CT Non-Gynecologic Cytology 3

Question 1

Which immunohistochemical marker panel BEST confirms mesothelioma versus metastatic adenocarcinoma in an effusion cell block?

Accepted Answer

Calretinin/WT-1 positive; CEA/BerEP4 negative

Answer

CK7/CK20 positive; TTF-1 negative

Answer

S-100/HMB-45 positive; Calretinin negative

Answer

CD45/CD20 positive; EMA negative

Question 2

Intranuclear pseudoinclusions (cytoplasmic invaginations into the nucleus) in thyroid FNA cytology are a hallmark feature of which diagnosis?

Accepted Answer

Papillary thyroid carcinoma

Answer

Hashimoto's thyroiditis

Answer

Follicular carcinoma

Answer

Medullary thyroid carcinoma

Question 3

In the Bethesda System for Reporting Thyroid Cytopathology, which category carries the highest risk of malignancy and typically warrants surgical resection?

Accepted Answer

Category VI: Malignant

Answer

Category II: Benign

Answer

Category IV: Follicular Neoplasm/Suspicious for Follicular Neoplasm

Answer

Category V: Suspicious for Malignancy

Question 4

Reed-Sternberg cells, which are large binucleated cells with prominent 'owl-eye' nucleoli, are pathognomonic for which diagnosis in lymph node FNA cytology?

Accepted Answer

Hodgkin lymphoma

Answer

Diffuse large B-cell lymphoma

Answer

Reactive lymphadenopathy

Answer

Follicular lymphoma

Question 5

In salivary gland FNA, which cytologic triad is most characteristic of Warthin tumor (papillary cystadenoma lymphomatosum)?

Accepted Answer

Oncocytic epithelial cells, mature lymphocytes, and granular proteinaceous background

Answer

Mucous cells, fibrillary stroma, and plasmacytoid cells

Answer

Basaloid cells with nuclear palisading and myxoid stroma

Answer

Clear cells, glycogen, and abundant necrosis

Question 6

What is the PRIMARY advantage of using an air-dried Diff-Quik (Romanowsky-type) stain over a wet-fixed Pap stain in FNA cytology?

Accepted Answer

Rapid staining with enhanced visualization of extracellular matrix, mucin, and myxoid stroma

Answer

Superior nuclear chromatin detail

Answer

Better identification of viral inclusions

Answer

Preferred for keratinizing squamous lesions

Question 7

In pancreatic FNA cytology, which finding BEST distinguishes a serous cystadenoma from a mucinous cystic neoplasm?

Accepted Answer

Small cuboidal cells with clear glycogen-rich cytoplasm in a honeycomb arrangement

Answer

Thick viscous mucin with tall columnar mucinous cells

Answer

Papillary clusters with psammoma bodies

Answer

Markedly atypical cells with prominent nucleoli and necrosis