1. Week of March 30, 2009

2. 17 year old female. Conventional pap A.Endocervical adenocarcinoma in situ B.Benign endometrial cells C.Viral changes consistent with Herpes D.Alternaria E.Trichimonas 1

3. 17 year old female. Conventional pap C. Viral changes consistent with Herpes This picture is slightly out of focus; however, you can still see the molding and margination of the nuclei c/w herpes 1

4. 2 69 year old male. FNA of Lung A.Granuloma B.Non-small cell carcinoma C.Small cell carcinoma D.Reactive bronchial cells E.Lymphoma

5. 2 69 year old male. FNA of Lung B. Non-small cell carcinoma – The cluster is cohesive with large pleomorphic cells. The cells are overlapping and disorganized.

6. 3 57 year old male. Urine cytology A. Polyoma virus B. Reactive urothelial cells C. High grade TCC D. Metastatic prostate carcinoma E. This picture is horrible…I can’t tell.

7. 3 57 year old male. Urine cytology C. High grade TCC -- Though this picture is horrible (much like the pictures on the test), you can tell this is high grade TCC. The cells are enlarged (compared to the polys) with irregular nuclear membranes, eccentric nuclei and dark/irregularly distributed chromatin.

8. 4 67 year old male. History of prostate carcinoma and squamous cell carcinoma of the lung. Now presents with bone pain. FNA of bone lesion A.Positive for tumor - Adenocarcinoma B.Positive for tumor - SCC C.Plasma cell neoplasm D.Positive for tumor – Lymphoma E.Positive for tumor - melanoma Diff Quick Pap

9. 4 67 year old male. History of prostate carcinoma and squamous cell carcinoma of the lung. Now presents with bone pain. FNA of bone lesion A.Positive for tumor – Adenocarcinoma The cells are cohesive with vague formation of acinar structures (seen in DQ). The monomorphic appearance of the cells along with the prominent nuclei favors prostate adenocarcinoma. Melanoma is in the differential; however, melanoma cells are usually more discohesive. Immunostains can always be done to help with the diagnosis. Diff Quick Pap

10. 5 34 year old female. Thin Prep Pap A. LSIL B. Squamous metaplasia C. Benign endocervical cells D. HSIL E. AIS

11. 5 34 year old female. Thin Prep Pap D. HSIL

12. 6 60 year old male. BAL A. Aspergillus B. Blastomycosis C. PCP D. A and B E. A and C

13. 6 60 year old male. BAL E. A and C – This is a case of Aspergillus and PCP together.

14. 7 51 year old female with extensive bilateral lung infiltrates. A BAL shows numerous amorphous globules as seen here. What stain should be ordered to confirm the diagnosis? A.Silver stain (GMS) B.PAS C.Iron stain D.Oil Red O E.Reticulin PAP

15. 7 51 year old female with extensive bilateral lung infiltrates. A BAL shows numerous amorphous globules as seen here. What stain should be ordered to confirm the diagnosis? B. PAS – PAS will confirm the diagnosis of Pulmonary Alveolar Proteinosis. PASSurgical

16. 8 41 year old female with newly developed breast mass. Breast FNA A. Positive for breast carcinoma B. Phyllodes tumor C. Fibroadenoma D. Consistent with breast cyst E. Reactive ductal cells

17. 8 41 year old female with newly developed breast mass. Breast FNA C. Fibroadenoma

18. 9 29 year old female. ThinPrep pap A.Reactive B.Squamous metaplasia C.ASC-US D.LSIL E.HSIL

19. 9 29 year old female. ThinPrep pap D. LSIL