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Cytologically Yours: Unknowns: 201401: Case 5

54 bytes added, 20:07, 16 January 2014
Resident Questions
===Resident Questions===
* <spoiler text="Diagnosis?">__NOGLOSSARY__
* Mucinous Pancreatic Neoplasm
** Includes two diagnostic entities:
** Best diagnosis is "neoplastic cells present, pancreatic mucinous neoplasm"
</spoiler>
* <spoiler text="What are some of the cytologic features that lead you to the diagnosis?">__NOGLOSSARY__
* Abundant thick mucin that may look colloid like
* Mucin can be so thick and tenacious it may cause difficulty in aspirating and making smears
* Single cells or groups trapped in mucus
</spoiler>
* <spoiler text="Differential diagnosis?"> __NOGLOSSARY__
* Contaminant gastrointestinal
** Brush border and interspersed goblet cells is seen in duodenal epithelium
* CAN NOT DIFFERENTIATE BETWEEN IPMN AND MCN ON CYTOLOGY ALONE
</spoiler>
*<spoiler text="What ancillary studies would you order?">__NOGLOSSARY__
* CEA levels are >200ng/mL in both MCN and IPMN
* Amylase will be high in IPMN and low in MCN (due to IPMN connection with the pancreatic duct)
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