchial ultrasound guided fine needle aspiration biopsy.
Pathology
Cytology
-
20x magnification showing adipose tissue, atypical cells and bubbly appearing nuclei. -
20x magnification showing adipose tissue -
60x magnification showing bizarre appearing malignant cells with unusual bubbly nuclei and adjacent adipose tissue. -
40x magnification showing bizarre appearing malignant cells with unusual bubbly nuclei and adjacent adipose tissue. -
40x magnification showing bizarre appearing malignant cells with unusual bubbly nuclei and adjacent adipose tissue.
Final Diagnosis
Cytology
- Positive for malignancy, favor liposarcoma.
Biopsy
-
20x magnification of pleomorphic nuclei and lipoblasts. -
40x magnification of pleomorphic nuclei and lipoblasts.
Previous Soft Tissue Biopsy Diagnosis
- High grade pleomorphic liposarcoma.
Discussion
The diagnosis of pleomorphic liposarcoma on cytology rests on the presence of highly atypical, sometimes multinucleated lipoblasts. The scalloped nucleus is an important diagnostic feature.
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