Small cell lung carcinoma represents a group of highly malignant tumors giving rise to early and widespread metastasis at the time of diagnosis. However, the pancreas is a relatively infrequent site of metastasis by this neoplasm, and there are only occasional reports on its fine needle aspiration (FNA) cytology diagnosis. A 66-year-old man presented with extensive mediastinal lymphadenopathy and a mass in the pancreatic tail. Ultrasound-guided FNA smears from the pancreatic mass contained small, round tumor cells with extensive nuclear molding. The cytodiagnosis was metastatic small cell carcinoma. Immunocytochemical staining showed that a variable number of neoplastic cell were positive for cytokeratin, chromogranin A, neurone-specific enolase and synaptophysin but negative for leukocyte common antigen. The trans-bronchial needle aspiration was non-diagnostic, but biopsy was suspicious of a small cell carcinoma. This case represents a rare metastatic lesion in the pancreas from small cell lung carcinoma, diagnosed by FNA cytology.
Sarcoidosis is a chronic multi-system granulomatous disorder of unknown etiology. Central nervous system involvement is relatively uncommon in sarcoidosis. Clinical manifestations and radiological appearances of neurosarcoidosis vary widely depending on the site and activity of the lesions. In most cases, the imaging appearance is nonspecific. We report a very rare case of extensive neurosarcoidosis with progressively enlarging cystic lesions in the right temporal lobe.
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