Pulmonary aspergilloma

48 year-old male patient is admitted in a hospital, due to cough & chest pain.
Bronchial washing cytology: There are numerous acute inflammatory cells (abscess) and a few acute angle branching fungal hypae are seen. Diagnosis of cytology: 1. Negative for malignancy. 2. Aspergilloma.

Gross findings: Pleural surface is irregular and slightly thickened. On CT guided sections, there are a dilated bronchi which filled with green muddy materials. The remaning parenchyma shows multiple curd-like caseous necrosis of variable sizes.

Microscopic findings: The dilated bronchi contains acute angle branching fungal material. The histochemical stain for fungi (GMS) shows definite acute angle branching and hypae, so consistent with aspergillus spp. The last photo shows chronic granulomatous inflammation with caseous necrosis, consistent with tuberculosis. The result of TB-PCR is positive for AFB.

Final pathological diagnosis:

1. Bronchiectasis

2. Aspergilloma

3. Chronic granulamatous inflammation, consistent with tuberculosis.

Tuberculous lymphadenitis

46 year-old female patient is admitted in a hospital due to cervical node enlargement. The following slides are come from FNA cytology of cervical nodes. The cytological findings show multiple granulomas composed of epitheloid cells, lymphocytes and macrophages, but giant cells aren't identified. The Ziehl-Neelsen stain for AFB is negative, but TB-PCR shows positive result. The cytological diagnosis of this specimen was tuberculous lymphadenitis.

Parathyroid carcinoma

28 настай эмэгтэй palpable neck mass гэсэн зовиуртайгаар эмнэлэгт хандсан бөгөөд лабораторийн шинжилгээгээр PTH- 1476 pg/mL (15-65 pg/mL), ALP-1072U/L (<85 U/L), Ca-11.1 mg/dL (8.6-10.0 mg/mL), P-2.1 (2.7-4.5 mg/mL) тус тус ихэссэн байв. Бусад лабораторийн үзүүлэлтүүд болон бамбайн дааврууд хэвийн хэмжээнд байсан.

Pre-op ultrasonography: Well-defined hypoechoic mass

CT findings:
FNA cytology: The immunohistochemical stain (IHC) for parathyroid hormone (PTH) is positive. The possibility of parathyroid neoplasm is suggested.

Gross findings:
Microscopic findings: There are capsular invasion and vascular invasion. IHC stain for vascular invasion (CD34) is positive.

Final pathological diagnosis:
Parathyroid gland, right, parathyroidectomy : Parathyroid carcinoma.