Cytologically Yours: CoW: 20140213: Difference between revisions - Pathology Education Instructional Resource

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====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>

* <spoiler text="What was the initial diagnosis on rapid interpretation?"> Adenocarcinoma. </spoiler>

====Cell Block====

CytologicallyYoursCoW20140213Biopsy1.jpg|40x magnification of cell block of pancreatic mass showing small glands with macronucleoli.

</gallery>

* <spoiler text="What stains do you order?"> We ordered PSA, CK7, and CA19.9. </spoiler>

<div class="usermessage mw-customtoggle-diagnosis" style="cursor:pointer">Click here to toggle the diagnosis and discussion.</div>

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==Final Diagnosis==

===Cytology===

* '''~~High grade sarcoma, favor osteosarcoma~~'''.

* '''Metastatic prostate carcinoma'''.

~~===Biopsy===~~

~~CytologicallyYoursCoW20140206Biopsy1~~.jpg|20x magnification of ~~bone biopsy showing sclerotic bone.~~

CytologicallyYoursCoW20140213Biopsy2.jpg|20x magnification of PSA shows positive staining

</gallery>

~~===Biopsy Diagnosis===~~

* CK7 Negative

* ~~'''Conventional high grade sarcoma, sclerotic type'''~~.

* CA19.9 Negative

* PSA Positive

===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~~.

Metastatic prostate carcinoma to the pancreas is rare; however, long term survival of prostate cancer may increase the incidence. Renal cell carcinoma is the most metastatic pancreatic tumor.

</div></div>

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 ====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>
+* <spoiler text="What was the initial diagnosis on rapid interpretation?"> Adenocarcinoma.   </spoiler>
+====Cell Block====
+<gallery heights="250px" widths="250px">
+CytologicallyYoursCoW20140213Biopsy1.jpg|40x magnification of cell block of pancreatic mass showing small glands with macronucleoli.
+</gallery>
+* <spoiler text="What stains do you order?"> We ordered PSA, CK7, and CA19.9.   </spoiler>
 <div class="usermessage mw-customtoggle-diagnosis" style="cursor:pointer">Click here to toggle the diagnosis and discussion.</div>
@@ Line 40: / Line 47: @@
 ==Final Diagnosis==
 ===Cytology===
-* '''High grade sarcoma, favor osteosarcoma'''.
+* '''Metastatic prostate carcinoma'''.
-===Biopsy===
 <gallery heights="250px" widths="250px">
-CytologicallyYoursCoW20140206Biopsy1.jpg|20x magnification of bone biopsy showing sclerotic bone.
+CytologicallyYoursCoW20140213Biopsy2.jpg|20x magnification of PSA shows positive staining
 </gallery>
-===Biopsy Diagnosis===
+* CK7 Negative
-* '''Conventional high grade sarcoma, sclerotic type'''.
+* CA19.9 Negative
+* PSA Positive
 ===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.
+Metastatic prostate carcinoma to the pancreas is rare; however, long term survival of prostate cancer may increase the incidence. Renal cell carcinoma is the most metastatic pancreatic tumor.
 </div></div>