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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 ..."
== 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===
<gallery heights="250px" widths="250px">
CytologicallyYoursCoW20140106Cytology1.JPG|10x magnification of a very cellular specimen. (DQ)
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)
CytologicallyYoursCoW20140106Cytology4.JPG|10x magnification of a very cellular specimen. (Pap)
CytologicallyYoursCoW20140106Cytology5.JPG|40x magnification of cells with prominent nucleoli and dusty cytoplasm. (Pap)
</gallery>
<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===
* '''Metastatic melanoma'''.
===Cell Block===
<gallery heights="250px" widths="250px">
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.
</gallery>
===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.
</div></div>
{{Cytologically Yours}}
[[Category:Case Reports]]
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===
<gallery heights="250px" widths="250px">
CytologicallyYoursCoW20140106Cytology1.JPG|10x magnification of a very cellular specimen. (DQ)
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)
CytologicallyYoursCoW20140106Cytology4.JPG|10x magnification of a very cellular specimen. (Pap)
CytologicallyYoursCoW20140106Cytology5.JPG|40x magnification of cells with prominent nucleoli and dusty cytoplasm. (Pap)
</gallery>
<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===
* '''Metastatic melanoma'''.
===Cell Block===
<gallery heights="250px" widths="250px">
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.
</gallery>
===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.
</div></div>
{{Cytologically Yours}}
[[Category:Case Reports]]
