CASE N°25 – Adenocarcinoma in bronchial washing

Clinical History:

Age: 60

Sex: male

Weight loss of 10 kg in the last month, oxygen-therapy permanent.

Broncoscpy: substenosis of the right main bronchus and intermediate bronchus due to extrinsic compression (BAL in this location).
Tac-scan: In the right lower lobe, neoplastic lesion axis of 7 cm. Are detected adenopathies in the right hilum greater axis of 15 mm. Are not
documented mediastinal adenopathy

Cytological Images:

Cytological speciemen: bronchial washing

Image 1

Image 2

Image 3

Image 4

Cytological Report:

Positive for malignancy, non small cell carcinoma, Adenocarcinoma

Discussion:

Image 1-3 neoplastic cells. Image 4 “normal cells”, in this picture we can see basally located nuclei, apical cytoplasm with terminal bar & cilia; the nuclei have inconspicuous nucleoli and relatively uniform chromatin pattern.
The neoplastic cells are more big in size, arranged in haphazard aggregates (no basally located nuclei), without cilia, atypical nuclei and sometimes with prominent nucleoli.

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