Any cytopathologists want to take a stab at this?

Re: Any cytopathologists want to take a stab at this?

James Laidlaw — Sat, 11 May 2013 07:51:47 GMT

I think we'll be operating this week. I'll let you know once we get definitive answer to it.

Re: Any cytopathologists want to take a stab at this?

John Flynn — Sat, 11 May 2013 03:31:40 GMT

[quote user="Stephen Courtney"]Are you sending the slides off to a proper cytologist? Would love to see the definitive answer![/quote]

www.televetdx.com

£15+VAT (or free for first case if not registered before) to get photos like this looked at by an experienced clinical pathologist - obviously only as good as the range of photos available.

Like others would be interested to hear results if get expert cytology interpretation or histo results if gets removed/biopsied.

Re: Any cytopathologists want to take a stab at this?

David Mills — Fri, 10 May 2013 23:43:20 GMT

I agree with Mr Courtney. The first two slides are pretty acellular apart from the odd lymphocyte - its mainly background.

On the third slide, you have round nuclei with indistinct cytoplasm, not in rafts or clumps but singular. There are a couple of oval shaped nuclei with wispy cytoplasmic tails in the centre with small nucleoli or chromatin aggregates. The round nuceli are a uniform shape and pretty similar size. There are some mature lymphocytes around too.

This looks like a round cell tumour, and on these pictures, a benign one, though these can be locally invasive. I think the spindle cells are reactive fibroblasts but they could be neoplastic, although there are few of them. I definitely would not wait and see with this and would be taking it off before it invades local tissue any more.

Re: Any cytopathologists want to take a stab at this?

Stephen Courtney — Fri, 10 May 2013 23:17:53 GMT

It is very basophilic on low power, never a good sign. Looks like some sort of round cell tumour, the top slide shows what i at first thought were rafts of epithelial cells but could accept they are drying artefacts as they seem very large and don't seem associated with normal cellular structures.

Are you sending the slides off to a proper cytologist? Would love to see the definitive answer!

Re: Any cytopathologists want to take a stab at this?

James Laidlaw — Fri, 10 May 2013 21:08:55 GMT

Thanks for having a crack anyway! It's what I was thinking, mainly mixed inflammatory cells. Didn't use a dryer, about 30 min drying on a rack at room temp then diff quick.

Re: Any cytopathologists want to take a stab at this?

John Flynn — Fri, 10 May 2013 19:45:28 GMT

I'm not a cytopathologist, but like a good stabbing, so here goes:

Top 2 images, basophilic crystalline material in background with small number of probable lymphocytes visible.

Third image down: simliar basophilic material in background, with moderate numbers of small, mature lymphocytes; also couple of fibroblasts centrally and few scattered neutrophils

bottom image: good for orientation, but cannot see cellular detail.

Conclusions:

Not sure! Basophilic material forming almost crystalline appearance possibly artifactual due to rapid drying of proteinaceous extracellular matrix - did you use a hair dryer? Small mature lymphocytes with other cells seen, probably predominantly lymphocytic inflammation. I don't see anything that screams neoplasia to me.

If it's come up acutely and local LNs palpate normal, I'd give this a few weeks as long as not growing in size as may be inflammatory reaction to sting/bite etc and may self-resolve; having said that I've not seen the lesion in question and don't really know what I'm talking about so probably shouldn't be making a recommendation!

Re: Any cytopathologists want to take a stab at this?

James Laidlaw — Fri, 10 May 2013 13:34:49 GMT