Cytologically Yours: CoW: 20140213
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
10x magnification of large cohesive groups of cells.
40x magnification showing atypical cells with large irregular nuclei.
20x magnification showing atypical cells with large irregular nuclei.
40x magnification showing large, markedly pleomorphic cells.
40x magnification of malignant cell groups.
60x magnification of malignant cells. Macronucleoli are easily identified.
Resident Questions
Final Diagnosis
Cytology
- High grade sarcoma, favor osteosarcoma.
Biopsy
20x magnification of bone biopsy showing sclerotic bone.
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.