Australian Society of CytologyCase of the Month
September 2002
Specimen type:
Pleural Fluid - 300 mls of pale pink fluid
Clinical History:
A 60 year old man with a long history of heavy smoking presented with a right pleural effusion.Images:
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| A low-power Pap showing a cellular smear consisting largely of cohesive sheets which have smooth edges. | A medium power MGG showing a cohesive group of epithelial cells with its enlarged atypical nuclei and abundant cytoplasm. Several clusters of macrophages are present to the left of the malignant group. | A high power Pap showing a cohesive group of epithelioid cells with large atypical nuclei and prominent nucleoli. The cytoplasm is vacuolated. One mitotic figure is noted. |
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| A high power MGG showing marked vacuolation of cell cytoplasm, ? represents mucin. | A cell block show a malignant epithelial cells forming gland like structures. Some may be in the result of central necrosis. Cytoplasmic vacuolation is noted. | A PAS/D stain does not show convincing intra cytoplasmic or luminal mucin. |
Instructions:
Click on each of the image thumbnails to view the full size image. It will open in a new window. Click on the 'x' in the top right corner to close the window and return to this screen.When you have made your diagnosis click on the answer link below for the answer and further discussion on the case.
Answer
