Week of Nov 5th 2007

1

51 year-old male with lung transplant. BAL.A. ReactiveB. CMVC. Bronchioloaveolar carcinomaD. TB granulomatous changesE. Non-small cell lung carcinoma

2

67 year old female with pulmonary infiltrate. BAL.A. Squamous cell carcinomaB. Small cell carcinomaC. AdenocarcinomaD. Bronchioloalveolar carcinomaE. Reactive

3

34 year old female. ThinPrep papA. Endocervical cellsB. Squamous metaplasiaC. ASCUSD. LSILE. HSIL

4

58 year-old male with lung mass.FNA cell block.A. Squamous metaplasiaB. Non-small cell lung carcinomaC. Small cell carcinomaD. Large cell variant neuroendocrine carcinomaE. Granuloma

44 year old female with “cold” thyroid nodule. FNA demonstrated scantcolloid and sheets of these cells in microfollicular pattern.A. Follicular adenomaB. Follicular carcinomaC. IndeterminateD. Papillary carcinomaE. Medullary carcinoma

5

6

34 year old female. ThinPrep papA. Endocervical cellsB. Squamous metaplasiaC. ASCUSD. LSILE. HSIL

7

59 year old female with breast cancer and pleural effusion. Pleural fluid cytospin.A. Metastatic breast carcinomaB. Reactive pulmonary macrophagesC. Reactive mesothelial cellsD. Viral inclusionE. Mesothelioma

8

29 year old female. ThinPrep papA. Endometrial cellsB. Endocervical cellsC. ASC-USD. LSILE. HSIL

9

49 year old female with thyroid nodule. FNA DiffQuik

A. GoiterB. Graves diseaseC. Cyst contentsD. NeoplasmE. Hurthle cells/reactive

10

67 year old male. Bladder wash.A. Reactive urothelial/umbrella cellB. Papillary neoplasm – low gradeC. Papillary neoplasm – high gradeD. Squamous cell carcinomaE. HPV effect

1. A Reactive• Multi-nucleated bronchial epithelial cell. Sometimes they do that…not related to tumor or specific virus

2. E Reactive – endobronchial cells and macrophages• Open chromatin, reactive nucleoli. No tumor in this.

3. E HSIL• High NC ratio, irregular nuclei

4. B Non-small cell lung CA• Probably squamous. Too much cytoplasm for neuroendocrine or small cell. NC ratio and

hyperchromatic nuclei would argue against granuloma

5. C Indeterminate• The scant colloid and sheets or follicular cells (photo) in a microfollicular pattern would suggest a

follicular lesion, but we can’t assess adenoma vs carcinoma on FNA so we call them indeterminate.

6. D LSIL• Koilocytes again!

7. A Metastatic breast CA• Mucin in the cytoplasm – almost forming a signet ring.

8. B Reactive endocervical cells• Normal. No dysplasia in this one.

9. D. Neoplasm – Papillary thyroid carcinoma• See the nuclear pseudoinclusion…….

10. A Reactive urothelium/umbrella cell• They can be binucleate. Looks like HPV – but it’s urothelium and not related in any way to HPV in

cervix