Paranuclear blue bodies in a CT-guided fine-needle aspirate of a poorly differentiated, small-cell variant of squamous-cell carcinoma of the lung

2011 ◽  
Vol 40 (3) ◽  
pp. 236-238 ◽  
Author(s):  
Linjun Xie ◽  
Jennifer D. Duven ◽  
Stefan E. Pambuccian
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Small Cell ◽  
Fine Needle Aspirate ◽  
Ct Guided ◽  
Fine Needle ◽  
Small Cell Variant ◽  
Poorly Differentiated ◽  
Cell Variant

scholarly journals Distinction of pulmonary small cell carcinoma from poorly differentiated squamous cell carcinoma: an immunohistochemical approach

2004 ◽  
Vol 18 (1) ◽  
pp. 111-118 ◽  
Author(s):  
Hong Zhang ◽  
Jing Liu ◽  
Philip T Cagle ◽  
Timothy C Allen ◽  
Alvaro C Laga ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Squamous Cell ◽  
Small Cell ◽  
Poorly Differentiated

scholarly journals DIAGNOSTIC CAPABILITIES OF FINE NEEDLE ASPIRATION OF LYMPH NODES METASTASES OF PRIMARY PULMONARY LYMPHOEPITHELIAL CARCINOMAS

2021 ◽  
pp. 59-64
Author(s):  
V. G. Kravtsov
Keyword(s):  
Lung Cancer ◽  
Squamous Cell Carcinoma ◽  
Lymph Nodes ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Lymphoepithelial Carcinoma ◽  
Fine Needle ◽  
Poorly Differentiated

Introduction. Primary pulmonary lymphoepithelial carcinoma is a poorly differentiated squamous cell carcinoma admixed with variable amounts of lymphoplasmacytic infiltrate, frequently associated with EBV. It is a rare cancer and have a better prognosis than other non-small cell lung cancer. The tumor can mimic metastatic non-keratinizing SCC of the naso-pharynx, poorly differentiated non-small cell carcinoma and NUT carcinoma arising in the lung, and non-Hodgkin lymphomas. Materials and methods. A 75-year-old man presented with peripheral mass of left lower lobe, maximal diameter was 5.1 cm, involving lingula and medial pleura, with mediastinal, and retroperitoneal lymphadenopathy revealed by computer tomography. Fine needle aspiration-EBUS was performed from hilar and interlobar lymph nodes. Papanicolaou smears and cell blocks were prepared. Additional CT-guided cor-needle biopsy and FNA were performed from lung lesion later. Results. A few large malignant epithelial cells, consistent with non-small lung cancer, were found on a background of lymphocytes in fine-needle aspiration from lymph nodes. Immunostain results: Pan-CK (AE1/AE3), p63 and Ki67 were positive in malignant cells, leukocyte common antigen (CD45) was positive in lymphocytes (negative in tumor cells), and negative markers were TTF1, chromogranin and synaptophysin. Cytological diagnosis was metastatic non-small lung cancer, favor squamous cell carcinoma. Biopsy and aspiration from left lung showed syncytial groups of large malignant epithelial cells with scant cytoplasm and prominent nucleoli on a background of prominent inflammatory infiltrate,consistent with lymphoepithelial carcinoma. Conclusion. It is impossible to correctly diagnose metastasis of lymphoepithelial carcinoma in lymph node by FNA only without FNA or biopsy of primary lesion, because cytological features and immunostains are identical to non-keratinizing squamous cell carcinoma.

scholarly journals Dual color multiplex TTF-1 + Napsin A and p63 + CK5 immunostaining for subcategorizing of poorly differentiated pulmonary non-small carcinomas into adenocarcinoma and squamous cell carcinoma in fine needle aspiration specimens

CytoJournal ◽  
2012 ◽  
Vol 9 ◽  
pp. 10 ◽  
Author(s):  
Seema Sethi ◽  
Lili Geng ◽  
Vinod B Shidham ◽  
Pamela Archuletta ◽  
Sudeshna Bandyophadhyay ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lung Adenocarcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Dual Color ◽  
Napsin A ◽  
Poorly Differentiated

Background: The distinction of lung adenocarcinoma (ADC) from squamous cell carcinoma (SCC) has important therapeutic implications. Napsin A is a recently developed marker, which has shown high specificity for lung tissue in the surgical pathology specimens. In this study, we have evaluated whether the use of a panel of novel multiplex cocktails of TTF-1 + Napsin A and p63 + CK5 for dual color immunostaining will improve the diagnostic accuracy of lung adenocarcinoma and squamous cell carcinoma in fine needle aspiration (FNA) specimens, usually with relatively scant microfragments of diagnostic material. Materials and Methods: Formalin-fixed, paraffin-embedded, adequately cellular FNA cell blocks with a confirmed diagnosis of either ADC (n = 22), SCC (n = 20) or poorly differentiated carcinoma (PDC; n = 7), from a total of 49 consecutive cases, were studied. All these cases had subsequently confirmed diagnosis in biopsies or resection specimens. The sections were immunostained with two color methods of TTF-1 + Napsin A and p63 + CK5 multiplex cocktails. The presence of one or more unequivocal individual tumor cells with convincing brown nuclear TTF-1 and red cytoplasmic Napsin A staining, and cells with brown nuclear p63 and membranous / cytoplasmic CK5 staining were interpreted as ‘positive’. Results: All 20 FNA cell blocks from SCC cases were positive for dual stain p63 + CK5 and negative for dual stain TTF-1 + Napsin A. The sensitivity and specificity of the dual immunoexpressions of p63 + CK5 for SCC of lung FNAs were both 100%. All 22 ADC cases were positive with dual stain of TTF-1 + Napsin A and negative for dual stain of p63 + CK5. On follow-up of the surgical pathology specimens, 22 cases were confirmed as ADC. The sensitivity of the dual immunoexpression of TTF-1 + Napsin A for ADC of lung FNAs was 100% and the specificity was also 100%. Of the seven PDC cases, five cases that were positive for dual stain p63 + CK5 and negative for dual stain TTF-1 + Napsin A could be categorized as SCC. Two of the seven (2 / 7) PDC cases were positive for dual stain TTF-1 + Napsin A and negative for dual stain p63 + CK5, consistent with ADC. Conclusions: Simultaneous coordinate or individual immunostaining for Napsin A / TTF-1 in ADC and p63 / CK5 in SCC demonstrated high sensitivity and specificity. The panel with multiplex Napsin A / TTF-1 and p63 / CK5 dual color immunostains could specifically subcategorize PDC into ADC and SCC in lung FNA specimens. Multiplex dual color Napsin A / TTF-1 and p63 / CK5 immunostaining is especially recommended for evaluation of FNA specimens with relatively scant cellularity.

scholarly journals A Case of Paraneoplastic Cushing’s Syndrome in Recurrent Squamous Cell Carcinoma

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A1036-A1036
Author(s):  
Travis Goettemoeller ◽  
Yumiko Tsushima ◽  
Nabil Zuhayr Madhun ◽  
Leann Olansky
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Neuroendocrine Tumor ◽  
Squamous Cell ◽  
Cushing’S Syndrome ◽  
Rare Case ◽  
Cushing's Syndrome ◽  
Small Cell ◽  
Free Cortisol ◽  
Poorly Differentiated

Abstract Background: Ectopic production of ACTH causing Cushing’s syndrome (CS) is rare but has been well described in association with bronchial carcinoids, thymomas, pancreatic malignancies, and small cell lung carcinomas. We report a rare case of CS caused by ACTH-producing non-small cell carcinoma. Clinical Case: A 71 year-old man with a history of squamous cell carcinoma of the lung (T2bN1M0) 10 years prior who underwent lobectomy and adjunctive chemotherapy, presented with a new cough, weight loss, and bilateral lower extremity edema. He was also noted to have significant fatigue, hypertension, symptomatic hyperglycemia, and hypokalemia. CT chest revealed a large right perihilar mass with mediastinal adenopathy and numerous hepatic lesions. A biopsy of the liver lesions revealed a poorly differentiated carcinoma with neuroendocrine features strongly positive for AE1/3 with focal p40+, CK7, synaptophysin, chromogranin, and TTF1. It was negative for p63, CK5/6, CDX2, CK20, and GATA3. The morphology and immunohistochemical staining favored a squamous primary. Unfortunately, there was insufficient tissue sample to stain for ACTH. Biochemical evaluation revealed: post-1 mg dexamethasone serum cortisol 74.8 µg/dL (N < 1.8 µg/dL), 24 hr urine free cortisol 2987 µg/g creatinine (normal: < 32 µg/g creatinine), and ACTH 170 pg/mL (N < 47 pg/mL). Other notable findings at presentation were potassium 2.8 mmol/L (N: 3.7-5.1 mmol/L) and glucose 371 mg/dL (N: 74-99 mg/dL). MRI brain revealed focal pituitary infundibular thickening up to 6 mm in diameter and an enlargement of the pituitary gland concerning for metastasis. The patient’s clinical course was complicated by persistent hypokalemia and hyperglycemia which were treated with spironolactone 100 mg twice a day and insulin therapy, respectively. Ketoconazole 100 mg twice a day was initiated for the hypercortisolemia; etoposide, carboplatin, and atezolizumab were started for the neuroendocrine tumor. The patient expired due to sepsis one month after the diagnosis of Cushing’s syndrome. Conclusion: We report a rare case of paraneoplastic Cushing’s syndrome due to poorly differentiated neuroendocrine tumor with a squamous cell carcinoma primary. ACTH producing non-small cell carcinomas have been seldom reported in the literature. Although we were unable to provide ACTH staining on pathology, the existence of an obvious neuroendocrine tumor, marked elevation in ACTH, and an MRI which was negative for a pituitary adenoma, strongly suggests paraneoplastic Cushing’s syndrome.

scholarly journals Cutaneous squamous cell carcinoma arising in hidradenitis suppurativa: A case report

2019 ◽  
Vol 7 ◽  
pp. 2050313X1984735 ◽  
Author(s):  
Catherine F Roy ◽  
Simon F Roy ◽  
Feras M Ghazawi ◽  
Erica Patocskai ◽  
Annie Bélisle ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Hidradenitis Suppurativa ◽  
Rare Complication ◽  
Excisional Biopsy ◽  
Necrosis Factor Alpha ◽  
Spindle Cells ◽  
Poorly Differentiated ◽  
Well Differentiated

We present a case of a 64-year-old man who presented with a rapidly growing tumor in the left buttock and intergluteal cleft area, which was affected by hidradenitis suppurativa. The patient was on tumor necrosis factor-alpha inhibitors for hidradenitis suppurativa for 2 years prior to the development of the mass. Initial biopsy of the mass showed a well-differentiated squamous cell carcinoma with spindle cells and positive epithelial immunomarkers. Subsequent excisional biopsy of the tumor showed an infiltrating poorly differentiated squamous cell carcinoma composed of islands of atypical sarcomatoid spindle cells. Squamous cell carcinoma arising in hidradenitis suppurativa is a rare complication which may occur secondary to chronic inflammation and epidermal hyperproliferation in hidradenitis suppurativa–affected areas.

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