Cytologically Yours: Unknowns: 201401: Case 5: Difference between revisions
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==Clinical History== | |||
58 year old female with a pancreatic mass. | |||
==Cytology== | ==Cytology== | ||
<gallery heights="333px" widths="333px"> | <gallery heights="333px" widths="333px"> | ||
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===Resident Questions=== | ===Resident Questions=== | ||
* <spoiler text="Diagnosis?"> | * <spoiler text="Diagnosis?">__NOGLOSSARY__ | ||
* Mucinous Pancreatic Neoplasm | * Mucinous Pancreatic Neoplasm | ||
** Includes two diagnostic entities: | ** Includes two diagnostic entities: | ||
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** Best diagnosis is "neoplastic cells present, pancreatic mucinous neoplasm" | ** Best diagnosis is "neoplastic cells present, pancreatic mucinous neoplasm" | ||
</spoiler> | </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__ | ||
* Abundant thick mucin that may look colloid like | * Abundant thick mucin that may look colloid like | ||
* Mucin can be so thick and tenacious it may cause difficulty in aspirating and making smears | * Mucin can be so thick and tenacious it may cause difficulty in aspirating and making smears | ||
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* Single cells or groups trapped in mucus | * Single cells or groups trapped in mucus | ||
</spoiler> | </spoiler> | ||
* <spoiler text="Differential diagnosis?"> | * <spoiler text="Differential diagnosis?">__NOGLOSSARY__ | ||
* Contaminant gastrointestinal | * Contaminant gastrointestinal | ||
** Brush border and interspersed goblet cells is seen in duodenal epithelium | ** Brush border and interspersed goblet cells is seen in duodenal epithelium | ||
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* CAN NOT DIFFERENTIATE BETWEEN IPMN AND MCN ON CYTOLOGY ALONE | * CAN NOT DIFFERENTIATE BETWEEN IPMN AND MCN ON CYTOLOGY ALONE | ||
</spoiler> | </spoiler> | ||
*<spoiler text="What ancillary studies would you order?"> | *<spoiler text="What ancillary studies would you order?">__NOGLOSSARY__ | ||
* CEA levels are >200ng/mL in both MCN and IPMN | * CEA levels are >200ng/mL in both MCN and IPMN | ||
* Amylase will be high in IPMN and low in MCN (due to IPMN connection with the pancreatic duct) | * Amylase will be high in IPMN and low in MCN (due to IPMN connection with the pancreatic duct) | ||
Latest revision as of 15:10, 16 January 2014
Clinical History
58 year old female with a pancreatic mass.
Cytology
Resident Questions
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