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CALIFORNIA TUMOR TISSUE REGISTRY

"GENERAL PATHOLOGY"

Study Cases, Subscription A

February, 2005

California Tumor Tissue Registry c/o: Department ofPatboJogy and Human Anatomy

Lorna Linda University School of Medicine 11021 Campus Avenue, AH335 Lorna Linda, California 92350

(909) 558-4 788 FAX: {909) 5~188

E-mail: cnr@linkline.com Web page: www.cnr.om

Web site & Case of the Month: www.dtr.org

I IIi

Ts!'J!el audience: Practicing pathologists and pathology residents.

Goal: To acquaint the participant with the hi•1ologic features ofo variety of benign and

malignant neoplasms and tumor-like conditions.

Objectives: The participant will be able to recognize morphologic features of a variety of benign

and malignant neoplasms and tumor-like conditions and relate those processes to pertinent references in the medical literature.

F,ducational methods and media: Review of representative glass slides with associated histories. Feedback on consensus diagnoses from participating pathologists. Listing of selected references from the medical literature.

Principal faculty: Weldon K. BuUock, MD Donald R. Chase, MD

CM.E Credit: Lorna Linda University School of Medicine designales this continuing medical

education activity for up to 2 hours of Category I of tho Physician's Recognition Award of the American Medical Association.

CME credit is offered for the subscription year only.

Accreditation: Lorna Linda University School of Medicine is accredited by the Accreditation

Council for Continuing Medicol Education (ACCME) to sponsor continuing medical education for pbysicians.

\ ,,

Contributor: Mark Janssen, M.D. Case No. 1 - February 2005 Anaheim,CA

Tissue from: Placenta Accession #29351

Clinical Abstract: This 34-year-old female had a nonnal full-tenn pregnancy with a spontaneous delivery.

Gross Pathology: The placenta measured 19.5 em in maximum diameter and 3.5 em in maximum thickness with

an eccentrically placed umbilical cord. A 6 x 5 x 4 em nodular mass occupied most of an extra placental lobe.

Contributor: LLUMC Pathology Group (ke) Lorna Linda, CA

Tissue from: Mandible

Clinical Abstract:

Case No. 2 - February 2005

Aceession #29943

A mass was found in the left mandible of this 13-year-old boy. Radiographs showed an 8.5 x 3.5 em radiolucency in the left mandible.

Gross Pathology: The 42 gram, 6.0 x 4 .5 x 3.0 em pink-tan soft tumor mass was replacing a portion of the left

mandible. The mass extended from the gingival surface to the lateral malar surface of the mandible with a residual thin rim of bone. The cut surface had a gelatinous white whorled appearance.

Contributor: Kenneth Frankel, M.D. Case No. 3 - February 2005 Glendale, CA

Tissue from: Left breast Accession #29563

Clinical Abstract: A 71-year-old female was found to have a mass in the left breast A lumpectomy was

perfonned.

Gross Pathology: The 10.0 x 9.0 x 6.5 em pale yellow specimen contained a 9.0 em cyst filled with hemorrhagic

fluid and lined by 1.5 to 4.0 em soft pink-tan papillary excrescences. The cyst wall varied in thickness from 0.2 to 0.3 em. •

Contributor: Xuedong Wang, M.D. Case No. 4 - February 2005 Pasadena, CA

Tissue from: Right breast Accession #29566

Clinical Abstract: After discovering a mass in her right breast, this 88-year-old female underwent a right

mastectomy.

Gross Pathology: The 480 gram, 16.0 x 11.0 x 6.5 em breast specimen was largely replaced by a I 0.5 x 8.5 x 6.8

em ovoid mass. The cut surfaces were soft, red-tan and focally hemorrhagic.

SPEClAL STUDIES: LCA CD20 CD3 CD30 Ki67

positive positive negative negative 75% displayed strong nuclear staining

Contributor. Phillip C. Gordon, M.D. Case No. 5 - February 2005 Winter Haven, FL

Tissue from: Left axilla Accession #29359

Clinical Abstract: This 50'-year-old male presented with an enlarged lymph node in his left axilla.

Gross Pathology: The 4.0 x 3.0 em lymph node had a uniform tan cut surface.

Contributor. William P.lllig, M.D. Case No. 6 - February 2005 Tulsa, OK

Tissue from: Thyroid Accession #29800

Clinical Abstract Because of an enlarged thyroid, a thyroidectomy was performed on this 75-year-old female.

Gross Pathology: The 126 gram total thyroid included a 4.0 x 3.8 x 2.5 em rounded bard mass in th.e left lobe.

Multiple smaller, focally calcified nodules were also present, up to 2 em in greatest diameter.

Contributor: LLUMC Pathology Group (bhl) Lorna Linda, CA

Tissue from: Adrenal

Clinical Abstract:

Case No. 7 - February 2005

Accession #29610

For four months this 62-year-old female experienced abdominal pain accompanied by a 35 poWld weight loss. CT scan revealed a right adnexal mass impinging on the right lobe of the liver as well as the vena cava. Functional studies were negative.

Gross Pathology: The 938 gram mass measured I 5.0 x 14.0 x 8.0 em.

SPECIAL STUDIES: Chromogranin Synaptophysin

negative focally positive

Contributor: LLUMC Pathology Group (bbl) Lorna Linda, CA

Case No. 8 - February 2005

Tissue from: Pancreas Accession #29634

Clinical Abstract: After six months of abdominal pain, this 19-year-old female was found to have a mass in her

right upper quadrant. CT scan showed a heterogenous mass in the region of the head of the pancreas.

Gross Pathology: The resected head of the pancreas contained a 7.5 x 7.0 x 3.5 em well-circumscribed tumor

with a brown-tan necrotic cystic cut surface.

SPECIALS STIJDIDS: Synaptophysin Keratin cocktain Chromogranin lnsulin Glucagon Ki-67 CAM5.2

positive positive negative negative negative very low proliferative index positive

Contributor: Mark Janssen, M .D. Case No. 9 - February 2005 Anaheim,CA

Tissue from: Thigh Accession #29499

Clinical Abstract: Approximately two years after excisioaof a right arm melanoma (Clark's level 4) and right

axillary dissection, a follow-up CT scan showed a small ovoid mass in the bead of the vastus lateralis of this 49-year-<>ld female.

Gross Pathology: The J;eSeeted portion of thigh muscle contained a 1.5 x 3.0 em ovoid mass.

Contributor: LLUMC Pathology Group (bbJ) Loma Linda, CA

Tissue from: Retroperitoneum

Clinical Abstract:

Case No. 10 - February 2005

Accession #29611

After complaining of pain in the right groin, ili.is 71-year-old female was worked up for a possible right inguinal hernia. A CT scan of the abdomen showed a 6 x 7 em mass in the rerroperitoneum, inferior to the right renal vein and encroaching on the vena cava.

Gross Pathology: The 132 gram, 10.0 x 8.5 x 5.0 em specimen consisted of multiple soft pink-tan to white tissue

fragments, 1he largest weighing 19 grams and measuring 4.5 x 3.5 x 2.5 em.

CALIFORNIA TUMOR TISSUE REGISTRY

GENERAL PATHOLOGY

Minutes - Subscription A

February, 2005

SUGGESTED READING (General Topics from Re<:eot Literature):

lnt~rventiooal Magnetic Resonance Imaging Cryotherapy of Uterine Fibroid Tumors: Preliminary Observat.ioo. Cowan BD, Sewell PE, Howard JC, et at. Am J Obstet Gyneco/2002; 186(6): 1183-1187.

MR lmaging-Guided Focused Ultrasound Surgery of Uterine Leiomyomas: A Feasibility Study. Tempaoy CM, Stewart EA, McDannold N., Quade BJ, et al. Radio/2003; 226(3):897-905.

Focused Ultrasound Treatment of Uterine Fibroid Tumors: Safety and Feasibility of a Noninvasive Thermoablative Technique. Am J Obstel Gyneco/2003; -189( I ):48-54.

California Tumor Tissue Registry c/o: Department of Pathology and Human Anatomy

Lorna Linda University School of Medicine 11021 Campus A venue, AH 33 5 Lorna Linda, California 92350

(909) 558-4 788 FAX: (909) 558-0188

E-mail.: cttr@linkline.com Web site & Case of the Month: www.cttr.org

Case 1:

Case 2:

Case3:

Case.4:

CaseS:

Case6:

C'ITR Subscription A Febrl!ary,2005

FILE DIAGNOSES (If possible, submit answers on website at www.cttr.org.

Click "subscri_ptions", then click submit answers".)

Placental mesencbyrnoma T-88100, M-89901

Ame1oblastic fibroma, mandible T-10180, M-93300

Intracystic papillary carcinoma, breast T-04000, M-80503

Diffuse large B-cel11ymphoma, immuooblastic type, breast T -04000, M-96123

Hodgkin' s lymphoma, predominantly nodular sclerosing, axilla T-Y8100, M-96503

Warthin-like papillary thyroid carcinoma (aka "papillary Hurth1e cell carcinoma with lymphocytic stroma''), thyroid

Case 7:

gland

Case 8:

Case 9:

T-96000,M-82903

Adrenal neoplasm, probably cortical adenocarcinoma, with neuroendocrine differentiation, adrenal

T-93000, M-83703

Solid pseudopapillary tumor, pancreas T-59000, M-80001

Intramuscular myxoma, tbigb T-Y9100, M-88400

Case 10:

2

Cellular scbwannoma, retroperitoneum T-Y4600, M-95600

CTTR, February 2005 "Minutes" (Subscription A)

Case Submissions by Studv Group

Case No. 1, Accession No. 29351 February 2005

Alameda IAinme!ln Coumv Medical Center) • Inflammatory pscudotumor Baldwin Park (Kaiser Pennanentel · Leiomyoma, placental vs. uterine (I); Leiomyoma (2) Glendale - lntlammatory myofibroblastic tumor Irvine IUnivcr.;ity of CalifOrnia) - l)ecidilal hyperplasia Laguna (Laguna Pathology Medical Group) - Choraogioma Loma Linda·universitv Medical Center Residents) ~ Placental site nodule Lon& !!each 0-al<ewood Regional Medical Center) - Leiomyoma (7) Michigan (Oakwood Hospitall - Gestational myoma Monterey Park martield Medical Center! - Leiomyoma consistent with decidual change Mopterey Pa!kiMonterey Peninsula Pathologists) -Nodular fasciltis Oakland (Kaiser Pennanegtel - Leiomyoma Orange (Orange County Medical Grauel - Decidua Sacramento llJniversity of California Davis) - ChOrangioma San Diego (Nayal Me<lical Center) - lntraplacentalltiomyoma San Francisco (San Francisco Genernl Hospital) - Mesenchymoma Santa Rosa (Santa Rosa Memorial Hospitall - Cborangioma with prominent fibrous component {I); Cborioangioma (I);

Chorioangioma with extensive stromal component (1) Venturn - Chorioangioma Arizona <Maryvale Medical Center> - ~1traplacental leiomyoma Colorado Evergreen - Chorangioma..:cllular type Florida CBAotist Hospill\ll - Mesenchymoma, mixed cell type (I); PibrotL< mesenchymoma; Chorangioma, fibrous variant (I);

Mcscnehymoma (I); Florida (Munroe Medical Center) - l'lacental site nodule florida. TaJI!!ha.ssee - Solitary fibrous tumor Florida (Winter Haven Hospitall - Neurofibroma nlinois. Burr Ridge - Angiomyxoma Illinois <Noithwe.<;teffi Memorial Hospital) ~ Leiomyoma consistent with pregnancy indu~d changes Illinois. Oak Brook - Mesenchymal dysplasia lnd!ana <Howard Community Hospjtall - Vascul.ar leiomyoma of placenta Louisiana !Louisiana.State Univcrsitv Health Sdence Center> - Pseudosarcomatous myofibroblastic proliferation Maryland IJohns Hookins Hospital) - Benign mixed mesodermal (epithelial-stromal) tumor (I); Nodular fusciitis vs. inflammation

myofibroblastic tumor (I) Maryland (National Naval Medical Center) - Diffuse mesenchymal dysplasia, placenta Massachusetts fficrkshirc Medical Center) - Leiomyoma Masf::a.Chusetts fNew -l!ngland Medical Center) • Sclerosing chorangioma Michi2llll 1St. JOS.:ph Men;y Hospjta!) - Chorangioll\(l Minnesota - lnflanunatory pscudotumor Minnesota (fairview Southdale Hosoitan · Nodular fasciitis New York <Nassau Unjvec;jty Medical Center) - Chorangioma (fibroangiotn}'><oma) New York (StonyBrook Universjtv Hospj!al Resident<) - Leiomyoma New York 1\Vcsichester Mc~ical Center) - Placental leiomyoma Nor!h Caro!ina !Mountain Area Pathology> - ·? chorangioma, cellular lYJ>e (!); Myomelriumlbenign smooth musele tumor (I);

lnllarnmatory myofibroblastic tumor vs. cellular chorangioma (I); Cellular chorangiomn (I) Ohio (McCul!ough-Hvde Memorial Hospital) - Dccidualiz.ed stromal nodule Ohio CMedjcal Co!fege of Ohjo l - Mescnchymoma Pennsylvania (Allegheny Generill Hospital) - Spindle cell tumor· P6nnsvlvania (Conemaugh Mcmorfal Medical Center) ~ Leiomyoma Pennsvlvania £Drexel University College ofMcdiciOel .. Reactive fibroblastic lesion in placenta Pennsv!vanja !Lehi!lb Valley Hoso.ill!U - Oanaglioneuroma Pennsylvania CMagce \\'omen'S Hospital> - Myofibroblastic tumor Pennsylvania (Mt Nittany Medical Center) • Decidual nodule, placenta Pennsvlyanja <Pennsylyanja Hospj!J!ll - Decidual pseudotumor T cxas. Lubbock - Hcmangiop<:ricytoma Texa< CPropath Associil!esl - Focal ischemia, hydropic change (2) Texas (SCott & \Vhite Memorial Hospital) - Leiomyoma \Vashin&ton. Vancol!ycr - Leiomyoma or nodular fasciitis West Vir&inia !Greenbrier Valley Medical Center) - Placental leiomyoma Wisconsin ffiellin Rgsniial) .. Leiomyoma AustniliaiNonh Queensland Pathology) - Placental leiomyoma

CTfR. February 2005 "Minutes .. (Subscription A) 3

Ausbjllia !Royal Prince Alfred Hosoital\ • Benign deciduoma Brazjl <VNIFESIEPMl • tlemangioma with exuberant myxoid stroma Canada (foo]bl!!s Medjca! Center\ • Leiomyoma Canada CW9odstock General Hospital\ • Teratoma. placcolll Hon• Kono <Hone Konc Banti.<t Hospjtall - Spindle cell lllld epithelial tumour ItalY. NaniC$ • Nodular fasclilis Netherland!. Am .. cn!am - Fibroma Pugto Rjoo IUnivqsity of Puerto Rico\ • lntraplocentallciomyoma ~ - Placcntallciomyoma

Case I - Dlaenosis:

Placental mescncbymoma T-88 100, M-89901

Case 1 - References:

Lewis Sll, et al. Placental Mesenchymoma Pathology oflbcl'l•ecma. 2"" f.d., Cbun:hill Livingstone, 1999. pp 301·303.

Case No. 2, Accession No. 29943

Alameda IAiamq!A Countv Medical Center) • Ameloblast.ic fibroma Baldwin Parle !Kaiser Pennancntel - Ameloblastoma (3) Glendale • Amcloblastic fibroma lryine ruoiycaity o(CaJifomja) - Arncloblastic fibroma Laguna rLaguna Pathology Medical Group) • Ameloblastic fibroma Lorna !.igc!a University Medical Center Residents\ - Amcloblastic fibroma Lono Beach ll&kcwood Regional Mesljcal l - Ameloblastoma (7) Mjchjnan COn!swood lio<nitall - Amelob!astic fibroma Monterov Park !Garfield Medical Center\ • Ameloblastic llbroma Monterey Park (Monterey Penin<ula Patholosists\ • Ameloblastie fibromo Oa!cland rKajser Peanaoeute\ - Ameloblastic fibroma Oruogc !OfliiiMC County Meslica! Group) • Amcloblostic fibroma Sacrnmcoto (lJojvcudty of California Oa\'ls) - Amcloblastic nbroma San Djego fNnval Medical Cenrerl - Amcloblastic fibroma San Francisco !San frpne!WQ General Hosoitall • Ameloblastoma Sanm Rosa ISanta Rosa Memorial Hospital\ • Amcloblastie fibroma (3) ~ • Amelob.lll!loma AtjlDna (Marvnle Meslieal Center) - Ameloblastoma Colo!l!do. Eyst~~ceen - Amcloblastic fibroma F!oris!a <BandS! I lomjtall - Amcloblastic fibroma (S) florida (Mynme Medical Center) - Ameloblastic fibroma Florid!!. Ta!lahamc; - Ameloblastic fibroma Florida IWjotq Haven Hospj!all - Amcloblastic fibroma lllinojs. Burr Rjdgt .. Ameloblastoma O!inois <NoJ1hwestcm Memorial Hospital\ - Amcloblostic fibroma Illinois. Oak Brook - Spindle cell carcinoma Indiana !Hownrd Community Hospital) - Ameloblastic fibroma l&uisjana <Louisiana State Unjversjty Health Science Cenl£r} .. Ameloblastic fibroma MaryiMd IJobos Hooklns Hospital) - Ameloblastic fibroma (2) Maryland !National Nav!!l Medical Center) - Ameloblastic tibromn MI!SS!IChusctts CBqlsshirc Medical Center\ - Amcloblastic fibroma Ma.s.achusptlS <New Eno!and Medical Center\ - Ameloblostic fibroma Michigan CSt Joseob Mercy Hospital! - Ameloblnstic fibroma Mjnneso!A • Amcloblastic fibroma Minnesota rFajrylew Soulbdalc Hospita!l • Ameloblastic fibroma New Mexico CUnjvqsity ofNew Mexico> - Ameloblastic fibroma New ym CNQWl" Univmitv Medical Ccntc:rl - Ameloblastoma New Yor!s fStony Brook llnjversity Hospital Residents) - Amcloblastic fibroma New York (Westchester Medical Center\ • Ameloblastic fibroma Nonl] Carolina !Mountain Area Pathology) - Amcloblastic fibroma (4)

February 2005

4 CITR, Febrwory 2005 "Minutes" (Sub•cription A)

Ohio IMcCullougb-Hyc!e Memorial Hosoital) - Ameloblastic odontoma Ohio <Medical College of Ohio l - Ameloblastic fibroma Pennsvlvania <Allesheny Gencml HoSpital\ - Ameloblastoma Peoosylvnnia (Conemaugh Memorial Medical Center) - Ameloblastoma Pcoosylvania fbrexel Unjversity College of Medicine) - Ameloblastic fibroma pennsylvania llehisb Valley Hospitall - Ameloblastoma pennsylvania (Magee Women's Hospital) - Ameloblastic fibroma Pennsvlvania IMt Njttany Medical Center) - Amcloblastic fibroma, mandible Pennsylvania !Pennsylvania }(ospjtaJl - Ameloblastic fibroma Texa.< Lubbock • Ameloblastoma Texas (propath As,<ociates) - Amcloblll!>'tic fibroma (2) Texa.< (Scott & White Memorial Hospj!all - Ameloblastic fibroma Washin!!lon.Vancouver - Ameloblastic fibroma We§\ Vjrginia (Greenbrier Valley Medical Cenl£rl - Amelobla.<tic fibroma Wisconsin !Bellin Hosoi!al) • Ameloblastic fibroma AustraliaJNorth Queensland Pathology\ - Amelobla.\1ic fibroma Australia <Royal Prince Alfred HoSpital\ - Ameloblastic fibroma Brazil CUNIFES/EPMl - Ameloblastic fibroma with jlentin-like material Canada (foothills Medical Center) - Ameloblastic fibroma Canada <Woodstock General Hospital\ - Ameloblastoma, mandible Hong Kong (Hong Kong BaPtist Hospital) • Ameloblastic fibroma Italy. Naples - Ameloblastoma Netherlands. Amsterdam - Ameloblastic fibroma Puerto Rico (University of Puerto Riool - Amcloblaslie fibroma Oatar - Amcloblastic fibroma

Case 2- Diagnosis:

Ameloblastic fibrom·a, mandible T-l 0 180, M-93300

Case 2 - References': Takeda Y. Amcloblastic.Fibroma and Related Lesions. Current Pathologic Concept. OrolOnco/1999; 35(6):535-540. KumarN and Jain S. Aspiration Cytology of Ameloblasticfibroma. A Diagnostic Challenge. Diogn Cytopotho/2003; 29(2):101-

104. Mohapatra PK, Choudhury AR and Parkash H. Ameloblastic Fibroma in the Midline of Mandible. A Case Rep!)rt. J Clin Ped/atr

Denl2000; 24(4):321-327. Takeda Y, Kaneko Rand Suzuki A. Ameloblastic Fibrosarcoma in the Maxilla. Malignant Transformation of Ameloblastic Fibroma.

Virchows Arch A P01ho/Anat Histopotho/ 1984; 404(3):253-263. Choudhury M, Dhar Sand Bajaj 1'. Primary Diagnosis of Ameloblastoma by fine-Needle Aspiration. A Report of Two Cases.

Dlagn CytopoJho/ 2000; 23(6):414-416.

Case No. 3, Accession No. 29563

Alameda (Alameda County Mes!ical Center) • l'apill'!fY carcinoma Baldwin Park !Kaiser Perroanente) - lntracystic papillary carcinoma (3) GJendaJe • Jntracystic pap.illary carcinoma frvine <University ofcaJjfomia)" · Papillary carcinoma Laguna (Laguna l'll!hology Medical Group) - lnuacystic papillarycarcinoma Lonia Linaa University Medical Center Residents> - Papillary carcinoma of the breast · Lono Beach !Lakewood Regional Medical Cenler) - lntraeyslic papillary carcinoma (7) Michigan !Oakwood Hospiral) - Papillary intracyslic carcinoma Monterey P.ark <Garfield Medical Center) - Atypical intraductal papilloma MontereY Park (Monterev Peninsula Pathologists) - Intraeystic papillary carcinoma O!!kland O<aiser PennW)cnte) - lntracyslic papillary carcinoma Orange <Orange Countv Medical Group) - Papilloma with atypia Sacramento <llnivenity of California Davis) - ln~n~cystic papillary carcinoma San Dieao (Naval Medical Center) • lntracystic papillary carcinoma San Francisco <San francisco General f-losnital> · Papillary carcinoma SW!ta Rosa !Santa Rosa Memorial Hospital) - Intracystic carcinoma V enwra - Intraductal papilloma ·

(.T!'R, Febru.uy 2005 "Minutes" (Subscription A)

February 2005

s

AriT,ona CMaryyale Me<lical Cegts;rl - lntracystic papillary carcinoma Colorn<fo Evenncn - lntmcystic papillary carcinoma Florida CBaptiS! Hospjtall - Papillary carcinoma (I); Wcll-ditfcn:ntiated papillary carcinoma (I); !ntracystic papillary can:inoma (3) Florida CMuorps Me<ljcal Center) - lnln!cystic papillary carcinoma Florida, Tallah.....,. - Papillary carcinoma. minintal!y in"11Sivc, intraductal papillary carcinoma Florida CWjOJq Hayen Homitall - Papillary aden~inoma n!inois. Bw Rjdec - Papillary carcinoma Illinois CNcnthwcstem Memorial HospitaJl - lmracystic papillary carcinoma of breast Dlinojs. Oak Bmok - lntracyStic papillary carcinoma Indiana fHoward CommunjlY Hospjtall - Intraductal papilloma Louisiana O,oujsjMa State Universitv HcaJth Science Center> • lntroductaJ papillary carcinoma Marvland (Johns Hopkins Horoitall - lntmcystic papillary carcinoma (2} M!!ll\]and CNatjono! Nova! Me<lical Center) - Papillary carcinoma, Invasive Massochuscm Olerksbjre Medical Center) - Papillary carcinoma Mj!SS!lcbuSet\S CNcw E.nsland Medical Centq l - lntmcystic p~plllary carcinoma Mjcbjgon 1St. Jo:reph Mcn;v Hospital) - Papillary car<:inoma Minnc•ota - Adenomyoepithelioma Minnesota lfAjrvjcw Southda!c !-lospita!) - lntmcystic papillary CIJCCinoma New Mexjco CUnjvcrnilY of New Mexiool - lotmcystic papillary CM:inoma New York fNai.W! UnjycQjiV Medical Center) - Adcnomyoepithclioma New Yorlc /Stony Brook University Hospital Residents! - lntracystic papillary carcinoma New York I Westchester Medical Center) - lntmcystic papillary carcinoma vs. adenoma Nortb Cwoijaa !MountAin Area Pathology) - Papillary carcinoma (4) Ohio (McCylloua!tHydc Memorial Horoitall - Papillary carcinoma ofbn:ast Ohio CMe<lica! College of Ohio) - lntracySiic papiUary carcinoma Pennsvlyaoja /AIIegl!egy Genera! Aospjtal) - Papillary carcinoma. intraductal Pcnnsv!yanja CConemau!!h Memorial Medical Center> - Papillary carcinoma Pennsvlvaoin <nrextl Uniyersitv College of Medicine) . Papillary carcinoma Peoosylvani•ll..ehi!!h Valley Homita!l - Papillary carcinoma PCMsylyanjg CMagcc Womea~s Hosoitall - Papillary carcinoma of thyroid PennsylvaniA CML NitJAny Medical Center) - Papillary carcinoma. cystic, non-invasive. breast flenns,ylvnojp (l'cnnsylvania Homltal> - IntraductaJ papilloma Texgs. Lubbock .. J'apillary carcinoma Texa.< Q>roputb Associates) - lntmductal papillary adenocun:inoma (2) Texo.< !Scott & While Memorial Hospital) - lntraeystic papillary can:inoma WAshington. YMcouver - lntracystlc papillary carcinoma (non-inva.,ive) West Virgjoja /Greenbrier valley Medical Centerl • fntnu:ystlc pap I! lilly carcinoma WiS<:onsin l!lellin Hospital) - Intraductal soUd papillary carcinoma Australia fNortb Oycm<land Pa!hology\ - Partial infraaed intraductnl papilloma Auslrnlia!Roya! Prince Alfred Hospital) - lnrracystic papil!ary/cribiform carcinoma

lntracystic papillary carcinoma

!~~~!~~~~~~-~ln~lnOCYsti~-;·c papillary carcinoma

- Papillary carcinoma, breast - Apocrine adenoma

cell tumOr papilliferum

- lntracystic papillary carcinoma QJ!mr. - Papillary adenocarcinoma

Case 3 - Diagnosis:

lntracy~tic papillary carcinoma, breast T -04000, M-80503

Case 3 - &eference~: Solorzano CC, Middleton LP, Hung KK. et aL Treatment and Outcome of Patients with lntracystic Papillary Can:inoma of the

Breast. AmJSurg2002; 184(4):364-368.

Dogan B£, Whitman GJ, Middleton LP and Phelps M. lntnocystic l'llpillary Carcinoma oftbeBICISL AJR AmJ Rotmgono/2003; 181(1):186.

Yamamoto D, VedaS. Senzaki H, ct al. New Diagnostic Approech to lntracystic Lesions of the Breast by Fibroptic Ducto.oopy. Ant/CD11CV Ru 2001; 21(6A):4113-41 16.

6 ClTR, February 2005 "MulUlcs" (SubS<ription A)

Matsuo K. Fukutomi T, Tsudal-1, et al. A CaseofMalignant PhyllodcsTumorofthe Breast with Osteosarcomatous Features. Breasl Cancer200l; 8(1):79·83.

l'aeelli A, EOck BI, Jensen EA, et at lntracystic Papillary carcinoma of the Breast in a Male Patient Diagnosed by Ultrsound· Guided Core Biopsy. A Case Report. HreaSI J 2002;·8(6):387-390.

Case No. 4, Accession No. 29566 February 2005

Alameda I Alameda County Medieal Center) - Non-Hodgkin's lymphoma, diffuse high-grade large B-eell Baldwin Parli fKaiscr Pennnnentt;l • Diffuse Large B-<:clllymphoma (3) Glendale • High-grade Burkitt's-like lymphoma Irvine (University of California\ • Large cell B-ee II lymphoma, immunoblastic type Laguna <Laguna Pathology Medieal Grouol • Diffuse large B-<:elllymphoma Loma Lindallniver.;ity Medical Center Resjdent<l • Diffuse large B-<:elllymphoma Long Beach (Lakewood Resional Medieal Center\ - Diffuse large cell lymphoma (7) Michigan !Oakwood Hospital\ • Non·Hodgkin's lymphoma B-cell, Burkitt-like diffuse large cell Monterey Parli (Garfield Medjcal Center) • Burkitt's Lymphoma Monterey Parle (Monterey Peninsula Pathologists\ • Dill\Jse large B·celllymphoma Oakland CKai<er l'ermanentcl • Diffusc large B-<:elllymphoma Orange !Orange Coumy Medical Group) • Large cell lymphoma Sacramento <University ofCalifomjQ Qavis) • Diffuse large B-<:clllymphoma San Diego <Naval Medical Center\ - Diffuse lati!e B-<:elllymphoma San Francisco (San Francisco General Hospital\ - Diffuse large B-<:elllymphoma Santa Rosa CSanta Rosa Memorja! Hospital) - Large cell lymphoma, B-<:ell pheootype (2); Diffuse large B-<:clllymphoma (with

some Bundtt·like features) Ventum - Small cl.eaved lymphoma Arizona fMarvvaleMes!ical Center) • Large B·cclllymphoina Colorado Evergreen - B-<:elllymphoma, diffuse large cell florjdJI CBantisi Hospital) • Burkitt's malignant lymphoma (5) Plorida (Munroe Medical Center\ • Burkitt's lymphoma Florida. Tallahassee • Diffuse large B-celllymphoma Florida (Winter Haveri Hospital) • Lymphoma Illinois. Burr Rjdge • Diffuse large B·cclllymphoma Jllinois llionhwes!em Memorial Hospital) • Buikitt's lymphoma Illinois. Oak Brook - Diffuse B-<:elllymphoma lndiana afowacd Community Hospital\ - High grade B-<:ell NI{L Louisi!Ula O&uisiana State UniverSity Health Science Center) - Malignant lymphoma large cell, immunoblastic Maryland (Johns Hopkjns Hospital\ • Diffuse large B-ecll lymphoma (2) Maryland <National Naval Medical Cen!Crl • fligh·grade B-eelllymphoma Massachu.<etts ffierkshlrc Mcdieal Center) - Malignant lymphoma, diffuse large B-cell Massachusetts CNew llngtand Medieal Center\ - Dlffuse large B-celllymphoma Michigan CSt. Joseph Mercy Hospital) • Diffuse large B-ee II lymphoma Minnesota • Diffuse large B-celllymphoma Minnesota (fairview Southdale Hospital\ - High grade B-celllympboma ~cw Mexico <University of New Mexico) • Burkitt's lymphoma New York <Nassau University Mcdjcal Center) • Large cell lymphoma New York (Stony Brook University Hospital Residents\ - Large B-<:ell lymphoma New York (Westchester Mes!ical Center\ • Diffuse large B-ccll lymphoma North Carolina (Mountain Area Pathology\ - B-<:elllymphoma, rule out Burkitt' s (I); High grade B-oelllymphoma (Burkitt's-like)

(2); Diffuse large B:.Celllynipboma (.I) Ohio fMcCUJiou2h·Hyde Mernorja! Hospital> • Ki67 positive diffuse B-cclllymphoma Ohio (Medical College afOhio\ - High grade B-eell non-Hodgkin's lymphoma Pennsylvania"(AIIcgheny General Hospital) - B-cell diffuse large cell lymphoma Pcnnsylyanla CConem8ll•h Memorial Medieal Center\ • B-cell lymphoma Pennsylvania !Drexel Uniyqsjty Co IIese ofMedieine\ • Diffuse large B-<:elllympboma Peposylvunia <Lehi•h Valley Hosoitall - Large cell lymphoma Pennsylvania (Magee Women's Hospiiall • B·cclllymphoma Pennsylvania fMI. Njt!anv Medical Center) • Diffuse large B-cclllymphoma, immunoblastic variant. breast Pennsylvania <Pennsylvania Hospital) - Non-Hodgldn's lymphoma Texas. Lubbock • Malignant lymphoma, large oell, B-celltype Texas IPropa!h AsSO£iRtes) • High grade B·cclllymphoma (2) Texas IScoti & White Memorial Hospital\ • Diffuse large B-<:clllymphoma Washington. vancouver • Diffuse large B·ccll lymphoma (vs. Burkill's lymphoma, atypieal variant)

CITR, l'eb.uary 2005 "Minutes" (Subscription A) 1

We!1. ViminiaiGreenbricr Vallev Medical Center\ • Diffuse lkell lymphoma Wisconsin (Bellin Hospitall · Burl<itt'~ lymphoma AuS!l'JIH[!INorth OueepsiMd Patholoi!Yl • Large B-celllymphoma Ausw1ia ffioyal Prince Alfred HosoiJnll • Diffuse lur&e B-ccU lymphoma, immunoblostic variant Brazil Cl!NJEES/EPM\ • Diffuse large B-c:elll)mphoma Cana4a1Eoothills Medical Center) • Malignant lymphoma. diffuse large B-<:ell type Canada !Woodstock Gepeml Hospila!) • Diffuse large B-eell lymphoma, brcasl Hong Konn (Honc Kona B!lJ)tist HospiJa!\ • Non·Hodgkin's lymphoma (Burldtt's·likc) lla!y Naoles · Burkitt's lymphoma Nethe<lands. Amsterdam • Non-Hodgkin'slympboma (dilfusc large B-eell NHL) Puer19 Rioo (l!nimsiiV ofPueno Rico\ • Diffuse 181iC B-<:elllymphoma Oatar - Durkin' s lymphoma

Case 4 - Olagno~is:

Diffuse large 8-ulllympboma, immuooblastic type, breast T-()4000, M-96123

Case 4 · References: Abbondanzo SL, Seidman ID, Lctkowitz M, c:t al. Primary Diffuse Large B-Cell Lymphoma of the Breast. A Clinicopathologic

Srudy of31 Cases. Pathol Res Proctl9:96; 192(1):37-43. Ball PJ, van der Valk P, KurverPH, ct al. Large CCII Lymph.o.lllllll. Dilferential Diagnosis ofCcmroblosticand B·lmmuaoblstic

Subtypes by Morphometl')l on Cytologic Preparations. Cancer 1985; SS(2):486-492. Arber DA. Simpson JF, Weiss LM. et al. Non·Hodgkin's Lymphoma Involving the Breast. Am J Surg Patho/ 1994; !8(3):288·295. MaRia AR. Feny JA and Hnnis NL. Breast Lympboma. A B-Cell Spectrum Including 1hc Lnw Grade B-Cell Lymphoma of Mucosa

Associated Lymphoid Tissue. Am J Surg P01hol 1993; l7(6):S74-S87.

Case No. 5, Attessioo No. 29359 February 2005

Alp.meda!Alarnecja COYDIY Medical Ccnterl - HodsJ<:in's lymphomA Baldwin I'Adc (Kiliser Pcnnanente\ - Cla.~iclil Hodgkin's lymphoma ( I ); Hodgk.in's lymphomt~ nodular sclerosis type (I );

Hodgkin's classical (I) Glendale • Syncytial Hodgkin's disease vs. ALCL tryjge C!Jgivmily of California> · Hodgkin's lympboma. oodulor scle<osing f.aguna O.mma Patholqi!Y Medical Group\ • Nodular sclerosing Hodgkin's discoso Lorna Linda Universjty Medical Center Re.._identsl - Lymphocyte predominant flodgkints disease: Long Bcru:h (Lakewood Rcaional Mcdjcal Cepteil · Hodgkin's discnse (7) Mjchigan !Oa!cwood Hosnjta!\ · Hodgkin's lymphoma, classical Monterey PN!s. (Garfield Medical Center\ • Hodgkin's disease, mixod cellularity type Monterey M (Momerey Peninsula PatholoiDS!Sl • Hodgkin's lymphoma, clas.<ica! nodular sclerosing Oakland (!(gig;r Permancptcl · Hodgkin's lymphoma, classic type Orange IODIOge County Medical Grouo\ • Hodgkin's disease Sacramento !University of California Pnyis) - Hodgkin 'slymphoma San Djego <Naval Mec!ica! Ccruerl - Nodular sclerosing Hodgkin's diseose San F!'8l!cigg !SanF!'8!1cigg Gcnc:rn! HO<pila)) - Hodgkin's lymphoma, nodular sclerosing Santa Rosa CS!Inta RoSJ! Memorial.Hosojtall • Hodgkin's disease (2); Hodgkin's lymphoma ( I) Venrum - Nodular sclerosis Hodgkin's disease Arizona (Maryyale Medical Cenlcr) • Nodular sclerosing Hodgkin's lymphoma Colorado. Emgrcen • Nodular sclerosing Hodgldn 's disease Florida CBaptig HosoitaJl - Nodular sclerosing Hodgkin's (3); Hodgkin's disease Florida (Muoroe Medical Ccnlcrl · Hodgkin's disease !'lorida. Tnllnhnssoc • Classical Hodgkin's lymphoma. {lfade I Plorida IWjnter Haven t!ospital\ - Hodgkin's disease Illinois, Burr Rjdge • Hodgkin's lymphoma D!inois <Nonhwcstern Memorial Hospil!!l> • Hodgkin'slympboma, nodulnr sclerosing type Dlinois, Oall Brook • Nodular sclerosing Hodgkin's disease Indiana Ctlowar!l ComnruniiY Hospitall • Hodgkin's disease Louisiana (Louisiana SlAte University t lenlth Sci epee Center) · Hodgkin's diseose. ntixcd cellularity Maryland lloh.ns Hookjns Hospital! - Classical Hodgkin's lympboma. nodular scleto5is type (I): Hodgkin's nodular sclerosis (I) Maryland <National Naval Me<fical Center\ · Hodgkin's lymphoma. classical, Jllvor nodular sclerosis MassachuSC!!S !Berkshire Medical Ccgtcr) • Hodgkin's lymphoma

8 CTrR, February 2005 "Minutes" (Subscription A)

M•S!!A£hUseJ!S CNew England Medical Center! • Hodgkin's lymphoma, nodular sclerosing type Micbi•M ISL Joscpb Mercy Hospillll\ • Classical Hodgltin's ltmphoma, nodular sclerosing type Mjnncsq!A • Nodular sclerosing Hodgkin's lymphoma MinnCSQIA (fairview Southdalc Hospitall • Hodgkin's lymphoma New Mcxjco CUnivmjiY ofNew Mgjeol - Hodgkin's lymphoma, mixed cellularity type New York CNassau Univmitv Medjcol Center> - Hodgkin's lymphoma, nodular sclerosis New York IStony Brook Universj!V llgsnjtol Residents) - Hodgkin's lymphoma, mixed oellularity type New York CWestcbester Medical Ccnterl • Nodular sclerosing Hodgkin's lympboma Noah CW1)1ina !Mountain Area Pathology! • 1-lodgkin's disease, mixed cellularity (2); Hodgkin's disease (I); Hodgkin's lymphoma,

nodular sclerosing subtype ( I) Ohio IMcCu!louch-Hydc Memorial HgsnjJnll - Hodgkin's disease Ohio !Medical College of Ohio\ - Hodgkin's lymphoma, nodular sclaosingtypc Pennsylyania !Allegheny General Homjllll) - Hodgkins lymphoma, mixed cellularity PenM>1vania CCoocmaugh Memorial Mesl jcaf Center\ - Hodgkin's disease Pennsylvl!li• CDrexel Univcrsi!V College ofMeslicine\ • Hodgkin's lymphoma (nodular sclerosis variant) Pennsylyania !Lchi!!h Valley Homi!all - Hodgkin's lymphoma, nodular ..:lcrosing type PenMYivania CMagce Women's Ho;;pjm!l - Hodgkin's lymphoma Pcnnsvlyi!Jja CML Nittaoy Medical Cen)erl • Classic Hodgkin's lymphoma, cellular phase o(nodular sclerosis, lymph node Pennwlyania CPcnnsvlwi• Ho;;pit11)\ • Hodgkin's lymphoma, mixed cellularity Texo.s. !.ubbock • Hodgkin's lymphoma, nodular sclerosis Tcxas(pro!llllh Ass9cia1es\ • 1-lodgkin's lymphoma, nodular sclerosis type (2) Texas CScou & Wbjte Memorial Ho•pitall • Hodgkin's lymphoma Wo.<!Jjnoton. YJl!lcOuyer - Classical Hodgkin's lymphoma, nodular sclerosing type West Vjrajnjaffireenbrier Valley Medical Cemerl - Hodgkin's diSC8SC, nodular sclerosing Wisconsin (Bellin Ho;;pillll\ - Classic Hodgkin's lymphoma Ausqalja fNorth Ol!censland Pathology! - Hodgkin's disease A~<walia IRova! Prince Alfred Hospj!Ail - Hodgkin lympbOJD8, nodular sclerosis type (grade 2) Brazil CVN!FES/EPMl • Hodgkin's lymphoma. nodular sclerosis type Canada lfootbj!ls Medica! Center\ - •lodgkin ·s lymphoma. nodular sclerosis type Cana4a1Woodstock General Hospi!Jill • Hodgkin's lymphoma nodulllt sclerosis subtype, axillary lymph node Hone Kona CHong Kong Bnoti$1 Hospj!aJl - Angioimmunoblastic T -cell lymphoma llaly. Nnnles • Nodular sclerosis Hodgkin's lymphoma Nclberlands. AmSterdam - Bodgkin's lymphoma (nodular sclerosis) Cueno Bjco <University ofPueno Rjco\ • Classic Hodgkin's lymphoma (nodular sclerosing type) ~ • Hodgltin's lymphoma-nodular sclerosing

CueS • Diagnosis:

Hodgkin's lympboma, predominantly nodular sderosing, axilla T·Y8100, M-96503

Case 5 • References: von Wasielewski S, Fnmldin I, Fischer R, et al. Nodular Sclerosing Hod)ll<in Disease. New Grading Prc:diciS Prognosis in

lntcnnediate nod Advanced Stages. Q/O<Jd2003; 10l(l0);4tl63-4069. Kis LL, Nagy N, Klein G, et al. Exprcoslon ofSH2DIA iJ.1 Five Classsiea.l Hodgkin' s Disease-Derived Cell Lines. /11/ J Cancer

2003; 104(S):6S8~1. wn den Berg A, Kroesen Bl, Kooislr8 K, eta!. High £><pression of B-tell Receptor Inducible Gene BIC in All Subtypes of Hodgkin

Lymphoma. Genu Chrom()SOmts CaiiCI!r 2003; 37(1):20·28,

Case No. 6, Acc:ession No. 29800 February 2005

Alnmcdp CA]wneda County Mediql CcntW ~ Oncocytic carcinoma arising in Hashimoto"s thyroiditis Da!dwjn Pork !Kaiser Pennaneme> - Papillary carcinoma thyroid with areas of poor differentiation ( I); Papillary carcinoma of the

thyroid with columnar nod follicular nnd poorly differentiated areas ( I); Papillary carcinoma (high grudc) ( I) Glendale - l'oorly diiTerentia!ed carcinoma lrvjnc OJniycrsity of California! - Wlltlllin's-likc variant ofpapilhuy curcinomn of the thyroid Laguna (!.aeuna Pathology Medical Grouo) • l'api!lary carcinoma !,ong Bcocb !J.alsew90d Regional Meslica! Center! - Papillary carcinoma wilh Hunhlc cell features (7) Micbi•an COakwood Hosoitall - Columnar cell variant, papillary carcinoma Monterey M CQarfield Medical Center! • Papillary carcinoma, tall cell variaot Mommy Park CMontqey Peninsula Ppthologists) - Papi!Jary carcinoma diffuse sclerosing

CTI'R, February 200S "Minutes" (Sub5c:riptio<l A) 9

Oal<IWJd <Knjser Pcnnanentel - Papillary carcinoma, tall cell type Or411•• COmnee County Me!lical Groupl - Papillary can:inoma Sacrnmcoto (lJojycrsity of California Davis} - Papillary c:arcinQma

~Sans~D~i•~•~o~CN~a~y~al~M~ed~i~ca!~C~en~w~>~-~;~~thyroid can:inoma in • background of Hashimoto's thyroiditis - Papillary carcinoma. Warthin's tumo<-like variant cell carcinoma (I); Poorly differentiated carcinoma of thyroid (I);

thyroid cell$, arising from papillary thyroid carcinoma ( 1) Vcntu!J - Oncocytic carcinoma Ari1,ona CMma!c Medical Center) - Squamous cell carcinoma of thyroid Cnlomdo Eyenzrecn - Papillary carcinoma-oncocydc variant Hashioto's thyroiditis florida CBaptjst!iospj!Ail - Anaplastic caTCinoma. squamoid type (2); Papillary carcinoma, poorly differentiated with squamoid

differentiation (2); Poorly differentiated papillary carcinoma ( I) Florido(Myome Me!ljcal Center) - Papillary carcinoma Florida, Tnl!ahg$S!X; - Papillary oncocytic ncopla.'ml f lorida CWioter l·loyen Hospitall - Papillary carcinoma Illinois. Burr BldQe - Anaplastic carcinoma l!!ingi~ CNortbwesJem Memoria! Hospital) - Warthin's-ll.ke papillary thyroid carcinoma , !l!inojs. On!s Brook - Anaplastic carcinoma with squamous differentiation (I) Jndjano CHoword Community Hospital) - Papillary Hurthle cen carcinorrus and Hashimoto's thyroiditis Louisiana fl .oujsjona S!lltc University Health Science Centerl - Papillary thyroid carcinoma v.ilb focal spindle nnd giant cell

tronsformarion In a background of Hashimoto's Maryland Uobm Hookins tlospjtall - Papillary carcinoma. Warth in tumor-like variant (2) Maryland IN!I!IQ!Jal Nml Medical Center\ - Papill81ycarcinoma with Warthin-like fcatwes arising in a lymphocytic thyroiditis (I) M•ssrhuseus CBerkshire Medical Center> · Hurtble ceU ce.reinoma Mnas'wsus ()l!ew Enalanc! Medical Centtrl - Hurthk cell neoplasm Michi811!J CSL losco!J Mcrey Hosoitall - Papillary carcinoma Minneso!A - IVarthin-li!sc papillary carcinoma Minnesota fFajrvjew Southdale Hospital\ - Papillary carcinoma, nodular sclerosing variant New Mexico aJnjymjty ofNew Mexico) - Anaplastic carcinoma New York ()l!ossqu University Medical Center) - 'Tall cell c:orclnoma New Xod< CS1ony Brook University Hospital Residents\ - Papillary carcinoma with background ofNoshimoto's discose New Yort. CWes!che:ger Medical Center) - Papillary Hurlhlc cell carcinoma Nortb C!lfolino (Mountain Area Pathology) - Undifferentiated carcinoma (I); Hurthle cell carcinoma (2); Annplostlc carcinoma (I) Ohio (MeCyllouj!h-!iydc Memorial HOSpital) - Maligmuu Uurthle cell tumor Ohio (Medjcal College ofOhiol - Papillary carcinoma, ditfusc sclerosing type Pennsylyan!a (AIIcaheny General Hosoi!all - Anaplastic carcinoma of thyroid Pcnnsy!yanja 1Conemuu2h Memorial Medical Center) - Papillary carcinoma, tlurthle type Pcnnsylynnja CDrcxelllnjversity College ofMedjcjpel - Papillary carcinoma Pennsylyanja CLchjoh Ya!ley tlosoital) - Papillary carcinoma, oncoeytic variant Pctwylyanja fMaaee Women's Hospital\ - Medullary carcinoma Penmy!ynnia fMt. Nilww Medica! Cooter\ - Undifferentiated (anaplastic) carcinoma, thyroid gland PennsylvMja CPmnsylvania Hospital) - Papillary carcinoma, diffuse sclerosing variant Tem Lubbock; - Hunhle cell carcinoma Texosll'to!N!h A!l<l!ciatcs\ - Thyroid carcinoma, tall cell variety in a background ofHasbimoto's thyroiditis (2) Tcxns CScou & White Memorial Hospital) - Papillary carcinoma, tall cell variant Washjogton. VMwuver - Anaplastic carcinoma of thyroid West Virainja IGn;enbrier Valley Medical Center) - MedullSJ)' carcinomo, papillary variant Wisconsin fficWn liomi!Al) - Papillary thyroid carcinoma Auswlin ()l!onh Oucensland Pathology) - High grade papillary curcinomn of thyroid Austrnlia!Rgval l'rinco Alfred Hospjta!l - Papillary carcinoma, dedifferenriaring (high grade) Brazil CUNIE!lS!EPM) - Papillary carcinoma, oncocytic vnrian~ Warthin-like Canada O:ootbil!s Medical Center> - Ditfuse S<:lerosing papillary carcinoma Cauadn CWoosh1ock Genernl!iospital) - Columnar cell variant papillary carcinoma, thyroid Hong Kong CHong Kong Bapti.st Hospital) - Papillary carcinoma, Warthin nunor-like variant lta!v. Naoles - Warthin's-like papillary thyroid carcinoma Netherland.:!. Amsterdam - Oncocytic papillary carcinoma of the thyroid and lymphocytic thyroiditis Puerto Rico CUnjymity of Puerto Rico} - Papillary thyroid carcinoma ~ - Papillary eon:inoma in a background of Hashimoto's thyroiditis

10 CJ1'R, FebruOJ)' 200S "Minutes" (Subscriprion A)

Case 6 • Diagnosis:

Wartbin·like papillary thyroid carcinoma (alul "papillary Rurthle cell carcinoma witb lympbocyllc stroma"), thyroid

T -96000, M-32903 Director's note: Ooc oflbe newes1 of the 20+ types ofpapilllll)' ca of thyroid. We have only two in the Registry. dn:

Case 6 - References: Urano M, Abc M, KW1l<la M, Mi:roguchi Y, et al. Warthin·Like Tumor Variant ofPapilllll)' Thyroid Cateinoma Case Report and

Literature Review. Polhoi /n/200 1; 51(9):707·712. D'Antonio A, De Chiara A. Santoro M, et al. Warthin-Like Tumour oftbc Thyroid Oland. R.ET/PTC Expression Indicates it is a

Vndnnt of Papillary Careinoma. f/islopotho/2000; 36(6):493-498. VR.SCi M, Kumnr I'V, Malekhoscini SA, ct al. Papillary Hurthlc Cell Carcinoma (Warthin·Likc Tumor) of the Thyroid. Report or a

Case with Fine Needle Aspiration Findings. A era Cyto/ 19')8; 42(6): 1437· 1440. Fadda G. Mule A, Zllnnoni OF. et al. Fine Needle Aspiration of a Warthln·Like Thyroid Tumor. Report of a Case with Dil'fcrcotlal

Diagnostic Criteria vs Other Lymphocyte-Rich Thyroid Lesions. Acta Cyto/ 1998; 42(<t):998·1002. Baloch ZW and LiVolsi VA. Warth in-Like Papillary Carcinoma of the Thyroid. Arch Patho/Lab Med 2000; 124(8): 1192· 1195. Maeak J. Vaverl<ova li. Dushova M, et al. Medullary and Mixed Medullary-Papillary Carcinoma of the Thyroid Gland. Pathologica

1997; 89(3):311-322. Ahlllhams, NA, Ayala AO, Cz.c:miak B, c:t al. Chromophobe Renal Cell Carcinoma "'ith Saroomatoid Transformation. Ann of Diag

Patho/2003; 7(5):296-299.

Case No. 7, Accession No. 29610 February 2005

Alameda CA!nmeda Countv Medical Center) - Pheochromocytoma. malignant Baldwin Park ll<ajscr Permanent c) - Pheoehroonoeyroma (3) Glendale • Adremtl conical carcinoma Irvine/University oCCalifomial • Adrenal cortical carcinoma Lagunn ILqsuno Pnthology Medical Group! · Neuroendocrine neoplasm (adrenal cortical carcinoma) Lorna Linda Un!yernitv Medical Center Residents! · Adrenal cortical caroinoma Lons Beach !l.akcwood Reaionnl Medical Center) • Carcinoma with neuroendocrine features (7) Michisan IOallwqod HospilaU - Adenocortieal carcinoma Monwrey Park <Gurfie!d Medical Center> · Pheochromocytoma Monterey Park (Monle!ey Penjnspla Pa!hologistsl • Adrenal cortical carcinoma Oakland <Kaiser Pcnnancntel · Pbeochromoc)~oma Qmnoe IOransc County Medical Group) - PheochromocytOma S8C!lllllCnto lUniymity ofCalifomia Davis) · Adn::nal cor1icaJ carcinoma San Diego /Nay&! Meclica! Center) - Adrenal oortica! carcinoma San Frencjsco CSag fmpcjsco General Aosoital) • Pheochmmocytoma Sanaa Ros ISan!A Rosa Memorial Hospital) - Pbeochromoe)1oma (2); Adrenocortical neoplasm, probably carcinoma ( I) Ventura • Malignant peripheral nerve shcalb tumor Arizona (Mamalc Medical Center> • Adrenal cortical carcinom• Colorado. Evqsrs:n • large cell ncwoendocdne carcinoma Florida O!aP)j:;t tln.<njtall • Pheochromocytoma (S) Florida CMuruo• Medical Center) • Neurocndocdnc carcinoma florida Tpllahasscc . Non-3mall neuroendocrine car(inon\& l'lorjda IWinJC[ Huvcn Hospital) · Pheochromocytoma Illinois. Burr Ridge - Neuroendocrine carcinoma Illinois <Northwestern Memorial Hosnitar> .. Adrenal cortical carcinoma !l!inois. Oa!c Drnok • Adrenal cortical carcinoma lndiana (Howard Community Hospital) - llcuroendocrinc carcinoma Louisiana CLouisiana State Uniyqsjty Health Science Centcrl · Adrenal cortical carcinoma MarvlMd llohns Hopkjns HOS!litall · Adrenal cortical carcinoma (I); Adrenal cortical neoplasm favor carcinoma (I ) Marvland <NNional Naval Me!lieal Center) • Adrenal cortical carcinoma (~); Malignant pheochromcyroma (2); Malignant

hemangiopcricytoma ( I) M•SS'ffi'k'iC\lS IBqlqbin: Medical Center! · Adrenal oortica! carcinoma M•mrhusns CNew F~gland Medical Center> • AdRnal conical carcinoma Micl!i!!l!l! IStJO!Cph Mqcy HospiWl • Carcinoma, neuroendocrine vs. adn:nal oortical Minnesota - MCiaStntie carcinoma MjnnespJA (fajrv!cw Southdalc Hosoitall - Pheochromocytoma

C1TR. February 200l "Mimrt.,.- (Subsaiption A) II

New MCltico Nnjvmjtv ofNcw Mgjc:o) - Phcocbromocytoma New yort CN"SO" Univmirv Medical Center) - Cortical carcinoma~ adrenal New Yolk (Stony llrook Uni>·CJ$ity Ho;mita! Residen!s} - Adrenal cortical carcinoma New York (We>1CbcS!er Medical Ccntcrl - Adreoooortical cotci.noma North Carolina (Mountain Area Patho!oayl - Pheochromocytoma (4) Objo {McCullouah-1-!yde Memorial Hospital) - Pheochromocytoma Objo Medical College ofOhjo) - Adrenal cortical carcinoma Pgmsylvania CAII<jhcny Gau:ral Hosp!!all - Pheochromocytoma Pennsy!yania (Congpau@ Memorial Mc!lical Ccoterl - Phcocbromocytoma Pennsylvania CDrcxel Universjtv College of Medicine> · Poorly differentiated carcinoma Pewsvh'80ia CJ.ebjoh Valley Hospital) - Adrenal cortical COJ'Cinoma Pcnnsvlvanja <Magee Women's Homjtqn • Pheochromocytoma PCJ!nsylvaoja (M t NiltMy Medical Cenu;rl - Granulosa cell tumor, poorly differentiated (difliJsc), ovoty Pennsylvania CPcpnsytv;mia tlospitnl> • Adrenal corticaJ carcinoma Texas, lubbock - Adrenal carciooma Texas fProoath t\ssociatesl - Pheochromocytoma (2) Texas CScon & White Memorial Hosnita!l - Poorly diffcn;ntioted carcinoma with neuroendocrine features WasbinOJoJL Vancouver - Adrenal conical rumor (possibly carcinoma) • West Virginia !Greenbrier Val!cv MediCAl Center) - Adrenal cortical carcinoma Wisconsjn CBcl!in t losnitall - Adrennl cortical tumor Australia (North Queensland Patholo!l)ll - P Net - D.O. Smn!l cell carcinoma Aus!!lllia CRoyal Prince Alfred lfomUa!l - Adrenal conical carcinoma B!!Zil ctJN!FES!f:PM} - Poorly ditren:ntiated carcinoma, rule out metastalic Canada !foothills Mc!lica! Center) - Adrenocortical carcinoma ClUlada CWoo<l>1ock Genertd Hospita!l - LOJ'ge cell neuroendocrine carcinoma, adrenal gland Hona Kong CHona Kong Baptist Rospj!llll - Poorly dillerentiated malignant endocrine tumor Itoly. Nantes - PhcochromOC)'IOma. probably malignant Netherlands. Amsterdam - Pheochromocytoma Pueoo Rico CUniveajtv of Puerto Ricol - Adrenoconica! carcinoma ~ - UDdiffermtiated malignant neoplasm most probably ma!i81'ant pan13811glioma

Case 7 - DlagnO!lis:

Adrenal neoplasm, probably cortical adenocartinoma, wltb neuroendocrine differenllalion, adrenal gland T -93000, M-83703 Di=tor's note: This case illustrates the difficully in sometimes distinguishing medullary tumors from cortical ones. drc

Case 7 - References: Saeger W, Fassnacht M, Cbita R, et at. High Diagnostic Accuracy of AdrenoJ Core Biopsy. Results of the German and Austrian

Adrenal Network Multiceoter Trial in 200 CO<J.sccUtivo Paticnls. Hum PaJhcl2003; 34:180-186. HOJ'B F, Ki.sbikawa I. Tomishig<; H, et aL A Child with Adrenocortical Carcinoma Who Underwent Pcreul8neous Ethl!Jlol!njcction

Therapy for Liver Mctasmsis. J Pedilllr Surg 2003: 38(8): 1237-1240. Toptas T, A!tiparmak MR, and Pamuk ON. Adrenal Carcinoma Causing Secondoty Amyloidosis. Report of the First case in the

LitertUure. NerhJ Med2003; 61(4):142-145. ruj iyoshi F, Nakojo M, Fukukura Y, eta!. Characterization of Adre11a! Tumors by Chemical Shift l'astlow-Angle Shot MR

Imaging. Comparison of Four MethodsofQuantillltivo Evaluation. AJR Am J Roenlgeno/2003; 180(6):1649-16S7. Kaddah NM and Oessouky NM Functioning AdrenoJ Tumors in Crutdren. A Report or 17 Cases. Saudi Mtd J 2003; 24(5):84647.

Case No. 8, Acces.1ion No. 29634 February 2005

Alameda (Alameda Counw Medical Ccnrerl - Solid·pseudopapilloty tumor Baldwin Park (Kaiser Pennancntcl - Solid cy>1ic papillary epithelial neoplasm of pnncreas (I); Neuroendocrine tumor ( I): Solid and

cystic papilloty careinoma (1) Glendale - Solid and cystic papillary tumor of pancreas Irvine lllnivcrsity ofCaUfomia) - Solid pseudopapil!oty tumor ofpaoaeas Lawna (laguna Pathology Medical Gmuol - Solid<ystic papilloty epithelial neoplasm (Gruber-Frantz tumor) lorna Linda Unjycrsi!Y Mcdjcal Center Residents) - Solid psetJdopapil!ary carcinoma of the plUlcrcas (AKA: solid cystic papillary

epithelia! neoplasm) J.ong Beach <Lakowood Regional Me!llca! Center) - Solid and cystic pscudopapil!ary 1umor of pancreas (7)

12 C1TR. Fcbruy 200S -Minutes" (Subscnprion A)

Michican IO!lkwood Hospital> - Solid cystic-papillaJY epithelia! neoplasm Monterey l'adl IGA!fiold Modiool C¢~~terl - Solid-pseudopJ!piliaJ)' twnor Monterey Pad< (Mootqey Peninsula Patholol>ists\ - Solid-cystic papillaJ)' twnor oakland (Kai<s;r Pgmancnte\ - Solid and cystic rumor Orange IOrange Countv Medical Groupl - Solid aod cystic pscudopapillary neoplasm Sacramento !Unjyqsj!V of california Davis\ - Solid cystic papillary tumor San Diego <Naval M<diCl!! Center) - Solid pscudopapillary tumor San franeim ISM f!j!!1eisoo General Hospital) - Pancreatic neuroendocrine carcinoma Santa Rosa (Santa Rosa Memorial Hospital) - Solid pscudopaplllary tumor of paoacas (3) Yml!!m - Lipoma Ari1pna (Mnryya!e Me!lical Center) - Solid-pscudopapillary tumor Colorado. Eymucen - Pancreatic endocrine neoplasm FloridaiBnptist t lospjtaJl - Solid pscudopapillary tumor of pancreas ( I); Gruber-Frantz tumor (I); Solid and cy>tic papilltll)' tumor

(2) f)oddn (Munroe Msdical Center) - Endocrine adenoma Florjda. Iollohwee - Solid pscudopapillary tumor florida IWjD[er Hayen Hospital) - Solid and cystic papillary tumor lll jnojs, Burr Rldae - Pancreatic endocrine neoplasm llljnojs <Northwestern Memorial Hospital) - Solid pscudopapillary tumor of pancreas Ulinois. OBls Brook - Solid pscudopapillaJY tumor (G-1' tumor) Indiana CHowaa! Community Hospital) - Cystic and papillary neoplasm l,oujsiana G.oul!lano Sunc Univcrsitv HCA]Jh Science Center) - Solid cystic pscudopapillary tumor of pancreas Morvll!ld Uobns Hookins Hospital) - Solid and cystic pscudopapillary (Hamoudi) tumor (I); Solid-pseudopapi!lary tumor (I) Marylond INP!jona! NAval M<djca! Center) - Solid pscudopapillary tumor Memcbu-..us CBcdcshirc; Medical Center! - Solid cystic pscudopapillary twoo< Massaohu-setts CNcw Enol and Medical Ceot«l - Solid pscudopJ!pillary tumor Michigan 1St. Joseph Mercy Hospital) - Solid-cystic pscudopapil!ary tumor Minncm - Solid and cySiic pseudopapillary tumor Minnesom IFAjryigw Southdaie Hosoi1all - Solid and papillary epithelial neoplasm New Mexjeo CUnjyer:;ity of New Mexico) - Solid pseudopapillary tumor New Yorls CN!!.SSfty !Jnjvcrsity Medical Center) - Solid pscudopapillary tumor New Xor!s (Stony Brook Unjversjty Hosnital Resident•) - Solid pscudopapillary tumor New york CWcstcbcstcrModisal Center) - Solid pscudopapillary tumor of pancreas North Corol!nn CMpuntain Arcu Pathology) - Solid pseudopapillnry tumor (4) Ohio (McCul!ough·l·lyde Memorial Hosoital) - Islet ceiVneuroendocrlnc tumor Ohio CM<dical College orOhjol - Solid pseudopapillary tumor Penn<yi\'Mio IAI!sohsny General Hospital) - Neuroendocrine carcinoma PC!l!lSJII\'MjA (Conemaugh Memorial Medical Center) - Solid cystic papillary epithelial neoplasm Penn!iliiVMi• COmssl Unjvqsjty College ofMedicincl - Solid cystic papillary epithelial tumor Pennsylvl!liA ll.ehjeh \'rulcy Hospjlll!\ - Solid pseudopapillary tumor Pcnn<YIVMi• (M .. ee Women's Hosoitall - Solid pscudopapillary tumor PcnnsyiYI!lia fMJ. Njuany Me!lica! Center> - Solid-pcudopapillary tumor. p&DCr<aS PennsyiYI!li& CPcnnsylyanja Hospjtall - Solid pscudopapillarytumor Iexa'!, bubbodc - Ncuroaxlocrine CATeinoma Tc."<8S f'Propath Assoc;iales.) - Carcinoid of pancreas (2) Texas IScon & Wbil• Memorial Hospital) - Solid pscudopapillary carcinoma Washinoton. Vancouysr - Solid and papiilary epithelial carcinoma

lW!e;st~Y~j~rg~j~nl~a;(Q~n:~en~b1r~ier~V~al!lcy;M~s;d!ical~jCten~l~erl - Solid pseudopaplllary tumor - Carcinoid tumor - Solid pseudopapillary tumour - Solid pseudopapillnry tumor

tumor of the panCTCas (l'l'llntz tumor)

~:5~~~5~~~~=~J pseudopapillary tumor cySiic-papillary epithelial neoplasm, pancreas - Solid pscudopapillary tumor

I !lily, Naples - Solid pscudopapillaJY tumor Netl!erlands, Am.<tca!Am - Solid and pscudopapillary epithelial neoplasm Pucno Rico O!njycrsjty of Puerto Riool - Solid.qstie pseudopcpillary tumor ~ - Solid Md cystic papillary tumour of pancreas

CITR, Fcbrullt)' lOOS "Minutes" (Subscription A) 13

Case 8 - .Diagnosis:

Solid pseudopapillary tumor, pancreas T-59000, M-80001 .Oin:ctor's note: Case'''"" originally mis-diagnosed as pancreatic endocrine neoplasm. dn:

Case 8 -References: l'elosi 0 , et ol. Solid and Cystic Papillary Neoplasm of the Pancreas: a Clinico-Cycopalhologic and Immunocycochemical Study of

Five New Cases DiagJIOSCd by FNA Cytology and a Review of !be Literature. Dlagn Cytopolhol 233-46, 199S de Ia Rosa Cl, et al. Solid and Papillary Tumor oflhe Pancreas: UllniSU'Uc:tural Obscmuions on Two ConltBSting Ca.<es. Ul/raslruCI

Palhol. 439-47, 1997. Kashima K, Cl al. Cytologic Feaiures of Solid and Cysllc Tumor of tho Pancreas. A cia Cylol, 443-9, 1997. Heitz PU. Kapper M, Polak JM, ct aJ. Pancrcalic Endocrine Tumou .... Immunocytochemical Analysis. Hum Palho/ 1981;

13(3):263-271.

Case No. 9, Accession No. 29499

Alameda CAI!l!l!eda Cougty Medica! Center> - Myxoid neoplasm of low malignant potential Baldwin Parll £Kaiser Pcnnanentel - ln<ramuscular myxoma (3) Glendale • Intramuscular myxoma Irvine Nnlvcrsity ofCnlifomial - Low grade fibromyxoid sarcoma vs. myxoma laguna !LAguna Pe.!ho!ow Medical G!OUp) - Myxoma Lorna Linc!a !/ojversity Mcdjcal Center Residents) - Intramuscular myxoma Lon& Bea!:b (lakewood Rcsjonal Medjcal Center) • IOlramuscular myxoma (7} Michigan !Oakwood Hospital) • Myxoma Monterey Pat!< £0arfjeld Medical Centcrl - Intramuscular myxoma Monterey Pwk <Monterey Peninsula Pathologists) - Intramuscular myxoma Oakland CKojsq PqmMgUel - Intramuscular myxoma Oranse !Ooose County Mc!lical Group) - Intramuscular myxoma Sacnuncmo <University of California Day is\ - -Intramuscular myxoma San Diegg <Nayal MediC!ll Center) - lntmmuscular myxoma San Franciwo ISan Fraocjsco General Hospital) - Low grade fibromyxoid sarcom Santa Rosa IS8!Jta Rosa Mqnorial HosnjWl - Intramuscular myxoma Ventura - Intramuscular myxoma Arizona CMarvyale Medical Center) • Spindle cell liposarcoma Colomdo. Eyenzrecn - Intramuscular myxoma

February 2005

florida IBPntist Hospital\ · lntrarnuscular myxoma vs. low grade fibromyxoid sarcoma ( I); Myxoma (3}: lntnunuseular myxoma ( I) florida !Munroe Medical Center) - Myxoma Florida, Tallahassee • Myxoma Florida !Winter Haven Hosnitall - Intramuscular myxoma Illinois, Burr Rldoc - Intramuscular myxoma Illinois <Northwestern Memorial HospjtpD - lntramuscuJar myxoma Illinois, Oak Brook • Intramuscular myxoma Indiana <Howard Communjtv Homitall · Intramuscular myxoma Louisiana <Louisiana State University HcaJth Science Center> - JnnmuS<:ular myxoma Marvland Uohns Hopkins Hosnital) - Intramuscular myxoma (2) Maryland CNationaj Naval Medjsal Center> · lntrarnuscular myxoma MassachUSJS Q3rlssbin: Mc!lical Ccnlcrl - lntrarnu:~CUiar myxoma Massacbuseus <New England Medical Center) - Low pde myxoid neoplasm Michigan lSt Josenh Mercv Hosnitall - Myxoma Minnesota - Myxoma MinnesoiA (fairview Sou)bda!e Hospil!lll - Intramuscular mJXoma New Mexjco CUniversitv of New Mexicol - Myxoma New York <Nassau Univqsitv Medica! Center) • l.ntramuscular myxoma New York !Stony Brook Unjvcrsity Ho~ohal ResideoJS) • Low grade myxoid ncopl115111 with recurrent potential New Ymk £Westchester Medical Center! • Intramuscular myxoma Nonh Cnrol!na<Mountarn Area Pathology) - Intramuscular myxoma (4) Ohio !McCul!oug!J-Hy<le Memorial Hospjtall - Myxoma Ohio (Mcc!ica! College ofQhio\ - lotRmuscular myxoma Pennsvlvania !Allegheny General HospiU!ll - Intramuscular myxoma

14 ClTR, Fcbrulll)l 2005 "Minutes" (Subscription A)

Pennsylvania fConem!!lJ!!h Memorial Medical Center\ - Angiomyxoma Pennsylvania (Drexel Univecsitv College of Medicine\ - Metastatic malignant melanoma Pennsylvania (Lehigh Valley Hospitllll - Intramuscular myxoma 'Pennsylvania {Magee Women's Hospital) - Myxoma Ponosylvania (Mt. Njttany Medical Center\ • Nodular fasciiris, intramuscular type, !high Pennsylvania f'Pennsvlvania Hospital) - Intramuscular myxoma Texa5. Lubbock • Myxoma Texas (Propalh Assocjatesl - Myxosarcoma ( 1 ); Intrarouscular myxoma ( 1) Texas (Scott & White Memorial Hosoita)l - lntramusuclar myxoma Washington. Vancouver .. Intramuscular myxoma West yjrginja Wrnenbrier Valley Medical Center\ - Intramuscular myxoma Wisconsin ffielHo Hospital> - Fibromatosis Australia <North Queensland Pathology\ - Intramuscular Austntlia fRoW Pdnce Alfred Rospitllll - Cellular myxoma Brazil {ONlFESIEPMl - Low grade myxoid neoplasm with recurrence potential Canada {Foothills Medical Center\ - Intramuscular myxoma Cana<la IWoo<lstogk General Hospital) - Intramuscular myxoma, thigb Hong Kong <Hong Kong Bamist Hosnitall .. Intramuscular myxoma ltalv. Nanles - lntnlmuscular myxoma • Net!Jerlan<IS. Amsterdam - Intrarouscular myxoma Puerto Rico <UniversitY of Puerto Rico) - Myxoma Qatar - lntranluscular myxoma·

Case 9 - Diagnosis:

Intramus~ular myxoma, thigb T-Y9100, M-88400 DireC(()r's note: Note the cireumscdptioo, the paucity ofvessels, !he lack of a plexiform capillary pattern, the lack of lipoblasts, and ihe tack of pleomorphism. drc

Case 9 -References: van Roggen W, McMenamin ME and Fletcher CD. Cellular Myxoma of Soft Tissue. A Clinicopathological Study of38 Cases

Confirming Indolent Clinical Behaviour. Nistopatlw/2001; 39(3):287-297. Prado MA, Miro RL, Leal IM, etal Intramuscular Myxoma Differential Diagnosis and Review of the Literature. Orthopedics

2002; 25(11):1297"1299. Catroppo W, Ole.<ni.cky L, Ringer P, ot at. Jntramuscutac Low-Grade Myxoid Neoplasm witb Recurrent Potential (Cellular Myxoma)

ofthe Lo\yer Extremity. Case Report with Cytobistologic Correlation and Review of the Literature. Diagn Cytopatho/2002; · 26{5):30 1"305.

Murphey MD, McRae GA., Panburg-Smith JC, et at. Imaging of Soft-Tissue Myxoma with Emphasis on CT and MR and ComparisOn of Radiologic and Pathologic Finding:;. Radiology 2002; 225(1):215-224.

Case No. 10, Accession No. 29611 February 2005

Alameda (Alameda County Medical Ceoterl - CelluJar schwannoma Baldwin Park fKalser Pennonentel - Spindle cell carcinoma (leiomyosarcoma) (t); leiomyosarcoma metastatic to a lymph node ( I);

Leiomyosarcoma, low grade ( I) Glendale - Scbwonooma Irvine IUni vcrsitv of Ca!ifomjal. - Cellular schwannoma l.aJ!!!!)a (Laguna Pathology Medical Group\ - Leiomyosarcoma Lorna Linda Universitv Medical Center Residents) - Fibromyoid !31COma (low grade) Long Beach (Lakewood Regional Medjca! Center\ • Schwannoma (7) Michigan (Qal.:wood Jfospitall - HistioC)1ic reaction, possibly malacoplakia Monl¢rey Park !Garfield Medical Center) - Atypical. schwannoma Montcrcy .Park <Monterey Peninsula pathologists> - Leiomyoma vs. low grade leiomyosarcoma Oakland CKaiser Pcrmancntcl - Schwannoma Orange <Orange County Medical Group) - Schwannoma Sacramento fUniversitv ofCaljfomia Davis) · Schwannoroa Sao Diego !Naval Medical Centerl - Smooth muscle tumor of uncertain malignant poteotial/schwonooma Sao Francisco <San Francisco Generat Hospitlll\ - Schwannoma Santi! Rosa !Santa Rosa Memorial Hospital} - Benign nerve sheath tumor (schwaonoma) {I); Schwannoma (neurilemmoma) (I);

Schwannoma (I}

crrR. febnuuy 2005 "Minutes" (Subsctiption A) IS

YJ;njym - Low 8f0de fibromyxoid sarcoma Arizona IMarxvale Medicul Center) - Dedifferentiated liposarcoma Colorad9. Eycrmcn - Sctlwannoma Florida lBoptiS! Ho:rnital) - Fibrous bistiOC)toma of deep soft tissue ( I); Malignant fibrous histiOC)toma (2); Favor sehwannoma,

would do SIOO (I); Schwannoma (I) florida <Munroe Mc!lical Center) - Sctlwannoma florida. Tallohmee - Scltwannoma florida !WJOJq Haven Ho:rniWl - Neurofibroma Illinois, Burr Ridae - MPNSI, wc!l-difl'erentialed Illinois !Nonhwescm Memorial Hosnitall - Scbwannoma Illinois OAk Brook • Schwannoma Indiana Oiowwd Community Hospi!31l • Neurilemmoma Louisiona O.oulsjnoa Suuc University Health Science Center) .. Neurilemmoma Mwy!WJd (}ohM Hopkins Homital\ - Schwannoma (I); Schwannoma vs. GIST (I} Mwy!and (National Naval Medical Center) - Low gmdc sarcoma, favor leiomyosarcoma M8Ssachus ns ffierksh!re Medical Center) • Fibrosarcoma, low 8f0de Ma..sachuseUS !New En•land Medical Center! - Musculoaponeurotic fibroma Mjcbjuo CSt. JosePh Mercy Hospi1an · Scbwannoma MiMesoln - Schwannoma Minneso!A !fairview Solllhda!e Hosoitall - Nerve sheath tumor favor neurofibroma New Mgjco CUnjversity ofNew Mexico) .. Leiomyoma New York, <Namu Uojversjw Medical Center) • Scbwannoma New Yod< !Smnv Proo!c. Univcrsitv HQSPital Reside!llsl - Scltwannoma New York CWes!cbc:stcr Medical Center) - Solitary fibrous tumor Noah CatpliM {MOW!taln Area Pathology) - Low grade spindle cx:llwmor (I); lnfi8JIIlll3lO<y myolibroblostic tumor (2); Solitary

fibrous tumor vs. inOammatory myofibrobi8Siie tumor (I) Ohio CMcCullou!!h-Hyde Memorial Hosojta!l - Fibrous histiocytoma Ohio !Medical Co!!eoe ofOhiol - Sebwannoma Pennsylyanja IAI!eMrov Geneml Hospital) - Spindle ex:!! sarcoma Pennsylyanlo !Cooemough Memorial Medical Center) - Fibrohistiocytoma Penn~lvanio <Drexel tlniversitv College of Medicine) p Schwan noma l'cnnsvlvonin (lehigh Valley Hosoitall - Scbwannoma PcnnsylyMia IMM•• Women's Hospital) - Schwnonomo Penpsylywljn CM,. Niuany Medical Center> • lnOnounutury myoflbroblnstic tumor, retroperitoncum PeMsylyWJja £Pennsylvania Hospital) - Retroperitonealleiomyotna ~ - Neurilemmoma Texas fProll3tb M;oc;!atesl - Rctroperitoocul librosarooma Texas !Sco!! & White Memorial Hospital> - Solitary fibrous tumor Wa.s!Jingtoo. Vancouver - GIST vs. leiomyoma vs. low gmde fibrosarcoma West Yirajnja !Gn.'!:nbder Valley Medical Centct) - Schwan noma

- Schwannoma - Leiomyoma or unccrtlin malignant potential - Schwanooma

- Dedifferentiotcd liposarcoma. retropcritoneum - Cellular schwannoma

lla!y. Naolcs • loiJlmuSCUiar myxoma NcthedWJds. Amsterdam - Liposarcoma of the retropcriconcum rueno Rico OJnJyer;sity gfPuqto Rico) .. Lipos:arcoma Oatat • Ocn!gn Spindle cell tumour, neurilemmomllisoliUll)' fibrous tumour 10 be considered

Case 1.0- J)lagnosis:

Cellu lar schwannomo, retroperitoneum T-Y 4600, M-95600 Director's note: Note mildly increased cellularity without atypia. the lack of mitotic figures. the laac of dense collagen buodlcs and vague attempts (but real) a1 p81isading. drc

Case 10 - References: HettiB£¥hchi JA, Flnkel.stein MP, Schwanz AM, ct aL Bcoian Rl:uopcritoneal Sctlwannoma Presenting as a Giant Adrenal Tumor.

Uro/ lnJ 2003; 71(2):231·232.

t6 CT!R. Februlll)' 2005 "Minutes" (Sub..Option A)

Yano S. Hida K, Scki T, et al. Surgical Trea~meru ofRwopcritoncel PTesacral Large Scbwannoma by the Anterior Transabdominal Approach. Two Cases Report. No Shinlei Gel:a 2003; 31(1):795-800. (Japanese)

Okada N, Hirooka Y, ltoh A, ct al. Retroperitoneal Neurilemoma Oi>I8Jlosed by EUS..(luided FNA. GastrinJest t:ndosc2003; s 7(6):790-792.

Dcscazenud A, Coggia M, 13ourriez A, ct nl. Lnpnroscopic Resection of a Retroperitoneal Scltwnnnoma. Surg Endosc 2003; 17(3):520.

Tong RS, Collier N and Kaye AH. Chronic Sciaticn Secondary to Retroperitoneal Pelvic Schwannoma. J Clin Neurosci 2003; IO(I ):IOIH II.

C'l"rR, Februwy 2005 "Minutes" (Sul»cription A) 17