Case 1 - Click here for Text and References
Submitted by: David S. Klimstra
Clinical Summary:
The patient was a 57 y.o. male with abdominal pain; there was no significant past personal or family medical history. An abdominal CT scan revealed an 8.5 cm solid mass in the pancreatic tail invading the spleen. An FNA was positive for malignant cells, consistent with a neuroendocrine tumor. An octreotide scan revealed uptake limited to the pancreatic mass. The patient underwent distal pancreatectomy and splenectomy.
Case 1 - Slide 1
Case 2 - Click here for Text and References
Submitted by: Stuart J. Schnitt
Clinical Summary:
A 67 year old female presented with a mammographically detected left breast mass. A wire-localized excision was performed. The specimen contained a tan-white circumscribed nodule measuring 2.0 cm.
Case 3 - Click here for Text and References
Submitted by: Kathleen Montone
Clinical Summary:
50 year old male with a history of chronic rhinosinusitis, hypertention, and progressively worsening epistaxis for 3- 4 months prior to presentation to an ENT surgeon. Orbital MRI showed a slightly lobular, intermediate signal and solidly enhancing mass measuring 4.1 x 3.9 x 3.0 cm arising in/involving the right sphenopalatine foramen extending into the right nasal cavity, right masticator space, parapharyngeal space, right sphenoid sinus, orbital apex and right cavernous sinus. The possibility of nasopharyngeal carcinoma was entertained. Functional endoscopic sinus surgery (FESS) and biopsy of the mass was performed.
Case 4 - Click here for Text and References
Submitted by: Victor E. Reuter
Clinical Summary:
This 31 year-old hypertensive female presented to the local emergency room complaining of acute right sided flank pain. She was sent home with a diagnosis of nephrolithiasis. After several months of intermittent pain, she underwent a CT of the abdomen which revealed a 4.1 cm upper pole mass in the right kidney, bilateral pulmonary nodules and a lytic/sclerotic in the right vertebral body of T10. A right radical nephrectomy was performed.
Case 4 - Slide 1
Case 5 - Click here for Text and References
Submitted by: Christopher Fletcher
Clinical Summary:
A 45 year old man presented with abdominal pain and was found to have a 6cm mass in the wall of the small bowel, with focal surface ulceration. Metastases to liver and subsequently bone developed some years later.
At very low power, there is a multinodular circumscribed mass extending through the full thickness of the bowel wall.
At low power, the submucosal component appears highly cellular, while tumor in the muscularis propria has a fibromyxoid appearance.
The submucosal tumor consists of rounded cells with a clear halo, distributed in a dense collagenous stroma.
High power examination demonstrates cords and strands of cells with round-to-ovoid nuclei and clear cytoplasm, located between hyaline collagen bundles.
Medium power view showing transition between cellular submucosal component (right) and fibromyxoid component located in muscularis propria (left).
The fibromyxoid areas consists of quite bland spindle cells with indistinct cytoplasm and tapering or more ovoid nuclei.
Staining for S-100 protein highlights only dendritic cells/macrophages. The tumor cells are negative.
Tumor cells show strong and diffuse positivity for MUC4. Note the internal control in adjacent non-neoplastic epithelium.