South Bay Pathology Society

                                                                        DIAGNOSES

                                                                        FOR THE MEETING OF MONDAY,12/4/06

SB-5011 Whipple's Disease, Duodenum and Terminal Ileum

Follow-up: The patient has a monoclonal gammopathy and has been treated with Bactrim with improvement of his malabsorption Note: PAS-D and GMS stains are positive, AFB negative. PCR + for Tropheryma whippleii.

SB-

5012 Cutaneous Larva Migrans, Skin of Left Buttock

              Follow-up: The Patient Is Currently Well.

SB-

5013 Papillary Carcinoma, Type 1, Left Kidney.

              Follow-up: Patient Well on Short Follow-Up.

SB-5014 Rosai- Dorfman Disease, Skin of Right Breast.

Follow-up: All of the patient's laboratory studies have been negative, she has no lymphadenopathy or monoclonal gammopathy and is currently well.               Consultant: G. Gottlieb, MD (Ackerman Academy of Pathology).

SB-5015 Malignant Spindle Cell Neoplasm Consistent with Neurofibrosarcoma, Scalp.

Follow-up: The patient had a re-excision which is negative. He has received radiation therapy and has no evidence of residual disease. He also has dysplastic Nevus syndrome and has had a schwannoma of the pleura. Note: S100 positive, SMA faint positive, HMB 45, Melan A, desmin and CD34 all negative.

Consultant: R. Fulton, M.D., PhD. (Kaiser IHC lab)

SB-5016 Malignant Fibrous Histiocytoma, Soft Tissue of Right Thigh.

Follow-up: The patient had a positive deep margin and received radiation therapy. He has had no recurrences after 3 1/2 years. Note: S 100, CD 34, SMA and CK 22 all negative.

Consultant: R. Fulton, M.D., PhD.(Kaiser IHC lab)

SB-5017 Malignant Peripheral Nerve Sheath Tumor with Angiosarcomatous and Rhabdomyoblastic Differentiation, Soft Tissue Left Thigh.

Follow-up: The patient had a very close resection margin and a recurrence within one month, which was re-excised. He's currently being evaluated for chemotherapy. Note: The lesional cells are focally strongly positive for CD 31, desmin and myogenin. Scattered cells are immuno-reactive for CD 34 and S 100.

             SMA and CK 22 are negative.

Consultant: A. Folpe, MD (Mayo Clinic, Rochester)

SB-5018 Angiosarcoma Associated with Diffuse Pulmonary Hemorrhage, Lung.

Follow-up: The patient has no right atrial lesions and is seeking a second opinion. She is HIV negative. Note: The lesional cells are strongly immunoreactive for CD31

            and CD34. Cam 5.2 and ER are negative.

Consultant: H. Tazelaar, M.D., T. Colby, M.D., K. Leslie, M.D. (Mayo Clinic Scottsdale)

SB-5019 Polymorphous Low-Grade Adenocarcinoma, Hard Palate.

Follow-up: The patient did not have a re-excision and has not had a recurrence in four years.              Consultant: G. Berry, M.D., and M. Hendrickson, M.D.

SB-5020 Low Grade Myofibroblastic Neoplasm, Left Posterior Mandible.

Follow-up: The patient is lost to follow-up. Note: The spindle cells are positive for SMA and vimentin; weakly positive for actin and negative for desmin, CD 34, S 100 and EMA.

Consultant: R. Sibley, M.D., R. Kempson, M.D.Reference: 1) AJSP 22(10): 1228-38, 1998; 2) J Oral Pathol Med 27(10): 508-10, 1998.