CASE N°14 – Cytology & Histology must go together

Mediastinal metastases from Renal

 Cell Carcinoma (clear cell subtype)

Clinical History:

Age: 73

Sex: Male

Matiastinal lymphadenopathy PET+, in patient with no pulmonary nodules. Two years before diagnosis of Renal Cell Carcinoma (GradeII – clear cell subtype – see thumbnail).

  

Cytological Images:

Cytological material: Trans-Bronchial FNAC

PAP100X

PAP100X

PAP200X

PAP400X

PAP600X

PAP400X

Cytological Report:

Positive for malignancy.  

Histological Images:

Histological material:  Trans-Bronchial FNAB

 TTF-1

 CD10

 EMA

 VIMENTINA

Histological Report:

 Clear Cell Renal Carcinoma metastases

Discussion:

In this case we have:

1) cytological speciemen in wich the morphology refer to the previous carcinoma. We cannot perform immunohistochemistry on cytological speciemen due to scant cellularity.

2) histological speciemen with few cells so it is hard to say “ok, metastases”. Fortunately here we can perform immunohistochemistry tha is coherent with the previously diagnosed carcinoma.   

Finally 1+2 = correct diagnosis

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