1. Cytopathology Challenge! Weekly Cases October 1st 2007

2. 66 year old female. BAL A.Oral contaminant B.Squamous metaplasia C.Inflammatory change/reactive D.Suspicious for tumor E.Squamous Cell CA

3. 54 year old female with liver transplant BAL for respiratory distress/infiltrates. A.Dirofilaria B.Strongyloides C.Enterobius D.Trichuris E.Ascaris

4. 23 year old female. ThinPrep pap. A.Reactive B.ASCUS C.LSIL D.HSIL E.Squamous metaplasia

5. 78 year old male. BAL. A.Pulmonary macrophages B.Atypical C.Suspicious D.Positive for tumor E.Reactive

6. 38 year old female. ThinPrep Pap A.Squamous metaplasia B.Reactive endocervical cells C.ASCUS D.LSIL E.HSIL

7. 57 year old female. Ovarian mass. Pelvic washing in OR. A.Reactive mesothelial cell B.Lymphoma C.Histiocyte D.Consistent with Ovarian CA E.Artifact

8. 45 year old female. Corneal scrape GMS A.Histoplasmosis B.Histoplasmosis C.PCP D.Candida E.Acanthameba

9. 72 year old female. Common bile duct brushing A.Reactive B.Atypical C.Suspicious D.Positive E.Epithelial Cell Abnormality

10. 38 year old female with thyroid nodule. FNA Pap stain. A.RET/PTC2 is the most common mutation B.RET/PTC1 is the least common mutation C.RET/PTC rearrangements are specific to this tumor D.These tumors are CK7-/CK20+ E.The proto-oncogene for this tumor is on 10q11.2

11. 26 year old female. ThinPrep Pap. A.Squamous metaplasia B.Reactive endocervical cells C.Atrophic changes D.ASCUS E.LSIL

12. Answers 1.Squamous cell Ca Large tumor cell with features of squamous cell 2.Strongyloides Coolest case of the week! 3.LSIL Koilocytes 4.Positive for tumor Non-small cell lung CA – probably squamous again. 5.HSIL NC ratio is increased, not koilocytes. 6.Consistent with ovarian cancer Tumor cell in peritoneal washing – used for staging purposes. 7.Candida Budding yeast 8.Positive for tumor Likely an adenocarcinoma, I put an image of some “Normal” reactive epithelium from the case in the image in the bottom right corner for comparison to the tumor in the rest of the images 9.Papillary thyroid tumor. Correct answer is “E” Check out Rosai page 535…. 10.Squamous metaplasia Normal finding