case_images: PMC11305519_01
case_images: Smears revealing clusters and single cells with abundant granular cytoplasm and monomorphic nuclei with granular chromatin and indistinct nucleoli, Pap stain. a x20 magnification. b x40 magnification. c x60 magnification.
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case_images: PMC11305519_01_acy-2024-0068-0003-538687_F01.jpg
case_images: F1
case_images: Patient underwent an endoscopic ultrasound-guided fine needle aspiration (FNA) of the mass that yielded a paucicellular specimen composed of clusters and single cells with abundant granular cytoplasm and monomorphic nuclei with indistinct nucleoli (Fig. 1).
case_images: PMC11305519_02
case_images: a-c Liquid-based preparation revealing clusters of epithelial cells with high-grade atypia (Pap stain. x60 magnification). d H&E section revealing detached atypical epithelial cells.
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case_images: PMC11305519_02_acy-2024-0068-0003-538687_F02.jpg
case_images: F2
case_images: An FNA of the nearby separate cystic lesion revealed at least high-grade epithelial atypia, from which an invasive carcinoma could not be ruled out (Fig. 2a-c). A subsequent core biopsy from the mass was performed 2 months later and revealed detached atypical epithelial cells (Fig. 2d).
case_images: PMC11305519_03
case_images: a, b Liquid-based preparation revealing clusters of atypical epithelial cells (Pap stain. x60 magnification). c H&E section revealing lymphoepithelioma-like carcinoma.
case_images: acy-2024-0068-0003-538687_F03.jpg
case_images: PMC11305519_03_acy-2024-0068-0003-538687_F03.jpg
case_images: F3
case_images: Morphologically, the cytological specimen was poorly preserved, paucicellular and composed predominantly of small clusters and single cells revealing mild nuclear atypia (high nucleus-to-cytoplasm ratio, irregular nuclear contours, and chromatin distribution) (Fig. 3a, b). The patient underwent a needle biopsy of the stricture that revealed an EBV-positive lymphoepithelioma-like carcinoma with positive in situ hybridization for EBER (Fig. 3c).
case_images: PMC11305519_04
case_images: a Liquid-based preparation revealing clusters of tumor cells (Pap stain. x60 magnification). b H&E section revealing clear cell renal cell carcinoma. Immunostains for PAX-8 (c) and CA-IX (d).
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case_images: PMC11305519_04_acy-2024-0068-0003-538687_F04.jpg
case_images: F4
case_images: An endoscopic FNA of one of the pancreatic masses was performed and yielded a specimen containing clusters and single cells with moderately abundant eosinophilic to clear cytoplasm with small round nuclei with inconspicuous nucleoli (Fig. 4).
case_images: PMC11305519_05
case_images: a Liquid-based preparation revealing clusters and single tumor cells (Pap stain. x60 magnification). b H&E section revealing melanoma. Immunostains for SOX-10 (c) and HMB45 (d).
case_images: acy-2024-0068-0003-538687_F05.jpg
case_images: PMC11305519_05_acy-2024-0068-0003-538687_F05.jpg
case_images: F5
case_images: An endoscopic FNA was performed and yielded a cellular specimen composed predominantly by small loosely cohesive clusters and single cells with variable N/C ratio, pleomorphic nuclei, and inconspicuous nucleoli (Fig. 5a). The suspicious cells stained positive for S100p, SOX-10, and HMB45 and were negative for cytokeratin, INSM1, synaptophysin, chromogranin, and CD163 (Fig. 5b-d).