Difference between revisions of "Cytologically Yours: Unknowns: 201401: Case 6"

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===Resident Questions===
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* <spoiler text="Diagnosis?">
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* Pseudocyst
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** Most common cystic lesion
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** Etiology is diverse (acute pancreatitis, recurrent chronic pancreatitis, trauma, chronic alcohol abuse)
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** Clinically patients present with jaundice, pain, nausea, vomiting, weight loss
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** Pathogenesis
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*** leakage of pancreatic enzymes into parenchyma
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*** necrosis and chemical peritonitis
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*** inflammatory response and pancreatic secretion accumulation occurs and fibrous tissue walls off irritants which causes cyst formation
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** Localized collection of amylase rich pancreatic secretions, necrotic debris and blood
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** Most occur in the tail of the pancreas
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** Usually solitary and unilocular
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** Lack a true epithelial lining
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</spoiler>
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* <spoiler text="What are some of the cytologic features that lead you to the diagnosis?">
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* Variable acute and chronic inflammation
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* Histiocytes
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* Giant cells
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* Necrotic debris
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* Granulation tissue may be present
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* No epithelium with atypia
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</spoiler>
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* <spoiler text="Differential diagnosis?"> 
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* Ductal adenocarcinoma with cystic degeneration
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** Atypia in the epithelium
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** Pleomorphic nuclei, cytoplasm variable (vacuolated to dense)
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** Cellular inflammatory background
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** Positive CEA and cytokeratin
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* Any neoplasm will have epithelial groups and single cells with atypia
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* Big diagnostic problem is the atypia that can be seen in the granulation tissue
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</spoiler>

Revision as of 12:32, 16 January 2014

Cytology

Resident Questions