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Disclosure for Education Planners

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.

Clinical History

A 25 year old female presented with tightness in her chest. A chest CT scan showed progressive bilateral effusions. A pleural fluid was tapped and submitted to cytology and processed by cytocentrifugation. This patient first presented at the age of 21 with a lump on the dorsum of her right foot, which was amputated 3 months later. Over the next 3 to 4 years, the patient underwent excision of a right thigh mass, right inguinal lymph nodes and a tumor debulking of an anterior pelvic sidewall.

Cytopathology Features

The Papanicolaou (Pap) and Diff-Quik (DQ) stains are highly cellular with a fibrinous background. The majority of the cells are cohesive with a 3-dimensional tufted appearance giving the impression of a papillary formation. The individual cells are small and monotonous with round to oval nuclei and tiny nucleoli. The nuclear membranes are irregular and the cytoplasm is scant and indistinct. Scattered mesothelial cells and some lymphocytes are also present. The cell block showed similar features.

Leigh Ann Cahill, CT(ASCP)
Virginia Commonwealth University Health System
Richmond, Virginia

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