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.
|Figure 1: Diff-Qik stain, 10x|
|Figure 2: Diff-Qik stain, 20x|
|Figure 3: Diff-Qik stain, 60x|
|Figure 4: Pap stain, 60x|
|Figure 5: Pap stain, 60x|
What is the most likely diagnosis?