Difference between revisions of "Cytologically Yours: CoW: 20140120"

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(Created page with " == Clinical Summary == The patient is a 46 year old female with a new pleural effusion, pelvic mass, and ascites. She presented to the ED with increasing abdominal distensio...")
 
(Cytology)
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===Cytology===
 
===Cytology===
 
<gallery heights="250px" widths="250px">
 
<gallery heights="250px" widths="250px">
CytologicallyYoursCoW20140120Cytology1.JPG|20x magnification of cohesive pleomorphic cells with abundant cytoplasm.(DQ)
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CytologicallyYoursCoW20140120Cytology1.jpg|20x magnification of cohesive pleomorphic cells with abundant cytoplasm.(DQ)
CytologicallyYoursCoW20140120Cytology2.JPG|40x magnification showing large atypical cells with abundant cytoplasm. (DQ)
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CytologicallyYoursCoW20140120Cytology2.jpg|40x magnification showing large atypical cells with abundant cytoplasm. (DQ)
CytologicallyYoursCoW20140120Cytology3.JPG|40x magnification showing large groups of cohesive cells that are pleomorphic. (DQ)
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CytologicallyYoursCoW20140120Cytology3.jpg|40x magnification showing large groups of cohesive cells that are pleomorphic. (DQ)
CytologicallyYoursCoW20140120Cytology4.JPG|40x magnification showing cells that are large and pleomorphic and in groups.(DQ)
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CytologicallyYoursCoW20140120Cytology4.jpg|40x magnification showing cells that are large and pleomorphic and in groups.(DQ)
CytologicallyYoursCoW20140120Cytology5.JPG|40x magnification of large atypical cells one nucleus appears to have an inclusion.(DQ)
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CytologicallyYoursCoW20140120Cytology5.jpg|40x magnification of large atypical cells one nucleus appears to have an inclusion.(DQ)
CytologicallyYoursCoW20140120Cytology6.JPG|40x magnification of atypical cells. Some of the cells appear to have material in their cytoplasm .(DQ)
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CytologicallyYoursCoW20140120Cytology6.jpg|40x magnification of atypical cells. Some of the cells appear to have material in their cytoplasm .(DQ)
 
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====Cell Block====
 
====Cell Block====
 
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CytologicallyYoursCoW20140120Cytology7.JPG|40x magnification cell block
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CytologicallyYoursCoW20140120Cytology7.jpg|40x magnification cell block
CytologicallyYoursCoW20140120Cytology8.JPG|20x magnification cell block
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CytologicallyYoursCoW20140120Cytology8.jpg|20x magnification cell block
 
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<div class="mw-collapsible mw-collapsed" id="mw-customcollapsible-diagnosis">
 
<div class="mw-collapsible-content">
 
<div class="mw-collapsible-content">
 
  
 
==Final Diagnosis==
 
==Final Diagnosis==

Revision as of 15:43, 26 June 2014

Contents

Clinical Summary

The patient is a 46 year old female with a new pleural effusion, pelvic mass, and ascites. She presented to the ED with increasing abdominal distension and discomfort. She also has nausea and has been unable to tolerate anything by mouth. She has shortness of breath and has had a recent >20lb weight loss in the last two months.

Past Medical History

  • Hyperlipidemia
  • Coronary artery disease
  • Hepatitis C

Past Surgical History

  • Cardiac stent (2011)
  • Exploratory pelvic surgery

CT

  • Ascites
  • Left hydronephrosis
  • enlarged uterus 12 x 7 x 7 cm.
  • 13 cm pelvic mass
  • Right sided pleural effusion

Clinical Plan

Therapeutic paracentesis.

Pathology

Cytology


Resident Questions


Cell Block


Click here to toggle the diagnosis and discussion.

Final Diagnosis

Cytology

  • Adenocarcinoma.

Surgical Pathology

  • Metastatic adenocarcinoma, consistent tiwht papillary serous carcinoma.

Discussion

Serous adenocarcinoma commoly presents with widespread peritoneal metastases. Microscopically the tumor can be papillary, solid or nested. Psammoma bodies may be present.