1. Cytopathology Challenge! Weekly Cases September 24 th 2007

2. 63 year old male with liver transplant BAL for pulmonary infiltrates A.PCP B.Candida C.Blastomycosis D.Histoplasmosis E.Coccidiomycosis

3. 25 year old female ThinPrep Pap A.Reactive/Infectious B.ASCUS C.LSIL D.HSIL E.AGC

4. 22 year old female ThinPrep Pap A.Reactive/Infectious B.ASCUS C.LSIL D.HSIL E.AGC

5. 66 year old female with Pancreatic Cancer. Pleural fluid cytospin A.Reactive Mesothelials B.Viral effect C.Atypical D.Suspicious E.Positive for tumor

6. 25 year old female ThinPrep Pap A.Reactive/infectious B.ASCUS C.LSIL D.HSIL E.AGC

7. 47 year old female with lung transplant. BAL Silver stain A.Aspergillus B.Penicillium C.Mucormycosis D.Actinomycetoma E.Artifact

8. 58 year old male with lung mass. BAL. A.Pulmonary Macrophages B.Reactive Endobronchial cells C.Bronchioloalveolar carcinoma D.Viral Effect (CMV) E.Adenocarcinoma

9. 67 year old female with axillary lymphadenopathy, breast mass, lung mass, liver Mass. Lymph node FNA cell block. A.Metastatic breast CA B.Metastatic lung CA C.Metastatic hepatocellular CA D.Metastatic leiomyosarcoma E.Fibrotic lymph node

10. 71 year old male. Bladder Washing A.Normal/reactive B.Low Grade TCC C.High grade TCC D.Metastatic tumor E.Artifact

11. 71 year old female Pancreatic mass. FNA cell block A.Reactive B.Atypical C.Suspicious D.Positive for tumor E.Indeterminate

12. Answers 1.Histoplasmosis Organisms inside macrophage, culture positive 2.LSIL Koilocytes! 3.Infectious Trichomonas (hiding next to PMN!) 4.Positive for tumor Metastatic Pancreatic Cancer 5.Infectious Yep, it’s trich again! 6.Artifact 7.Reactive Endobronchial cells See the cilia….. 8.Metastatic leiomyosarcoma Spindle cells. Immunos were helpful, but no other choice listed is morphologically feasible 9.Normal Normal urothelium with an umbrella cell 10.Positive for tumor Adenocarcinoma