SOUTH BAY PATHOLOGY SOCIETY
DIAGNOSES FOR THE MEETING OF MONDAY August 6, 2007
SB 5081Squamoid Cyst of the Pancreatic Ducts, Pancreas.
Diagnostic Talley: Benign cyst-6, squamoid cyst of the pancreatic ducts-8.
Follow-up: The patient is well.
Consultant: R. Kempson, MD
Reference: AJSP 31(2): 291, 2007.
SB 5082Pancreatoblastoma, Pancreas.
Diagnostic Talley: Acinar cell carcinoma - 42, neuroendocrine tumor-12.
Follow-up: Patient died 17 months after diagnosis.
Note: CK 7-weak to moderate staining, CD99 weak to moderate staining, Trypsin-Moderate to strong staining. CK 20, CD5/6, CK 17, HMWK, vimentin, chromogranin, synaptophysin, AFP, p 53 and insulin are all negative.
Reference: AJSP 19: 1371-89, 1995.
SB 5083Adrenocortical Neoplasm with Oncocytic Features, Adrenal Gland.
Diagnostic Talley: benign oncocytoma-2, oncocytic adenoma-26, oncocytoma of UMP-2.
Follow-up: Patient well following surgery.
Consultant: L. Weiss, MD
Reference: Int. J. Surg Path. 12(3): 231-43, 2004.
SB 5084Rhinoscleroma, Right Nasal Cavity.
Diagnostic Talley: Rhinoscleroma-unanimous.
Follow-up: Patient has responded to Cipro treatment.
Note: Giemsa- positive, GMS negative Klebsiella rhinoscleromatis grew on culture.
SB 5085Biphasic Synovial Sarcoma, Soft Tissue of Right Supraclavicular Area.
Diagnostic Talley: High grade synovial sarcoma-10, PNET/Ewing's-8, small cell tumor/neuroblastoma-1, MPNST-1, rhabdomyosarcoma-1.
Follow-up: The patient had a subtotal resection and is being seen at UCSF.
Note: Focal EMA, AE1/AE3 positivity. S100, chromogranin, synaptophysin,
CD 34, NSE, LCA all negative. FISH positive for X;18 translocation.
Consultant: R. Sibley, M.D.
Reference: Atlas of Tumor Pathology, 3rd series, AFIP, pp 472-84, 2001.
SB 5086Low Grade Fibromyxoid Sarcoma, Soft Tissue Mass of Left Neck.
Diagnostic Talley: Low grade fibromyxoid sarcoma-24, cellular schwannoma, DFSP-1.
Follow up: Patient had positive margins and was seen at Stanford where evaluation showed involvement of the brachial plexus.
Note: vimentin positive, S100, SMA, CK cocktail, HMB 45, CD 68 and CD 34 all negative.
Consultant: Dr. Chris Fletcher.
References: 1. AJSP 17: 595-600, 1993.
2. Semin. Diag. Path, 12: 87-97, 1995.
3. AJSP 24(10): I 353-1360, 2000.
SB 5087Wegener's Granulomatosis with BOOP- like Features, Lung.
Diagnostic Talley: Wegener's granulomatosis - 28, rule out infection-3, lymphomatoid granulomatosis- 2, necrotizing sarcoid granulomatosis-1.
Follow-up: The patient has cleared the nodules on Cytoxan. She currently has early renal failure and CMV infection and bone marrow suppression.
Note. AFB, GMS and gram stains are negative.
Consultant: T. Colby, MD
Reference: AJSP 20: 794-801, 1996.
SB 5088Airway Inflammatory Changes with Extensive Embolic Material, Lung.
Diagnostic Talley: Inflammatory changes secondary to embolic material-unanimous.
Follow-up: The patient had a history of hemoptysis and head undergone at least six embolization with a variety of materials. Possibly some polyvinyl alcohol spheres, possibly acrylic glue and possibly acrylic gelatin might spheres. Multiple individuals performed the embolizations. This material is present within lymphatics and lymph nodes.
SB 5089Angiomyolipoma with Extra Medullary Hematopoiesis, Liver.
Diagnostic Talley: Angiomyolipoma-14, angiosarcoma-8,
Follow up: The patient has tuberous sclerosis complex and has two large kidney tumors and is receiving pain management.
Note: The patient has an incidental renal cell carcinoma. HMB 45 is positive in the angiomyolipoma and negative in the renal cell carcinoma.
References: 1. AJSP 22(1): 34-48, 1998.
2. AJSP 22(2): 180-188, 1998.
SB 5090Treated Wilm's Tumor, Right Atrium of Heart.
Diagnostic Talley: Teratoma-4, metastatic Wilms tumor-36, retroperitoneal embryonic tumor-1.
Follow up: The patient was treated with 3 cycles of vincristine/actinomycin D. with minimal responds and also had tumor lysis syndrome. She has also had a minimal response to radiation therapy.
Reference: Cancer 68: 385, 1991.
Post Conference Evaluation Case: Rhinoscleroma, Left Nasal Cavity.