Week of September 29, 2008

24 year old female. ThinPrep pap

A. Lactobacillus B. Gonorrhea C. Trichomonas D. Bacterial Vaginosis E. Artifact

1

24 year old female. ThinPrep pap

D. Bacterial Vaginosis – coccobacilli cover the squamous cells. Also called “Clue cells”

1

43 year old male. FNA of neck mass

A. Nematode worm B. Rhabdomyosarcoma C. Normal muscle D. Squamous cell carcinoma E. Colloid

2

43 year old male. FNA of neck mass

C. Normal muscle – strips/chunks of muscle with peripherally placed nuclei and striations

2

57 year old male. Urine cytology

A. Reactive urothelial cells B. High grade TCC C. Low grade TCC D. Squamous cell carcinoma E. Polyoma virus

3

57 year old male. Urine cytology

E. Polyoma virus – enlarged cell with smudgy intranuclear inclusion. Do not mistake for High grade TCC!

3

62 year old female. Peritoneal fluid

A. Positive for tumor - Adenocarcinoma B. Reactive mesothelial cells C. Atypical D. Positive for tumor – Lymphoma E. Benign lymphocytic effusion

4

62 year old female. Pleural fluid

A. Positive for tumor - Adenocarcinoma “ Cannonball” group of epithelial cells with large nuclei and distinct cell borders. Pleomorphism and irregular nuclear membranes are seen. Patient had history of breast cancer.

4

53 year old female. Pleural fluid

A. Positive for tumor - Adenocarcinoma B. Reactive mesothelial cells C. Atypical D. Positive for tumor – Lymphoma E. Benign lymphocytic effusion

5

53 year old female. Pleural fluid

A. Positive for tumor – Adenocarcinoma Large pleomorphic single cells with secretory vacuoles c/w adenoca. Signet rings forms are noted. Pt also has history of breast cancer. Don’t miss single malignant cells in effusions!

5

36 year old female. Thyroid FNA

A. Goiter B. Indeterminate C. Positive for tumor – papillary thyroid carcinoma D. Positive for tumor – follicular carcinoma E. Hurthle cell neoplasm

6

36 year old female. Thyroid FNA

B. Indeterminate – multiple microfollicles with no colloid in the background. This is suspicious for a potential follicular neoplasm. On cytology we call this indeterminate because we cannot determine whether this is a follicular adenoma or a follicular carcinoma (for which you need to see either capsular +/or vascular invasion on histo)

6

60 year old male s/p bilateral lung transplant. BAL

A. Aspergillus B. Candida C. PCP D. Mucor E. Fusarium

7

60 year old male s/p bilateral lung transplant. BAL

A. Aspergillus – septated hyphae with 45 degree branching

7

29 year old female. ThinPrep pap

A. Reactive B. Endocervical cells C. ASC-US D. LSIL E. HSIL

8

29 year old female. ThinPrep pap

D. LSIL – enlarged nuclei with koilocytic change. Also have binucleates

8

63 year old male. FNA of lung

A. Adenocarcinoma B. Squamous cell carcinoma C. Small cell carcinoma D. BAC E. Reactive lymphocytes

9

63 year old male. FNA of lung

C. Small cell carcinoma – note the molding

9

26 year old female. ThinPrep pap

A. LSIL B. HSIL C. Endometrial cells D. Squamous cell carcinoma E. Tubal metaplasia

10

26 year old female. ThinPrep pap

B. HSIL

10