From Pathology Education Instructional Resource
				
								
				
				
				
				
				
				
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|   | ===Resident Questions===  |   | ===Resident Questions===  | 
| − | * <spoiler text="Diagnosis?">  | + | * <spoiler text="Diagnosis?">__NOGLOSSARY__  | 
|   | * Lymphoma  |   | * Lymphoma  | 
|   | ** Occurs in elderly  |   | ** Occurs in elderly  | 
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|   | * Rare tissue fragments  |   | * Rare tissue fragments  | 
|   | </spoiler>  |   | </spoiler>  | 
| − | * <spoiler text="Differential diagnosis?">    | + | * <spoiler text="Differential diagnosis?">__NOGLOSSARY__   | 
|   | * Pancreatic neuroendocrine tumor  |   | * Pancreatic neuroendocrine tumor  | 
|   | ** Uniform, small/medium sized, round, plasmacytoid cells  |   | ** Uniform, small/medium sized, round, plasmacytoid cells  | 
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|   | CytologicallyYoursUnknowns201401-04-10.jpg  |   | CytologicallyYoursUnknowns201401-04-10.jpg  | 
|   | </gallery>  |   | </gallery>  | 
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|   | + | </div>  | 
|   | + | </div>  | 
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|   | {{Cytologically Yours}}  |   | {{Cytologically Yours}}  | 
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|   | [[Category:Unknowns]]  |   | [[Category:Unknowns]]  | 
		Revision as of 20:06, 16 January 2014
Cytology
Resident Questions
- Lymphoma
- Occurs in elderly
 
- Diffuse large B cell lymphoma is the most common
 
- Presentation includes abdominal pain and jaundice due to bile duct obstruction
 
- Pancreatic primary lymphoma accounts for less than 0.5% of all pancreatic malignancies and 1% of extranodal lymphomas
 
- Secondary involvement of the pancreas by lymphoma has been reported to occur in 5-30% of all lymphomas.
 
 
 
 
- Cellular specimen
 
- Monotonous population of cells that are discohesive
 
- Look for lymphoglandular bodies in the background
 
- Cells will have high N/C ratios with round nuclei
 
- Mitosis
 
- Karryorrhexis
 
- Lack nuclear molding
 
- Rare tissue fragments
 
 
 
- Pancreatic neuroendocrine tumor
- Uniform, small/medium sized, round, plasmacytoid cells
 
- Cells in groups
 
- Scant cytoplasm
 
- Salt and pepper chromatin
 
- Positive CD56, Synaptophysin, Chromogranin
 
 
- Pancreatic duct adenocarcinoma (small cell pattern)
- Generally cellular
 
- Groups and single small/medium cells
 
- Irregular nuclear membranes and variable cytoplasm (scant/moderate, vacuolated/dense)
 
- Positive CEA, Cytokeratin, EMA
 
 
- Lymphoepithelial cyst
- Rare benign cystic lesion with lymphocytes
 
- Most occur in male patients who are in the 5th decade
 
- Unilocular or multilocular lined by squamous epithelium and have numerous lymphocytes
 
- Cytology will have many lymphocytes and squamous cells
 
- Not associated with immunosuppression
 
 
- Flow cytometry is helpful when lymphoma is suspected
 
 
 
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