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Created page with "== Clinical Summary == The patient is a 69 year old female with a new mass in the right pulmonary hilum. === Past Medical History === * Hyperlipidemia * Osteoporosis * Chron..."
== Clinical Summary ==
The patient is a 69 year old female with a new mass in the right pulmonary hilum.
=== Past Medical History ===
* Hyperlipidemia
* Osteoporosis
* Chronic obstructive pulmonary disease
* Hepatitis
* Smoker (1 pack per day for 40 years, quit in 2002)
=== Past Surgical History ===
* Hysterectomy (1975)
* Hernia repair (1992)
* Cardiac catheterization (2002)
* Lumbarsacral discectomy (2008)
* Lumbarsacral fusion with rod placement (2013)
== CT ==
* 4.8 x 3.1 cm mass in the right hilum.
* 4.4 x 1.5 cm nodular densityin the right upper lobe.
* 1.5 cm enlarged paratracheal lymph node.
*CT with contrast: mass in the right hilum extends into the mediastium and the SVC is compressed.
===Clinical Plan===
Bronchoscopy for furhter evaluation.
==Pathology==
===Cytology===
<gallery heights="250px" widths="250px">
CytologicallyYoursCoW20140113Cytology1.JPG|10x magnification of a cellular specimen.(DQ)
CytologicallyYoursCoW20140113Cytology2.JPG|40x magnification showing cohesive groups of atypical cells adjacent to bronchial cells. (DQ)
CytologicallyYoursCoW20140113Cytology3.JPG|40x magnification showing a large group of cohesive cells that are molding upon one another. (DQ)
CytologicallyYoursCoW20140113Cytology4.JPG|40x magnification showing cells that are molding and forming a row of cells.(DQ)
CytologicallyYoursCoW20140113Cytology5.JPG|20x magnification of cells with chromatin that looks punctate.(pap)
CytologicallyYoursCoW20140113Cytology6.JPG|60x magnification of cells with punctate chromatin and molding.(pap)
</gallery>
====Resident Questions====
* <spoiler text="What was the initial diagnosis on rapid interpretation?"> Positive for malignancy. </spoiler>
* <spoiler text="What stains would you order?"> CD56, Synaptophysin, Chromogranin, TTF-1 </spoiler>
<div class="usermessage mw-customtoggle-diagnosis" style="cursor:pointer">Click here to toggle the diagnosis and discussion.</div>
<div class="mw-collapsible mw-collapsed" id="mw-customcollapsible-diagnosis">
<div class="mw-collapsible-content">
==Final Diagnosis==
===Cytology===
* '''Small Cell Carcinoma'''.
===Discussion===
Small cell carcinoma is associated with smoking and is generally a central lesion that arises in larger airways. Small cell carcinoma is prone to central necrosis and radiologically this may be seen.
</div></div>
{{Cytologically Yours}}
[[Category:Case Reports]]
The patient is a 69 year old female with a new mass in the right pulmonary hilum.
=== Past Medical History ===
* Hyperlipidemia
* Osteoporosis
* Chronic obstructive pulmonary disease
* Hepatitis
* Smoker (1 pack per day for 40 years, quit in 2002)
=== Past Surgical History ===
* Hysterectomy (1975)
* Hernia repair (1992)
* Cardiac catheterization (2002)
* Lumbarsacral discectomy (2008)
* Lumbarsacral fusion with rod placement (2013)
== CT ==
* 4.8 x 3.1 cm mass in the right hilum.
* 4.4 x 1.5 cm nodular densityin the right upper lobe.
* 1.5 cm enlarged paratracheal lymph node.
*CT with contrast: mass in the right hilum extends into the mediastium and the SVC is compressed.
===Clinical Plan===
Bronchoscopy for furhter evaluation.
==Pathology==
===Cytology===
<gallery heights="250px" widths="250px">
CytologicallyYoursCoW20140113Cytology1.JPG|10x magnification of a cellular specimen.(DQ)
CytologicallyYoursCoW20140113Cytology2.JPG|40x magnification showing cohesive groups of atypical cells adjacent to bronchial cells. (DQ)
CytologicallyYoursCoW20140113Cytology3.JPG|40x magnification showing a large group of cohesive cells that are molding upon one another. (DQ)
CytologicallyYoursCoW20140113Cytology4.JPG|40x magnification showing cells that are molding and forming a row of cells.(DQ)
CytologicallyYoursCoW20140113Cytology5.JPG|20x magnification of cells with chromatin that looks punctate.(pap)
CytologicallyYoursCoW20140113Cytology6.JPG|60x magnification of cells with punctate chromatin and molding.(pap)
</gallery>
====Resident Questions====
* <spoiler text="What was the initial diagnosis on rapid interpretation?"> Positive for malignancy. </spoiler>
* <spoiler text="What stains would you order?"> CD56, Synaptophysin, Chromogranin, TTF-1 </spoiler>
<div class="usermessage mw-customtoggle-diagnosis" style="cursor:pointer">Click here to toggle the diagnosis and discussion.</div>
<div class="mw-collapsible mw-collapsed" id="mw-customcollapsible-diagnosis">
<div class="mw-collapsible-content">
==Final Diagnosis==
===Cytology===
* '''Small Cell Carcinoma'''.
===Discussion===
Small cell carcinoma is associated with smoking and is generally a central lesion that arises in larger airways. Small cell carcinoma is prone to central necrosis and radiologically this may be seen.
</div></div>
{{Cytologically Yours}}
[[Category:Case Reports]]