Difference between revisions of "Cytologically Yours: Unknowns: 201401: Case 1"

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==Clinical History==
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72 year old female with jaundice and a pancreatic mass.
  
 
==Cytology==
 
==Cytology==
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===Resident Questions===
 
===Resident Questions===
* <spoiler text="Diagnosis?">
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* <spoiler text="Diagnosis?">__NOGLOSSARY__
 
* Adenocarcinoma
 
* Adenocarcinoma
 
** Most common malignant tumor of the pancreas
 
** Most common malignant tumor of the pancreas
 
** Accounts for approximately 85% of all pancreatic tumors
 
** Accounts for approximately 85% of all pancreatic tumors
 
** Patients are commonly women in the 6th and 7th decades of life
 
** Patients are commonly women in the 6th and 7th decades of life
** Prognosis is poor 90% of patients die within a year of diagnosis
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** Prognosis is poor
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*** 90% of patients die within a year of diagnosis
 
** Association with cigarette smoking, high fat diet, and diabetes mellitus
 
** Association with cigarette smoking, high fat diet, and diabetes mellitus
 
** Triad of weight loss, pain, and jaundice
 
** Triad of weight loss, pain, and jaundice
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** Can obstruct the biliary or pancreatic ducts which can cause a double duct sign on imaging and can also cause painless jaundice  
 
** Can obstruct the biliary or pancreatic ducts which can cause a double duct sign on imaging and can also cause painless jaundice  
 
</spoiler>
 
</spoiler>
* <spoiler text="What are some of the cytologic features that lead you to the diagnosis?">
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* <spoiler text="What are some of the cytologic features that lead you to the diagnosis?">__NOGLOSSARY__
 
* Cellular specimen
 
* Cellular specimen
 
* Predominantly ductal type cells and sparse/absent acinar cells
 
* Predominantly ductal type cells and sparse/absent acinar cells
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* Drunken honeycomb
 
* Drunken honeycomb
 
</spoiler>
 
</spoiler>
* <spoiler text="Differential diagnosis?">
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* <spoiler text="Differential diagnosis?">__NOGLOSSARY__
 
* Chronic pancreatitis
 
* Chronic pancreatitis
 
** Occurs in 4th and 5th decades
 
** Occurs in 4th and 5th decades
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* The presence of mitotic figures does not support the diagnosis of carcinoma. Mitotic figures can be seen in chronic pancreatitis.
 
* The presence of mitotic figures does not support the diagnosis of carcinoma. Mitotic figures can be seen in chronic pancreatitis.
 
</spoiler>
 
</spoiler>
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{{Cytologically Yours}}
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[[Category:Unknowns]]

Latest revision as of 20:14, 16 January 2014

Clinical History

72 year old female with jaundice and a pancreatic mass.

Cytology

Resident Questions