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Presented by Ralph Hruban, M.D. and prepared by Lynette S. Nichols, M.D.
Case 6: This 90 year old man presented with a firm inguinal hernia.
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Question 1 of 1
1. Question
Week 106: Case 6
This 90 year old man presented with a firm inguinal hernia./images/Lyn’s/9-2-02-Hruban-6.a.jpg
/images/Lyn’s/9-2-02-Hruban-6.b.jpg
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/images/Lyn’s/9-2-02-Hruban-6.d.jpgCorrect
Answer: Metastatic adenocarcinoma
Histology: Numerous poorly formed glands were scattered throughout this hernia sac. At higher power the nuclei show significant pleomorphism. A panel of immunostains was performed and the neoplastic cells express TTF-1 and CK7, but not CK20.
Discussion: The pattern of immunostaining was most consistent with a metastatic adenocarcinoma of the lung. On imaging, the patient was found to have a large lung mass.
Incorrect
Answer: Metastatic adenocarcinoma
Histology: Numerous poorly formed glands were scattered throughout this hernia sac. At higher power the nuclei show significant pleomorphism. A panel of immunostains was performed and the neoplastic cells express TTF-1 and CK7, but not CK20.
Discussion: The pattern of immunostaining was most consistent with a metastatic adenocarcinoma of the lung. On imaging, the patient was found to have a large lung mass.
