CALIFORNIA TUMOR TISSUE REGISTRY

"LUNG AND MEDIASTINAL PATHOLOGY"

Study Cases, Subscription A

October 2000

California Tumor Tissue Registry do: Department of l'atbology and Human Anatomy

!Alma Linda Universily School of Medicine 11021 Campus Avenue, AH 335 Lorna Linda. California 92350

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

E-mail: £!!!@linklinc.cont

Target audience: Practicing pathologists and pathology resideniS.

Goal: To acquaint the participant with the nisrologic f""tures of a variety of benign and

malignant neoplasms and rumor-like conditions.

Ob!eetlves: 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.

Educational methods and media: Review of representative glass slides 'vith associated biSiories. Feedback on consensus diagnoses from participating pathologiSIS. l.isting of selected references from dJeJDedicalliterature.

Principal faculty: Weldon K. Bullock, MD Donald R. Olase, MD

CME Credit: Lorna Linda University School of Medicine designates this continuing medical

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

CME credit is o.frered for lhe subscription year only.

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

Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians.

Contributor: Charles I. Goldsmith, M.D. Case No. 1 - October 2000 Santa Monica, CA

Tissue from: Left pleura Accession #28892

Clinical Abstract: While being evaluated for pneumonia, this 56-year-old man was noted to have a pleural-based

mass on the left side. One year earlier a chest x-ray had been normal. A 6.5 em mass was resected along with attached parietal pleura. During routine follow-up eight years later, a CT scan revealed a Tecurrent disease in the form of multiple pleural nodules. These were resected.

Gross Pathology: An en bloc resection of ribs and soft tissue included three tumor nodules up to 2.5 em in

greatest diameter.

SPECIAL STUDIES: CD34 Vimentin CD31 Keratin SIOO Actin

moderate to strongly positive strongly positive weakly positive negative negative negative

Contributor: Paul Meyer, M.D. Los Angeles, CA

Tissue from: Pleura

Clinical Abstract:

Case No. 2 - October 2000

Accession #26863

After working for 40 years as a Longshoreman, with numerous exposures to asbestos, this 68-year-old man presented with a two week history of difficulty breathing. Following biopsy, be was sent home with oxygen. After a second attack of shortness of breath, he was re-admitted and expired one week later. An autopsy was performed.

Gross Pathology: Autopsy findings included a tumor involving mediastinum, pericardium and left pleura along

with multiple pleural plaques on the left side.

Contributor: K. Greg Peterson, M.D. Case No. 3 - October 2000 Sioux Falls, SD

Tissue from : Medias ti.num Accession #28905

Clinical Abstract: Following a one-year history of left shoulder pain, this 11-year-old girl was found to have no

breath sounds on her left side. ACT sean showed a left sided mass with calcifications. At surgery, a left sided mediastinal mass was found compressing the left lung. The tumor had ruptured and caused a local reaction making the resection difficult due to adhesions.

Gross Pathology: A 730 gram shaggy but encapsulated~ was 14.5 x I 0 x 9.5 em. The cut surface showed

variegated, multicystic fibroadipose tissue with focal calcification and larger cysts containing grumous yellow-tan material.

Contributor: Pamela Boswell, M.D. Case No. 4 - October 2000 Sa.n Diego, CA

Tissue from : Mediastinum Accession #28751

Clinical Abstract: This 33-year-old female was found to have a large anterior mediastinal mass.

Gross Pathology: The I 0.0 x 2.0 x 1.0 em fatty specimen included a 5.0 x 5.0 x 5.0 em mass.

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

Tissue from: Right lung

Clinical Abstract:

Case No. 5 - October 2000

Accession #28725

A lobectomy was performed on this 70-year-old male with a right upper lobe mass.

Gross Pathology: The 224 gram lobe contained a 5.1 x 4.1 x 4.0 em firm, yellow mass within the largest

bronchus. The mass extended peripherally to the pleura.

SPECIAL STUDIES: Chromogranin 1-2+ NSE 4+ CAM5.2 4+

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

Tissue from: Right lung

Clinical Abstract:

Case No. 6 - October 2000

Accession #28874

After a reported 10 pound weight loss, this 75-year-old Caucasian male was found to have a ~.5 em cavitary lesion in his right middle lobe. He had a long history of chronic obstructive pulmonary disease associated with a 60 pack-year smoking history.

Gross Pathology: The I I 0 gram right upper lobe contained a 5.0 x 5.0 x 3.4 em white-tan nodule which was

located 5 em from the bronchial margin and extended to the superior and inferior pleural surface.

Contributor: Philip Robinson, M.D. Case No. 7 - October 2000 Boynton Beach, FL

Tissue from: Right lung Accession #28701

Clinical Abstract: An 80-year-old male presented with a nodule in the middle lobe of his right lung.

Gross Pathology: The II 0 gram lobe oflung was 12.2 x 9.2 x 2.6 em and had a 2.0 x 1.8 x 2.6 em gray nodule

which infiltrated through the visceral pleura.

Contributor: Joseph Carberry, M.D. Case No. 8 - October 2000 Los Angeles, CA

Tissue from: Right lung Accession #26198

Clinical Abstract: During workup for dyspnea, this 59-year-old male was found to have a pleural effusion on the

right with an underlying tumor mass on the diaphragm.

Gross Pathology: The resected right lobe oflung with attached portion of diaphragm was 2200 grams and 20.0 x

16.0 x 12.0 em. Tt contained a 15 x 12 x 12 em gritty white tumor with areas of hemorrhage and softening.

SPECiAL STUDIES (outside facility): Keratin SlOO CEA EMA NSE Desmin Virnentin Actin

negative negative negative negative negative negative strongly positive focally positive

Contributor: Octavio.Armas, M.D. Case No. 9 - October 2000 LaMesa,CA

Tissue from: Left lung Accession #28921

Clinical Abstract: For two to three weeks this 72-year-old Caucasian female experienced cough and chest pain. A

chest x-ray revealed a large left lung mass.

Gross Pathology: Within the parenchyma of the 20 x 18 x 12 em left lower lobe was a 12.0 x 11.0 em globoid,

necrotic tumor mass. ·

SPECIAL STUDIES: Cytokeratin cocktail Vimentin Chromograoin Des min

Contributor. Pamela Boswell, M.D. San Diego, CA

Tissue from: Left lung

Clinical Abstract:

positive positive negative negative

Case No. 10 - October 2000

Accession #28877

After experiencing fatigue for six months, this 64-year-old female was found to have a left lower lobe mass.

Gross Pathology: The 17.0 x 13.0 x 3.5 em lobe oflung contained a 3.4 x. 2.5 x 1.8 em spongy, hemorrhagic,

mottled gray-tan tumor.

CALIFORNIA TUMOR TISSUE REGISTRY

LUNG AND MEDIASTINAL PATHOLOGY

Minutes- Subscription A

October 2000

SUGGESTED READING (General Topics from Recent Lllnaturr):

Association Between Medications TI1at Relax the Lower Esophagral Sphincter and Risk for Esophageal Adenocarcinoma. Lagergren J, Bergstrom R. Hans-Oiov A, and Nyren 0. Annals of /merna/ Medicine 2000; 133(3): 165- 175.

Mandatory Second Opinion Surgical Pathology at a Large Referral Hospital. Kranz JD. Westrn WH. and Epstein Jl. Cancer 1 999~ 86(11):2198-2220.

Embryonal ~Botryoid" Rhadomyosarcoma of the Lruynx. A Clinicopathologic and lmmWlohistocbemical S!Udy of Two Cases. L.ibera DO, Falconicri G and Zanella M. Annals of Diagnostic Pathology 1999; 3(6):341-349.

"Vinual Microscopy" and the lnlcntet as Telepathology Consultation Tools. Diagnostic Accumcy in Evaluating Melanocytic Skin Lesions. The Am J of Dermatopathol 1999; 21(6):525-531.

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

Lorna Linda University School of Medicine 11021 Campus Avenue, AH 335 Lorna Linda, California 92350

(909) 558-4788 FAX: (909) 558-0188

E-mail: cnr't1 hnklinc com Case o f' the M<llllh: www.llu.edu/llu/cnr/cotm

Web Page: www.ctir.org

Case No. I, Accession No. 28892

L!.UMC Pntholoay Rcsisknts • Solitaty fibrous tumor (3 mali@IWll. 2 benign) Mounlflin View l EI camjno Parhologv Ornunl .. Solitary {ibrous lurnor Kh-ersisk · Mesocheliomu Oaklnnd CKai,.,rl • Solitary fibrous tumor (4) Sebast0001 IPIIIholo•v S.:rvioesl • Solitary librous turnor of pleura Montro;y CCommunjtr l·lospjt.al o(Momcrev PenjmuJal - Mesothelioma Bakersfield - Hcmnngiopcricytoma Long Bead! - Malignam bcmangiop..-icytoma (7) Santa CI!U11 !Lorna Prie!Ul - Malign1Ult fibrous tumor of pleura (6) :is;nlll!l! CUgjlabl - Fibrous tumor of pleura (2) S8J)ta Ro<a - Solitary fibrous tumor (2) Sucrameoto Q JC Duvjs Health Svstem<l • Solitary fibrous tumor of pleura HI!\'Wllrdlfmnom - Epilhelioid ongio<arooma (4): Benign fibrous rumor ofpiCilra ( I) Nevada (Reno) • Soli wry fibrous tumor Wisoonsjn <Meritcr) - Mnlignant solitary fibrous tumor of the pleura witl1 recurrence Looisiana O.ouisjana State Unhqsiw Medical Center> - HemangiopcriC)1oma

Oetober 2000

Illinois <Puoagc PruhoiQ&v Asso<;iutcsl • Locnli;o;d fibrous tumor of the pleU11l (cellular, likely malignMt) Mjcru!!jlp IDakwoocj Hospj!all • Malignant solitwy fibrous tumor lndjana lfon Wuvne) • Solitary fibrous tumor. pleum Keprucl.:y (\Jnivejcyity of LoWsvme Resjskmts) - Mali~ulnt solhary fibrous tumor florida IMO!!!OC Rcgiooal Medic:ol Cmql - Solitary fibrous rumor J'lorjda (Wjnter Haven) - MaliJ.11111nt mesothelimnn (I): Mnlignnnt fibruus mesothelioma ( 1); Mnlignant mesothelioma (saroomatoid

type) (I) Florjdu CfallabAA."'el • Solilary flbrotJS tumor (4) North Camlina ( WNC PothoiMy Group) • Solitury tib1'0us tumor (3) MIID'Iaod <Woos!hinel • Malignllllt solitary fibrous rumor (2) Mqryland ( l Jniver;qity of Ma.rvlood) - Mnlignru11 solitary fibrous tumor New Jc:rn;v (Overlook l lsl!lpital) • Fibrous tumor of plc'Uru (recurrent) (3); l'ibrous·tumor of low malignunt pOtential (I) l'cnnwlvunia <Conc:mauob Medical Cemsr Resjd<.'fl!-<l • Solitary fibrous tumor Pconsvl\•anla <Lehigh Vllllev liospitall • Solitary fibrous tumor of pleura NJ;w York <SUNY Stonv Hrook Unhmilv HO<Qjtal R<Sidcntsl • Hemangioendothelioma (10) New York !Beth Israel Medical Center Rcsidenq) - Solitary fibrous tumor New York (New Hyde l'arkl • Solitary fibrous tumor Mnssach~>wns fPerkshjn: Medicol Center> · Solitary fibrous tumor Massachusetts CNew J.ogtund Medical Center) - Solitary JibtO\IS turnor of p letlr'd

Canad;l Cfoolhil!s I lpspjlol, Call!l!O'l • Solitaty fibrous tumor Jopan <Kvmol • Soliw y librou$ tumor (2); Malignant mcsotheliomn(l ) Japan Kyrashikj CKawaSi!);i Medical Sc!tool Hu:spl!all • Soliwry fibrous tumor (4) SjngaQOrc - Soli wry fibrous tumor Snudj Arubja fKjng Kh!llid Uni ver~itv l losnitaD · Mali~1an1 solitary fibrous rumor of the pleurd (4)~ Kuposi"s sarcon1a ( 1)

DIAGNOSIS: Malignant solitary fibrous tumor, pleura

T -29000, M-905 10

CONSULTATION: (AFIP) "Malignant solitary fibrous lumor."

REFERENCES: llanau CA and Mieninen M. Solitary Fibrous Tumor. ll islological ond lmmunohistOohcmical Spo:cu11m of Rcnign ruxl Mulignant

Varillnts PrCllenting at DiOi:r.-nt Sites. Hum Pathol 1995: 26(4):44~9. l lliSega .. ut. Hirose r, Scki K. ct ul. Solilllry Fibrous TUI\lOr of the Sot\ 'li~<ue. An Immunohistochemical and lJltrnstructurul Study .

• 4mJC/i" Patho/1996: 106(3):325-33 I. Woynand H. Collard P and Galont C. Cytopalhological F<:>turcs ofSolitllt) FibrotLS Tumor of the Pleuru. A Swdy of5 Cuscs.

Diagn Cyropatho/1998: 18(2):1 18·124. 1\pple SK. Nleb.:111 RK and Hirschowit7 SL. Fine Needle Aspirutioo Biopsy of Solitary Fibrous Tumor of the Pleura. A Repo11 or

Two Cases with" Discussion ufDingnostic Pitfalls. Acta (vto/ 1997; 41(5):1528-1533.

2 ClTR, Octobc< 2000 "Minut<> .. (S.bo<rtptloo AI

Case No. 2, AtteSSion No. 2~863 Oetober 2000

!.!.liMC Pathology Residen!S . Mali8Jl311t mesott.!lioma (biplulsic) Moumnin View CEI C..amii'IO P.uhology Grouol · Mesothelioma. cpithtliul nnd desmoplastic type Rjycr~jde . Mesothelioma Quk!uml (Kaiser) · Mesothelioma. epithelioid t4)

Selwropol <Pathology $eryiocs) · Mulig:nunt mesothelioma MoO! ere\' <Commtmity HospjutJ qf Monterey l'cnir~llla - Mesot.heliornu Bnkcrslield • Mesothelioma. biphasic J..png Beach • Malignant mosothelic>rna (7) Sanm tl!l!a !!.oma Priellll • Mali(!l1ant mcsotbclioma (6) Vemym <Unilabl • Biphasic malipnt mcsodlclioma (2) San !A Rosa • Malignant mesothelioma ( oonfinn with !POX) (I): Mali(!l1ant mesothelioma vs. adenocardnoma, need !POX

fii'qnmcnro CUC l)a\fis Hcahh Systems) · Pa\•or mesotheliom~ amnot exclude adenocarcinoma HuywgrsVFrsmonr • Mali(!l1ant mesothelioma (S) Neygdil (Reno> - Mesolhelioma. biphosic Wjscnns!n{Mclj!$rl - f)itfuse maligntU1l ltlCSOihclioma, biphallio type invoh•ing rw ietal and visceral pleura with inva'1iOil of the

lung Louj:tkt!)Q. <l.ouisiana State UnivJ:.T!jity Medical Center) - Mesolhe1iomll, malignan1 llljnojs !!Jupage PO!hology AssociOIW • Diffuse malignant meso~1elioma (pleura) MicbiAAn !Oalm·ood Hospital) • MCSO!hc!ioma Indiana !fort \Vamel • Diffuse n01lipnt mesothelioma. pleura \\ith mixed sarcomaloid. desmoplastic.. epithelioid and tubulo

pattsms

Kcntudsy <Upjversitv oflouis\illc RsisJents) .. Malignant mesothelioma Florjd:J <Monroe Regional Medigll Ccmcr> - DiflUse mnligo..'lnl mesothelioma epithelial type !'!prj@ <Winter U<~•·enl · Mali(!l1ant epithelioid mesothelioma (3) Florldo.ITallaha"ee) · Molignnnt mc$othcliomu, spindled and epithelioid l)'pC

N!lnh Cam!inufWNC Pathology Qrounl • MHiignant mesothelioma, bipha;ic (3) MUQ•Iond !Woodbine) • Mali!!Jlant rncsuthelioma (2) Muo•lund t lJni\•crsiiY of Mwylnnd) .. Molignant mesothelioma, mixed N!;w JqscyiO••erlook Hosoita!l • Malill"ant mesothelioma with focal psCitdosaroomatous features (4) l'ennn·l\11!lja !kehi!!h Vallev Hosojtall • Malignant mcsotbcliorna Psnm' boni3 <Conemaugh Medical CCP(et Re;;idems) - Malipnt mcsothdiom~ N!;w V!lfk !SUNY S10m Brook !JnhmiiY 1-!ospital Re.•idcnc•) • Mcwthelioma (10)

New York (Qeth Israel Medical Cc;nu;r Residents) - MaJignam mcsothclion1a Now York (New H\"de f'arkl - Muli,gl'Uun mcsotheUorna Mu&suchusc!!S (L1erk5hire Medical Center} .. Malignant meso!hc1iorna Mns(Qc:hu~ctt~ (New Englund Medjcu! Center> . Mesothelioma Canac!a (Foothills I-lospjtal Calsarvl • Mesothelioma JnpM !Kvotol - Mali(!l1ant mcs01hclioma (J) JllO!VIo Kl!!llshiki <KawaS!l);j M¢ieal Scbrol Hc>5pitali · Mali(!l1antmewt.hcliomo (~) Sjnya('!('!r( • Mesothelioma Snuslj Ambia <Kioe K.halid Uni'JtQitY llmpitall - MCSO(helioma

OIAGNOSIS: Ma lignant mesothelioma, pleura

T -29000, M-90503

REFERENCES: Walts AI~. Said JW wtd Kodllcr HP. ls lnunullOreactiviry for p53 Use1111 in Distinguishing Benign Crom Mu.lignont Effits ions'?

l.ocali:>-ation ofp53 Gene Product in Bc-nlgn Mesothelial and Adenocarcinoma Cells. Mcd Pmlto/ 1994: 7(~):462-46&. An3Dd /1. PrognOStic Faetors of Malignant MCSO!hclioma of the Pleura. Cancer 1994: 73(3):755. Cristlludo A. Vi>-aldi /\. Sc:nsalc:s G. •1 al. Molecular Biology Studies on Mesothelioma Tumor Samples. Preliminary lJata on H·ros.

p2 I and SV40. J £11Viron Pnrhol TmiCtJI Onco/1995: 14( 1):29-34.

CTTR. Ck1ober 2000 -Min1.1te;; .. (Subli<:rtp1ton A) J

Case No. 3, Accession No. 28905

Ll.lfMC Patholggy Residents - Mature teratoma Mountain View ft.:l Camino l)llthofooy Orouo> - Muturc ~ric teratoma Ri\eajdc - Teratoma. maaun: Onklood CKaiwrl - Marurc lctllloma (•I) Sehwuoool <Parhl)loav Servjces) - Hfunartoma Monterey (Q)mmunilv Hospital of MOQl£tey PeninSula) · Terntoma Ba!;mficld - M111ure rennom.. Loog Beach - Murure rermoma (7) Santa Clara ll&mn Pricral • Ex1ralobular sequcslt8lion (6) Vent!Q CUnilabl - Cysric teratoma (2)

Sanm Rosa • Teratoma (mlllure) (2) SacrurncnJt) (UC l)avis: Ht."Uith Svstcms) • Favor inlmature-tcn.nomu Haywardlfremoot - Mature teratomo (S) Nevpda (Rene> I - Mature tcr111oma Wisconsin fMcrjtsr) - Mature teratomn lp uisjrma 0-.00j~jMn State University Medical Center> - MatlU'C tcnl.lOnll\ !lljnojs <Dunoge Parbologv Amriotcsl - Marun: teratoma, 8"'de 0 (m<:diauinwn) Mjchhmn (()akwqod i'f<xmj!Qil - Hamartoma

Odober2000

lndjona (Fort Wavncl - E>:tralobular pulmonary sequestration. (I..) thor!IX - media>1ionl r..onc Kentucky CUnhmitvofLoyjsyille Rqjd;:ntsl • Bronchogenic c~'St EJorjd.' 1 Monroe Rc•ionnl Modjca! Ccntql - Benign teratoma Florida {Wimer Haven! - Benign (mmure) teraromn (3)

Florida !Tallaha•=J - Teratoma (4) Nooh Cwvljnn !WNC Patbg!ogy Group\ - Mature tctaiomo (3) MnrvJ j\Jid IWoodbjncl - Moturc teratoma ( 1}: Hamrmoma ( I) MfiO'lnnd CUnjvcrsityofMorylandl - MallJre teratoma New J<rsc'' !011:dook Hmnilall - Mnrurc temoma (4) Pcnnsy!yonia !!.&high Valley Hoopitnll - Bronchorulmonary sequcstmrion ( I): 8!'0nchogeoicc)~t (10 Pennsylvania <Conemaugh Medical Center) - 'fetaroma. mature New yort; !SUNY Stonv Brook Uni,mhy Hosojti!l Resident<! - Teratoma. m~ (10) Nc\o,' York tBccb Is rae! Medjcal Center Residents> - Hamartoma New York CNcw J Iyde Park) • Mature teratoma Mr"mtrfn.ascn., {)krkshin: Medical Cemer) - Congenital cystic acknomatoid malform(lllon vs. mature cystic tcrotoma Massachusett'i <New England Medical \gal - Tcr.uoma Canud!L(foothjlls !lo;mitnl. Calgary) .. Mature cyMic t<..·nuoma Jap;w !K \"0!2) - Muture C)~tic rerniomn (3) Ja!lj!ll. KU!llShikj !Kawmki Medical Scbool Ho5oitnll - Tc::n11oma. mann (4) Singanme - Mnture cystic tcrmoma Saudj Arabia <King Kbalid University l losnitaJ> · Mature cystic teratoma

OIACNOSIS: Mature cystic teratoma. mediastinum

T-Y2300. M-90800

RT;EERENCES; Robinson LA, Rik.kcrs I. E W'ld Dobson JR. Denign M<diastina! Tcraromn Masquc.rading as a Lurse MultiloClllutod Efll1Si01L A1u1

1"h<>oc Surg I 994: 58(2);545-548. Dehn<T LP. Gcm1 Cell ThmO<S of the Mediastinu111. Semin Dlagn PtJJINJI 1990; 7(4);266-284. Weidner N. Germ-Cell tumors of the Mediastinum. Semi11 Diagn Par hoi 1999; 16(1);42-SO. Verhacghe W, Mcys1nan M, No.ppcn M. ~t aL Benign Cystic 'reratoma. An Uncommon Cause of Anterior Mediastinal Mass. lktfl

Cii11 Belg (Belgium) 1995; 50(2); 126-129.

Case No. 4, Accession No. 2875 I October 2000

LLUMC Pathology Residents · !Jcnlsn th~mo•na (3): l .• ymphocyt~ predominant vs. mixed (2) Moumpjn View CE! Cnmjno Parhology Group) - 11t)'lnQmu Riverside · ll>ymoma QdklandfKajserl • Th)moma.l)mphoc)te prcdooiinant (4) SgbqsJO!Xll (f>mho!ogy Services! • Favor lh)moma. !)mplioe)te ricb · (need immunostains) Mcmterey(Commuuity Hospital ofMnmcrcy Peninsula) .. Thymoma, l}mphoc)1~: predominant Bllkendield · Lymphoc)1e predominllnt thymoma Long Bench • Thymoma (7) Santa Oarn C!.pma Prieta\ • Hodgkin'$ disease (6) \f<ntur3ll/nilab\ • L)mphoc}te predominant th)moma (2)

Santn Rosa • Th)moma vs l}mphoma, (confirm with !POX) (2) Sqcmmento IUC P'•vis Hea!!lJ Systems! • L)mphoc)'te predominant th>moma l ln>ward!FremoJl! • Lymphnc}te predominant tbymomu (3); M.ulignantlymphoma, small l>mphoc)tic, type (2) Nevada I Reno\ • Thymoma. l)mphoc.)1c predominant \Vjsoon.<in (Meritcr) • 1ltynloma, l)mpho<')te predominant with udjacent? ofin>·oluted th)mus Jl)and l.ooisiana floujsiaoa S!a!e Universitv Mc!lical Ce!l!er\ • Th)moma. mixed l)mphoepithelial Illinois !Duoogc Pathology Associates\ • Likdy molisnantl)mphoma. rult out low·grnde MALT -assoc:iated type (th>mus) Michigan IOJkwood HosojJall • Th)mO<nt• l)mp.hoc)'te predominant Indiana (fort Wuyuel • Th>mie Hodgkin's (so-<:allcd "Qtnnulomatous thymonw'' of Lanes?) KentuckY <lJnjvcrnjty<)rLoujsvj lle B~.¢.\ldcntsl - Thymomo Florida !Monroe Rni1:1nal Mcdicnl Ccoterl ~ Th)'moma florida /Wjnrq I IA•·cn) • L)mplioe)tic predominant tlt)moma (3) florida ITallahos!CC) • L)mphOC}tic thymoma North O.rolina IWNC Palhologv Grounl • Thymoma (3) M!U'l'land IWQQdbincl • Lymphoc)'te predominant thymoma (2) MW'\~und /UnjyersilyofMarvlandl • Lymphoc)1ic ihymo1nn New Jcr.;cy /Qvedook Hmoirall • Thymoma (2); L)mphocytic tb)momn (2) Pennsyhoania (Lcbjg)• Vallev Hn<pi!j!ll • Th)moma (I); L)mpboblastic l)lllphoma (I) Pennsvlvania CCongnwgh Medicll Ccmq Rs;ideru) · Th)moma New York (SUNY SIQ!!V Brook !lnivcrnity Hmpital &'llidcnL<l • Thymoma. lymphoc)te predomln:un (American classification) vs

lym11homo (prol>mphocytic ?) (I OJ Nc"' Ywk CBeth l::racl Medical Ccmer Jlgsidcntsl .. 1l1ymoma New York (New llvdc Park\ · Th)momo. cortical typo M3SSl'.chUS£t)slllq!;shirc Medical Center) • Th)"ltloma vs. ll-«11 th)mic lymphoma Massachusctt< IN<;w England Medico! C<!l!q\ • Th)mama. predominamly l)mphoe)tic Canada (foothills llrnmital Calgarv) • 'J'hyn1oma, encapsulated Ja)liln ! Kyoto\ • 1ltynloma, lyn1phooytic pr«lominrull (3) Jnpan Kurushikj /Knw;~sa!d Medical SchQSlll losnitall • Thymoma (4) Sinoa(!(lf< · Burkitt's l)mphorno Saudj Arabia (King KhaHd Unh•t-rsitv IIQSpilal) - 11l)1nm1a

DIAGNOSIS: Thymoma, lymphocyte predominant

1'· 98000, M-53850

REFERENCES: Walker AN. Mills SEand fecbner RE. lllymomas and llt)mic Carcinom:~>. &min Diogn Pat/1011990: 7(4):250.265. Koga K, Matsuno Y. lli<>l!l•chi M, et al. A Review <>1'79 Th)mmnas. Modificotion ol'Smging $)11em and Reappraisal of

Conventional Division into lnvnsivo Olld Non-Invasive Til)'llloma. Pnthollw 1995; 45(1):87·89. Cooper JD. CU11'Cn1 Therapy for Thymoma. Chest 1993; 103( 4 Suppi):334S-336~. Sustcr Sand Rosui J. Cystic Thymomas. A Clinioopnthologic Study ofTen Cases. Cancer 1992: Ci9(1):92·97.

CTTR. October 2000 .. M1nu1es"' (SubscrtpttOn A)

Cau No. S, Aeeession No. 28725

LLL JMC J•uthology Residents - L..nr,'\: cell n..:uroendt)Crine carcinoma Mauntain Vjcw IE! Camjno Patbolocy Group) - Atypical careinoid Rjyccsidc - Carcinoid Oakland (Kaiser) - Wcl!-d!H'cremiwcd neuroendocrine carcinoma (4) S.:bi!stQQOI C!'a!bologv Services) - At)'Pica! c:arcinold tumor Monterey (Community Ho.•mjtal of Monterey Peninsula) • NeumendO<.Tine carcinoma Bpl;ersticld • Alypica! carcinoid tumor L.oo• Beoch - Neurocndoerinc carcinoma (intennediate grade) (1) Spnta CJnru CLomn l'rieta) • Atypicn! carcinoid tumor (6) Venun (!Jujlabl • At~'Pical careinoid (2) Santa ROS!l • Neuroendocrine c:arcinoma (2) Sqcranlento Cl JC Dq\•js Hcalt!• Svste1nsl - Al)'pical cnrcinoid/neunx:aldocrine carcinomu Hgvwardlfmnonl • L.argc cel!llCU!'OCildocrine car<inoma (5) Nevada !Reno) - l.arge cell neuroendocrine carcinoma Wi<oonsip !Meriterl - Neuroendocrine carcinoma, !l11'(1e 2 (W)l'ical <'llrcinoid) louisjana !Louisiana Stmc Uni\·ersilv Medic;at Ccnrc:rl • Neuroendocrine carcinoma !lljnois !Dupagc Prubo!ogy 1\ssocjotc:;) - Atypical carcinoid tumor (lung) Mjcbi2M (Oa!,•wooc! HQSpito!l • Carcinomll. Iorge cell neuroendocrine lype !ndhma (Fort Wayne) - L'l!gC cell neuroendocrine can:iooma, lung (risht upper lobe)

Odober 2000

Kentucky C l Jnivcr$jtv of U)t!j;willst ltcsidemsl · Lnrg.c cell Cllreinoma with neuroendocrine femurcs Florida !Mgnroe Rclliona! Mcdjcal Ccmer\ • Anapl;utic carcinoid rumor Florida !Wjmer liayco) • Malignant carcinoid (neurocndoerine earcinoma) (2): Atypical careinoid (I) !'lorida !Tallnhassccl - Neuroendocrine eareinomil (4) North Cwlirm IWNC !'Juho!ogy Group) • Atypical eareinold (J) Mw-y!and fWooc!bjncl • At )'Pica! carcinoid (2) Morv!and runi>·ealty of Morv!nndl • Neuroendocrine carcinoma, grudc lll New Jersey {Ovqlook HospjtaD - L.argc cell neuroendocrine carcinoma (4) f,cnnsylvuniu 11-&hjnb ynllev J lo~mjtuU · Atypical carcinoid Ps:nrmivania <Com:maugh Medical Center Bcside!JI-S) · Atypical carcinoid vs. large cell ncuroelldocrine carcinoma New York !SUNY Stonv Brook Uojvc!lljll' l lospitlll Resident\) - Carcinoid tllmor. l)l'ica!. insular paatem {10) Nttw York l Beth 'lsmel Medjco! Ceptcr ResjdsnlS) - Carcinoid tumor New York !New H)'de Ml • Al)'Pica! careinoid MnssachustWtts CB£rkshire ML'<iical C<ntcr} - Atypicol carcinoid tumor Mpssachuscrts(New EnglnndMedical Centgr) - Large cell carcinoma with neurocndocl'ine di rrcrcntiation (I); Atypical cl\r~inoid

(2) Cnnada Cfwthills I lo:mitol. Calgary) · Large cell nt..'\lroendoaine carciooma JaP!!Il O<vmo) • Atypical careinoid ( 1); Lart~e cell neuroendocrine carcinoma (2) JJ)ml!!. Ku!ll,<hiki <Ka\111S-'\kj MediC!!! Schon! HOS!lj(lll - Neuroendoerine carcinoma. \1'011-difTemttiated (2): t\t)l'ical carcinoma ( 1 );

Small cell carcinoma ( l ) Sirwawr · Large ccJI neuroendocrine carcinoma Sgudi Ambia CKjnq Khalid University tlospj!al) - Atypica1 careinotd

DIAGNOSIS: Large cell neuroendocrine careinoma, lung

T-28000. M-80103

&15FERENCES: !Iammond ME and Sause WT. !..argc Cell Neuroendocrine Tumors of the Lung. Clinical Significance ond Hi$toputhotogjc

Definition. Cmrer !985: 56(7):1624-1629. Trovis WO.l.ionoilu R!. Tsokos MO. eta!. Neuroendocrine Tumoo;ofthc L.ung ,_;th Proposed Criteria lOr larv.,.Cel!

Neurcx:ndOLTinc Carcinoma. An Ultrastructural, lnuuunohistochcmical and Flow Cytometric Study of' 35 Ca'U!~. Am J Sttrg Patho/1991; 15(6):529-$53.

Kusai K, Kumeya T. Kawnkubo Y, ct a!. Pulmonary t~'lge Cell Corel noma Expressing Neuroendocrine Markers. The Morphologic.:ll. Biolog.icol. and Nc:urocndocrjne F~turcs of their Cell Lim.'S and Sllr')l:iC{-d CaM:s. Jpn .J Cam:t.~r R('.f l992; 83(9):1002-10!0.

Wick Mit Berg L.C and llcrtz MI. L.argc Cell Carcinoma of the Lung with Neurreodocrine Dirfc:remiation. II Comparison \\ith Large Cell ·'Undiftl:rentiuk-d"' Pulmonary Tumors. Am J Cli11 Patho/ 1992; 97(6):796·805.

6 CTTJl Oa6ber 2000 .. Minutes•· (Subscriptic~~tt A)

Case No. 6, Accession No. 28874 Octobe r 2000

LLUMC Pathology Residents - Poorly diiTerentiated squamous cell carcinoma Mountain View CEJ Camino Pathology Group) - Squamous cell carcinoma, basaloid t)tpe

Rjvs:rside - Mixed squamous and bronch-alveolar carcinoma QakiMd CKaise.r) - Squamous cell carcinoma (3); Squamous cell carcinoma (3); Basaloid squamous oell carcinoma ( I)

Seba.'!onol (Pathology Services) - Squamous cell carcinoma Mont<..Tev <Community Hospital ofMonlerey Penin:oula> - Squamous cell carcinoma Bakersfield - Squamous cell carcinoma Long Bcacb - Squamous cell carcinoma (7) Santa Clara (Lorna Prieta> - Squamous carcinoma (6)

Ventura (Unilabl - Well-<li!Teremiated squamous cell carcinoma (2) Santa Rosa - Squamous cell carcinoma (2)

fiacrnmemo fUC Davis Heallh Svstems) - Ba~aJoid squamous cell carcinomu Hal~'ard/Fremont - Squamous carci.noma (5) Nevada rRenol - Squamous (.X.!II carcinoma Wisconsin fMeritcr) - Basaloid squamous cell carcinoma Louisiana <Louisiana State Unjvs.rsjtv Medical Center) · Squamou:H:ell carcinoma with ba~aloid difterentiation l!ljnojs {[)upace l'01hologv Associ!lles) - !3asaloid squamotL< carcinoma (lung) Miehi£il!l (Oakwood Hospital) - Well-diiTerentiOled squamous cell carcinoma Indiana (Fort Wa\nel · Ba'ialoid squamous cell corcinoooa, rule out lung KeQJucl;v <University ofLouis\~tle Resjdeotc;) - Adenosquamous carcinoma Florida fMonroe Regional Medical Center) - Squamous ce:ll carcinoma Florida (Wimer Haven> · Adcnosquamous carcinoma (3) Florida CT!lJiahasscel - Squamous cell carcinoma with basaloid featUre< North Caro]jna CWN'C Pathology Group) - Basaloid squamou.< cell carcinoma (3)

Maryland (Woodbine) - Adenosquamous carcinoma (2)

Marvla.nd !UniversitY pf Maryland) - Ba.saloid squamoos cell carcinon1a N'ew Jcr.;cv (Overlook Hospjtal) - Squamous carcinoma, poorly-dilrerentiated (3); Adenosquamous (I) pennsylvania !Lehigh Valley Hospjmll - Squamous cell carcinoma Pennsvlvania <C'.onemaugh Medical Center Residents) - Basaloid squamous cell carcinoma New york (SUNY Stonv Brook llnjversjN H~nital) - Adcnosquamou.s carcinoma with ''basnloid features~ New York <Bcth Israel Medical Cemer Residell!S.) · BasiiQid squamous cell carcinoma New York (New Hvde Park) - Wcll-dit1¢rcntiated squamous carcinoma Massa.chusetts (Berkshire Mcdicnl Cemerl - Basatoid squamous cell carcinom·a Massac-husells fNew England Medical Center) - Squamous cell carcinoma with ba;.;aloid Rilturc.'i Canad~1 (Foothill:; l-lospital) • Mucocpidcnnoid carcinoma Japan !Kyot<>) - Squamous cell carcinoma (2) Japan Kurushiki (Kawosaki Medical School Hospital) - Squamous cell carcinoma(4) Sintm:pore - SquammJS ce.JI carcinoma with ucanthol}1ic and ctenr cell fearures Saudi Arabia (King Khalid University Hospital> • Basosquamous carcinoma

DIAGNOSIS: Sq uamous cell carcinoma, lung

T-28000, M-80703

REFERENCES: l)ejui· Thivolct F, Liagrc N. Chignol MC. el al. Deletion of Human Papi 11om a Virus DNA in SquamOU$ Bronchial Metaphll.sin and

Squamous Cell CarcinomitS of tho Lung by In-Situ ~lybridigz.atiori Using Biotinylaled Probes in .Paraffin-Embedded Sp<Cilli<:JlS. Hum l'atho/1990; 21:1 11-116.

Bennett WI'. Colby TV, Trill'is WD, ct aL p53 Protein Accumulates Fre<lll<ntly in Early lirooo:hial Neoplnsia. Canrer fie.< 1993: 53(20):4817-4822.

Carter D. Squamous Cell Carcinoma of the Lung. An lJpdme. &min Diagn Pmho/ 1985; 2(4):226-234. Khud.:r SA, Dayal HH, Mutgi AB, ct a!. Effect of Cig-dreuc Smoking on Major Histological Types of l ung C'anccdn Me~. Lung

Cancer (ireland) 1998: 22( 1):15-21.

ClTR, Oclobcr 2000 '·Minutes" (Subscrip~ ion A) 7

Case No. 7, Accession No. 28701

l.I.\JMC Pathology Rssjdems • Poor!)• ditfen.niated squamous cell carcinoma MountWn Vjew CEl Cwnino PAthology Group) • Adcnosquamous carcinoma Riycrsjde · Poorly differentiated adenocarcinoma with signcl ring cc:n feutun..-s Oakland !KWgrl - Mucoepidermoid cnrcinoma (3); Adcnosquamoos can:inoma (I) Scbo.<toool !l'n!hology Services! • Poorly differentiated corcinoma, non small cell Monterev£Community Hosnjud ofMnntcrey l'cnillSula> · Muoocpidcnuoid carcinoma Bakersfield . Poor!) diffi!tmiated adenocamnoma I.,Qng Beacb • Mucoepidermoid carcinoma (high grade) (7) Santa CIO!ll! Lorna 11dc't1l) · Mucoepidermoid CArcinoma (6) Vcn!!p !lJnjlabl • Squamous carcinoma wilh mucin production (2)

Octo~r2000

Sqrua Roou • Bronchogenic <'Urcinomn, mixed puttem ( l ); Undifferentiated carcinoma. possibly mixed {I) SllC!l!!!!en!O cue Davj' Heal! I! Svs!CUI$) • Poorly differ<ntiated squwnous cell carcinoma Havwardlfrcmont • Large cell oon-kcratinizing carcinoma (poorly differentill!ed adellOC:3l'Cinoma) {2); AdellOC:3l'Cinoma with signet

ring c.:lls (2); Mucocpidem,oid (I) Nc\:pda CRcno) • Adcnosquamous carcinoma Wj'i:OO(!sin CMcrit~r) · Adenosquamous cx:U c:erdnoma with vascular in"asjon invoh ing IWlg 1• \>"S. ~

l,ouisiana UA>uisiqno S1ate lJniycrsitv Medical Center) - Squamous a:Jl avcinoma lllioojs fDuouoe Pathology A<sociatesl • Mucoepidermoid can:inoma. high grade vs. ? lung Mjchisan ((};,],·wooc! Hospital! • Adenocarcincrna. solid \\ilb mucus fuundalion Indian• CFon Wayne) • Grade 2, mucoepidermoid carcinoma. right lung Kcntud:v OJnhersitv oC Loui!yj!!e Resjdent~) .. Large C\!ll enrcinomu. giant cell 1)'1'e florida fMomoe Regional Medical Cemer> • Adcnocan:inoma filorida <Winll.T Haven) - Adcn()S(funmous car..:inoma (3) !'lorida C!'!!llah!!SS!lel - Bronchoalveolor =cinoma North Caro!jna fWNC Patho!ggv Grounl · Muooepidermoid can:ioocna (2): High grade mucoepidermoid carcinoma Mwvland <Woodbine> - Mucoepidermoid curcinoma (I); i\dcnosquamous carcinomo (1) Moryland Cllni>-ersitvo(Man1andl · Non-small ocll carcinoma wi~l giant cells New Jersey !Oyerlools Hospilllll · Adcnosquamous carcinoma (2); Mucocpicknnoid can:inoma (2) l'ennsylvaoju CLehjoh Valley liospitnll • Non small cell carciooma ( I); Adenosquamous carcinoma (1) Pcnns,1wnja !Coosmaug!J Mcdjcal Csn!er Residents) · Acinar (tubular) adenocarcinoma ofbronchial glund New York CSVNY Swnv B!!J<!k UniV<:Qjtv Hospju!l Residents) · MctiiSiatie muc:o.'J)idcnnoid carcinoma •·s. adtttOSqlJaTilOU.'

curcinorna New York (Qe!h Israel Medical Centa Residents) - Malil1Jlant me:rothelioma New York CNcw Hyde Par!j) • Unditfcr<:ntiBied oon-~;mall c:arcinccna f.!\'or mucoepidcnnoid carcinoma (adeoosquamous

curcinomH) My.~sachus,;ns CBedishin: Medical eemcrl - Mucoepidermoid carcinoma M<J.SSachll<c!ls IN"'' Ensland Medical Cg,terl • Adenosquamous carcinoma {I); Poorly differentiated adenocarclooma (2) Conada (FOQthills llospital) • Glassy cell carcinoma. ferrusinous bodies pre;;ent JP!lOJ! IK)(II<il • Muoocpidcrmoid carcinoma (I); Large cell carcinoma (I); CllrcinoSUr<'Qma ( I) l.,oon, KliDlShikj !Ko"~i Mqljcal School Homjtall • Adenosquumous carcinocna (4) Sjngo.oor!( .. Non smull cell corcinomn, ~ugges1h•e of poorly differentiated adenocarcinoma Saudi Arebja (King Khalid Unj"crsily l!osoitan .. Adenocarcinomtl (primary Ji"om other sites like Stomach should be exclud,cd)

DIAGNOSIS: Adenosquamous carcinoma, lung

T-28000, M-80703

RCrJ' RENCES: Tnkamori S. Noguchi M and Morinago . OiniCOjlUthol()@ic Chaructcristies of Adcnosquamous Carcinoma of the l.ung. Ctmcer

1991: 67(3):649-654. Yousem SA. Pulmonary Adcno.<quamotJs Carcinomas with Amylnid·L.ike Slrol!la. Mod Patlllll 1989; 2(5):420·426. Nounhdm KS. Ta>lor JR. Sl:oscy C. t1 ol. Adenosquamous Lung Carcioomll. Clini<.'ll Charoolcristie5. TrcaunentruJd Prognosis .

• Inn n,ortiC Surg 1987; 44(5):-462-466. F'lury-t--Jerard A. Vicgus-Pesuignot 8, Crcmoux II. ct aJ. Cytogcnic Study nf Fl\•e Cases ofLttn@ Adenosquamous Carcinom a.

Cwrer G.nt1 Cytognl€'1 1992: 59(1):1 -8.

Cl"l'lt October 2000 ''MUIUI~:s'' (Subsc.riptiOI'I A)

Case No. 8, Accession No. 26198

LLL!MC Patholog)' Resjdents . Mt~iljlullll tibrous hbtiocytoma Mountain View CEI Camino Pathology Groun> · OstCOSW"CCilUt

Ri,·ersjde • Sarcoma. high grade 9alllarnl IKaixrJ - Pleomorphic lciomyosan::oma (4) Sebastopol • Sarcoma (favor rhalxJomyQ$01CQma) Monterey CCnmmunHy Hospilft] of Monterey Peninsylal · Surroma. rhabdomyosarcoma Bakersfield - lligh grade sarcomu, rulu out muscle origin Long Beach • l ligh grade sarcomo (myogenic} (7}

Santa Qj!!j!{!,gma Prieta I • Saroomo, NOS (6) Ventura lllnil3bl • Pleomorphic rholxlomyosarcoma (2)

October 2000

Santa Rosa • Ma!ignantmescnch)mal neoplasm, possibly myosarcoma (I); SarcorniL possibly rllabdorn)'OSlll'COOln (I) Sacramento tUC payis Health S"'tcm3l - PoorlydiftCrcntiatcd sarcoma favor leiomyosarcoma 1-!avward/Frcmom - Desmoplastic myosarcoma (2); l'I<X>rnorphic librosarcorno ( I); Pleomorphic mo!ignam fibrous histiocytoma ( l) Ncyada <Reno> • tciomyosarooma vs. high grade s:~toomo Wi§C!QQ,<in IMeritcrl - Pleomorphic malignant spindle and gjni11 cell tumor inl'olving diaphragm. probably high grade sarooma Looisiana (Looisjana S!a!e 1/nin.njl\ Mc:djcal Center) • Malignant fibroos hi>tioc)1oma vs. malignanl meseoch)malrumor Illinois <Duooes Pjl!h!!!ogy A'I.'!OCij!!q) · Pleomorphic SOIOOma,? lciomyosnrcoma (of diaphragm) Michigan l<hkwood Hospjta!l • High gmdc sarcoma Indiana IF on Wuynel • Epithelioid mesothelioma right pleura (do calcitonin. etc) Kentucl:v lUnjyqsityofLouj~wille RC!:i jdcntsl · PleomOt')>hic sarcoma

Florida IMoome Rc•ional Mes!iCAI Ccrncrl • Leiomyosarcoma Florida IWinrer I Lwcnl - Sarooma (MFH) (2); Malignant fibroos mcsothclioma (I) !'lorida ITal!ahamel • M)'Osarcomo. rhabdomyosaroorna Nonh Carolina I WNC Patholoov Grouol • Sarcoma ? MFI I? Osteo (2); Sarooma. high grade ( ll Maryland IIV<Xx!bjncl - Leiomyosot·coma ( I): Undifli:rcnliatcd sarcoma ( I) MarYland <Unjywity of Maryland) . l'oorly d.iffcrcntioted sarcoma consistent with leiomyosaroomu New JcrscvfQ,crlook Hospitall ·Sarcoma, NOS(!); Snrooma.? MFH (3) renns,·lvania (LehjJII! Vallev Hospj!all - Rllab<bnyosarc:oma (1): Plcomorpllic malignant fibroos hiSiioc)torna ( I) Pennsvlvania ICgncm""eh Mcdic!!l Center Residcrnsl • High grade sarcoma (MFH?) New York IS!!NY Stony Brook Uni•cr.i!y HqspjtaJ RcsjdsaJL,) • RhabdomyOSllrcoma, plcomorphic(IO) New York (Beth lsrucl Medical Ccms;r Residenu) - Malignant Ubrous histlocy(oma New YQrk /New Hyde Pad!) - High grade pleomorphic sarcoma favor MFI L recommend Cl)34 staining to exclude moll gnant

soliwy Ohrous tumor Massacbu.telu Clkrtshire Medical Cemcrl · Pleomorphic saroorna vs. saraxno~toid carcinoma Massachuseus CNe" England Medico! Ccmcrl • Poorly difTeremimcd $llnl01118 ( !}: Leiom)"®>tCOmo (2): Angiosnrcomo (3) Canada lft)(lthill< llospita!, Calruuyl • Pleomorphic soroomo. llwor MPH Japan fK voto) • Undifferentiated c(ltcinoma (1 ); Epithe lioid leiomyosarcoma ( I): Malignunl fibrous histioc)1oma ( I) Japan. Kuras!Jjkj I Kawasaki MC!lical School 1-!osoitall • Pleomorphic carcinoma (3): Malignant llt>rous histiocytoma ( I) Singaoorc • l lif!)l grade malignant tumor suggesti\'e of malignant fibrous histiOC)toma fu!udi Ambia I!Gp• .Khalid Uni.-crsil> llosoita!l • Pleomorphic lciom)osatcorna

DIAGNOSIS: Pleomorphic high grade sarcoma (M FI-1 pb•noty!l") with focal osseous difTcrcntintion, lung

T-28000. M-88023

REFERENCES; McOonndl T. K)Tinkos M, Roper C and Ma.roujian 0. Malignant Rbrous !listioc)toma of the lung. Ca11cer 1988: 61( 1):137-145. Yousem SA ond Hochholzer L Malignant Fibrous HistiOCytoma t)f the Lung. Cancer 1987: 60:2532-254 1. Vigucra Jl .. Pujol JL Rcboiros Sl>. et ol. Fibrous l listiocytoma or the Lun~;. 71wrat 1976; 31(4):475-179. aijad SM, !lcgjn i.R, Dail DH and Lukeman JM. Pihrn"' l listioc)1oma or Lung. A Clinicopathologic Study of r wo Cases.

Hisriopatholog,v 1981: 5(3):325-334.

CTTR. ~Iober 2000 .. Mmutcs .. (SubscnpctOn t\) 9

Case No. 9, Accession No. 28921 October 2000

I ,!.UMC Patholoov Residents • Malignant spindle eelltumor (lllOilOpbasic $)'110viol sarcoma vs. rare CK+ MPNST. (!( leiomyosarcoma)

Mountain Vi"'' lEI Camino !'l!Jbo!ogy Gn>uol • Sarooma!oid carcinoma Rlyer<id~ • Con:inO«arooma (@!dand !Kaiser) • Sluwmatoid carcinoma ( 4) ScbastoMI (pathology Scryice..'l - Spindle cell carcinoma Momerev <Communhv Hospital of Monterey Pcnjnsula> - Saroomu Bnkeo;field • San:omatoid carcinoma !..ong [leach - 1'1scudosru·c(lllliltous corcioomll (7) Soma Qftr!l 0.90Ju Priaal · Carcinoma with spindle and giant <lOll foci (6) Ventum !l!nilabl • Spindle cell squamous eel! carcinoma (2) Santa Rm • Spindle cell carcinoma (2) Sacramento !UC Davis Health Svstems) • Spindle a>teinoma (saroomatoid c:arcinomn) liayward!l'remoOJ • Dediffcrentimcd (metaplastic) lnrge cell carcinoma (3): Pleomorphic carcinoma (2) Nevada !Reno) • Sarcomatoid can:incma Wjsoonsjn !Mcrjterl • l'leomorphic malignnnl spindle und giunt eel! tumor involving luns. consistent with spindle ocll (sarcomatoid)

carcinoma. rule: out mas from ss L&yjsiana (Loujsiooa S~;~te tJnjvcrsity Medicpl Center) - Carcinoma with sarromatoid rcatures Illinois <Ouoage J>athoJt)gy Associate~) • High grade saroo1natoid carcinoma. Jung Michigan (Oakwood tlospilAll - Carcinoma. sarcomasoid/spindle cell '-arinm Indiana lfon Wamel - Sarcomatoid carcinoma. len !ower lobe lung Kcntuckv <Unh•qsirvoCLouisvme RsSden~) - Sarcomatoid carcinoma Florida <Monroe Regional Mcdjcal Cemt.Tl - Carcinosarcoma Florida IWjnter ~Ia, en) - Ou-cinosarccma (3) florida ITa!lnhMS<el • Sarcomotoid curcinoma (4) North Cl!rolina 1\VNC l'ntholooy Groun\ • St>roomatoid curcinoma (2); Carcinosaroomu (!) Mao·land CWonslbioel • Synovial saroomn (2) Mwyland CUni\·crsjtvofMarv1flQdl - Sarcomatoid carcinomu New Jcr;jcy COycrlook llosoimll • Sarcoma/? Pscudosaroommous auciOC!<Oa (I); Pleomorphic """'-inoma (3) l'CIWSYiyMiA !LA;higll Valley Hospjw!\ . Carcinomn with spindle ocllltslurcs (1): Spin<ll< cell squamous cell C(lrcinoma (I)

PennslhJDi• CConem••i!h Msdjcal Cemer Rglden!,•l • Undi!lerenliated lw-ge eell carcinoma (alant cell type) New Yprk !SUNY Stony Brook Univccsjty Hosllilll!) • Leiomyosaroomo (10) New Yod< (BC!b Israel McdjC!!I Ceni<'I Resj<!enls) • S)novlnl saroornu New Yorls <New Hyde Park! • St>rcoma favor leiomyosarcoma, would ~rform SMA and ca!desmin scains to oonfirm oh<o diaanosis M!lSSl!c!wsens !Berkshire Me4ica! Ccmerl • S(!T()Omutoid c;~cinomo Mg;ssaCbi!SCII!I {New !:noland Med"!C;II Center) • Spindle cell carcinoma (I): Carcinosarooma (2): Mesahelioma (3) C!rnadlo I FQO\hjl!sliospj!al. Cnlgnrv\ • S)'noviol sarcoma Japon I KlO!O) • Spindle a:ll carcinoma (3) Jnnan. Ku!!IShikj CKawnsaki Medical Sd1ool l!ospil!lll • Snrcomatoid carcinoma (4) Sjmmoorc - Sarcomatoid carcinoma Saudi Ambia <King Kholid llnjversiJy Hospitull • Sarcomatoid cnrcinomolspindle cell carcinoma

DIAGNOSIS: Sarcomatoid carcinoma (spindle cell carcinoma), lung

T-28000, M-80323

REFP.RENC:ES: Nappi 0. Glasner SD. Swanson PEaud Wick MR. lliphasic und Monophte~ic Sarcomatoid Carcinomas ofth¢ Lung. J\ Rcappl'aisal

or-Carcioosurooma- and -sp;ndle-Ccll Can:inocnas.·• Am J Clln Pmho/!994; 102(3):331-340. Wick MK Ritter JH and Nappi 0 . lntlnmmaJory Sarwmatoid Carcinoma oft he Lung. Report ofTim:c Cases nnd OiniiXJfl"thologic

Comparison .-ilh lnflarnmut~· Pscudotunwrs in Adult l'atients. Hum /'athol 1995; 26(9):10 14-1021. Nakajima M. Knsai T, Hasimoto H. et ul. San:omatoid Carcinoma of !be Lung. 1\ CliniOOfl"lhologic Studyof37 Cases. Can<..-r

1999: 86( 4):608-616 .. Wick MR. Riner JH and Humphrey PA, Saroomruoid tan:inanasofthe Lung. A Clinioopathologic Rc••iew. AmJ Cl/n Patlro/

1997: 108(1):40-53 .

10 CTTR. (kaobcr 2000 "Minuws"' (Subscrip1!on A•

Case No. 10, Accession No. 28877

!..l.UMC l'luhoi<M!V Rcsjdcms o Papillary adenocaroinoma, favor meltl>intic Mountain View CEI ComjrXJ Pqthology Group) ~ Oronchioalvoolar carcin<>rnu Rjycrsidc - Oronchoalvcolnr carcinoma Ooklwtd (Kaiser) • llrunchioloolveolar carcinomo ( 4) Sebastonol rpathology Scrvjcesl ~ Bronchioal,·eolar l)'pc adenocarcinoma

October 2000

Mootaey fCommunirv l lo;sPitaJ ofMomen...;y Penjnsulgl 4 llronchoah·oolar cell carcinoma llakcr:sfidd 0 Bronchiolooh'COiut catcinoma l.onu Beach 0 Aden~inoma (bronchoalveolar t}'pc) (7) Santa Clara (LQma Prjctul 0 Adenocarcinoma with bronchioah'<olar featur.:s (6) Ventura 1\Jnilab} o Elronchloalvcolar t-arcinoma (2)

Smua Rosa 0 Bronchioal vcolar ( I); AJ voolllt carcinoma ( I) SOcmmcmo <UC Davis l lenlth Systems) - Bronch0-4tlvcolar carcinoma l!ayward!frcmonl o Adenocarcinoma with papillllt)l feat=(5) Ncvac!a !Reno) 0 Bronchoo.h-colar carcinoma WjS<9Qsjn IMeriter\ o Bronehioloalveolar cell carcinoma in absence of a 1° tumor elsewhere Louj3jana <Louisiana State Unj•tersin• Medif.:a1 Cquq> .. Broncho-alvcolar c.:arcinorna llljnois C0UP..1£e Pathology A:;socjmc:s> - Mucinous bronchioloat,·eolat carcinoma Mk hjgan (Oakwood 1-!osnjta!l - Adeoocarcinomu. papillary type Indiana <Fort Waynel 0 Mucinous bronchiolo-nlvoolar curcinoma, lower lobe. left lung Kentucky CUnjversiw nfLoul!\''illc ResidenL~l - Bronchoalvcolar carcinocnrt l'lgrida !Monroe Recionnl Medical Center\ 0 llronehioalvoolar adenoc:an:inocna f!c.-jda ('Wimer Haven\ 0 Bronchoah-colar carcinocna (l) florida !Tallahassee> 0 MuciOOU$ bronch<>-nlveolar cru-cinoma Nnnh Carolina CWNC Pathology Group) - Oron<.Jhioloalve<)lar carcinoma (3) Mji(Yiand (Woodbjncl 0 Bronchioloalveolar carcinoma (I); Adenocarcinoma ( I) Mwvland {University of MONtnnd) - Bronchioloulvcolw· carcinoma New Jerscv!Ovcrloo~ ll!><piu•ll o Bronehioloul veolnr cell carcinoma (4) J•cnosylvanja {Lehigh Valley llosnitall · Bronchoai'-"'CO!at carcinoma Pcnn-.lvania ICoocmau!!h Medical C.m~cr Rcsj&:n!Sl o Oronchoah"COiar turcinoma Nsw York !SVNY Stony Brool; Unjvep;itv Hospj!al RQidcn§l 0 llronchiooh'C."Oiar carcinoma New York <Beth ls.rael Medical Center Residents) · Mdustadc adenocarcinoma New Yurk CNew Hyde Pnrk> - Bronchioalveolar CI:V'cinoma. memstatic carcinoma to lx excluded Mas.suchuselt~ fBcrkshjr" Mcdjcnl Center> · Bronchioloul\·eolar carcinoma. non-mucinous cype MiL.$Sachusetts l'New Englund Medical Center) .. Uronchioah•eolar carcinoma ( I); Metas[atic adenocarcinoma (2) Cunusb !Fooahillslio.<phal. Q li!Wn·l 0 13roochoalvc:olllf carcinoma Jnpm CK''()Iol 0 13ronchio-nh·colar carcinoma (3) Jgpan. Kurnsbi!si !KawaM!si Medical School l!nspj!!!ll • Adcno<:arciooma (4) Sjnnaoore - Broochiolooln:olar "'31'(inorna Smodi Arabia fKing K1!.1!jd l!nivcrsitv Hospi!QI) o llronchioloolveolar carcinoma (3); AdcnOC"drCinoma (3)

OIAGNOSIS: Bronchoa lveola r carcinoma. lung

To28000, Mo82503

REFERENCES: Ohorin NP. Yousem SA. Griffin J. e1 al. Comp;:~ri<On ofE.x!ra·Cellular MU!ri' Antigens in Subi)JlC> ofllronchoolvoolar Can.; oomu

and Conventionall'lolmmmry Adenocarcinoma. An lnununohistochcmi!:lll Stud). AmJ Surg Pathol 1992: 16(7):675-686. Tuo LC. Weisbrod GL. I'"'"""" FG, ea al. Cytologic Diagnosis of'Bronchoalveolar Curci noma hy Fine Nc"Cdle Aspiralion Diops~.

Cancer 1986; 57(8): 1565°1570. A"'\iotcs C:'\ and Jc:nnings 'l'A. Observations on Uroncho--AI ''ooJar Cnrcinomns with Special Emphash on l"'lcalized L~sion. A

Clinioopathologicol. Ultra<tructural and lmmunochemic.1J Study or II Cusos. AmJ Surg l'atho/198K; 129(12):918-93 1. l)aly RC. Trostel< VF and Pairolcro PC. 13ronchoa1vcolar Carcinoma. fii(.10r. t\ITt"ding Suf\;val. Am1 ThQrm: .Sicrg 1991:

51(3):368°377.

(..TI·k. (ktotx.T 2000 "'MinLill."> .. (SubscriptiOn A) I I