Difference between revisions of "Cytologically Yours: CoW: 20140106"

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(Created page with "== Clinical Summary == 64 year old male who presented to the ED with shortness of breath. === Past Medical History === * Hypertension * Dyslipidemia * Recent diagnosis of ...")
 
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===Cytology===
 
===Cytology===
 
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CytologicallyYoursCoW20140106Cytology1.JPG|10x magnification of a very cellular specimen. (DQ)
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CytologicallyYoursCoW20140106Cytology1.jpg|10x magnification of a very cellular specimen. (DQ)
CytologicallyYoursCoW20140106Cytology2.JPG|40x magnification showing cells that have ample cytoplasm and prominent nucleoli.(DQ)
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CytologicallyYoursCoW20140106Cytology2.jpg|40x magnification showing cells that have ample cytoplasm and prominent nucleoli.(DQ)
CytologicallyYoursCoW20140106Cytology3.JPG|40x magnification showing Cells with abundant cytoplasm some with granular material in the cytoplasm. These cells also have prominent nucleoli.(DQ)
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CytologicallyYoursCoW20140106Cytology3.jpg|40x magnification showing Cells with abundant cytoplasm some with granular material in the cytoplasm. These cells also have prominent nucleoli.
CytologicallyYoursCoW20140106Cytology4.JPG|10x magnification of a very cellular specimen. (Pap)
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CytologicallyYoursCoW20140106Cytology4.jpg|10x magnification of a very cellular specimen. (Pap)
CytologicallyYoursCoW20140106Cytology5.JPG|40x magnification of cells with prominent nucleoli and dusty cytoplasm. (Pap)
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CytologicallyYoursCoW20140106Cytology5.jpg|40x magnification of cells with prominent nucleoli and dusty cytoplasm. (Pap)
  
 
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===Cell Block===
 
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CytologicallyYoursCoW20140106Cytology6.JPG|40x magnification of cell block showing cells with pigment in the cytoplasm.
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CytologicallyYoursCoW20140106Cytology6.jpg|40x magnification of cell block showing cells with pigment in the cytoplasm.
CytologicallyYoursCoW20140106Cytology7.JPG|20x magnification of MITF staining of the cell block.
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CytologicallyYoursCoW20140106Cytology7.jpg|20x magnification of MITF staining of the cell block.
 
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Latest revision as of 21:33, 26 June 2014

Clinical Summary

64 year old male who presented to the ED with shortness of breath.

Past Medical History

  • Hypertension
  • Dyslipidemia
  • Recent diagnosis of metastatic melanoma of unknown primary

Past Surgical History

  • Metastatic melanoma of unknown primary diagnosed in an enlarged axillary mass that was removed several months previously.

Radiology

  • CXR and CT showed multiple pulmonary nodules and bilateral pleural effusions.

Clinical Plan

Thoracentesis

Pathology

Cytology

Click here to toggle the diagnosis and discussion.

Final Diagnosis

Cytology

  • Metastatic melanoma.


Cell Block

Discussion

Melanoma is "the great mimicer", it's cytomorphology can be very variable. Prominent nucleoli and pigment are some of the features that can help guide a pathologist to the diagnosis. The use of the immunohistochemical markers MART-1, S100, MITF,and MelanA are useful for the diagnosis of melanoma.