Cytologically Yours: CoW: 20140113

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Contents

Clinical Summary

The patient is a 69 year old female with a new mass in the right pulmonary hilum.

Past Medical History

  • Hyperlipidemia
  • Osteoporosis
  • Chronic obstructive pulmonary disease
  • Hepatitis
  • Smoker (1 pack per day for 40 years, quit in 2002)

Past Surgical History

  • Hysterectomy (1975)
  • Hernia repair (1992)
  • Cardiac catheterization (2002)
  • Lumbarsacral discectomy (2008)
  • Lumbarsacral fusion with rod placement (2013)

CT

  • 4.8 x 3.1 cm mass in the right hilum.
  • 4.4 x 1.5 cm nodular densityin the right upper lobe.
  • 1.5 cm enlarged paratracheal lymph node.
  • CT with contrast: mass in the right hilum extends into the mediastium and the SVC is compressed.

Clinical Plan

Bronchoscopy for furhter evaluation.

Pathology

Cytology


Resident Questions



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Final Diagnosis

Cytology

  • Small Cell Carcinoma.


Discussion

Small cell carcinoma is associated with smoking and is generally a central lesion that arises in larger airways. Small cell carcinoma is prone to central necrosis and radiologically this may be seen.