Australian Society of Cytology

Slide Seminars

Saturday 1400 - Session 3: Head and Neck

Dr Matthew Zarka Case 1:

79 year old male with a 2.5 cm right parotid mass

Dr Matthew Zarka Case 2:

66 year old man with a right submandibular mass. 2 yrs ago he had a "biopsy" which was benign. Over the last 2 years the mass had doubled in size.

Dr William Geddie Case 1:

•52 yo woman, abnormal CXR at routine examination (asymptomatic) •Normal CXR on immigration 15 years prior •BAL submitted with clinical information “pulmonary infiltrate” ?Infectious ?Neoplastic •Transbronchial bx attempted but unsuccessful

		BAL RLL (DfQk) 10x

DfQk 63x	DfQk 63x	DfQk 63x

Dr William Geddie Case 2:

55 year old woman presenting with orbital mass and proptosis.

Surgical biopsy:Orbit, Right lower lid and conjunctiva, Left lateral: Lymphohistiocytic infiltrate, consistent with reactive process	FNA Right axillary Lymph Node:2 passes – 27G needle

Diff-Quik 63x	Diff-Quik 63x	Pap Stain 63x

MGG 63x	MGG 100x	MIB1 63x

Dr Alastair Deery Case 1:

History: 39 year old female complaining of a lump in neck for 8/52. No other symptoms. No other significant illness.

On examination: Multinodular goitre with a dominant nodule in the (L) lower pole of thyroid of approximately 20mm maximum diameter on palpation. Bilateral thyroid nodules both lower poles. No lymph nodes palpable.

FNA performed of the (L) lower pole nodule by “capillary” technique x 1, through a 23 gauge needle, by the attending pathologist.

Dr Alastair Deery Case 2:

History: 21 year old female complaining of a lump in neck for 5/52. No other symptoms. ALL (Acute lymphoblastic leukaemia) age 2. Rx Chemotherapy and radiotherapy. Complete remission. CT and Ultrasound reveal MNG; Large spleen; Hepatic nodules; Gastric polyps; Intrauterine ?foetal sac.

On manual examination at Ultrasound: 35mm nodule in (L) lower pole of thyroid. Ultrasound reveals several other nodules in both lobes. No pathologically enlarged nodes (no nodes > 4mm short axis diameter).

FNA was performed of the palpable (L) lower pole nodule by capillary technique x 1, through a 23 gauge needle by the attending pathologist.

Saturday 1600 - Session 4: The case I'll never Forget

Case 1: Dr Matthew Zarka

Hx is a 32 year old woman with a solitary nodule in the left thyroid lobe, 2.5 cm in greatest dimensions. No other symptoms.

Case 2: Dr William Geddie

FNA of tumour left submandibular trigone An 84 year old woman was referred for aspiration of a mass in the left submandibular trigone. The referral itself was remarkable in that it came from a radiation oncologist with a skeptical view of diagnosis by FNA, fond of characterizing it as "a convenient means of obtaining incomplete and inaccurate information". The patient was remarkable in that she had been treated with surgery and radiation in 1952 (54 years prior to referral) for a tumour in the same area. The histologic diagnosis of the neoplasm treated at that time was "malignant angioendothelioma". On examination a firm to hard mass measuring about 2.5 cm in diameter was found on the anterior edge of, and partially overlapping, a 6x6 cm zone of marked atrophy and telangiectasia. An FNA was performed using a 27G needle.

Case 3: Dr Alastair Deery

History: Private patient. A 51 yr old man who had a CT scan as part of a company insurance policy condition. Otherwise well. CT scan revealed two intra-abdominal masses plus several small lymph nodes in the cervical levels. The patient was referred for Ultrasound guided FNA of a neck node. The largest node was in (R) level VI and slightly rounded; measuring 8 x 7mm diameter. No thyroid/ other abnormalities were sounded.

On examination: No palpable abnormalities.

FNA was performed x 2 by “capillary” technique under guidance, by the ultrasonologist, with the pathologist attending. Immediate direct preparations are shown.