MEETING No. 24, HELD ON OCTOBER 18, 2000,
AT MULTIMEDICA PRIVATE HOSPITAL, SESTO S. GIOVANNI

Case 1 Case 2 Case 3 Case 4 Case 6 Case 7
Case 5

"ASCITES"
F. SPARACIO Fatebenefratelli Hospital - Milano
(pict. by dr. Faravelli)

Clinical history: a 57y.o. man presents with ascites and undergoes paracentesis.
The cytological examination of the peritoneal fluid shows malignant tumoral cells consistent with small cell carcinoma (pict. 1).
An abdominal ultrasound shows a 5 cm. nodule at the liver hilum and a FNA and a needle biopsy of the mass are performed.
The smears from the FNA (pict. 2) - (pict. 3) confirm the previous diagnosis.
Sections from the biopsy (pict. 4) show marked desmoplasia of the lesion and no lymph node residual parenchyma.
The man undergoes surgery to remove the mass and during the operation it appears that the mass is related to the gall bladder and therefore this is removed too.
Microscopic description: sections show small cells, with high N/C ratio, proliferating in the wall of the gall bladder without ulcerating the mucosa (pict. 5) - (pict. 6).
The cells are focally positive with Grimelius staining but they are negative for Chromogranin and Synaptophysin. In other sections of the tumor a second component adenocarcinoma-like is also present (pict. 7) - (pict. 8) - (pict. 9) - (pict. 10).

Diagnosis

pict. 1	pict. 2
pict. 3	pict. 4
pict. 5	pict. 6
pict. 7	pict. 8
pict. 9	pict. 10

Case 1 Case 2 Case 3 Case 4 Case 6 Case 7





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