Surgical Pathology
Monday, February 13, 2006 - 7:30 PM
Centennial Ballroon II - IV
Moderator:
Elvio Silva MD Anderson Hospital Houston, TX
Disclosure: The speakers have indicated they have nothing to disclose.
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
Case 1
Submitted by: Cesar A. Moran M.D. Anderson Cancer Center Houston, TX
Clinical Summary:
A 49-year-old female presented with chest pain and some respiratory difficulty of several months. Radiographic examination revealed the presence of an anterior mediastinal mass. Surgical resection of the anterior mediastinal tumor was performed.
Case 2
Submitted by: A. Kevin Raymond M.D. Anderson Cancer Center Houston, TX
Clinical Summary:
The patient is a 46-year old woman who complained of severe, progressive knee pain. Imaging studies show a destructive lesion involving the distal femur. The patient underwent a surgical procedure.
Case 3
Submitted by: John R. Goldblum The Cleveland Clinic Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio
Clinical Summary:
43-year-old female with a slowly growing 2 cm mass on the ring finger.
Case 3 - Figure 1 - Low-magnification view of this patient's finger mass. The lesion appears to be well circumscribed and show an intermixed pattern of inflammatory cells associated with small myxoid foci.
Case 3 - Figure 2 - Low-magnification view of intermixed inflammatory and myxoid zones.
Case 3 - Figure 3 - Most of the inflammatory cells are lymphocytes or plasma cells. This myxoid zone shows vacuolated cells that can resemble lipoblasts.
Case 3 - Figure 4 - Some of these cells in the cellular zones are binucleated and resemble Reed-Sternberg cells.
Case 3 - Figure 5 - Other cells in the cellular zones are mononucleated and resemble CMV-infected cells.
Case 4
Submitted by: Robert J. Kurman Johns Hopkins University School of Medicine Baltimore, MD
Clinical Summary:
A 53 year old woman presented with a pelvic mass and underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy. At surgery bilateral ovarian tumors were found one measuring 8 cm and the other 6 cm in greatest dimension. Microscopically, the tumors were similar. Slides were from one of the ovarian tumors.
Case 4 - Figure 3 - Low grade serous carcinoma, area of stromal invasion
Case 5
Submitted by: Juan Rosai Centro Diagnostico Italiano Milano, Italy, and Genzyme, Inc., New York
Clinical Summary:
(Contributed by Dr. Sanford Robbins, Annapolis, MD) 52-year-old male with bilateral thyroid nodules, which had been demonstrated on an MRI done for work-up of shoulder pain. The larger nodule was located in the left lobe; it measured 4.2 x 3.7 x 4.9 cm and according to the patient it had been present for about 10 years. A FNA of this nodule was interpreted as "hypercellular, with changes suggestive of a neoplasm". A total thyroidectomy was carried out. Grossly, the left thyroid lobe contained an encapsulated lobulated, solid, pink-tan mass measuring 4.5 cm in greatest diameter. The right lobe had a multinodular appearance with focal cystic changes. The Seminar sections are from the nodule located in the left lobe.
Case 5 - Figure 1 - Peripheral portion of the thyroid tumor showing evidence of capsular invasion.
Case 5 - Figure 2 - Medium-power view of tumor showing solid nests and colloid-containing follicles.
Case 5 - Figure 3 - High-power view showing large size of tumor cells, abundant granular amphophilic cytoplasm and centrally located nucleus. The nucleoli are not particularly prominent. A thick fibrous band is seen in one corner of the photograph.
