Case Study: September 2009

History

A 60 year-old female presents with a cream mass on the iris surface spreading over 3 clock hours. The patient is well systemically.

A fine needle aspirate cytology specimen is obtained from the iris lesion.

Figures 1 and 2 show the cells aspirated.

Questions

1. What type of tumour is shown in the aspirate?
2. Which stains can be performed to confirm your diagnosis?
3. Which pointers can be included in the histopathology report?

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1. This is metastatic adenocarcinoma in the iris.

2. Cytokeratin (see Figure 3).

3. Suggest potential primary sites. In this case, the sites suggested were lung, breast and bowel primarily. Figure 4 shows histology of the lung tumour discovered after the suggestion of the possible primary sites.