Week of Nov 5 th 2007

51 year-old male with lung transplant. BAL.
A. Reactive
B. CMV
C. Bronchioloaveolar carcinoma
D. TB granulomatous changes
E. Non-small cell lung carcinoma
1

67 year old female with pulmonary infiltrate. BAL.
A. Squamous cell carcinoma
B. Small cell carcinoma
C. Adenocarcinoma
D. Bronchioloalveolar carcinoma
E. Reactive
2

34 year old female. ThinPrep pap
A. Endocervical cells
B. Squamous metaplasia
C. ASCUS
D. LSIL
E. HSIL 3

58 year-old male with lung mass.
FNA cell block.
A.
Squamous metaplasia
B.
Non-small cell lung carcinoma
C.
Small cell carcinoma
D.
Large cell variant neuroendocrine carcinoma
E.
Granuloma
4

44 year old female with “cold” thyroid nodule. FNA demonstrated scant colloid and sheets of these cells in microfollicular pattern.
A.
Follicular adenoma
B.
Follicular carcinoma
C.
Indeterminate
D.
Papillary carcinoma
E.
Medullary carcinoma
5

34 year old female. ThinPrep pap
A. Endocervical cells
B. Squamous metaplasia
C. ASCUS
D. LSIL
E. HSIL
6

59 year old female with breast cancer and pleural effusion.
Pleural fluid cytospin.
A. Metastatic breast carcinoma
B. Reactive pulmonary macrophages
C. Reactive mesothelial cells
D. Viral inclusion
E. Mesothelioma
7

29 year old female. ThinPrep pap
A. Endometrial cells
B. Endocervical cells
C. ASC-US
D. LSIL
E. HSIL
8

49 year old female with thyroid nodule. FNA DiffQuik
A. Goiter
B. Graves disease
C. Cyst contents
D. Neoplasm
E. Hurthle cells/reactive
9

67 year old male. Bladder wash.
A. Reactive urothelial/umbrella cell
B. Papillary neoplasm – low grade
C. Papillary neoplasm
– high grade
D. Squamous cell carcinoma
E. HPV effect
10

1.
A Reactive
•
Multinucleated bronchial epithelial cell. Sometimes they do that…not related to tumor or specific virus
2.
E Reactive – endobronchial cells and macrophages
• Open chromatin, reactive nucleoli. No tumor in this.
3.
E HSIL
• High NC ratio, irregular nuclei
4.
B Non-small cell lung CA
•
Probably squamous. Too much cytoplasm for neuroendocrine or small cell. NC ratio and hyperchromatic nuclei would argue against granuloma
5.
C Indeterminate
•
The scant colloid and sheets or follicular cells (photo) in a microfollicular pattern would suggest a follicular lesion, but we can’t assess adenoma vs carcinoma on FNA so we call them indeterminate.
6.
D LSIL
• Koilocytes again!
7.
A Metastatic breast CA
• Mucin in the cytoplasm – almost forming a signet ring.
8.
B Reactive endocervical cells
•
Normal. No dysplasia in this one.
9.
D. Neoplasm – Papillary thyroid carcinoma
• See the nuclear pseudoinclusion…….
10.
A Reactive urothelium/umbrella cell
• They can be binucleate. Looks like HPV – but it’s urothelium and not related in any way to HPV in cervix