21st European Congress of Pathology Istanbul, Turkey, September 08-13, 2007 http://www.ecp2007istanbul.org/ Slide Seminar 3, September 9th Cytopathology
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Case 1
Presented by: Ika Kardum Skelin
Clinical History
Female, 17 yrs. Abdominal pressure without gastrointestinal symptoms. She was in good general health and well nourished. US and CT Scan showed a large cystic tumor lesion in caput pancreatis. No other clinical history given.
Ultrasound and contrast-enhanced CT scan reveals a 10x7x6 cm well-defined mass with solid and cystic portions arising from the pancreas with compression of surrounding abdominal structures. fine needle aspiration cytology (FNAC) was performed.
Clinical History A 63 year-old women presented a few days history of a right upper quadrant pain. No other medical history was referred. Surgical history included a previous cholecystectomy. There was no personal or family history of liver disease. Physical examination showed a soft tender abdomen, with positive bowel sounds. Computed tomographic (CT) scan of the abdomen demonstrated multiple hepatic nodular lesions. Fine needle aspiration cytology was performed (25-gauge needle).
Clinical History A 48-years old female patient had a 3- month history of back pain which radiated into the abdomen. She was first treated wih analgetics and physiotherapy. When symptoms persisted a more thorugh investigation was undertaken. Laboratory tests disclosed normochromic anemia and thrombocytopenia, gynecologic examination and esophagoduodenoscopy were unremarcable. US examination revealed condensed liver parenhima with multiple round lesions, some of them cystic, measuring 2-3 cm. Similar lesions were also seen in the spleen. The patient was transferred to the Institute of Oncology where a CT scan was performed confirming the US examination and showing enlarged lymph nodes in the retroperitoneum. An US-guided FNAB was performed from one of the lesions in the liver. The cytologic diagnosis was angiosarcoma. A core needle biopsy was performed to confirm the diagnosis of the unusual tumor.
The patient´s condition deteriorated rapidly. She developed acute abdominal pain, jaundice, and ascitic fluid. Medrol and Taxol (50% of regular dose) were administered. She was seen a month afterwards in a slightly better condition but refused further chemotherapy. The patient has not returned the following month for the scedualed check up.
Clinical History 36-year-old woman presenting with abdominal pain was suspected for an ovarian neoplasia. Abdominal computed tomography revealed a retroperitoneal mass without any relationship to uterus. Complete blood tests, tumor markers, liver and renal function tests were normal. Fine needle aspiration was performed under CT guidence.
Clinical History
Gender: Male Age:59
Patient admitted to the hospital with cough and haemopthysis. Physical examination was unremarkable, smoker 45p/y.
CT scan Findings: Multiple nodular lesions 1.5 cm and 2.5 cm nodules in the right lung upper lobe superior segment and left lung upper lobe superior segment, respectively. A 2 cm subpleural nodule in the left lung lower lobe superior segment was also detected.
Bronchoscopic Findings: No endobronchial was detected.
PET scan Findings: Positivity in the left upper lobe (SUDmax 10.5). Positivity in the left lower lobe (SUDmax 3.4). No uptake was detected in the right upper lobe
FNA was performed for the lesion in the left lung upper lobe
Clinical History The patient was a 70-years old man. Ex-smoker with chronic obstructive airway disease. A malignant melanoma in the scalp was operated 5 years ago. Thickness 8 mm, Clark level V.
The patient had a thrombosis in the lower leg, and pulmonary embolism.
CT-scan of the thorax also showed enlarged mediastinal lymph nodes and a small dense area in the right upper lung lobe.
Clinical History Fine needle aspiration cytology material from a liver mass in a 67-year-old woman. Six years before the patient underwent surgery because of an ovarian neoplasm. Computed tomography revealed no other lesions.
Clinical History A 79 year old woman presented for evaluation of a long history of pain in the right lower chest, dyspnoea and cough. Chest radiography showed a peripheral lung mass of 9 cm. Bronchoscopy was negative for malignancy. FNA was performed using liquid based cytology.
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