Blog Archives

CASE N°50 – Gastrointestinal stromal tumor (GIST) of the rectum

Click here for the new case report

Advertisements

CASE N°39 – PERIGASTRIC LYMPHOMA

Click here for the new case report

Case Report N° 18 – Thymic carcinoma

Click HERE to enjoy the new case report

Case Report N°16 – Neuroendocrine neoplasm of the Pancreas

Click here to join in the new case report

Pancreatic Cytopathology Page

Visit the new page about Pancreatic Cytopathology on my Blog. Click here to join in.

One simple trick to obtain paraffin embedded tissue from cytological specimen

Intro:

In some selected cases, in addiction to the diagnosis oncologists are asking cytopathologists to do immunohistochemistry they need to make decisions about patient. Gold standard is biopsy but this can’t be done in all of the cases.

Often the cytological specimen is too much bloody and the cells are dispersed in more than one slide, also considering the extracellular substances may inhibit immuno-reaction, we find very difficult to meet the demand.

This is the way to obtain material to obtain paraffin embedded tissue for further investigation/ancillary methods:

  • wash the syringe & the needle used to obtain material with saline solution
  • centrifuge (2000 rpm 2 min.)

  • discard excess fluid
  • sediment: add 10% formalin  & alcohol 95% solution (50%/50%) 
  • centrifuge (1500 rpm 2 min.)
  • transfer the sediment in the cassette

  • processing and inclusion in paraffin
  • ready to go

Example – Case Report: Peri-rectal lymphadenopathy

 Clinical History:

 Age: 71, Sex:  female

Patient previously trated with surgery and chemoterapy for right colon adenocarcinoma (2007) T3N1, M1

 Cytological specimen: EUS-FNA

PAP 200X

PAP400X

PAP200X

PAP400X

Preliminary cytological diagnosis : Positive for malignancy – adenocarcinoma

Paraffin embedded tissue from cytological specimen

H/E 20X

H/E 100X

H/E 200X

CDX2+

 CDX2+

final diagnosis: Metastasis from colonic adenocarcinoma (recurrence of disease)