Difference between revisions of "Cytologically Yours: CoW: 20140206"

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(Final Diagnosis)
 
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==Final Diagnosis==
 
==Final Diagnosis==
 
===Cytology===
 
===Cytology===
* '''Positive for malignancy, the differential diagnosis includes melanoma and Hodgkin lymphoma'''.
+
* '''High grade sarcoma, favor osteosarcoma'''.
  
  
 
===Biopsy===
 
===Biopsy===
 
<gallery heights="250px" widths="250px">
 
<gallery heights="250px" widths="250px">
CytologicallyYoursCoW20131202Biopsy1.jpg|20x magnification of bone biopsy showing sclerotic bone
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CytologicallyYoursCoW20140206Biopsy1.jpg|20x magnification of bone biopsy showing sclerotic bone.
  
 
</gallery>
 
</gallery>

Latest revision as of 15:45, 4 March 2014

Contents

Clinical Summary

The patient is a 12 year old female with a six month history of left shoulder pain. The patient had tried Aleve and had several chiropractic visits which were unsuccessful at relieving the pain.

Past Medical History

  • Previously heathy

Past Surgical History

  • No surgical history

Radiology

  • AP/Lateral images show a destructive and aggressive appearing lesion in the left proximal huerus in the metaphysis extending 7.5cm distally in the diaphysis.

Clinical Plan

The differential diagnosis included osteosarcoma and Ewing sarcoma. MRI and CT guided biopsy are scheduled.

Pathology

Cytology


Resident Questions


Click here to toggle the diagnosis and discussion.

Final Diagnosis

Cytology

  • High grade sarcoma, favor osteosarcoma.


Biopsy

Biopsy Diagnosis

  • Conventional high grade sarcoma, sclerotic type.


Discussion

The experience of FNA of osteosarcoma is mainly with conventional high-grade intramedullary sarcoma and to the rare high-grade surface osteosarcoma. Smears usually contain dissociated neoplastic cells and cell clusters.