Cytologically Yours: CoW: 20131216

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Clinical Summary

The patient is an 66 year old white male with a history of smoking, COPD, and diabetes. The patient presented with increased shortness of breath.

Past Medical History

  • Diabetes
  • COPD
  • Squamous cell carcinoma of skin

Past Surgical History

  • Excision of squamous cell carcinoma
  • Removal of adenomatous polyp of sigmoid colon


Clinical Plan

The differential diagnosis includes worsening of COPD. CT imaging of chest is performed.

Radiology

  • CT Chest shows hilar lung mass and multiple mediastinal lymph nodes showing increased uptake on PET scan.

Pathology

Cytology

Immunohistochemistry

Other immunostains performed

  • BerEp4 Positive
  • Moc31 Faintly positive
  • Calretinin Negative
  • TTF1 Negative
  • Chromogranin Positive
  • Synaptophysin Positive
  • CD56 Positive
  • Napsin A Negative


Resident Questions

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Final Diagnosis

Cytology

  • Small cell carcinoma


Case Discussion

This is a classic case of metastatic small cell carcinoma in pleural fluid.