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Continuing Medical Education (CME): The American Society of Cytopathology is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The American Society of Cytopathology designates this enduring educational activity for a maximum of 1 AMA PRA Category 1 credit(s).TM Physicians should only claim credit commensurate with the extent of their participation in the activity.
American Board of Pathology Maintenance of Certification (MOC): This product can help fulfill the CME requirements and Self-Assessment Modules (SAMs) mandated by the American Board of Pathology MOC process.
Continuing Medical Laboratory Education (CMLE): The ASC designates this activity for the indicated number of CMLE credit hours and also fulfills requirements of the ABMS to participate in the Maintenance of Certification program.
This program is approved for continuing education credits in the State of Florida for 1 credit and the State of California for ½ credit.
A 13 year old female presented to her primary care provider with new onset fatigue and an enlarging right forearm mass. Complete blood count performed at that time revealed anemia and thrombocytopenia as well as circulating blasts. CT scan revealed a 3.5 cm pancreatic tail mass along with an enlarged right axillary lymph node. The differential diagnosis of the pancreatic mass by imaging included primary and metastatic neoplastic processes. Core needle biopsy of the right forearm mass was performed followed by excisional biopsy of the enlarged axillary lymph node and endoscopic ultrasound-guided (EUS) fine needle aspiration of the pancreatic mass.
The cytology specimen from EUS-guided FNA of the pancreatic mass revealed hypercellular smears composed of single and scattered large clusters of neoplastic cells (Figures 1-3). Some round pseudoglandular structures simulating rosettes were present. The tumor cells exhibited anisonucleosis, high nuclear-cytoplasmic ratios, irregular nuclear membranes, and inconspicuous nucleoli. The nuclei were predominantly round to ovoid in shape with focal nuclear molding. Rare mitotic figures were present without apparent necrosis. Fine cytoplasmic vacuoles were apparent. The cell block sections showed similar cytomorphologic features (Figures 4-5).