Case of the Week: Lucky

Case of the Week: Lucky

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Case History

Lucky, a 15-year old, M/N, DSH named Lucky presented with decreased appetite, weight loss, vomiting and diarrhea of several weeks duration. Recently Lucky has been coughing and has nasal and ocular discharge. Lucky is diabetic, but has not been receiving insulin due to inappetence, and blood glucose levels have been normal, per owner. Clinical suspicion of carcinomatosis. FNA of a lymph node was submitted.

Scopio Practice Tip

To aid interpretation of lymph node aspirates, it is important to indicate which lymph node was submitted. For each slide, there is a free text box available to add site/slide specific details. Multiple lymph nodes are charged as a single site, so submission of more than one is recommended for comparison if peripheral lymphadenopathy is present, with each clearly indicated in the event that microscopic features vary among them. The free text box is similarly useful for synovial fluids and multiple cutaneous masses.

Microscopic Features

Necrotic cellular material with a central vacuolated macrophage.

Interpretation: Carcinomatosis with associated necrotic ischaemic (mesenteric) steatitis.

Case follow up: This patient was a referral and was discharged for follow up care. Unfortunately, additional information is not available at this time.

Cytologic Criteria of Malignancy Refresher! Anisocytosis (variation in cell size), anisokaryosis (variation in nuclear size), prominent/multiple nucleoli, mitotic figures, inappropriate location (eg. metastasis)

NOTE: These criteria do not apply equally for all sample types! These are used as a guide for assessment and descriptive purposes, but final interpretation includes complex variables. For example, benign reactive mesothelial/epithelial/mesenchymal cells can display several of these criteria in the absence of malignant neoplasia, particularly when inflammation is present.

Case of the Week patient information has been altered for client confidentiality.

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