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Surgical Pathology
Tuesday, March 1, 2011, 7:30 PM
CC BRA
Clinical histories are printed below.
Click on the case numbers for text and references of each case.
Click on each slide thumbnail image for an enlarged view
Panelist will present a case, not necessarily a diagnostic problem but one
for which there is new and interesting and clinically critical information
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Moderator:
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HENRY D. APPELMAN
University of Michigan Hospital
Ann Arbor, MI
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Disclosure:
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In accordance with ACCME guidelines regarding disclosure, the USCAP policy requires that faculty members who have a significant financial or other relationship with a commercial company, entity, or service (which will be discussed in this Symposium) must disclose this to attendees. The Academy also requires that speakers disclose any products that are not labeled for the use under discussion. The speakers listed below have indicated they have nothing to disclose.
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Panelists:
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Zachary D. Goodman, Inova Fairfax Hospital, Falls Church, VA
L. Priya Kunju, University of Michigan, Ann Arbor, MI
Marc K. Rosenblum, Memorial Sloan-Kettering Cancer Center, New York, NY
Bruce R. Smoller, University of Arkansas for Medical Sciences, Little Rock, AK
Laura H. Tang, Memorial Sloan-Kettering Cancer Center, New York, NY
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Clinical histories are displayed below.
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for Text and References
Submitted by: Zachary D. Goodman -
This 24 year old man presented because of the sudden onset of right periumbilical pain. This persisted, despite treatment with antacids, and further evaluation with upper and lower endoscopy were unrevealing. He was found to have serum alkaline phosphatase five times the upper limit of normal, leading to a CT scan that revealed a large mass in the right lobe of the liver, followed by angiography showing the mass to be well vascularized. A right hepatic lobectomy was performed.
Case 1 - Slide 1
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for Text and References
Submitted by: L. Priya Kunju -
A 59 Y male underwent work-up for painless gross hematuria. Cystoscopy was negative. CT urogram showed a large(6 cm) renal mass. There was no evidence of retroperitoneal adenopathy. The patient underwent excision of kidney as definitive treatment. Can a definitive diagnosis be rendered based on the provided representative HE images and immunohistochemical stains? Are additional immunohistochemical stain(s) needed? If yes, which stains would be useful?
Case 2 - Slide 1
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for Text and References
Submitted by: Marc K. Rosenblum -
This 34 year old man was evaluated for peripheral visual loss and found to have an intrasellar mass. Transphenoidal resection was performed.
Case 3 - Slide 1
This representative section demonstrates a spindle and epithelioid cell neoplasm exhibiting distinct cytoplasmic granularity at the cytologic level.
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for Text and References
Submitted by: Bruce R. Smoller -
56 year old man with variegated, pigmented lesion on the back.
Case 4 - Slide 1
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for Text and References
Submitted by: Laura H. Tang -
17 years old male with an anterior mediastinal mass, multiple liver lesions (biopsied), and Cushing's syndrome.
Case 5 - Figure 1
Liver biopsy reveals several large and irregular tumor nests with prominent spindle cell morphology with noticeable whorl-formation. |
Case 5 - Figure 2
The epithelioid nature of the tumor is better appreciated at a higher magnification. |
Case 5 - Figure 3
The tumor cells reveal low nuclear to cytoplasmic (N/C) ratio with identifiable mitoses and single cell necrosis. |
Case 5 - Figure 4
Significant nuclear pleomorphism is depicted by enlarged and bizarre nuclei with intranuclear inclusions. |
Case 5 - Figure 5
The highest proliferative activity, assessed by Ki67 nuclear immunoreactivity, is 2%. |
Case 5 - Figure 6
The tumor cells are diffusely positive for chromogranin. |
Case 5 - Figure 7
The tumor cells are focally positive for ACTH. |
Case 5 - Figure 8
Surgical resection of the mediastinal tumor reveals an epithelial neoplasm with typical histologic pattern of a carcinoid tumor. |
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Handouts for all Specialty Conferences will be accessible via the
"Educational Materials" section on the homepage the morning after each respective conference. Printed
copies of the handout will not be available at the meeting.
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