Quiz-summary
0 of 1 questions completed
Questions:
- 1
Information
Presented by Dr. Argani and prepared by Austin McCuiston.
This is a 43 year old male with multiple pleural nodules.
You have already completed the quiz before. Hence you can not start it again.
Quiz is loading...
You must sign in or sign up to start the quiz.
You have to finish following quiz, to start this quiz:
Results
Time has elapsed
Categories
- Not categorized 0%
- 1
- Answered
- Review
-
Question 1 of 1
1. Question
This is a 43 year old male with multiple pleural nodules.
Correct
Answer: Metastatic thymoma
Histologic Description: The pleural nodules are characterized by dominant infiltrate of immature lymphocytes, which raises the differential diagnosis of small cell malignancies such as small cell carcinoma or, more significantly, lymphoblastic lymphoma. However, interdigitating between the dominant lymphoid components are epithelial cells with squamoid features and prominent processes, suggesting the possibility of thymoma. The epithelial cells are cytologically bland and lack malignant features. The epithelioid cells label for cytokeratin in a dendritic pattern, where the immature lymphocytes label for CD99 and TDT. The features are diagnostic of thymoma.
Differential Diagnosis: Small cell carcinoma would be expected to show cytokeratin labeling of the primitive small cells. Lymphoblastic lymphoma may have a phenotype similar to that of the immature lymphocytes of thymoma; however, lymphoblastic lymphoma would lack the dominant epithelial component of thymoma, and it occurs in a younger age group. Thymic carcinoma demonstrates cytologic features of malignancy in the epithelial component.
The current patient had a mediastinal mass, so this represents drop metastasis of thymoma.
Incorrect
Answer: Metastatic thymoma
Histologic Description: The pleural nodules are characterized by dominant infiltrate of immature lymphocytes, which raises the differential diagnosis of small cell malignancies such as small cell carcinoma or, more significantly, lymphoblastic lymphoma. However, interdigitating between the dominant lymphoid components are epithelial cells with squamoid features and prominent processes, suggesting the possibility of thymoma. The epithelial cells are cytologically bland and lack malignant features. The epithelioid cells label for cytokeratin in a dendritic pattern, where the immature lymphocytes label for CD99 and TDT. The features are diagnostic of thymoma.
Differential Diagnosis: Small cell carcinoma would be expected to show cytokeratin labeling of the primitive small cells. Lymphoblastic lymphoma may have a phenotype similar to that of the immature lymphocytes of thymoma; however, lymphoblastic lymphoma would lack the dominant epithelial component of thymoma, and it occurs in a younger age group. Thymic carcinoma demonstrates cytologic features of malignancy in the epithelial component.
The current patient had a mediastinal mass, so this represents drop metastasis of thymoma.
