Difference between revisions of "Cytologically Yours: CoW: 20140213"

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(Created page with "== Clinical Summary == The patient is a 66yo old male presenting with jaundice. === Past Medical History === * History of prostate cancer 5 years ago. * Hyperlipidemia * Chr...")
 
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====Resident Questions====
 
====Resident Questions====
* <spoiler text="The radiologic differential diagnosis was between osteosarcoma and Ewing sarcma. What would be a possible diagnostic pitfall?"> The confusion between osteosarcoma and Ewing may occur with the small cell variant of osteosarcoma.   </spoiler>
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* <spoiler text="What is your initial diagnosis?"> This was initially called adenocarcinoma on rapid diagnosis during the endoscopic ultrasound guided procedure. </spoiler>
  
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===Cell Block===
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CytologicallyYoursCoW20140213Biopsy1.jpg|40x magnification of cell block of pancreatic mass showing small glands with macronucleoli.
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* <spoiler text="What special stains do you order?">  </spoiler>
  
 
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==Final Diagnosis==
 
==Final Diagnosis==
 
===Cytology===
 
===Cytology===
* '''High grade sarcoma, favor osteosarcoma'''.
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* '''Metastatic prostate carcinoma'''.
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===Biopsy===
 
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CytologicallyYoursCoW20140206Biopsy1.jpg|20x magnification of bone biopsy showing sclerotic bone.
 
  
 
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Revision as of 16:11, 4 March 2014

Contents

Clinical Summary

The patient is a 66yo old male presenting with jaundice.

Past Medical History

  • History of prostate cancer 5 years ago.
  • Hyperlipidemia
  • Chronic back pain

Past Surgical History

  • Prostatectomy (2009)
  • Thyroidectomy (2004)

Ultrasound

  • Ultrasound of head of pancreas shows a 43mm x 23mm ill defined mass.

Clinical Plan

The differential diagnosis included pancreatic adenocarcinoma and metastatic prostate cancer.

Pathology

Cytology


Resident Questions


Cell Block

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.

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