Difference between revisions of "Cytologically Yours: Unknowns: 201401: Case 5"

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(Resident Questions)
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===Resident Questions===
 
===Resident Questions===
* <spoiler text="Diagnosis?">
+
* <spoiler text="Diagnosis?">__NOGLOSSARY__
 
* Mucinous Pancreatic Neoplasm
 
* Mucinous Pancreatic Neoplasm
 
** Includes two diagnostic entities:
 
** Includes two diagnostic entities:
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** Best diagnosis is "neoplastic cells present, pancreatic mucinous neoplasm"
 
** Best diagnosis is "neoplastic cells present, pancreatic mucinous neoplasm"
 
</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__
 
* Abundant thick mucin that may look colloid like
 
* Abundant thick mucin that may look colloid like
 
* Mucin can be so thick and tenacious it may cause difficulty in aspirating and making smears
 
* Mucin can be so thick and tenacious it may cause difficulty in aspirating and making smears
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* Single cells or groups trapped in mucus
 
* Single cells or groups trapped in mucus
 
</spoiler>
 
</spoiler>
* <spoiler text="Differential diagnosis?">
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* <spoiler text="Differential diagnosis?">__NOGLOSSARY__
 
* Contaminant gastrointestinal  
 
* Contaminant gastrointestinal  
 
** Brush border and interspersed goblet cells is seen in duodenal epithelium
 
** Brush border and interspersed goblet cells is seen in duodenal epithelium
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* CAN NOT DIFFERENTIATE BETWEEN IPMN AND MCN ON CYTOLOGY ALONE
 
* CAN NOT DIFFERENTIATE BETWEEN IPMN AND MCN ON CYTOLOGY ALONE
 
</spoiler>
 
</spoiler>
*<spoiler text="What ancillary studies would you order?">
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*<spoiler text="What ancillary studies would you order?">__NOGLOSSARY__
 
* CEA levels are >200ng/mL in both MCN and IPMN
 
* CEA levels are >200ng/mL in both MCN and IPMN
 
* Amylase will be high in IPMN and low in MCN (due to IPMN connection with the pancreatic duct)
 
* Amylase will be high in IPMN and low in MCN (due to IPMN connection with the pancreatic duct)

Revision as of 20:07, 16 January 2014

Cytology

Resident Questions