Oncocytic-Appearing Salivary Gland Tumors. Oncocytic, Cystic, Mucinous, and High Grade Salivary Gland Tumors SALIVARY GLAND FNA: PART II

Size: px
Start display at page:

Download "Oncocytic-Appearing Salivary Gland Tumors. Oncocytic, Cystic, Mucinous, and High Grade Salivary Gland Tumors SALIVARY GLAND FNA: PART II"

Transcription

1 William C. Faquin, MD, PhD Professor of Pathology Harvard Medical School Director of Head and Neck Pathology Massachusetts Eye and Ear Massachusetts General Hospital SALIVARY GLAND FNA: PART II Oncocytic, Cystic, Mucinous, and High Grade Salivary Gland Tumors Oncocytic-Appearing Salivary Gland Tumors 1

2 Acinic Cell Carcinoma Second most common salivary gland malignancy 2-6% of all salivary gland neoplasms Low-grade malignancy : Recapitulates growth of normal acinar cells F>M, 90% parotid Histology of Acinic Cell Carcinoma Basophilic zymogen granules Acinic Cell Carcinoma Cytologic Features: Cells (high cellularity): Serous-type acinar cells (low N/C ratio) Background: Stripped nuclei + lymphocytes Clean may be cystic Capillary meshwork Psammoma bodies 2

3 Acinic cell carcinoma with fragile cytoplasm and many background stripped nuclei Acinic cell carcinoma with dispersed cells Acinic cell carcinoma with low N:C ratio cells, basophilic cytoplasm, and cytoplasmic vacuoles 3

4 Papillary-Cystic Acinic Cell Carcinoma Acinic Cell Carcinoma Papillary-Cystic Variant Papanicolaou stain Diff Quik stain DOG1 and Acinic Cell Carcinoma Discovered on GIST Calcium-activated chloride channel protein Strong diffuse staining seen in most acinic cell carcinomas 4

5 SOX-10 and Acinic Cell Carcinoma SRY-related HMG-box 10 (SOX10) protein Transcription factor: neural crest formation, and maintenance of Schwann cells and melanocytes. Acinar cells and intercalated ducts Diffuse strong nuclear staining seen in most acinic cell carcinomas SOX10 and Salivary Gland Tumors POSITIVE Acinic cell carcinoma Adenoid cystic carcinoma Epithelial-myoepithelial carcinoma Myoepithelial carcinoma Pleomorphic adenoma NEGATIVE Salivary duct carcinoma Mucoepidermoid carcinoma Oncocytoma Warthin tumor Pitfall: Normal Salivary Gland FNA Misinterpreting normal acinar cells as acinic cell carcinoma 5

6 PITFALL: FNA OF THE NORMAL SALIVARY GLAND Normal Salivary Gland Acinic Cell Carcinoma DDX of Oncocytic Tumors Acinic cell carcinoma Oncocytoma Warthin tumor PA with oncocytic metaplasia Mucoepidermoid carcinoma (oncocytic variant) Oncocytic carcinoma Metastatic renal cell carcinoma Problem: How is oncocytoma distinguished from acinic cell carcinoma? 6

7 Oncocytoma Oncocytoma: Note background crystaloids Acinic Cell Carcinoma vs. Oncocytoma ACC is distinguished by DOG1+, SOX10+, PAS-D+ Oncocytoma Acinic Cell Carcinoma 7

8 What about Warthin Tumor? Warthin Tumor: Lymphocytes, oncocytes, and background debris Warthin Tumor: Waxy cytoplasm and lymphocytes 8

9 Warthin Tumor: Abundant background mucin Cystic and Mucinous Salivary Gland Tumors Low Grade Mucoepidermoid Carcinoma Most common salivary gland cancer in children and adults Usually slow growing and painless Residual mass post-aspiration Often a good clinical prognosis 9

10 Mucoepidermoid Carcinoma Cytologic Features: 3 Cell Types: Mucus, epidermoid, and intermediate Mucinous background with cellular debris Other variations: Columnar, clear, oncocytic Keratinization is absent P63+ but negative for myoepithelial cells Histology of Low Grade Mucoepidermoid Carcinoma Typical Hypocellular FNA of Low-Grade Mucoepidermoid Carcinoma Rare epithelial groups 10

11 Pitfall: Low-Grade Mucoepidermoid Carcinoma Low grade mucoepidermoid carcinoma is the most common cause of false negative salivary gland diagnoses: Hypocellularity due to cystic nature Bland cytology of cells Mucinous cells resemble foamy histiocytes Low Grade Mucoepidermoid Carcinoma: Rare bland epidermoid cells in sheets MEC Mucoepidermoid Carcinoma: Epidermoid Cells 11

12 Low Grade Mucoepidermoid Carcinoma: Epidermoid cells and mucinous cells Low-Grade Mucoepidermoid Carcinoma: Mucus-Containing Epithelial Cells Low Grade Mucoepidermoid Carcinoma: 3-D collection of mucinous cells and epidermoid cells 12

13 Mucicarmine Stain Mucoepidermoid Carcinoma: Epidermoid & Intermediate Cells 13

14 Mucoepidermoid Carcinoma: IHC is non-specific Immunohistochemistry: Positive for: Keratin 5,6,7,8,19 EMA CEA p63 Negative for: SM actin Calponin S-100 SOX10 Mucoepidermoid Carcinoma: Can be useful for difficult cases Cytogenetics: t(11:19) translocation MECT1/MAML2 FISH or NGS More common in low grade Seethala et al Am J Surg Pathol (2010) 60% overall LG 74%, IG 63%, HG 32% Useful in small biopsies FISH contributed by Dr. Joaquin Garcia, Mayo Clinic Key Point: Low grade mucoepidermoid carcinoma should be considered in the differential diagnosis of any salivary gland FNA with significant amounts of background mucin. 14

15 DDX of MEC Mucocele Salivary duct cyst Mucinous cystadenoma Mammary analogue secretory carcinoma PA with mucinous metaplasia Warthin tumor with mucin Sclerosing polycystic adenosis Metastatic renal cell carcinoma Mimic of Low Grade Mucoepidermoid Carcinoma Mimic of Low Grade Mucoepidermoid Carcinoma 15

16 Pitfall: Mimic of MEC: Keratinization NOT a feature of MEC Pitfall: Mimic of MEC: Calponin+ - NOT a feature of MEC Mucoepidermoid carcinoma can easily be confused with a mucocele. 16

17 Mucocele Cytologic Features: Hypocellular Scant to absent epithelium Foamy macrophages and inflammation Pitfall: Low-Grade Mucoepidermoid Carcinoma vs. Mucocele A cell block is diagnostically useful to stain for keratin, p63, CD68, and mucin. LG Mucoepidermoid Ca Mucocele Mammary Analogue Secretory Carcinoma 17

18 Mammary Analogue Secretory Carcinoma Analogous to secretory carcinoma of breast Previously classified as acinic cell carcinoma or adenocarcinoma, NOS Absence of serous-type acinar differentiation- lacks zymogen granules Low-grade biologic behavior FNA of Mammary Analogue Secretory Carcinoma Mammary Analogue Secretory Carcinoma: Numerous small cytoplasmic vacuoles 18

19 Mammary Analogue Secretory Carcinoma: Abundant Secretions MASC Immunohistochemistry: Positive for: S-100 Mammaglobin Keratin 7, 8, 19 EMA GCDFP-15 MUC1, MUC4 Negative for: Myoepithelial markers (p63 etc) Androgen receptor DOG1 +/- MASC: Immunohistochemical Studies GCDFP-15+ S-100+ Mammoglobin+ 19

20 Mammary Analogue Secretory Carcinoma: Cytogenetics: For difficult cases, test for rearrangement ETV6-NTRK3 rearrangement: T(12:15)(p13;q25) MASC is only known salivary gland primary Detected on histology or cytology using: FISH RT-PCR Next-Gen Sequencing FISH Contributed by Dr. Joaquin Garcia, Mayo Clinic High-Grade Salivary Gland Tumors Differential Diagnosis of High-Grade Salivary Gland Carcinoma Salivary Duct Carcinoma High Grade Mucoepidermoid Carcinoma Carcinoma Ex Pleomorphic Adenoma Squamous Cell Carcinoma Metastasis 20

21 Salivary Duct Carcinoma Uncommon Clinically aggressive/poor prognosis Parotid in elderly men Resembles high grade comedo-type breast carcinoma Androgen receptor +, Her2neu +, p53+, GATA-3+ Salivary Duct Carcinoma: Resembles ductal breast carcinoma Cells Salivary Duct Carcinoma Cytologic Features Overtly malignant cytomorphology Sheets, clusters, papillae, cribriform groupings Polygonal with abundant vacuolated cytoplasm Large hyperchromatic, pleomorphic nuclei, prominent nucleolus Background Necrosis 21

22 Salivary Duct Carcinoma: Glandular Groups with Marked Atypia Salivary Duct Carcinoma: High grade nuclear features Salivary Duct Carcinoma: Background Necrosis 22

23 Salivary Duct Carcinoma: Tumor Diathesis Salivary Duct Carcinoma: High Grade Nuclear Features and Prominent Nucleoli High-grade carcinomas: Can be difficult to distinguish, but clinical management is usually similar Salivary duct ca High-grade MEC Ca Ex PA 23

24 Carcinoma Ex Pleomorphic Adenoma: Retains its PLAG1 gene rearrangements HG Mucoepidermoid Carcinoma: Resembles Non-Keratinizing SCC Diff-Quik Stain Pap Stain HG Mucoepidermoid Carcinoma: Rare Mucinous Cells Favor This Diagnosis 24

25 High Grade Squamous Cell Carcinoma: Can be Primary or Metastatic Squamous Cell Carcinoma, Primary Often Non-Keratinizing Squamous Cell Carcinoma, Metastatic: Often seen in elderly with history of facial skin cancer and parotid nodule 25

26 Metastatic Squamous Cell Carcinoma: Keratinization Favors This Diagnosis Summary Use a combination of cytologic features, special stains, IHC, and molecular when possible Adequate specimen with material for FFPE cell block, DQ and Pap stains Clinical management will often be guided by classification as low-grade versus high-grade Thank You! 26

27 Case: 87 y.o. woman with 4.0 cm right parotid gland mass 27

28 Cytologic Diagnosis: ATYPICAL Suggestive of oncocytic neoplasm ddx includes MEC. 28

29 Sclerosing Polycystic Adenosis: Mimic of Low Grade Mucoepidermoid Carcinoma Reactive and inflammatory process analogous to adenosis of breast Parotid gland is most common site Age range: 9-80 yo 2.5:1 female: male Unencapsulated Lobules of tubules and ductal hyperplasia with apocrine change in fibrotic stroma Case History A 49 year-old woman with a several year history of rheumatoid arthritis presents with a markedly enlarged left parotid gland. By clinical exam, the parotid gland was diffusely firm; however, a discrete mass was not identified. An FNA was performed. 29

30 The initial working diagnosis based upon rapid interpretation included reactive lymph node, chronic sialadenitis, LESA, and lymphoma. Therefore material for flow cytometry was sent and was negative for lymphoma. 30

31 Cytologic Diagnosis LYMPHOEPITHELIAL SIALADENITIS (LESA) LYMPHOEPITHELIAL SIALADENITIS (LESA) Variety of names: Benign lymphoepithelial lesion Myoepithelial sialadenitis (MESA) Mikulicz s disease Often associated with Sjogren s syndrome, rheumatoid arthritis or other autoimmune disorders Can be unilateral, bilateral, solid, or cystic Increased risk of B-cell lymphoma, esp. MALT-type 31

32 LYMPHOEPITHELIAL SIALADENITIS (LESA) LYMPHOEPITHELIAL SIALADENITIS (LESA) Cytologic Features: Cellular aspirate Mixed population of lymphocytes and plasma cells Germinal center fragments Tingible body macrophages Lymphoepithelial lesions Absence of acinar cells LYMPHOEPITHELIAL SIALADENITIS (LESA) 32

33 Differential Diagnosis of LESA Chronic sialadenitis Reactive intraparotid lymph node HIV-associated lymphoepithelial cyst Lymphoepithelial carcinoma Metastatic squamous cell carcinoma B-cell lymphoma A key pitfall in the diagnosis of LESA is metastatic squamous cell carcinoma. SCC LESA LESA vs. Chronic Sialadenitis Chronic Sialadenitis differs from LESA by: Hypocellularity Fewer lymphocytes and germinal centers Smaller angulated groups rather than sheets Absence of lymphoepithelial lesions 33

34 LESA vs. Lymphoepithelial Carcinoma Usually EBER Positive LESA vs. Lymphoma Immunophenotyping is essential for distinguishing LESA from lymphoma, especially MALT lymphoma. 34

PRELIMINARY CYTOLOGIC DIAGNOSIS: Suspicious for Acinic Cell Carcinoma. Cell Block: Immunohistochemical Studies CYTOLOGIC DIAGNOSIS:

PRELIMINARY CYTOLOGIC DIAGNOSIS: Suspicious for Acinic Cell Carcinoma. Cell Block: Immunohistochemical Studies CYTOLOGIC DIAGNOSIS: 1 PRELIMINARY CYTOLOGIC DIAGNOSIS: Suspicious for Acinic Cell Carcinoma. Cell Block: Immunohistochemical Studies GCDFP-15 S-100 CYTOLOGIC DIAGNOSIS: Consistent with mammary analogue secretory carcinoma.

More information

Salivary Gland Cytology

Salivary Gland Cytology Salivary Gland Cytology Diagnostic challenges and potential pitfalls Tarik M. Elsheikh, MD Professor and Medical Director Anatomic Pathology Cleveland Clinic FNA Salivary Gland Lesions Indications Distinguish

More information

Objectives. Salivary Gland FNA: The Milan System. Role of Salivary Gland FNA 04/26/2018

Objectives. Salivary Gland FNA: The Milan System. Role of Salivary Gland FNA 04/26/2018 Salivary Gland FNA: The Milan System Dr. Jennifer Brainard Section Head Cytopathology Cleveland Clinic Objectives Introduce the Milan System for reporting salivary gland cytopathology Define cytologic

More information

Review and Updates of Immunohistochemistry in Selected Salivary Gland and Head and Neck Tumors

Review and Updates of Immunohistochemistry in Selected Salivary Gland and Head and Neck Tumors Review and Updates of Immunohistochemistry in Selected Salivary Gland and Head and Neck Tumors. Monophasic tumors : myoepithelioma, acinic cell carcinoma, and salivary duct carcinoma. Biphasic tumors includes

More information

Salivary Glands 3/7/2017

Salivary Glands 3/7/2017 Salivary Glands 3/7/2017 Goals and objectives Focus on the entities unique to H&N Common board type facts Information for your future practice Salivary Glands Salivary Glands Major gland. Paratid. Submandibular.

More information

Update in Salivary Gland Pathology. Benjamin L. Witt University of Utah/ARUP Laboratories February 9, 2016

Update in Salivary Gland Pathology. Benjamin L. Witt University of Utah/ARUP Laboratories February 9, 2016 Update in Salivary Gland Pathology Benjamin L. Witt University of Utah/ARUP Laboratories February 9, 2016 Objectives Review the different appearances of a selection of salivary gland tumor types Establish

More information

04/09/2018. Salivary Gland Pathology in the Molecular Era Old Friends, Old Foes, & New Acquaintances

04/09/2018. Salivary Gland Pathology in the Molecular Era Old Friends, Old Foes, & New Acquaintances Salivary Gland Pathology in the Molecular Era Old Friends, Old Foes, & New Acquaintances Jennifer L. Hunt, MD, MEd Aubrey J. Hough Jr, MD, Endowed Professor of Pathology Chair of Pathology and Laboratory

More information

ARIZONA SOCIETY OF PATHOLOGISTS 13 TH APRIL 2013 HEAD AND NECK CYTOPATHOLOGY. F ZAHRA ALY, MD, PhD

ARIZONA SOCIETY OF PATHOLOGISTS 13 TH APRIL 2013 HEAD AND NECK CYTOPATHOLOGY. F ZAHRA ALY, MD, PhD ARIZONA SOCIETY OF PATHOLOGISTS 13 TH APRIL 2013 HEAD AND NECK CYTOPATHOLOGY F ZAHRA ALY, MD, PhD The main areas sites amenable for cytopathology include lymph nodes, thyroid, major salivary glands especially

More information

Salivary Gland FNA ATYPICAL : Criteria and Controversies

Salivary Gland FNA ATYPICAL : Criteria and Controversies Salivary Gland FNA ATYPICAL : Criteria and Controversies W.C. Faquin, M.D., Ph.D. Director, Head and Neck Pathology Massachusetts General Hospital Massachusetts Eye and Ear Infirmary Harvard Medical School

More information

FNA OF SALIVARY GLANDS: A PRACTICAL APPROACH

FNA OF SALIVARY GLANDS: A PRACTICAL APPROACH FNA OF SALIVARY GLANDS: A PRACTICAL APPROACH FNA of Salivary Glands: Challenges Wide range of neoplastic and non-neoplastic lesions Cytological overlap between the different benign and malignant tumors

More information

An Integrated Cytologic and Histologic Approach to the Diagnosis of Salivary Gland Tumors

An Integrated Cytologic and Histologic Approach to the Diagnosis of Salivary Gland Tumors An Integrated Cytologic and Histologic Approach to the Diagnosis of Salivary Gland Tumors W.C. Faquin, M.D., Ph.D. Massachusetts General Hospital Massachusetts Eye and Ear Infirmary Boston, MA An Integrated

More information

Salivary gland cytology. Salivary gland cytology. Triage helps the clinician. Salivary gland tumors. Diagnostic difficulties

Salivary gland cytology. Salivary gland cytology. Triage helps the clinician. Salivary gland tumors. Diagnostic difficulties Salivary gland cytology Salivary Gland Cytology Pınar Fırat, MD Professor of Pathology İ.U. İstanbul Faculty of Medicine Çapa, İstanbul It is a reliable diagnostic test However, definitive subclassification

More information

4/17/2015. Case 1. A 37 year old man with a 2.2 cm solitary left thyroid mass.

4/17/2015. Case 1. A 37 year old man with a 2.2 cm solitary left thyroid mass. Case 1 A 37 year old man with a 2.2 cm solitary left thyroid mass. Case 1 Case 1 1 Case 1: Diagnosis? A. Benign B. Atypia of undetermined significance/follicular lesion of undetermined significance C.

More information

Salivary gland tumor cytologic and histologic correlation: Algorithmic and risk stratification based approaches

Salivary gland tumor cytologic and histologic correlation: Algorithmic and risk stratification based approaches Salivary gland tumor cytologic and histologic correlation: Algorithmic and risk stratification based approaches Christopher C. Griffith, MD, PhD Raja R. Seethala, MD 1. Salivary gland tumor cytology: A

More information

Salivary gland neoplasms: an update 29th Annual Meeting of Arab Division of the International Academy of Pathology MUSCAT, OMAN 2017

Salivary gland neoplasms: an update 29th Annual Meeting of Arab Division of the International Academy of Pathology MUSCAT, OMAN 2017 Salivary gland neoplasms: an update 29th Annual Meeting of Arab Division of the International Academy of Pathology MUSCAT, OMAN 2017 Dr Mary Toner Consultant Pathologist St James Hospital Trinity College

More information

Mammary analogue secretory carcinoma of salivary gland A case report of new entity

Mammary analogue secretory carcinoma of salivary gland A case report of new entity Case Report Mammary analogue secretory carcinoma of salivary gland A case report of new entity Vaibhav Bhika Bari 1*, Sandhya Unmesh Bholay 2 1 Assistant Professor, 2 Associate Professor Rajiv Gandhi Medical

More information

FNA Biopsy of Salivary Gland

FNA Biopsy of Salivary Gland FNA Biopsy of Salivary Gland Richard M. DeMay, MD Professor of Pathology Director of Cytopathology The University of Chicago Objective: To describe the use of FNA Bx to diagnose salivary gland lesions

More information

Salivary gland Workshop Trondheim 31th may 2012

Salivary gland Workshop Trondheim 31th may 2012 Salivary gland Workshop Trondheim 31th may 2012 Peter Jebsen cytopathologist Oslo University Hospital Rikshospitalet Anna Bofin ass. Professor St. Olavs Hospital, Trondheim Drying artifacts Lymfocytes

More information

Disclosure of Relevant Financial Relationships

Disclosure of Relevant Financial Relationships Squamous entities of the thyroid: Reactive to Neoplastic Michelle D. Williams Associate Professor Dept of Pathology, Head & Neck Section University of Texas MD Anderson Cancer Center Disclosure of Relevant

More information

Molecular Diagnostics of Head and Neck Tumors Justin A. Bishop, M.D. Associate Professor of Pathology The Johns Hopkins University Baltimore, Maryland

Molecular Diagnostics of Head and Neck Tumors Justin A. Bishop, M.D. Associate Professor of Pathology The Johns Hopkins University Baltimore, Maryland Molecular Diagnostics of Head and Neck Tumors Justin A. Bishop, M.D. Associate Professor of Pathology The Johns Hopkins University Baltimore, Maryland Two Main Topics Molecular insights in salivary gland

More information

Salivary Gland Neoplasms. Salivary Gland Neoplasms Outline 4/16/2018. MUSC Pathology Multi-Specialty Course Kiawah Island, SC April 19, 2018

Salivary Gland Neoplasms. Salivary Gland Neoplasms Outline 4/16/2018. MUSC Pathology Multi-Specialty Course Kiawah Island, SC April 19, 2018 Salivary Gland Neoplasms MUSC Pathology Multi-Specialty Course Kiawah Island, SC April 19, 2018 Bruce M. Wenig, MD Moffitt Cancer Center Tampa, FL Salivary Gland Neoplasms Outline Basic concepts of salivary

More information

My Journey into the World of Salivary Gland Sebaceous Neoplasms

My Journey into the World of Salivary Gland Sebaceous Neoplasms My Journey into the World of Salivary Gland Sebaceous Neoplasms Douglas R. Gnepp Warren Alpert Medical School at Brown University Rhode Island Hospital Pathology Department Providence RI Asked to present

More information

Enterprise Interest None

Enterprise Interest None Enterprise Interest None What are triple negative breast cancers? A synopsis of their histological patterns Ian Ellis Molecular Medical Sciences, University of Nottingham Department of Histopathology,

More information

Los Angeles Society Of Pathologists Dr. Shobha Castelino Prabhu

Los Angeles Society Of Pathologists Dr. Shobha Castelino Prabhu Los Angeles Society Of Pathologists Dr. Shobha Castelino Prabhu Loma Linda University Medical Center June 12, 2007 CASE 1 76 year-old gentleman Status post right parotidectomy 1 year ago for a rare tumor

More information

Salivary Gland Neoplasms. Napa Valley Pathology Conference Silverado Resort & Spa May 18, /22/2018. Salivary Gland Neoplasms Outline

Salivary Gland Neoplasms. Napa Valley Pathology Conference Silverado Resort & Spa May 18, /22/2018. Salivary Gland Neoplasms Outline Salivary Gland Neoplasms Napa Valley Pathology Conference Silverado Resort & Spa May 18, 2018 Bruce M. Wenig, MD Moffitt Cancer Center Tampa, FL Salivary Gland Neoplasms Outline Basic concepts of salivary

More information

Evening Specialty Conference: Cytopathology

Evening Specialty Conference: Cytopathology : Cytopathology N. Paul Ohori, M.D. University of Pittsburgh Medical Center Disclosure of Relevant Financial Relationships Disclosure of Relevant Financial Relationships USCAP requires that all planners

More information

WHO 2017: New Classification of Head and Neck Tumours

WHO 2017: New Classification of Head and Neck Tumours WHO 2017: New Classification of Head and Neck Tumours Ilmo Leivo Department of Pathology University of Turku & Turku University Hospital FINLAND Suomen IAP Aulanko 18.05.2018 WHO 2017 New entities Simplification

More information

Lesions Mimicking Adenoid Cystic Carcinoma. Diagnostic Problems in Salivary Gland Pathology An Update 5/29/2009

Lesions Mimicking Adenoid Cystic Carcinoma. Diagnostic Problems in Salivary Gland Pathology An Update 5/29/2009 Diagnostic Problems in Salivary Gland Pathology An Update Lesions Mimicking Adenoid Cystic Carcinoma Stacey E. Mills, M.D. W.S. Royster Professor of Pathology Director of Surgical and Cytopathology University

More information

A Cutaneous Facial Mass Identified as the New Entity Mammary Analogue Secretory Carcinoma of Probable Salivary Gland Origin

A Cutaneous Facial Mass Identified as the New Entity Mammary Analogue Secretory Carcinoma of Probable Salivary Gland Origin A Cutaneous Facial Mass Identified as the New Entity Mammary Analogue Secretory Carcinoma of Probable Salivary Gland Origin Scott W. Binder, MD Professor and Senior Vice Chair Chief, Dermatopathology Geffen/UCLA

More information

Ben Witt, MD University of Utah/ARUP Laboratories Assistant Professor of Anatomic Pathology

Ben Witt, MD University of Utah/ARUP Laboratories Assistant Professor of Anatomic Pathology Ben Witt, MD University of Utah/ARUP Laboratories Assistant Professor of Anatomic Pathology Review some of the more common cytodiagnoses of the Head and Neck Establish an approach to some of the diagnostic

More information

PLEOMORPHIC ADENOMA ( BENIGN MIXED TUMOR )

PLEOMORPHIC ADENOMA ( BENIGN MIXED TUMOR ) ( BENIGN MIXED TUMOR ) Grossly, the tumor is freely movable, solid, sometimes lobulated and occasionally cystic. If recurrent, multinodular masses are common. Histologically, within a fibrous capsule,

More information

Fine-Needle Aspiration Cytology of Low-Grade Cribriform Cystadenocarcinoma with Many Psammoma Bodies of the Salivary Gland

Fine-Needle Aspiration Cytology of Low-Grade Cribriform Cystadenocarcinoma with Many Psammoma Bodies of the Salivary Gland The Korean Journal of Pathology 2013; 47: 481-485 CASE STUDY Fine-Needle Aspiration Cytology of Low-Grade Cribriform Cystadenocarcinoma with Many Psammoma Bodies of the Salivary Gland Ji Yun Jeong Dongbin

More information

Presentation material is for education purposes only. All rights reserved URMC Radiology Page 1 of 98

Presentation material is for education purposes only. All rights reserved URMC Radiology Page 1 of 98 Presentation material is for education purposes only. All rights reserved. 2011 URMC Radiology Page 1 of 98 Radiology / Pathology Conference February 2011 Brooke Koltz, Cytopathology Resident Presentation

More information

Educational Cases EQA November T.J. Palmer Raigmore Hospital Inverness

Educational Cases EQA November T.J. Palmer Raigmore Hospital Inverness Educational Cases EQA November 2013 T.J. Palmer Raigmore Hospital Inverness Case 2 Clinical Details Dob 11 February 1951 PMH: 1964 Extraction of 45 aet 13 yr 1966 Cyst between 44 and 46 enucleated 1973

More information

Pancreatitis: A Potential Pitfall in Endoscopic Ultrasound Guided Pancreatic FNA

Pancreatitis: A Potential Pitfall in Endoscopic Ultrasound Guided Pancreatic FNA Pancreatitis: A Potential Pitfall in Endoscopic Ultrasound Guided Pancreatic FNA Jack Yang, MD Department of Pathology, Medical University of South Carolina Objectives Understand the indication of EUS

More information

Case #1 FNA of nodule in left lobe of thyroid in 67 y.o. woman

Case #1 FNA of nodule in left lobe of thyroid in 67 y.o. woman Challenging Cases Manon Auger M.D., F.R.C.P. (C) Professor, Department of Pathology McGill University Director, Cytopathology Laboratory McGill University it Health Center Case #1 FNA of nodule in left

More information

Zubair W. Baloch, MD, PhD: Consultant for Veracyyte, INC Tarik M. Elsheikh, MD: Nothing to disclose

Zubair W. Baloch, MD, PhD: Consultant for Veracyyte, INC Tarik M. Elsheikh, MD: Nothing to disclose Cytology Works shop #8 Zubair W. Baloch, MD, PhD: Consultantt for Veracyte, INC Tarik M. Elsheik kh, MD: Nothing to disclose Controversies and Diagnostic Challenges in Head and Neck Cytopathology Zubair

More information

Notice of Faculty Disclosure

Notice of Faculty Disclosure California Society of Pathology Diagnostic Problems in Surgical Pathology December 2015 Case 2 Laura C. Collins, M.D. Associate Professor of Pathology Associate Director of Anatomic Pathology Beth Israel

More information

Low-grade cribriform cystadenocarcinoma arising from a minor salivary gland: a case report

Low-grade cribriform cystadenocarcinoma arising from a minor salivary gland: a case report 145 Journal of Oral Science, Vol. 58, No. 1, 145-149, 2016 Case Report Low-grade cribriform cystadenocarcinoma arising from a minor salivary gland: a case report Masashi Kimura 1), Shinji Mii 2), Shinichi

More information

EQA Circulation 43 Educational Cases

EQA Circulation 43 Educational Cases EQA Circulation 43 Educational Cases E1-E2 Monica Agarwal Monklands Hospital E1 38 yrs male Submandibular gland tumour E1 Formal excision following diagnosis of poorly differentiated carcinoma on core

More information

ACCME/Disclosure. Time to Standardize the Cytology Reporting of Salivary Glands: Introduction of the Milan System. Salivary Gland FNA

ACCME/Disclosure. Time to Standardize the Cytology Reporting of Salivary Glands: Introduction of the Milan System. Salivary Gland FNA Time to Standardize the Cytology Reporting of Salivary Glands: Introduction of the Milan System ACCME/Disclosure W.C. Faquin, M.D., Ph.D. Director Head and Neck Pathology Massachusetts General Hospital

More information

FNA of Thyroid. Toward a Uniform Terminology With Management Guidelines. NCI NCI Thyroid FNA State of the Science Conference

FNA of Thyroid. Toward a Uniform Terminology With Management Guidelines. NCI NCI Thyroid FNA State of the Science Conference FNA of Thyroid NCI NCI Thyroid FNA State of the Science Conference Toward a Uniform Terminology With Management Guidelines Thyroid Thyroid FNA Cytomorphology NCI Thyroid FNA State of the Science Conference

More information

Papillary Lesions of the Breast A Practical Approach to Diagnosis. (Arch Pathol Lab Med. 2016;140: ; doi: /arpa.

Papillary Lesions of the Breast A Practical Approach to Diagnosis. (Arch Pathol Lab Med. 2016;140: ; doi: /arpa. Papillary Lesions of the Breast A Practical Approach to Diagnosis (Arch Pathol Lab Med. 2016;140:1052 1059; doi: 10.5858/arpa.2016-0219-RA) Papillary lesions of the breast Span the spectrum of benign,

More information

New/Emerging Entities in Salivary Gland Pathology

New/Emerging Entities in Salivary Gland Pathology New/Emerging Entities in Salivary Gland Pathology Alena Skalova, MD, PhD Professor of Pathology Charles University, Faculty of Medicine in Plzen, Czech Republic 2018 IAP Congress; Jordan, 14 18 October

More information

Case year female. Routine Pap smear

Case year female. Routine Pap smear Case 1 57 year female Routine Pap smear Diagnosis? 1. Atypical glandular cells of unknown significance (AGUS) 2. Endocervical AIS 3. Endocervical adenocarcinoma 4. Endometrial adenocarcinoma 5. Adenocarcinoma

More information

Outline 11/2/2017. Pancreatic EUS-FNA general aspects. Cytomorphologic features of solid neoplasms/lesions of the pancreas

Outline 11/2/2017. Pancreatic EUS-FNA general aspects. Cytomorphologic features of solid neoplasms/lesions of the pancreas ENDOSCOPIC ULTRASOUND GUIDED-FINE NEEDLE ASPIRATION CYTOLOGY OF PANCREAS Khalid Amin M.D. Assistant Professor Department of Laboratory Medicine and Pathology University of Minnesota Outline Pancreatic

More information

Cytomorphological study of major salivary gland lesions: a 5-year experience at a tertiary care center

Cytomorphological study of major salivary gland lesions: a 5-year experience at a tertiary care center Original article Cytomorphological study of major salivary gland lesions: a 5year experience at a tertiary care center Aruna S, Prathiksha Pai, Shreekant K. Kittur Department of Pathology, Belagavi Institute

More information

See the latest estimates for new cases of salivary gland cancers in the US and what research is currently being done.

See the latest estimates for new cases of salivary gland cancers in the US and what research is currently being done. About Salivary Gland Cancer Overview and Types If you have been diagnosed with salivary gland cancer or are worried about it, you likely have a lot of questions. Learning some basics is a good place to

More information

Differential Diagnosis of Oral Masses. Palatal Lesions

Differential Diagnosis of Oral Masses. Palatal Lesions Differential Diagnosis of Oral Masses Palatal Lesions Palatal Masses Periapical Abscess Torus Palatinus Mucocele Lymphoid Hyperplasia Adenomatous Hyperplasia Benign Salivary Neoplasms Malignant Salivary

More information

Disclosure. Relevant Financial Relationship(s) None. Off Label Usage None MFMER slide-1

Disclosure. Relevant Financial Relationship(s) None. Off Label Usage None MFMER slide-1 Disclosure Relevant Financial Relationship(s) None Off Label Usage None 2013 MFMER slide-1 Case Presentation A 43 year old male, with partial nephrectomy for a right kidney mass 2013 MFMER slide-2 2013

More information

Slide Seminar of the Head and Neck Session of the European Congress of Pathology Bilbao, Spain, 2018.

Slide Seminar of the Head and Neck Session of the European Congress of Pathology Bilbao, Spain, 2018. Slide Seminar of the Head and Neck Session of the European Congress of Pathology Bilbao, Spain, 2018. Prof Sulen Sarioglu, MD Dokuz Eylul University Faculty of Medicine Department of Pathology Graduate

More information

A 60-year old Man with Left Jaw Mass. Simon Chiosea, MD University of Pittsburgh medical Center 3/15/2016

A 60-year old Man with Left Jaw Mass. Simon Chiosea, MD University of Pittsburgh medical Center 3/15/2016 ACCME/Disclosures The USCAP requires that anyone in a position to influence or control the content of CME disclose any relevant financial relationship WITH COMMERCIAL INTERESTS which they or their spouse/partner

More information

Diseases of the breast (1 of 2)

Diseases of the breast (1 of 2) Diseases of the breast (1 of 2) Introduction A histology introduction Normal ducts and lobules of the breast are lined by two layers of cells a layer of luminal cells overlying a second layer of myoepithelial

More information

1 NORMAL HISTOLOGY AND METAPLASIAS

1 NORMAL HISTOLOGY AND METAPLASIAS 1 NORMAL HISTOLOGY AND METAPLASIAS, MD Anatomy and Histology 1 Metaplasias 2 ANATOMY AND HISTOLOGY The female breast is composed of a branching duct system, which begins at the nipple with the major lactiferous

More information

ISPUB.COM. Salivary duct carcinoma of parotid gland. V Kinnera, R Nandyala, M Yootla, K Mandyam INTRODUCTION CASE REPORT

ISPUB.COM. Salivary duct carcinoma of parotid gland. V Kinnera, R Nandyala, M Yootla, K Mandyam INTRODUCTION CASE REPORT ISPUB.COM The Internet Journal of Pathology Volume 10 Number 1 V Kinnera, R Nandyala, M Yootla, K Mandyam Citation V Kinnera, R Nandyala, M Yootla, K Mandyam.. The Internet Journal of Pathology. 2008 Volume

More information

BREAST PATHOLOGY. Fibrocystic Changes

BREAST PATHOLOGY. Fibrocystic Changes BREAST PATHOLOGY Lesions of the breast are very common, and they present as palpable, sometimes painful, nodules or masses. Most of these lesions are benign. Breast cancer is the 2 nd most common cause

More information

Benign Mimics of Malignancy in Breast Pathology

Benign Mimics of Malignancy in Breast Pathology Arthur Purdy Stout Society of Surgical Pathologists Companion Meeting Benign Mimics of Malignancy in Breast Pathology Stuart J. Schnitt, M.D. Beth Israel Deaconess Medical Center and Harvard Medical School,

More information

Gross appearance of nodular hyperplasia in material obtained from suprapubic prostatectomy. Note the multinodular appearance and the admixture of

Gross appearance of nodular hyperplasia in material obtained from suprapubic prostatectomy. Note the multinodular appearance and the admixture of Tiền liệt tuyến Tiền liệt tuyến Gross appearance of nodular hyperplasia in material obtained from suprapubic prostatectomy. Note the multinodular appearance and the admixture of solid and microcystic areas.

More information

Departments of Pathology and *Otorhinolaryngology, Faculty of Medicine, University of Malaya, Kuala Lumpur

Departments of Pathology and *Otorhinolaryngology, Faculty of Medicine, University of Malaya, Kuala Lumpur Malaysian J Pathol 2002; 24(2) : 107-112 CASE REPORT Papillary cystic type of acinic cell carcinoma of parotid: fine needle aspiration cytological features of a high grade variant with oncocytic metaplasia

More information

(CYLINDROMA) ATLAS OF HEAD AND NECK PATHOLOGY ADENOID CYSTIC CARCINOMA

(CYLINDROMA) ATLAS OF HEAD AND NECK PATHOLOGY ADENOID CYSTIC CARCINOMA (CYLINDROMA) This malignant tumor is poorly encapsulated and while seemingly well defined within the affected gland, there is usually infiltration of surrounding tissue on closer examination. The cut surface

More information

Salivary Gland Pathology

Salivary Gland Pathology IN THE NAME OF GOD Salivary Gland Pathology CHAPTER 11 Dr.kheirandish Oral and maxillofacial pathology Sialadenosis Adenomatoid Hyperplasia of the Minor Salivary Glands Necrotizing Sialometaplasia Pleomorphic

More information

Respiratory Tract Cytology

Respiratory Tract Cytology Respiratory Tract Cytology 40 th European Congress of Cytology Liverpool, UK Momin T. Siddiqui M.D. Professor of Pathology and Laboratory Medicine Director of Cytopathology Emory University Hospital, Atlanta,

More information

DIAGNOSTIC SLIDE SEMINAR: PART 1 RENAL TUMOUR BIOPSY CASES

DIAGNOSTIC SLIDE SEMINAR: PART 1 RENAL TUMOUR BIOPSY CASES DIAGNOSTIC SLIDE SEMINAR: PART 1 RENAL TUMOUR BIOPSY CASES Dr. Andrew J. Evans MD, PhD, FACP, FRCPC Consultant in Genitourinary Pathology University Health Network, Toronto, ON Case 1 43 year-old female,

More information

Workshop 2. Controversies and Diagnostic Challenges in Head and Neck Cytopathology. Zubair Baloch, MD,PhD. Veracyte, Inc: Consultant

Workshop 2. Controversies and Diagnostic Challenges in Head and Neck Cytopathology. Zubair Baloch, MD,PhD. Veracyte, Inc: Consultant Workshop 2 Controversies and Diagnostic Challenges in Head and Neck Cytopathology Zubair Baloch, MD,PhD Veracyte, Inc: Consultant Tarik Elsheikh, MD There are no disclosures necessary. Controversies and

More information

Breast pathology. 2nd Department of Pathology Semmelweis University

Breast pathology. 2nd Department of Pathology Semmelweis University Breast pathology 2nd Department of Pathology Semmelweis University Breast pathology - Summary - Benign lesions - Acute mastitis - Plasma cell mastitis / duct ectasia - Fat necrosis - Fibrocystic change/

More information

Disclosures. Parathyroid Pathology. Objectives. The normal parathyroid 11/10/2012

Disclosures. Parathyroid Pathology. Objectives. The normal parathyroid 11/10/2012 Disclosures Parathyroid Pathology I have nothing to disclose Annemieke van Zante MD/PhD Assistant Professor of Clinical Pathology Associate Chief of Cytopathology Objectives 1. Review the pathologic features

More information

DIAGNOSTIC DILEMMA. Case Reports Clinical history. Materials and Methods

DIAGNOSTIC DILEMMA. Case Reports Clinical history. Materials and Methods DIAGNOSTIC DILEMMA A Metastatic Renal Carcinoid Tumor Presenting as Breast Mass: A Diagnostic Dilemma Farnaz Hasteh, M.D., 1 Robert Pu, M.D., Ph.D., 2 and Claire W. Michael, M.D. 2 * We present clinicopathological

More information

Mody. AIS vs. Invasive Adenocarcinoma of the Cervix

Mody. AIS vs. Invasive Adenocarcinoma of the Cervix Common Problems in Gynecologic Pathology Michael T. Deavers, M.D. Houston Methodist Hospital, Houston, Texas Common Problems in Gynecologic Pathology Adenocarcinoma in-situ (AIS) of the Cervix vs. Invasive

More information

PROSTATIC ADENOCARCINOMA: DIAGNOSTIC CRITERIA AND IMPORTANT MIMICKERS PROSTATIC ADENOCARCINOMA: DIAGNOSTIC CRITERIA

PROSTATIC ADENOCARCINOMA: DIAGNOSTIC CRITERIA AND IMPORTANT MIMICKERS PROSTATIC ADENOCARCINOMA: DIAGNOSTIC CRITERIA PROSTATIC ADENOCARCINOMA: DIAGNOSTIC CRITERIA AND IMPORTANT MIMICKERS PROSTATIC ADENOCARCINOMA: DIAGNOSTIC CRITERIA 1 A good H & E helps! ADENOCARCINOMA DIAGNOSTIC CRITERIA Relatively uniform proliferation

More information

40th European Congress of Cytology Liverpool, UK, 2-5 th October 2016

40th European Congress of Cytology Liverpool, UK, 2-5 th October 2016 40th European Congress of Cytology Liverpool, UK, 2-5 th October 2016 EUS FNA of abdominal organs: An approach to reporting and triage for ancillary testing Date and time: Sunday 2 nd October 2016 15.00-16.30

More information

Thyroid master class. Thyroid Fine needle aspiration cytology and liquid-based techniques: Hologic and Becton Dickinson

Thyroid master class. Thyroid Fine needle aspiration cytology and liquid-based techniques: Hologic and Becton Dickinson Thyroid master class Thyroid Fine needle aspiration cytology and liquid-based techniques: Hologic and Becton Dickinson Principle of LBC Collection of cells in liquid medium Immediate fixation Processor-prepared

More information

Proliferative Breast Disease: implications of core biopsy diagnosis. Proliferative Breast Disease

Proliferative Breast Disease: implications of core biopsy diagnosis. Proliferative Breast Disease Proliferative Breast Disease: implications of core biopsy diagnosis Jean F. Simpson, M.D. Breast Pathology Consultants, Inc. Nashville, TN Proliferative Breast Disease Must be interpreted in clinical and

More information

04/10/2018. Intraductal Papillary Neoplasms Of Breast INTRADUCTAL PAPILLOMA

04/10/2018. Intraductal Papillary Neoplasms Of Breast INTRADUCTAL PAPILLOMA Intraductal Papillary Neoplasms Of Breast Savitri Krishnamurthy MD Professor of Pathology Deputy Division Head The University of Texas MD Anderson Cancer Center 25 th Annual Seminar in Pathology Pittsburgh,

More information

Diagnostic Cytology of Cancer Cases

Diagnostic Cytology of Cancer Cases Diagnostic Cytology of Cancer Cases Somporn Techangamsuwan Companion Animal Cancer Research Unit (CAC-RU) Department of Pathology, Faculty of Veterinary Science, Chulalongkorn University 1 Tumor or Non-tumor

More information

BOSNIAN-TURKISH CYTOPATHOLOGY SCHOOL June 18-19, 2016 Sarajevo. Case Discussions. 60 year old woman Routine gynecologic control LBC

BOSNIAN-TURKISH CYTOPATHOLOGY SCHOOL June 18-19, 2016 Sarajevo. Case Discussions. 60 year old woman Routine gynecologic control LBC BOSNIAN-TURKISH CYTOPATHOLOGY SCHOOL June 18-19, 2016 Sarajevo Case Discussions Prof Dr Sıtkı Tuzlalı Tuzlalı Pathology Laboratory 60 year old woman Routine gynecologic control LBC 1 2 Endometrial thickening

More information

BSD 2015 Case 19. Female 21. Nodule on forehead. The best diagnosis is:

BSD 2015 Case 19. Female 21. Nodule on forehead. The best diagnosis is: BSD 2015 Case 19 Female 21. Nodule on forehead. The best diagnosis is: A. mixed tumour of skin B. porocarcinoma C. nodular hidradenoma D. metastatic adenocarcinoma BSD 2015 Case 19 Female 21 Nodule on

More information

Research Article Transmucosal Fine Needle Aspiration of Oral and Pharyngeal Lesions

Research Article Transmucosal Fine Needle Aspiration of Oral and Pharyngeal Lesions International Scholarly Research Network ISRN Pathology Volume 2011, Article ID 267145, 7 pages doi:10.5402/2011/267145 Research Article Transmucosal Fine Needle Aspiration of Oral and Pharyngeal Lesions

More information

Synonyms. Nephrogenic metaplasia Mesonephric adenoma

Synonyms. Nephrogenic metaplasia Mesonephric adenoma Nephrogenic Adenoma Synonyms Nephrogenic metaplasia Mesonephric adenoma Definition Benign epithelial lesion of urinary tract with tubular, glandular, papillary growth pattern Most frequently in the urinary

More information

DISORDERS OF THE SALIVARY GLANDS Neoplasms Dr.M.Baskaran Selvapathy S IV

DISORDERS OF THE SALIVARY GLANDS Neoplasms Dr.M.Baskaran Selvapathy S IV DISORDERS OF THE SALIVARY GLANDS Neoplasms Dr.M.Baskaran Selvapathy S IV NEOPLASMS A) Epithelial I. Benign Pleomorphic adenoma( Mixed tumour) Adenolymphoma (Warthin s tumour) Oxyphil adenoma (Oncocytoma)

More information

From Morphology to Molecular Pathology: A Practical Approach for Cytopathologists Part 1-Cytomorphology. Songlin Zhang, MD, PhD LSUHSC-Shreveport

From Morphology to Molecular Pathology: A Practical Approach for Cytopathologists Part 1-Cytomorphology. Songlin Zhang, MD, PhD LSUHSC-Shreveport From Morphology to Molecular Pathology: A Practical Approach for Cytopathologists Part 1-Cytomorphology Songlin Zhang, MD, PhD LSUHSC-Shreveport I have no Conflict of Interest. FNA on Lymphoproliferative

More information

ORIGINAL ARTICLE. Fine-Needle Aspiration Biopsy of Salivary Gland Lesions in a Selected Patient Population

ORIGINAL ARTICLE. Fine-Needle Aspiration Biopsy of Salivary Gland Lesions in a Selected Patient Population ORIGINAL ARTICLE Fine-Needle Aspiration Biopsy of Salivary Gland Lesions in a Selected Patient Population Erik G. Cohen, MD; Snehal G. Patel, MD; Oscar Lin, MD; Jay O. Boyle, MD; Dennis H. Kraus, MD; Bhuvanesh

More information

THE NATURAL HISTORY OF TUMORS PECULIAR TO THE SALIVARY GLANDS

THE NATURAL HISTORY OF TUMORS PECULIAR TO THE SALIVARY GLANDS THE NATURAL HISTORY OF TUMORS PECULIAR TO THE SALIVARY GLANDS FRANK VELLIOS, M.D., AND DALE DAVIDSON, M.D. Departments of Clinical Pathology and Surgery, Indiana University School of Medicine Tumors of

More information

Enterprise Interest None

Enterprise Interest None Enterprise Interest None Risk stratification of salivary gland lesions on cytology based on the proposed Milan System for reporting salivary gland cytopathology: A pilot study Kartik Viswanathan, M.D.,

More information

Urinary Bladder: WHO Classification and AJCC Staging Update 2017

Urinary Bladder: WHO Classification and AJCC Staging Update 2017 Urinary Bladder: WHO Classification and AJCC Staging Update 2017 Houston Society of Clinical Pathologists 58 th Annual Spring Symposium Houston, TX April 8, 2017 Jesse K. McKenney, MD Classification

More information

Takako Inaba, 1 Yuki Fukumura, 2 Tsuyoshi Saito, 2 Junkichi Yokoyama, 3 Shinichi Ohba, 3 Atsushi Arakawa, 2 and Takashi Yao 2. 1.

Takako Inaba, 1 Yuki Fukumura, 2 Tsuyoshi Saito, 2 Junkichi Yokoyama, 3 Shinichi Ohba, 3 Atsushi Arakawa, 2 and Takashi Yao 2. 1. Case Reports in Pathology Volume 2015, Article ID 656107, 6 pages http://dx.doi.org/10.1155/2015/656107 Case Report Cytological Features of Mammary Analogue Secretory Carcinoma of the Parotid Gland in

More information

3/28/2017. Head and Neck/Endocrine Pathology Specialty Conference Case 4 Raja R. Seethala, M.D. University of Pittsburgh Medical Center

3/28/2017. Head and Neck/Endocrine Pathology Specialty Conference Case 4 Raja R. Seethala, M.D. University of Pittsburgh Medical Center Head and Neck/Endocrine Pathology Specialty Conference Case 4 Raja R. Seethala, M.D. University of Pittsburgh Medical Center Disclosure of Relevant Financial Relationships Disclosure of Relevant Financial

More information

Macro- and microacinar proliferations of the prostate

Macro- and microacinar proliferations of the prostate Macro- and microacinar proliferations of the prostate (with emphasis on cancer mimics) Rodolfo Montironi, MD (IT), FRCPath (UK), IFCAP (USA) Polytechnic University of Marche Region (Ancona) School of Medicine,

More information

Case # year old man with a 2 cm right kidney mass

Case # year old man with a 2 cm right kidney mass Case # 4. 52 year old man with a 2 cm right kidney mass Figure 1 Figure 2 Figure 3 Figure 4 Diagnosis: Negative/Non-diagnostic Normal kidney tissue Fine needle aspiration (FNA) of the kidney is performed

More information

Update on Thyroid FNA The Bethesda System. Shikha Bose M.D. Associate Professor Cedars Sinai Medical Center

Update on Thyroid FNA The Bethesda System. Shikha Bose M.D. Associate Professor Cedars Sinai Medical Center Update on Thyroid FNA The Bethesda System Shikha Bose M.D. Associate Professor Cedars Sinai Medical Center Thyroid Nodules Frequent occurrence Palpable: 4-7% of adults Ultrasound: 10-31% Majority benign

More information

Slide seminar. Asist. Prof. Jože Pižem, MD, PhD Institute of Pathology Medical Faculty, University of Ljubljana

Slide seminar. Asist. Prof. Jože Pižem, MD, PhD Institute of Pathology Medical Faculty, University of Ljubljana Slide seminar Asist. Prof. Jože Pižem, MD, PhD Institute of Pathology Medical Faculty, University of Ljubljana Case 5 A 57-year-old man with a dermal/subcutaneous lesion on the scalp, which was interpreted

More information

Papillary Lesions of the breast

Papillary Lesions of the breast Papillary Lesions of the breast Emad Rakha Professor of Breast Pathology The University of Nottingham Papillary lesions of the breast are a heterogeneous group of disease, which are characterised by neoplastic

More information

WHO classification salivary tumours: What's new?

WHO classification salivary tumours: What's new? WHO classification salivary tumours: What's new? Alena Skalova, MD, PhD Professor of Pathology Charles University, Faculty of Medicine in Plzen, Czech Republic An update on Histopathology of Salivary Gland

More information

Whitney A. High, MD, JD, MEng

Whitney A. High, MD, JD, MEng ADS Dermatopathology Meeting 2014 Selected Adnexal Tumors Whitney A. High, MD, JD, MEng Associate Professor, Dermatology & Pathology Director of Dermatopathology (Dermatology) University of Colorado School

More information

5/21/2018. Difficulty in Underdiagnosing Prostate Cancer. Diagnosis of Prostate Cancer. Evaluation of Prostate Cancer and Atypical on Needle Biopsy

5/21/2018. Difficulty in Underdiagnosing Prostate Cancer. Diagnosis of Prostate Cancer. Evaluation of Prostate Cancer and Atypical on Needle Biopsy Evaluation of Prostate Cancer and Atypical on Needle Biopsy Jonathan I. Epstein Difficulty in Underdiagnosing Prostate Cancer Limited tissue on needle biopsy (1 cm. x

More information

6/3/2010. Outline of Talk. Lobular Breast Cancer: Definition of lobular differentiation. Common Problems in Diagnosing LCIS in Core Biopsies

6/3/2010. Outline of Talk. Lobular Breast Cancer: Definition of lobular differentiation. Common Problems in Diagnosing LCIS in Core Biopsies Outline of Talk Lobular Breast Cancer: Common Problems in Diagnosing LCIS in Core Biopsies Definition of lobular differentiation Variants of LCIS that: carry risk for unsampled invasive cancer mimic DCIS

More information

DOWNLOAD ENTIRE DOCUMENT FROM

DOWNLOAD ENTIRE DOCUMENT FROM PREVIEW ONLY 1 Atlas on Bethesda system for reporting Thyroid Cytology PREVIEW ONLY 2 OVERVIEW 1. Indications and goal of thyroid FNA 2. Contraindications 3. Procurement of cell sample 4. Staining methods

More information

Oncocytic carcinoma: A rare malignancy of the parotid gland

Oncocytic carcinoma: A rare malignancy of the parotid gland ISPUB.COM The Internet Journal of Pathology Volume 8 Number 2 Oncocytic carcinoma: A rare malignancy of the parotid gland K Mardi, J Sharma Citation K Mardi, J Sharma.. The Internet Journal of Pathology.

More information

Salivary gland cytology is especially challenging due to the extensive overlap between many benign and malignant tumors. Salivary Gland Cytology

Salivary gland cytology is especially challenging due to the extensive overlap between many benign and malignant tumors. Salivary Gland Cytology William C. Faquin, MD, PhD Professor of Pathology Harvard Medical School Director of Head and Neck Pathology Massachusetts Eye and Ear Massachusetts General Hospital SALIVARY GLAND FNA: PART I Salivary

More information

CHRONIC PANCREATITIS OR DUCTAL ADENOCARCINOMA? N. Volkan Adsay, \ MD

CHRONIC PANCREATITIS OR DUCTAL ADENOCARCINOMA? N. Volkan Adsay, \ MD CHRONIC PANCREATITIS OR DUCTAL ADENOCARCINOMA? N. Volkan Adsay, \ MD Case for discussion 67 y/o male Back pain and weight loss CT: 4.5 cm ill-defined, solid lesion in the head FNA/Core bx: Inconclusive

More information

Case 3 - GYN. History: 66 year old, routine Pap test. Dr. Stelow

Case 3 - GYN. History: 66 year old, routine Pap test. Dr. Stelow Case 3 - GYN History: 66 year old, routine Pap test Dr. Stelow Case 3 66 year year old woman Routine Pap Test Cytologic Features 3 dimensional clusters of cells with small to moderate amount of

More information