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Cytopathology
Palpation Guided Fine Needle Aspiration
Patient History and Exam

Author: Joe D. Jakowski, M.D. (see Reviewers page)
Revised: 19 August 2013, last major update August 2013
Copyright: (c) 2013, PathologyOutlines.com, Inc.

Focused Patient History and Physical Exam for the FNA Patient
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Evaluating the Patient History of Symptoms: Physical Examination of the Patient’s Lump:

Physical Exam Signs and Findings to Assess the Differential Diagnoses of in the FNA Patient
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General: Common Painful Skin Tumors: Can be remembered by using the pneumonic "LEND AN EGG": (J Am Acad Dermatol 1993;28:298) Sister Mary Joseph sign or node: palpable nodule of the umbilicus as a result of metastasis of a pelvic or abdominal cancer (most commonly gastric, colonic or pancreatic cancer or gynecologic tract cancer in women)

Virchow's node: lymph node in the left supraclavicular fossa that is enlarged, firm, and strongly indicative of metastatic cancer from the abdomen (especially gastric cancer); differential also includes lymphoma, other intra abdominal malignancies, breast cancer, and infection (e.g. of the left arm)

Dimple sign or Fitzpatrick's sign: dimpling of the skin with lateral compression, considered by many to be pathognomonic for dermatofibroma

Transillumination test: Positive Tinel's sign: paresthesias / pain / tingling elicited by mechanical stimulation over the distribution of the nerve suggest peripheral nerve tumors (schwannona, neurofibroma)

End of Cytopathology > Palpation Guided Fine Needle Aspiration > Patient History and Exam


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