Cytologically Yours: Unknowns: 201401: Case 3 - Revision history

Seung Park at 20:09, 16 January 2014

2014-01-16T20:09:42Z

Seung Park: /* Resident Questions */

2014-01-16T20:04:53Z

‎Resident Questions

Seung Park at 18:34, 16 January 2014

2014-01-16T18:34:40Z

Stephanie Simmons at 18:28, 16 January 2014

2014-01-16T18:28:24Z

Stephanie Simmons: Created page with "==Cytology== CytologicallyYoursUnknowns201401-03-01.jpg CytologicallyYoursUnknowns201401-03-02.jpg CytologicallyYoursUnknowns201401-03..."

2014-01-15T19:42:09Z

Created page with "==Cytology== <gallery heights="333px" widths="333px"> CytologicallyYoursUnknowns201401-03-01.jpg CytologicallyYoursUnknowns201401-03-02.jpg CytologicallyYoursUnknowns201401-03..."

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==Cytology==
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← Older revision		Revision as of 20:09, 16 January 2014
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		+	==Clinical History==
		+	45 year old male with weight loss and jaundice.
		+
	==Cytology==		==Cytology==
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 ===Resident Questions===
-* <spoiler text="Diagnosis?">
+* <spoiler text="Diagnosis?">__NOGLOSSARY__
 * Chronic pancreatits
 ** Occurs in the 4th and 5th decades
@@ Line 19: / Line 19: @@
 ** Strictures of the biliary or pancreatic ducts occurs as well as calcification
 </spoiler>
-* <spoiler text="What are some of the cytologic features that lead you to the diagnosis?">
+* <spoiler text="What are some of the cytologic features that lead you to the diagnosis?">__NOGLOSSARY__
 * Variable cellularity depending on the fibrosis in the specimen, however usually low cellularity
 * Smears are polymorphous (ductal cells, acinar cells, macrophages, inflammatory cells, fibrosis, debris, calcification, fat necrosis)
@@ Line 27: / Line 27: @@
 * Ductal cells out number acinar cells (acinar atrophy)
 </spoiler>
-* <spoiler text="Differential diagnosis?">
+* <spoiler text="Differential diagnosis?">__NOGLOSSARY__
 * Adenocarcinoma
 ** Occurs later (6th and 7th decades)

← Older revision		Revision as of 18:34, 16 January 2014
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	* Pancreatic cancer is often surrounded by a zone of pancreatitis, therefore pancreatits does not exclude malignancy nor does inflammation		* Pancreatic cancer is often surrounded by a zone of pancreatitis, therefore pancreatits does not exclude malignancy nor does inflammation
	</spoiler>		</spoiler>
		+
		+	{{Cytologically Yours}}
		+
		+	[[Category:Unknowns]]

← Older revision		Revision as of 18:28, 16 January 2014
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		+
		+	===Resident Questions===
		+	* <spoiler text="Diagnosis?">
		+	* Chronic pancreatits
		+	** Occurs in the 4th and 5th decades
		+	** Clinically presents as chronic recurrent abdominal pain
		+	** Triad steatorrhea, diabetes mellitus, and weight loss
		+	** Can present as a solid mass in the head of the pancreas
		+	** Radiologically can appear as an ill defined lobulated mass and the periphery of the lesion can look irregular
		+	** Strictures of the biliary or pancreatic ducts occurs as well as calcification
		+	</spoiler>
		+	* <spoiler text="What are some of the cytologic features that lead you to the diagnosis?">
		+	* Variable cellularity depending on the fibrosis in the specimen, however usually low cellularity
		+	* Smears are polymorphous (ductal cells, acinar cells, macrophages, inflammatory cells, fibrosis, debris, calcification, fat necrosis)
		+	* Hyperplastic and atypical ductal cells can be present, and can make it difficult to distinguish from adenocarcinoma.
		+	* Although markedly atypical cells may be present there will not be many and there will be no single atypical cells
		+	* Reactive cells will not have anisonucleosis and will not have nuclear irregularity
		+	* Ductal cells out number acinar cells (acinar atrophy)
		+	</spoiler>
		+	* <spoiler text="Differential diagnosis?">
		+	* Adenocarcinoma
		+	** Occurs later (6th and 7th decades)
		+	** Irregular nuclear contours, macronuclei, anisonucleosis
		+	** Positive staining for p53 and CDx-2
		+	** Negative staining for SMAD4
		+	* The presence of mitotic figures does not support the diagnosis of carcinoma. Mitotic figures can be seen in chronic pancreatitis.
		+	* Pancreatic cancer is often surrounded by a zone of pancreatitis, therefore pancreatits does not exclude malignancy nor does inflammation
		+	</spoiler>