May 2014
Author: Jeff Wang, MD, Dept. of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, U.S.A.
Reviewer: Christopher van den Bussche, MD, MIAC, Dept. of Pathology, Johns Hopkins Hospital, Baltimore, MD, U.S.A.
CASE: The patient is a 62 year old man with a newly diagnosed bladder cancer. CT shows multiple ill-defined hypodense lesions in the liver, the most prominent of which is in hepatic segment 5/8, measuring 1.4 x 1.1 cm. Multiple circumscribed hypodense lesions are also found in the spleen, likely secondary to metastatic disease. Ultrasound-guided FNA was performed on the liver lesion.
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| Figure 1: Diff-Qik stain, 10x |
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| Figure 2: Diff-Qik stain, 20x |
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| Figure 3: Diff-Qik stain, 60x |
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| Figure 4: Pap stain, 60x |
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| Figure 5: Pap stain, 60x |
What is the most likely diagnosis?