A Quality Exercise for Cytopathology Laboratories
Brian K. Theisen, MD and Sara E. Monaco, MD
Presentation Date: October 1, 2016; Expires October 1, 2019
Recognize the prevalence of quality issues in cytopathology
Review potential sources of tissue contamination
Review immunohistochemical and molecular methods for identifying potential tissue contaminants
Review concept of root cause analysis as a method for process improvement
An 80-year-old male presented with shoulder pain and a 7 cm right renal mass showing enhancement on a CT scan with contrast and FDG-avidity on PET scan. Prior FNA of the renal mass was non-diagnostic. The patient was then found to have a 3.5 cm FDG-avid, expansile, lytic lesion of the right scapula and was referred for a biopsy. Thus, a CT-guided FNA of a right scapular bone lesion was performed. Aspirate smears showed loosely cohesive clusters of epithelioid tumor cells with increased nuclear-to-cytoplasmic ratios and vacuolated cytoplasm with discrete ‚?opunched out‚?Ě vacuoles. The cell block showed similar tumor cells with clear cytoplasm and hyperchromatic nuclei. On the periphery of the cell block, was another group of neoplastic cells with more eosinophilic cytoplasm, cohesion, and a lymphoid infiltrate.