—  SHORT COURSE #59  — In Situ Hybridization in Diagnostic Pathology Ricardo V. Lloyd and Arie Perry Part 1 - Powerpoint Presentation Part 2 - Powerpoint Presentation Part 3 - Powerpoint Presentation Part 4 - Powerpoint Presentation Introduction Utility of FISH in Anatomic Pathology Case 1 - Undifferentiated Nasopharyngeal Carcinoma Case 2 - Adenovirus Pneumonia Case 3 - Combined Hepatocellular - Cholangiocarcinoma Case 4 - Paraganglioma Case 5 - Legionella Pneumonia Case 6 - Ductal Breast Carcinoma with Lymph Node Metastasis and Her 2/neu Amplification Case 7 - Anaplastic Oligodendroglioma with Codeletion of 1P and 19q Case 8 - Malignant Rhabdoid Tumor of Soft Tissue, Congenital Case 9 - Extraskeletal Ewing's Sarcoma/Peripheral Primitive Neuroectodermal Tumor (PNET) Case 10 - Desmoplastic Small Round Cell Tumor (DSRCT) Appendix 1 - Glossary Appendix 2 - ISH Protocols - EBV Appendix 3 - ISH Protocols Appendix 4 - ISH Digoxigenin Probes Appendix 5 - FISH Protocols Click on each Case number below to display the text and references for that section Click on any thumbnail image for an enlarged view of that slide Case #1 - Undifferentiated Nasopharyngeal Carcinoma (Lymphoepithelioma) Clinical Summary A 47-year-old man presented with an enlarged cervical lymph node which was excised. Case 1 - Figure 1 Case 1 - Figure 2 Case 1 - Figure 3 Case #2 - Adenovirus Pneumonia Clinical Summary This 60-year-old woman presented with a low-grade fever and cough. Chest x-ray showed a patchy infiltrate. She died with organizing diffuse alveolar damage. The section is from the right upper lobe. Case 2 - Figure 1 Case 2 - Figure 2 Case 2 - Figure 3 Case #3 - Combined Hepatocellular - Cholangiocarcinoma Clinical Summary This 36-year-old man presented with an enlarged right upper quadrant mass. Case 3 - Figure 1 Case 3 - Figure 2 Case 3 - Figure 3 Case #4 - Paraganglioma Clinical Summary A 37-year-old woman had a retroperitoneal mass and mild hypertension. The mass was excised and reported to be keratin and chromogranin negative. The tumor was large (10 x 8 x 6 cm) and was located in the region of the bifurcation of the aorta. Cut section was hemorrhagic with some firm, tan areas. Case 4 - Figure 1 Case 4 - Figure 2 Case 4 - Figure 3 Case #5 - Legionella Pneumonia Clinical Summary A 60-year-old man presented with high fever and diarrhea. Chest x-ray showed areas of consolidation. He had an open lung biopsy. Case 5 - Figure 1 Case 5 - Figure 2 Case 5 - Figure 3 Case #6 - Ductal Breast Carcinoma with Lymph Node Metastasis and Her 2/neu Amplification Clinical Summary This 52-year old woman presented with an enlarging breast mass. Needle biopsy revealed an invasive ductal carcinoma and Her2/neu immunostaining was interpreted as 2+ positive. The patient was treated with neoadjuvant chemotherapy followed by mastectomy and axillary lymph node dissection 3 months later. Case 6 - Figure 1 Case 6 - Figure 2 Case 6 - Figure 3 HER2/neu Case 6 - Figure 4 CEP17 (green); HER2/neu (pink) Case 6 - Figure 5 CEP17 (green); HER2/neu (pink) Case #7 - Anaplastic Oligodendroglioma with Codeletion of 1P and 19q Clinical Summary This 35-year old woman underwent a frontal lobe biopsy for an enhancing intraparenchymal neoplasm. She was treated with radiation therapy and did well until 14 years later when imaging abnormalities were once again noted. Case 7 - Figure 1 Case 7 - Figure 2 Case 7 - Figure 3 Case 7 - Figure 4 Case 7 - Figure 5 GFAP Case 7 - Figure 6 MIB-1 Case 7 - Figure 7 1p32 (green); 1q42 (pink) Case 7 - Figure 8 19p13 (green); 19q14 (pink) Case #8 - Malignant Rhabdoid Tumor of Soft Tissue, Congenital Clinical Summary This 7-day old girl presented with a large soft tissue neck mass. Case 8 - Figure 1 Case 8 - Figure 2 VIM Case 8 - Figure 3 CD99 Case 8 - Figure 4 BCR-22q11 (green); NF2-22q12 (pink) Case #9 - Extraskeletal Ewing's Sarcoma/Peripheral Primitive Neuroectodermal Tumor (PNET) Clinical Summary This 11-year old girl presented with a large pelvic mass adjacent to the urinary bladder. Multiple lung nodules were seen on imaging studies. Case 9 - Figure 1 PAS Case 9 - Figure 2 PASD Case 9 - Figure 3 CD99 Case 9 - Figure 4 FLI1-11q24 (green); EWS-22q12 (pink) Case #10 - Desmoplastic Small Round Cell Tumor (DSRCT) Clinical Summary This 31-year old woman presented with multiple intraperitoneal and pelvic masses that were resected and recurred several times over the next 2 years. Case 10 - Figure 1 Case 10 - Figure 2 DESMIN Case 10 - Figure 3 EMA Case 10 - Figure 4 SMA Case 10 - Figure 5 WT1-11p13 (green); EWS-22q12 (pink)