{"id":46756,"date":"2026-02-17T22:54:27","date_gmt":"2026-02-17T14:54:27","guid":{"rendered":"https:\/\/medicine.nus.edu.sg\/pathweb\/?page_id=46756"},"modified":"2026-02-17T23:44:21","modified_gmt":"2026-02-17T15:44:21","slug":"feb2026","status":"publish","type":"page","link":"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/sscyto\/feb2026\/","title":{"rendered":"CytoPage Quiz &#8211; 2026 Feb"},"content":{"rendered":"\r\n<h2>CytoPage Quiz 2026 February<\/h2>\r\n<p>&nbsp;<\/p>\r\n<p>Question:\u00a0<strong><u>An enlarged lymph node<\/u><\/strong><\/p>\r\n<p>A 67-year-old man presents with an enlarged left level 2 cervical lymph node. Ultrasound-guided FNA of the cervical lymph node is performed. Representative images from the smears are shown below.<\/p>\r\n<p><strong>No<\/strong>\u00a0material is available for ancillary testing. Which of the following options reflects the\u00a0<strong>most appropriate<\/strong>\u00a0diagnostic category and management recommendation for this case, according to the WHO Reporting System for Lymph Node Cytopathology?<\/p>\r\n<p>(A) Benign; Material sampled may not correlate with the clinical findings, recommend repeat FNA with ROSE and ancillary testing<\/p>\r\n<p>(B) Benign; Recommend correlation with microbiological investigations<\/p>\r\n<p>(C) Atypical; Recommend repeat clinical and imaging examination<\/p>\r\n<p>(D) Suspicious for malignancy; Recommend repeat FNA with flow cytometry<\/p>\r\n<p>(E) Malignant; Recommend core biopsy<\/p>\r\n<p>Figure 1: Hemacolor 10x<\/p>\r\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2026\/02\/HC-10X-1024x768-1.jpg\" alt=\"Figure 1: Hemacolor 10x\" itemprop=\"image\" height=\"768\" width=\"1024\" title=\"HC-10X-1024x768\" onerror=\"this.style.display='none'\" \/><\/p>\r\n<p>&nbsp;<\/p>\r\n<p>Figure 2: Hemacolor 20x<\/p>\r\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2026\/02\/HC-20X-768x576-1.jpg\" alt=\"HC-20X-768x576\" itemprop=\"image\" height=\"576\" width=\"768\" title=\"HC-20X-768x576\" onerror=\"this.style.display='none'\" \/><\/p>\r\n<p>&nbsp;<\/p>\r\n<p>Figure 3: Pap 20x<\/p>\r\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2026\/02\/Pap-20X-768x576-1.jpg\" alt=\"Pap-20X-768x576\" itemprop=\"image\" height=\"576\" width=\"768\" title=\"Pap-20X-768x576\" onerror=\"this.style.display='none'\" \/><\/p>\r\n<p>&nbsp;<\/p>\r\n<p>Figure 4: Pap 40x<\/p>\r\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2026\/02\/Pap-40X-768x576-1.jpg\" alt=\"Pap-40X-768x576\" itemprop=\"image\" height=\"576\" width=\"768\" title=\"Pap-40X-768x576\" onerror=\"this.style.display='none'\" \/><\/p>\r\n<p>&nbsp;<\/p>\r\n<p><em>Quiz written by Dr Darren Chua, National University Hospital<\/em><\/p>\r\n<p><a href=\"#\" id=\"fl-accordion--label-0\" aria-controls=\"fl-accordion--panel-0\" tabindex=\"0\">Answer<\/a> <a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"-1\"><i title=\"Expand\">Expand<\/i><\/a><\/p>\r\n<p>&nbsp;<\/p>\r\n<p><strong>Answer: (E) Malignant; Recommend core biopsy<\/strong><\/p>\r\n<p>Explanation: The smears show cohesive sheets of epithelial cells with enlarged ovoid nuclei, prominent nucleoli, and limited to moderate amounts of cytoplasm. The findings most likely represent a metastatic carcinoma. Therefore, options (A) and (B) are not appropriate as this is not a benign finding. Both the diagnostic category and recommendation in option (C) to repeat the clinical and imaging examination are also not appropriate.<\/p>\r\n<p>As no material for ancillary testing is available, a repeat procedure to obtain additional material for further workup will likely be necessary. However, given that this most likely represents a metastatic carcinoma rather than lymphoma, the recommendation in option (D) to repeat the FNA with flow cytometry is not appropriate.<\/p>\r\n<p>Follow up revealed this to be metastatic undifferentiated nasopharyngeal carcinoma.<\/p>\r\n","protected":false},"excerpt":{"rendered":"<p>CytoPage Quiz 2026 February &nbsp; Question:\u00a0An enlarged lymph node A 67-year-old man presents with an enlarged left level 2 cervical lymph node. Ultrasound-guided FNA of the cervical lymph node is performed. Representative images from the smears are shown below. No\u00a0material is available for ancillary testing. Which of the following options reflects the\u00a0most appropriate\u00a0diagnostic category and [&hellip;]<\/p>\n","protected":false},"author":828,"featured_media":0,"parent":46656,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-46756","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>NUS Pathweb<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/sscyto\/feb2026\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:description\" content=\"CytoPage Quiz 2026 February &nbsp; Question:\u00a0An enlarged lymph node A 67-year-old man presents with an enlarged left level 2 cervical lymph node. 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