Case Study: Subcutaneous Mass in a 53 year old Man

Case Study: Subcutaneous Mass in a 53 year old Man

Volume LII | Number 6 | November 2015 Subcutaneous Mass in a 53 year old Man Jaclyn L. Jerz, MD and Mojgan Amrikachi, MD Houston Methodist Hospital H...

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Volume LII | Number 6 | November 2015

Subcutaneous Mass in a 53 year old Man Jaclyn L. Jerz, MD and Mojgan Amrikachi, MD Houston Methodist Hospital Houston, Texas

Disclosure: We do not have any affiliations or financial interests in any of the corporate organizations involved with the products to which our case study will refer. Continuing Medical Education (CME): The American Society of Cytopathology is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Figure 1: Diff Quik stain

The American Society of Cytopathology designates this enduring educational activity for a maximum of 1 AMA PRA Category 1 credit(s).™ Physicians should only claim credit commensurate with the extent of their participation in the activity. American Board of Pathology Maintenance of Certification (MOC): This product can help fulfill the CME requirements and Self-Assessment Modules (SAMs) mandated by the American Board of Pathology MOC process. Continuing Medical Laboratory Education (CMLE): The ASC designates this activity for the indicated number of CMLE credit hours and also fulfills requirements of the ABMS to participate in the Maintenance of Certification program. This program is approved for continuing education credits in the State of Florida for 1 credit and the State of California for ½ credit. Disclosure for Education Planners: http://www.cytopathology.org/wp-content/uploads/2014/06/6-4-14Educational-Planners-Disclosures.pdf

Figure 2: Papanicolaou stain

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Clinical History A 53 year old male presented with a subcutaneous right upper medial thigh nodule. He had a history of a right knee soft tissue mass resected the previous year, with reconstructive flap and radiation. The current subcutaneous nodule was palpable. Fine needle aspiration biopsy was performed. Cytopathology Features The cytology touch preparations of the core needle biopsy show a monomorphic population of loosely cohesive small blue round/oval cells. The cells are more uniform than small cell carcinoma. The nuclear to cytoplasmic ratio is high. The nuclei are round with powdery chromatin, and inconspicuous nucleoli. Cytoplasm is scant.

IV