..

CALIFORNIA TUMOR TISSUE REGISTRY

"SOFT TISSUE PATHOLOGY"

Study Cases, Subscription A

April, 2004

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

Loma Linda University School of Medicine 11021 Campus Avenue, A11335 Lorna Linda, California 92350

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

E-mail: cnrl1illink l inc~cw Web page: www.cnr.org

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

Target audience: Practicing palhologiSI!I and pathology residents.

Goal: To acquaint the participant with the histologic features of a variety of benign and

malignant neoplasms nnd tuJ!lor-like conditions.

Objectives: The participant will be able to recognize morpholor,ic features of a variety of benign

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

Educational methods and media: Review of representative glass slides with assoc:iatcd histories. Feedback on consensus diagnose.:; !Tom participating pathologists. Listing of selected references trom the medicallitemturc.

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

CMECredit: Lorna Linda University School of Medicine designates this continuing medical

education activity for up to 2 hours of Category I of the Physician's Recognition Award of the American Medical Assoc:iation.

CME credit is offered for the subscription year only.

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

Council for Con[inuing Medical Education (ACCME) to sponsor continuing medical education for physicians.

Contributor: Arthur Williams, M.D. Case No. 1 - April 2004 San Gabriel, CA

Tissue from: Left thigh Accession #29698

Clinical Abstract: For two months this 45-year-old female observed a mass on her left thigh which seemed to be

enlarging. Workup revealed a tumor involving the muscle of the left quadriceps. 111e mass was excised.

Gross Pathology: The 40 gram, ovoid, very firm, sharply circumscribed neoplasm was 6.5 x 5.0 x 4 .5 em and had

a pale yellow-whi te cut surface.

SPECIAL STUDIES: Pancytokeratin Vimentin S IOO HMB45 CD3 and CD20 CD30 CD34 CD31 Factor Vill

strongly positive strongly positive negative negative negative negative strongly positive positive focally positive

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

Tissue from: Abdomen

Clinica.l Abstract:

Case No. 2 - Apri1 2004

Accession #29667

Tills 19-year-old female had a history of pancreatitis with a pancreatic cutaneous fistula. An enlarging pelvic mass was thought to be due to retroperitoneal inflaDlDlatioo. Because of continued discomfort and enlargement, the mass was excised.

Gro~~ Pathology: The 3,350 gram brown-white fibrous mass was 36.9 x 29.2 x 8.3 em and had attached segments

of small bowel.

SPECIAL STUDIES: CDJ17 CD30 ERIPR CD34

positive positive negative negative

Srudy Cases, April 2004, Subscription A 3

Contributor: Gholam Peushkpour, M.D. Case No. 3 - April 2004 Fontana, CA

Tissue from: Great toe Accession #29681

Clinical Abstract: A mass on the left great toe of this 57-year-old female led to an amputation at the

metatarsophalangeal joint.

Gross Pathology: The yellow-tan, multilobular, gelatinous mass measured 3.5 x 2.2 x 2.5 em.

Contributor: Alexander K. Lyster, M.D. Case No. 4 - April 2004 Victoria, TX

Tissue from: Intra-abdominal Accession #29706

Clinical Abstract: An intra-abdominal tumor was noted in this 45-year-old female.

Gross Patbology: The 35.0 em diameter tumor included gray gelatinous tissue.

Contributor: Alexander K. Lyster, M.D. Case No. 5 - April 2004 Victoria, TX

Tissue from: Groin Accession #29709

Clinical Abstract: This 56-year-old female presented with an ulcerating mass in her left groin.

Gross Pathology: The 13 x 8 x 2 portion of skin and subcutis had a 9.0 x 5.5 x 4.0 em area of multiple confluent,

firm, gray nodules ranging in size from 0.5 to up to 6.0 em in b>reatest diameter. The tumor appeared to blend with the adjacent fibroadipose tissue.

SPECIAL STUDIES: CD34 positive

Contributor: Mark Janssen, M.D. Case No. 6 - April 2004 Anabe.im, CA

Tissue from: Right kidney Accession #29641

Clinical Abstrac~: Following discovery of a suspicious lung nodule, aCT scan revealed a right renal mass in this

53-year-old female. Eight years earlier, she had had a hysterectomy for a leiomyosarcoma A Japaroscopic right nephrectomy was performed.

Gros!l Pathology: ThE; 90.5 gram specimen consisted of six pieces ofkjdney including a 4.0 x 3.5 x 3.0 em firm

mass.

SPECIAL STUDIES: Pankeratin negative EMA negative S I 00 negative Chromogranin negative Synaptophysi n negative Vimentin positive Desmin positive SMA positive MSA positive CD10 negative Estrogen & Progesterone receptors positive

Contributor: JozcfKollin, M.D. Case No. 7 - April20Q4 Lakewood, CA

Tissue from: Right index finger Accession #29601

Clinical Abstract: This 33-year-old female had a progressively enlarging mass on her right palm and index finger

that was present for several months.

Gross Pathology: The yellowish lobulated mass measured 3.0 x 2.5 x 1.7 em.

Contributor: Faramarz Azizi, M.D. Fontana, CA

Tissue from: Back

Clinical Abstract: A mass was taken from the back of this 48-year-old female.

Gross Pathology,: The soft \issue mass was 4.0 em in greatest diameter.

SPECfAL STUDIES: EMA Pan-cytokeratin CD31 SlOO SMA HHF-35 Myo-Dl CD57 (Leu-7)

negative negative negative negative focally positive focally positive positive positive

Case No. 8 - April 2004

Accession #29652

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

Tissue from: Back

Clinical Abstract:

Case No.9 - April2004

Accession #29110

For two months this 54-year-old male noticed an expanding mass on his posterior neck.

Gross Pathology: The 144 gr'dl!l, 13.5 x 11 .0 x 3.5 em red-tan, soft tissue specimen contained a centrally located

8.5 x 7.2 x 2.4 em hemorrhagic, ftrm, white tumor.

SPECIAL STUDIES: Immunohistochemistries were negative for markers of epithelial, melanocytic, vascular or

muscle differentiation.

Contributor: Jeree A Stroh, M.D. Case No. tO - April 2004 Camarillo, CA

Tissue from: Left anterior cbcst ACCl'SSion #24073

Clinical Abstract: For 20 years this 53-year-old female had noticed a soft tissue mass in the left upper chest wall.

When new growth in tumor size was accompanied by skin deformity, the patient elected to have it removed.

Gross .Pathology: The 230 gram soft yellow-tan tissue mass was 11.0 x 9.0 x 4.0 em.

CALIFORNIA TUMOR TISSUE REGISTRY

SOFT TISSUE PATHOLOGY

Minutes - Subscription A

April, 2004

SUGGESTED READING (General Topic~ from Recent Literature): Fetsch JF, Davis Jr. CJ, Miettinen M and Sesterhenn lA. Leiomyosa~;coma of the Penis. A Clinicopathologic Study of

,1 4 Cases with Review of the Literature and Discussion of the Differential Diagnosis. t! m J Surg P athol; 2004:28(1):i 15-125.

DuBay D, Cimmino V, Lowe L, et al. Low Recurrence Rate after Surgery for Dermatofibrosarcoma Protuberans. A Multidisciplinary Appwach From a Sillgle Institution. Cancer 2004; I 00: I 008-1016.

Kooby DA, Antonescu CR, Brennan MF, et al. Atypical Lipomatous Tumor/Well Differentiated Liposarcoma of the Extremity and Trunk Wall. Importance of Histological Subtype with Treatment Recommendations. Aw• Surg On col 2004; 11 :7 8-84.

California Tumor T-issue 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: cttr@linkline.com Web site & Case of the Month: www.cttr.org

FILE DIAGNOSES

CTIR Subscription A Apri1,2004

Case 1: Epithelioid angiosarcoma, thigh

T-Y9100, M-91203

Case 2:

Cue3:

Case 4:

Case 5:

Case 6:

Case 7:

Case 8:

Case?;

Mesenteric fibromatosis T-Y4100, M-76100

Acral myxoinflammatory fibroblastic satcoma, great toe T-Y9800', M-88003

Extraskeletal myxoid chondrosarcoma, intra-abdominal T-Y4100, M-92203

Dermatofibrosarcoma protuberans, groin T-Y7000, M-88323

Epithelioid leiomyosarcoma, kidney T-71000, M-88903

Localized tenosynovial giant cell tumor (giant cell tumor of tendon sheath), finger T-Y8800, M-40000

Leiomyosarcoma of soft tissue, back T-Y1100, M-88903

Hjgh grade pleomorphic sarcoma (with phenotype of SCKallcd "MFH''), back T-YllOO, M-88023

Case 10: Pleomorphic lipoma, anterior chest wall

T-Y2130, M-88500

Cue No. 1, AccessioD No. 29698

AwllliJI - Epithelioid hemangioendothelfoma Ba)sersfle!d - Angiosan:oma Bo!dwjn Park <Kaiser Pcrrooncnto\ - Epithelioid hemangioendothelioma (2) Fomana <Kaiser Pennanemo) - Epithelioid angiosarcoma Haywardlfremont - Epithelioid angiosan:oma l,agyna Bcacb (South C911<1 Modical Ccntal - Angiosarcoma Logg Beach - Aogi0$8t'COma (8) Mountain View lEI Camino Pa!bg!ogy Group) - Epithelioid angiosarcoma. hich grade Oa)slnod (Kaiser Pcnmnnemcl - Epithelioid angiosarcoma (6) Orange COrangeCountv Palholoav Medical Grounl · Epitheliold sarcoma Sacramento CUC Davis Medical Center\ - Epithelioid angiosarcoma San Djcgq (Naval Medica! Cepter\ - Epithelioid angiosarcoma San Francisco <University ofCalifomial - Epithelioid sarcoma Santa Rosa !Santa Rosa Memorial Hospitall - Epithelioid angiosan:oroa (2); Angiosan:oma (I) Ymwm - Undiffacotiatod carcinoma, metastatic Ala<lg! !Alaska Natiye McdjSJ! Center) - Angiosan:oma ColoradO CEvcrgreenl - Epithelioid hemangioendothelioma Colomdo CI.AHheran Medical Csotq) - Epithelioid angiosarcoma

Apri12004

florida !Baptist HOspita!l - epithelioid angiosarcoma vs. epithelioid monophasic synovial sarcoma with hemnogloperic)'toma features (I); l:lpiiheliold angiosarcoma (I); Angiosarcoma (3)

Florida fMwuoc Regjonol Medjc;.pl Center) - Epithelioid BllgiosllJ'Coma Florida fiaJ ia!J!!SSeel - Epithelioid angiosarcoma Florid& (Winter Haven HosojJAil - epithelioid angiosarcoma lllipgjs CBurr Ridgel - Angiosarooma, high grade llljnoj• 1£\yan:!!on Hosnital) - Epithelioid angiosarcoma Indiana <Howard Community Hospital) • Epithelioid angiosarcoma Loujsjfyta <Louisiana State Unlyersity Medical Center) · Epithelioid angiosnrcomn MAiy!And (National Naval Me<licnl Center) - Angiosarcoma. epithelioid Musoehusctts CBCI"kshire Mcdjca! Center) - Epithelioid W\giosarooma. grade ll!n II Mas.ucbusetts (New Eng!Md MediSJ! Cmtcr Resideptsl - Angiosarcoma Micbii!!IO !Oakwood Hospj!Ail - Epithelioid angiosarcoma Mkhi•M <St. Joseph Mercy Hospirall - Epithelioid anglowcoma MiMesola Cfajrvjew Soutbdalc Hosnita1l · Angiosarcoma Nebmska <Cceighton Univeajty School ofM¢jcjne Resjdentsl • Epithelioid a.naiosarcoroa New Jersey I Overlook Hosnlta!l - Angiosarcoma, epithelioid variant New Yod< ll..()ng Island Jewish Hospital) - Angiosarcoma New yom (Nessa" Unlveajtv Mesfical Q;nter> - Angiosarcoma New York, New York - Angiosarcoma New Yor!c.INY Presbyterian tlospitall - High grade angiosarooma New Yosk IStonv Brook Unjymitv Hosnita! Resjdepts) - Epithelioid angiosan:oma North Carolina (Mounlllin Ag Pa!bg!ogy\ - Epithelioid angiosarcoma (4) Ohio !M<'Cullougb:Hyde Mcmorio! Hospital) - 1\ngiOWQOD!a Pennsv!yanjo !Allegheny Qemnl HospjJAI\ - Poorly dillerentiatod angiosarcoma Peooty)yania <Conemaugh Memorial Medical Center) - Angiosarcoma Pcoosvlyanja ILebioh Valley Ha<pital) - Epithelioid onaiosarcoma Peoosylvania (York Ho<pital\ - Angiosarcoma (7) Rhode Island IR! Hosoita! Residents! - Epithelial angiosan:oma Tcxy !Lubboc:kl - Angi0$8t'COma Tcw <ProPatb Associates> - Epithelioid angiosarcoma (2) Texas ISM Antpnjo) - High grade epithelioid angiosarcoma Tcxa1 !Scott & White Mcmodg! Hospital) - Epithelioid angiosarcoma 'fcxos aJniyernitv ofl)xns Medjcal Branch · Epithelioid angiosarcoma Wyoming IGtcepbrier valley Medical Center) - l:lpilhelioid san:oma Ausrrn!ia CNorth Ouccnsland Pathology) - l:lpithelioid angiosarcoma Aygm!ia fRoval Prince Alf@ Hospjta!l - Epithelioid lfl3losareoroa

CTCR. April 2004 "Minutes" (Subscription A) 3

Cl!!lda Cfoothills Medieal Cen!ttl - llpilhelfold angiosan:omJt Hons Koog CHonR Kong Bantist Homjtall • Angiosarcoma Italy INM!es Naval Medical\ - Epithelioid qiosarcoma laQM Cbjba - Epithelioid hemangioendothelioma Ne!her(unds. Amsterdam - Epithelioid ongiosan:oma Oa1ar fl:lamQ£1 Medical ComorntioN • Epithelioid angiosarcoma Saudi A!llbia. A!hassa - Epilhe!ioid angiosan:oma Saudi A!llbia <King Khalid UniversiN) - llpithe!ioid angiosarcoma

Case I - Diaanosis: Epithelioid angiosarcoma. thigh

T-Y9100, M-91203

Consultation: Dr. P818knuna Chand.-soma, M.D., AD Path Labs. "HiaJt an<1e epithelioid angiosarcoma, Jell !high".

Case I - References: _ Rossi Sand Pletcher CD. Angiosarcoma Arising In HemangiomoiVIISCltlar Malformation. Report of Pour Ca.•es and Review of tile

Lllemturc. Am J Surg Pat/rc/ 2002; 26(10): 1319·1329. Menu ol T Md Katenkamp D. lntr•ncura! Angiosarcoma and Angiosarcoma Arising in-Benign and Malignant Peripheral Nerve

Sheath Tumour.;. Clinioopathological and Immunohistochemical Analysis ofPour Cases. Hlstopatho/1999; 35(2); 114-120. Meis-Kiodb!om 1M and Kiodblom LG. Angiosarcoma of Soft Tissue. A Study of 80 Cases. Am J Surg Pathol 1998; 22(6): 683-

697. 'l'rusarcl M, Le Doussal V, et al. Angiosarcoma Arising in a So1ital)' Schwannoma (Neurilemoma) of the Sciatic Nen•e. Am J Surg

Patho/ 1996; 20(11):1412-1417.

Case No. 2, Accession No. 19667

~- GIST B!!keaOe!d - Gastrointestinal stromal tumor Bn!dwjn !'ark (J(aiser Pcrmancntc) - Gastrointestinal stromal tumor (GIST) (2) fon!A!la (Kaiser Pcrmanentel · GIST vs. fibromatosis Haywardlfmnont - GIST (possibly extra 01) I.AJ!IIIIA llcy=h !South Coast Medical Ccnlcrl - Fib<omalosis Lons!Jwb • Mesenteri<: fibromalosis (8) Mpuntaio View CEI Camjno Pathology Group) · GIST Oa)(land {)(aiscr Pcrmancntel - GJ Stromal tumor (6) Oranse !Orange Countv Pathology Medical Group) • GIST Sacrameplo fUC Davjs Medical Center) ~ Fibromatosis San Qicao CNaval Medical Center\ - Mesenteric fibromalosis San Fmocisco CUniyrnity ofCnlifom!A) - Desmoid fibromatosis SoniA Rosa ISsntaRosa Memorial Howita)l • Gastrointestinal stromal tumor (3) Yalnwl · Gastrointestinal stromal tumor Alasl;a IA!asl-a Native Medical Center\ - Reactive nodular fibrous pseudotwnor CoiO!Jdo fEvcrgrecul - Intra-abdominal fibromatosis Colo!ldo ILu!hmn Medical Center) - Pelvic fibromatosis

Aprll2004

F!odda I Baptist Hosnitall - Law g>'lldcllbromyxoid sarcoma (I): GIST consistent with myxoid change(!); (GIST) (2); Extraintestinal GIST (I)

Floridg (Munroe RegionaJ Medical Center) ~ Gastrointestinal stromal tun1or F!odda !TnllahBsseel . Fibromatosis Florida !Wlnter Hayep Hospital) - Oesmoid fibromatosis !l!lnols !Burr Ridge) - GIST with myxold change ll!lno!s <Evanston HoSpital) • GIST vs. rnyofibroblastic tumor Indiana CHOWl!!d CommunilY Hospilall - Retroperitoneal fibrosis l,OujsjMa {Louisiana State Uniyenity Mgijcal Center) - Fibromatosis M!IOIIOQd CNational Naval Medical Centsr) - FibromalOSis Mnwhy.wtts !Berkshire Mc!lica! Centq) - Fibromatosis

4 Cl"lR Apri1 2004 "Minmcs· (Subscripoion A)

Mas.sachusctts fNew Bng1and Medical Center Residents) - Desmoid fibromatosis Michigan !QaJtwood Hospital) - Aggressive angiomyxoma Michjgan !St. Josenh Mercv Hospjta!l - Gastrointestinal •tromal tumor (GIST) Minnesota (fairyiew Southdale HospjtaO · Gastrointestinal stromal tumor Nebraska (Creighton Unjversitv School of Medicine Resjdents\ • Fibromyxoma (6); GIST (4) New Jersev (Overlook Hospital) - GlST New Yor!s l!.ong Island Jewish Hospjta!l • Fibromatosis New York !Nassau University Medical Center) • GIST New York. New YOrk - Favor fibromatosis New York fNY Presbvterian Hospital) - GIST New York (Stony Brook Universjtv Hospital Residents) - lnlrn·abdominal fibromatosis (demoid) North Carolina/Mountain Area Pathology) • GIST (2); Fibromatosis (2) 'Ohio !McCullough· Hyde Memorial Hospital) - GIST (01 stromal tumor) Psoosylvania (Allegheny Gentnll Hospj(ill\ • Fibromatosis Pennsylvania !Conemaui!IJ Memorial Medical Center\ - GIST -Pennsvlyanja <Lehigh Valley Hospltan - Gastrointestinal stromal tumor ·pennsvlvania (York Hospita!l - OIST (5) Rhode Island <RJ Hospiml Residents) • Mesenteric fibromatosis Texas (Lubbock> • Aggressive angiomyxoma Texas <ProPath Associates) - Gastrointestinal stromal tumor (2) Texas (San Antqniol .. lntra-abdoniinal desmoid tlbromatosis Texas !Scott & White Memorial Hospiiatl - GIST texas (()Diversity ofTexas Meiljcal Branch · Myofibroblastic tumor Wyoming <Groenhrier Valley Medical Genter) · Gl stromal tumor AuS(rlllia <North Queensland Pathology) - GIST, differential diagnosis, fibromatosis Australia <Royal Prince Alfred Hospi(illl - Intra-abdominal fibromatosis Canada <Foothjl!s Medjca! Center) - Fibromiltosis HQDil Kon11 CHon• Kong Baptist Hospjf81l · Fibromatosis !tilly <Naples Naval Med[call - Gastrointestinal stromal tumor Japan. Chiba · Gastrointestinal stroma) tumor Netherlands. Amsterdam • Gastrointestinal stromal rumor (GIST) Oatar <Hamad MediCal Comorntionl - Gastrointestinal stromal tumor Saudi Arnbia. A1hassa - Gastrointestinal stromal tumor Saudi Arabia O<ing Kbalid Universitvl • Gastrointestinal tumor

Case 2. Diagnosis: Mesenteric fibromatosis

T-Y4100, M-76100

Case 2 - References: ROdriguez JA. Guarda LA and Rosai J. Mesenteric Fibromatosis with Involvement of the Gast rointestinal Tract. A GIST Simulator.

A Study of25 Cases. Am J Clin Pntho/2004; 121(1):93·98. Tonelli F, Fieari 1', Valanzano R, et al. Treatment of Desmoids and Mesenteric Fibromatosis i<> Familial Adenomatous Polyposis

with Ra!oxifene. Tunwrl2003; 89(4):39!-3%. Griever GE and van UnnikJG. Fibromatosis of the Abdominal Wall. JBR-BTR2003;.86(3):162·163. lmai l , lkeya S, Takahashi M, et al. A Case oflntra·Abdominal Mesenteric Desmoid tumor with Feature of Giant Cystic

Component. Nippon Shokal<ibyo GakkaiZasshi-2002; 99(1 I): 1388-1393. (Japanese) Montgomery E, Torbensoo MS. Kausha\ M, et at. Beta-Catenin Immunohistochemistry Separates Mesenteric Fibromatosis from

Gastrointestinal Stromal Tumor and Sclerosing Mesenteritis. Am J Surg Patho/2002; 26(10):1296-1301. Bus PJ, Verspaget HW, van Kriekken 1H, et al. Treatment of Mesenteric Desmoid Tumours with the Anti.QestrogSl)ic Agent

Toremifene. Cases HiSiories and an Overview of the Literature. Eur J Ga.•troentero/ Rep<Jro/1999; 11(10); 1179· 1183. AI Jlidaan SA and AI Rabeeab A. Mesenteric Fibromatosis. Case Report and Literature Review. J PedlatrSurg 1999; 34('7):1130·

1132.

ClTI\, Apri1.2004 "Minutes" (Subscri~tion A) s

Case No. 3, Accession No. 29681

Arcadia - Acral myxoinflammatory fibroblastic san:oma Bal<ersfield - Myxold chondrosarcoma Baldwin Park (Kaiser Penilancnte) - Acral ffi}'Xoid inflammatory fibroblastic sarcom .. (2) Fontana {!(aiser l'ermanentel - Myxoinllammatory fibroblastic sarcoma Havward/Fremont - Extra-skeletal myxoid chondrosan:oma (chordoid sarcoma)

April2004

Laguna Beach <South Coa<t Medical Center) - Adenocarcinoma vs. malignant eb.oodroid· syringoma vs. signet ring cell melanoma Long 6eB&h - Myxoid ebondrosarcoma (8) Mountain Vjew !EI Cwnino Pathology Grouo) - Acral myxoioflammatory fibrobl.,1ic sarcoma Oakland <Kaiser Pcrmruientel : Myxoid extraskeletal chondrosarcoma (6) Orange (Qmgg~ Countv Pathologv Medical Grouol · Myxoid chondrosarcoma Srurramento C!JC Davis Medical Center! - MyxoinOammatory fibroblastic sarcoma San Diego <Naval Medical Center) - lnJlammatory myxobyuline tumor San Francisco CUnjyersitv of California\ - Extra-skeletal myxoid chondrosarcoma Santa Rosa <Santa Rosa Memorial Hqspiiall • M}'Xochondrosarcoma (I); Myxoid chondrosarcoma (I): Inllammatory myxo-byaline

tumor of distal extremities (l) · ~ • Myxoid malignant fibrous bistioc}1oma Alaska CA!aska.Nativo MC<!i¢al Centet\ - Myxoid MFH (2); Chondromyxoid fibroma (I) ColOradO !Eyergreen) - Myxoid MFH Colorado {Lutheran Medical Cenrerl - lnJlammatory myxohyaline tumor Florida <Baptist Hospiiall - Myxoid malignant fibrous histiocytoma (4); Chordoid sarcoma vs. myxoid MFH ( I) FIOrjda <Munroe Regional Medical Center> • CleM cell sarcoma Florida Cl'allahasseel - Myxoid synovial sarcoma, myxoid sarcoma Florida <Winter Haven Hosoltau - Pleomorphic liposarcoma Illinois ffiurr Ridoe) - Fibrous histiocytoma !Uinois (Evanston Hospital) - Myxoid MFH Indiana <Howard Community HosnitaD . Myxoid chondrosarcoma Louisiana (Louisiana State Universitv Medical Center) ~ Atypical myxofibroma Maryland <National Nayal Medical Ce01£r) - Myxoid malignant fibrous histiocytoma (8); Myxoid liposarcoma (2) Meswnhusetts CBerlcsbjre Medical Center> - Liposarcoma. Grade lll/10 Messrhusetts <New England Medica1 Center Resident.c;l .. Myoepithelioma Michi!!l!!l (Oakwood Hospital) - Myxoid chondrosarcoma Michigan CSt. Joseph Mercy Hospital! - Myxoid chondrosarcoma Minnesota (Fairview Southdale Hosnitall - Myxoid chondrosarcoma Nebraska <Creighton Universitv School of Medicine Residents) - Intermediate grade sarcoma with cartilaginous and lipomatous

features'(9); Gout tophus (I) New 1C!SCY (Overlook Hospiiall • Low gmdc myxosarcoma New )'ork <Lon• Island Jewjsb Hospital) - Myxofibrosarcoma New York <Nassau Universitv Medical Center) - Myxofibrosarcoma New York, New York - Malignalit neoplasm with myxoid background f.wor clear cell sarcoma/melanoma New YorkfNY Presbvt'erian Hospit!\ll - Myxoinllammatory fibrosarcoma New Yorl< I Stony Brook llnive!llitv HOSJijtal !{es jdents> - Extraskeletal myxoid chondrosarooma North'Carplina/Mountain Area Pathology) - Myxoid chondrosarcoma (4) Ohio /McCul!ougb,-Hvdc Memorial Hpspjtal\ - Myxoid liposarcoma Pennsylvania CA!l~gheny General Hospiral) - lnJlammatory myxo~aline tumor of distal extend Pennsylvania £Conemaugh Memorial Medical Center) .. Chondroblastic osteosarcoma l'ennsvlvania (lehigh Val lev HoSpital) - Inflammatory myxohyaline tumor Pennsylvania CYori< Hosoltall - Myxold melanoma (7) Rhode Island CRI HOspital Residents> - Myxoinflammatory fibroblastic sarcoma Texas (Lubbock) - Chondrosarcoma Texas CProPath Associates) • Chondrosarcoma(!); Chordoid sarcoma(!) Texas <San Anronjol - Myxoinflammatocy fibroblastic sarcoma (WHO) vs. intermediate grade myxofibrosarcoma ("myxoid MFH") Texas £Scott & White Memoria) Hospital) .. Myxoid liposarcoma Texas CUniversitv ofTexas Medical Braneb - Superficial acral fibromyxoma Wyoming !Greenbrier Valley Medical CCnterl - Myxofibrosarcoma Aus!nl!ja CNQrth Oueensland Pa!ho!ooyl - Inflammatory myxohyaline tumour of distal extremities

6 CITR, April 2004 "1\-linu~es" (SUbscription A)

Australia I Royal Prince Alfred Hospital\ - Myxofibrosarcoma Canada IFomhi!!s Medical Centq\ - Chordoma periphicum Hong Kong (Hong Kong Ranti.~ Hosnital) .. Myxofibrosarcoma Italy !Naples Naval Medical\ - InflammatoJY myxobyaline rumor of the distal extremities Japon; Chjba - JnflammatoJY myxohyallne tumor Nethedands.. .~msterdam - Malignant melanoma Qatar !Hamad Medical Corporation\ - Myxosarcoma, low grade; Malignant myoepithelioma (low grade) saudi Arobia. Alhassa - Myxofibrosarcoma (low grade myxoid fibrosarcoma) Saudi Arabia CK.ing Khalid University) .. Myxoid malignant fibrous histioc)toma

.Ca1e 3 -Diagnosis; Acral myxoinflammatory fibroblastic sarcoma, great toe

T-Y9800, M-88003

Case 3 - References: Jurcic V, Zidar A, Montiel MD, et al. MyxoinOammatory Fibroblastic Sarcoma. A Tumor Not Restricted to Acrol Sites. ~·m Diagn

Pathol2002; 6(5):272-280. Fetsch JF, Laskin WB and Miettinen M. Superficial Acral Fibromyxoma. A Clinicopathologic and Immunohistochemical Analysis

of37 Case.< of a Distinctive Soft 'llssue Tumor with a Predilection for the Fingers and Toes- /fum Patho/2001; 32(7):704-714. Sak.!lkl M, Hlrokawa M, Wakrusulci S. et al. Aero! MyxoinOarmnatOJY Fibroblastic sarcoma. A Report of Five cases and Review of'

the Litc.rnturc. Virchows Arch2003; 442(1):25-30.

Case No. 4, Accession No. 29706

Arcadia - Chondrosarcoma, high grade Bakersfield - Chondrosarcoma. Baldwin Park !Kaiser Pennanente) - (:bondrosarcoma (2) Fontana IKaiseT Pennanente) - Extra-skeletal chondrosarcoma Hayward/fremont - Mesenchymal chondrosarcoma L.aeuna Beach (South Coast Medical Center) - Extraskeletal chondrosarcoma vs. myxoid liposarcoma Lon• Bcacb - ~tra-sl:eletal chondrosarcoma (8) Mou01ajn View lEI Camino Patholo"" Group) - Leiomyosarcoma vs. cxtraskeletal myxoid chondrosarcoma Oakland !Kaiser Permaneote) - Chondrosarcoma (6) Saenunento /UC Davis Medical Center\ - l'amchordoma San Diego <Naval Medical Center\ - Malignant neoplasm, NOS San Francisco (lJniversitv ofCnlifomjal - Mesenchymal chondrosarcoma

April2004

Santa Rosa !Santa Rosa Memorial Hospital) - Chondrosarcoma (t); .Extrosk.eletal chondrosarcoma (I); liposarcoma, round cell type, vs. extraskelelal myxoid chondrosarcoma (I)

V enturo - Poorly differentiated carcinoma Alas)(a CAlas)(aNatlve Medical Center} - Myxoid liposarcoma (2); Chondrosarcoma (1) Colorado l£ve!llreen) - £xtragaslrointestinal stromal iumor Colorado (Lutheran Medical Center\ - Extraskele.taJ rnyxoid chondrosarcoma florida fBantj§\Hosp[ta]\ - Epithelioid stromal sarcoma (1); Undifferentiared stromal sarcomn (probably uterine) (I): Sarcom!l'with chondroid features (I); Chordoma (1) florida !Munroe Rel?ional Mcdicar Center\ - Chondrosarcoma, high grade Florida (Tallahassee) - Round cell liposarcoma, extraskeletal myxoid chondn)sarcoma florida 0\"mter Haven Hospital\ - Mesenchymal chondrosarcoma ll!inojs fBurr Ridge\ - Extra.skeletal myxoid chondrosarcoma lllinois !Evanston Hospital) - ~pitltelioid GIST or leiomyosarcoma Indiana fRoward Community HOspital) - Extraskeletal chondrosarcoma J.:2ujsiana (louisiana State University Medical Center\ - Round cell liposarcoma Maryland <National Naval Medical Center\ - Round cell liposarcoma(!); Extraskeletal myxoid chondl'Qsarcoma (9) Massachuselt< {Berlgbjre Medjcal Center> - Chondrosarcoma, grade Ill of ill Massachusetts (New England Medical Center Resident<\ - Liposarcoma, round cell

· Micbigan IOalswood Hospital\ - Mesenchyntal chondrosarcoma Michigan 1St Joseph Morey Hospjtall - Desmoplastic small round cell tumor Minnesota (fairview Southdale HosnitaJ\ - Poorly differeotlatcd sarcoma, favor round cell dedifferentiated liposarcoma

CITR, Apnl2004 "Minutes" (Subscription A) i

Ncbra.!k' ICrcjshton University School of Medicine RC$idcnJSl - Chondro.sarooma, high gtade New Jmey <OVerlook Ho<pjm!l - Round cell liposatCOma New Yodc ll,ona Island Jewish Hosoitllll - Epithelioid hemansioendomel!oma New York IN!Wiu Unjversitv Medical Center\ - Intra-abdominal desmoplostie snm!l round cell tull!Of

New Yor!c. New york - Favor epithelioid GIST New Yor!c INY Pls$b>1erjan HmiWl - Extraslreleta! chondrosarcoma New Yor!c <Stony Drool< University Hosoita! Residents\ - Myxoidlround cellliposan:oma North Carolina !Mountain Area Pa!ho!ogyl - ? cboodrosarooma ( I); Mesenchymal chondrosarcoma (3) Ohio {MeCullgysh-Hyc!e Memorial Hospital\ - Chondrosarcoma Pennsylxanlo {AIIeeheny General Rospitlll\ - Eruaskeletal mesenchymal chondrosoreomo. Pennsvlyunja !Conemaugh Memorial Medical Center) - Myxoid type lipos:U"C:oma Pennsylynnia (J.ehigh Valley Hospilsll - Epithelioid hemangioendothelioma PC!!nsylyagja <vor!s Hosaillfl - Chondrosarcoma (6) Rh9dc Island <RI Hospillll Residents\ - Extmskclcm! myxoid chondrosarcoma TgxM tLybb()ek) · Round C(llJ liposarcoma Texas IProPo!h Associates) - Malignant hemangiopericytomo (2) Texas ISan Amonjol - Epithelioid malignant neoplasm (CXlniSkcletal myxoid chondrosarcoma vs. epithelioid

hemangioendothelioma vs. myoepithelial carcinoma vs. ovatii!Jl sex-cord stromal tumor) Texas IScou & Wblte Memorial Hospital\ - Extraskcleta! mesenchymal chondrosarcoma Tpas CUnjymisv o(Tem Medical Branch - Gastroint.cslinal stromal tumor Wyomjps IGrscpbrjer Valley Medical Centfrl - Desmoplastic small cell rumor Au!ll!l!i• <Nonb Oue<!!!land Pathology) - Extra osscal chondrosarcoma AuS!Jl!lia <Royal Prince Al!'n;d Hosoitall - Malignanl myoepithelioma vs. epithelioid GIST Canada CFQoth!J!s Medic:al Cenwl - Round cell liposarcoma Hong Kooo IHono Kon• Baptist Hosoital\ - Chondrosarcoma Italy CNap!cs Naya! Mc!lica!l - MetaStatic signet ring cell carcinoma 11!1!!!!1. Chjba - Chondmsoreoma, extraSkeletal Nelher!Mds Amsterdam .. Sarcoma, NOS Oatar <Hnmad Mcdjcal Corporation) - Liposarcoma Saydl A<abla. Alhn.'3a - Myxoid/rou~d cellliposareoma Saudi Ambia I Kino Khalid University) - Extraskeletal myxo!d chondrosarcoma

Co.e 1 - Diagno•i•: Exlnl.Skeleta! myxoid chondrosarcoma, intra-abdominal

T-Y4100, M-92203

Case 4 - References: Gaudier F, Khurana JS, Dewan S, ct a!. Fino-Needle Aspiration Cytoi08)' of Intra-Abdominal Wall Extraskeletal Myxoid

Chooclrosarcoma. A Case Repon and ReYiew oftl1e LitenUurc:. Arch Pathol Lab Med2003; 127(9):1211-1213. Gch YW, Spagnolo OV, Platten M. ct al. Extraskelctal Myxoid Chondrosarcoma. A Light Microscopic, JmmunohiSiochemic:al,

UltraStrucruml and lmmuno UllliSttuctural Study Indicating Neuroendocrine Dill'crcntiation. Histopatho/2001; 39(S):.S\4-S24. Harris M, Coyne J, Tariq M, et al. Eruaskelelal Myxoid Chondrosarcoma with Neuroendocrine Differentiation. A Pathologic,

Cytogenetic. and Molecular Stud)' of a Case v.ith a Novel Translocation t(9; 17)(q22; q 11.2). Am J Surg Patho/2000; 24(7):1020-1060.

Rubin BP and Fletcher JA. Skeletal and Extraskelctal Myxo!d Chondrosareoma. Rela!cd or Distinct Tumors? Adv A nat I' athol 1999; 6(4):204-212.

FoiJ>e AL. Asoff SN, Willis J, et al. Parachordoma is !mmunoh!slOchemica!!y and Cytogenetically Distinct from Axial Chordoma and Extmskelctal Myxoid Chondrosarcoma. Am J Surg Patho/ 1999; 1059-!067'.

Kawaguchi S, Wilda 1', Nagoya S, eta!. Extraskcleta! Myxoid Chondrosarcoma. A Multi-Institutional Study or 42 Cases in Japan. Cancer 2003; 97(S): 1285-1292 ..

Case No. 5, Accession No. 29709

Am!dil - Dermatofibrosarcoma proluberans Bllkmficld - Dermatofibrosarcoma prorubcrans Baldwjp Pads {J(Ajsq Pcrmancntel - Dermatofibrosarcoma protuberans (2) Fontana CKejw Peqnaoen1el - Dermatofibrosarcoma protubcrans

8

April2004

CTTR, Apri12004 "Minutes" (Subscription A)

Hayward/Fremont • Dermatofibrosarcoma protubernns [,aguna Beach (South Coast Mes!ical Center) · Dermatofibrosarcoma protubcrans Long Beach • Dermatofibrosarcoma protuberan_ce (8) Mountain View <EI Camino Pathology Group) • Dermatofibrosarcoma protubernns Oai<land CKaiser Permanentel · Uermatofibrosarcorna protuberans (6) Orange IOranse Countv Pathology Medjcal Group\ • Dermatofibrosarcoma protuberans Sacramento IUC Davis Medical-Center\ • Dermatofibrosarcoma protuberans San Diego (Naval Medical Center) • Dermatofibrosarcoma protuberans San Francisco CUniversity of California) - Dermatofibrosarcoma protubcrnns Santa Rosa (Santa Rosa Memorial Hospjtal\ • Dermatofibrosarcoma protubenms (3) Ventura • Dermatofibrosarcoma protuberans Alaska (AiaskaNatlyc Medical Center\ • Dermatofibrosarcoma protuberans Colorado (Evergreen\ · Dermatofibrosarcoma protuberans Colorado !Lutheran Medical Center\ • Dermatofibrosarcoma protuberans florida ffiaptistHospitrul · Dermatofibrosarcoma protuberans (5) Florida £Munroe Regional f>.fed!OA] Cente.r) - Dermat~fibrosarcoma protubcrilns Florida ITallahasscel • DcrmaiotibroSlU'coma protuberans florida IWiOler Haven Hospital\ · Dermatofibrosarcoma protuberans Illinois (Burr Ridge\ • Dermatofibrosarcoma protuberans Illinois CEvanston Hosoitall • Dermatofibrosarcoma protuberans Indiana CHoward Cornmuniw Hospita)l - Neurofibroma Louisiana (Louisiana State Uni\·ersity Medical Centet) - Dermatotibrosarcoma protuberans Marvland <National Naval Medical Center) • Dermatofibrosarcoma protuberans Massachu..'\ett.~ fBerkshire Medjcal Center) - Dermatofibrosarcoma Massachusetts CNew England Mes!jcal Center Residents\ • Dermatofibrosarcoma protubernns Michigan (Oakwood Hospital\ • Dermatofibrosarcoma protuberans Michigan <SL Joseph Msrey Hosoitall - Dermatofibrosarcoma protuber:ans Minnesota CFairview Southdale Hospital) - Dermamfibrosarcoma protubcrans consistent with fibrosarcomatous transformation Neb!llSka /Creighton Univcrsitv School ofMcdicine Residents) . Dermatofibrosarcoma Protuberans New Jersey (Overlook HOspital) - Dermato.fibrosarcoma New Yorlc !Long Island Jewish Hospjta]l • Dermatofibrosarcoma protuberans New Yorlc !Nassau University Medical Center> • Dermatofibrosarcoma protuberans N'ew Yo ric. New Y cirlc · Dermatofibrosarooma protuberans New York !NY Presby(edan Hosp!tall · Dermatofibrosarcoma protuberans New· York <Stony Brook University Hosniuil Re.<:identsl - Dermatofibrosarcoma protuberans North Carolina !Mountain Area Pathology) • Dermatofibrosarcoma protuberans (4) Ohio IMcCul!ougi!-Hyde Memoda! Hos'Pjqi!l · Dermatofibrooarcoina protuberans PennsyiYDpja (Allegheny Geneni! Hospital\ • Dermatofibrosarcoma protuberans Pennsylvania IConemavsh Memorial Medical Center) • Dermatofibrosarcoma protuberans Pennsylvania !Lehigh Valley Hospltall . Dermatofibrosarcoma protuberans Pennsvlvania fYork Hosoitall • Dermatofibrosarcoma protuberans (7) Rhode Island CR! Hosnita! Residents) • Dcnnatofibrosarcoma pmtuberans Textis ILubboc!cl • Dermatofibrosarcoma protuberans Texas IProPath Associates\ • Dermatofibroma protuberans (2) Te.'JlS <San Ant9niol - Fibrosarcomarous DFSP Texas (Scott& White hlemorja! Hospital) • 'DFSP Texas·<Universitv of Texas Medical Branch - Dennatofibrosarcoma-protuberans Wyoming <Greenbrier Valley Medical Center) .. Dermatofibrosarcoma protuberans Australia (North Queensland Pathology\ • Dermatofibrosarcoma protuberans Australia CRoyal Prince Alfred HOSJ!itall - Dermato!ibrosarooma protuberans Canada (foothills Medical Center\ • Dermatofibrosarcoma protuberans Hona Kong (Hong Kong Baptist Hospital\ · Dermatofibrosarcoma protuberans llllly !Naples Naval Medica!) · Dermatofibrosarcoma proruberans Japan. Chiba • Dcnnatofibrosarcoma protuberans Netberlands. AmSietdam • Dcrmatofibrosarooma protuberans (DFSP) Oatar (Hamad Medical Comorn!jonl · Dermatofibrosarcoma-protubernns Saudi Arabia. Alhassa • Dennato6bro~oma protuberans Saudi Ar1\bja <King Khalid University) • Dermalofibrosarcoma protubcrans

CTIR, Aprl12()04 "Minu<cs" (Subscription A) 9

Case 5 - Diagnosis: Dermatofibrosarcoma protuberans, groin

T-v?ooo.~-88323

Case 5 - References: Minter RM. Reith ID and Hochwald SN. Metastatic Potential ofDermatot)brosarcoma Protubcrnns with Fibro;arcomatous Change.

J'Surg Onco/2003; 82(3):201-208. Zamecnik M. Fibrosan:omatous Dermatofibrosan:oma Protubcrans with Giant Rosettes. Am J Dtrmatopatho/200 1; 23(1 ):4l-4S. Ghorbani RP, Mal pica A and Ayala AG. Dennatofibrosarcoma .Protubernns oftbc Vulva. Clinicopathologic and

lmmunohistocbcmieal Analysis of Four Cases. One with Fibrosan:omatous Change, and Review of the Literatll!e. lnt J GynecQ/ Patlro/1999; 18(4):366-373.

Linn SC, West RB, Pollack JR. et al. Gene Expression J>attems and Gene Copy Number Changes in Dermatofibrosarcoma Protubernns. Arn J Ptiilzo/2003: l63(6):2383-239S.

Bowne WB, Antonescu CR, Leung QH, ct al. Dennatofibrosarooma Protuberans. A Clinicopatllologic Analysis of Patients Treated and Followed at a Single Institution. Cancer 2000; 88(12):271 J-2720.

Case No. 6, Accession No. 29641

Arl;adia - Leiomyosarcoma Bal<ersfield - Metastatic leiomyosarcoma BaJ<h<in Park (Kaiser Permanentel - Epithelioid leiomyosarcoma (I); Leiomyosarcoma (I) Fontana (Kaiser Permanentel - Epithelioid leiomyosarcoma Haywardlfreinoot - llpilhelioid leiomyosarcoma, rrictlistatic Laguna Beach (South Coast Medical Cepter) - Epithelioid leiomyosnrcoma Long Beach - Leiomyosarcoma (8) Mountain View (El Camino )>athoJogy Grouo> - Metastatic leiomyosarcoma Qaklaad fl<aiscr PC:rmancntc) - Metastatic epithelioid leiomyosarcoma (6) Orange IQrange County Pathology Medical Group) - Metastatic (epilhelioid) leiornyosan:oma Sacramento (UC Davis Medical Center) - Metastatic epithelioid leiomyosarcoma

Apri12004

San Diego !Naval Medical Center> - Endometrial stromal tumor l'e-stiJibling Ovarian se.x cord tumor. metastatic vs. leiomyosarcoma Sag Francisco £Universiw of California) · Epithelloitl leiomyosarcoma Santa Rosa (Santa Rosa Memorial Hosoital) - Leiomyosarcoma, epithelioid type (I); Leiomyosarcoma ( 1 ); Metastaiic epithelioid

leiomyosarcoma ( 1) · · Ventura - l..eiomyosarcoma Alaska (Alaska Native Mec!ical Center) - Epithelioid leiomyosarcoma Colorado !Evergreen) - Epithelioid leiomyosarcoma Colora!lo <'Lutheom Medical Center) - Met.,1atic leiomyosarcoma (vs. Sltomal sarcoma) Florida fBantist Hospi!a!l - Epithelioid leiomyosarcoma (S) florida (Munroe Regional Mcdieal Center) - Rllabdomyosan:oma Florida IT!l]IMQ,S$¢1!) - LeiomyoSarcoma Florida (Winter Haven Bosoilall - Mesenchymal chondrosarcoma Illinois fBurr Rldgcl - Round cellleiomyos.vcoma lmnojs reyanston Bospitall - Epithelioid leiom>·osarcoma Indiana (Howard Community Hospital) - Rhabdomyosarroma Louisiana CLouisiana State I Jniversjty Medical Center) - Epithelioid JCiomyosarcoma Miuyland INatjonal Nayal Medical Center\ - Adult Wilms tumor (neuroblastoma) (S); Alveolar rhabdomyosarcoma (5) Massachusetts CBerJsshirCMedical Center) - Leiomyosarcoma, Grade lll of m Massachusetts <New England Medical Center Residen1sl • Leiomyosarcoma, epithelioid Michilllln IOal·wood Hospital\ - Metastatic leiomyosarcoma Michigan (St Joseph Mercv Hospital> - Epithelioid leiomyosan:omu Minnesota {Fajrvjew Southdale Hospital\ - Metastatic leiomyosarcoma Nebraska (Creighton llniversitv School of Medicine Residents) - Epithelioid leiomyosarcoma N¢w Jersey (Overlock Hosnital) - Epithelioid leiomyosarcoma New york CLpng Island Jewish Hospital) .. Epithelioid leiomyosarcoma New York fNas.,\iau t Jniversiw Medical Center) .. Epithelioid leiomyosarcoma, metastatic

tO C1TR, Aprii20<H "Minutes" (Subscription A)

New York. New Yod< • Likely metastatic epithelioid leiomyosarcoma New Yoril: CNY Plqbyttrian Ho!lJ!iral) - Epithelioid angiomyolipoma, pccoma New Yot1< !S!ODY Droolc Univ.,..;tv Ho!lJ!iral Residents\ • Epithelioid leiomyosarcoma NO!!h Carolina (Mountain An:a Pathology) • Metasllltic leiomyosan:oma (4) Ohio (McCI!IIousb-Hvde Memorial Hosuirall - Epithelioid leiomyosarcoma Pennsvlvania !AIIsgbeny General Hospj!J!Il • Mctas~atic epithelioid leiomyosarcoma Pennsylyanla !Concmauch Memorial Medical Center\ • Leiomyosarcoma Pcnnsvlvania Cl.ebjab valley HOS!>i!l!!l - Leiomyosarcoma PcnoMyania CYork; tfosnital) · Epilhelioid leiomyosarcoma Rhode Island !RI HospiJal Residents) • Epithelioid leiomyosarcoma Texas CLubb9!!kl - Alveolar rhabdomyosarcoma Texas (proPalh A:!sociA!!l<l • Leiomyosarcoma with epiJhclioid features (2) Tew !Snn An!opiol • High IVBde epi!helioid leiomyosarcoma Texas !Soon & White Mcmoriol Ho;;pirall • Metastatic epilhclioid leiomyosarcoma Texas (Uniycnjty of Texas MediAAl Brpnch - Metastatic epithelioid leiomyosarcoma Wvornjpg CGru;obrier Valley Medical Center) • Clear cell sarcoma AustruliqfNonh Queensland Pathology) • l:pithclioid leiomyosarcoma AuS!rl!,lia <Royal Prince Nfred Ho!!pitall • Epithelioid leiomyosarcoma Can&da !fogthm• Mcdjcal Center) - Epithelioid leiomyosarcoma Hong Kong !Hong Kong Baptist Hmirall • Mctastalic epithelioid leiomyosarcoma 11!!1!! Chilli • RIW>domyosarcoma. alveolar type Ne!hedand5. A!DJ!S!Iatn • Sarcoma. NOS Oa!ar IHPIIlad Medical Co!!!0!'8tionl • Mctastalic epithelioid leiomyosarcoma Saudi Ambia, AlhLUO · Leiomyosarcoma, metastatic Saudi ArAbia CKjng l)haHd Uojversjtyl - Leiomyosarooma

Case 6 - Diaggosls; Epithelioid leiomyosarcoma, kidney

T-7 1000, M-88903

Case 6 - References: Minami H, Ueld 0, TanAka T, eta!. Case of Leiomyosarcoma of the Renal Pelvis. lm J Uro/2004; II (2):122-124. Moazzam M. Ather MH and Hussainy AS. Leiomyosarcoma l'Tcscnting as a SJ)Ontancously Ruptured Renal Tumor-Case Repon.

Uro/2002; 19:2(1):13. Klijanicnko I, Caillaud IM,I..agjlee R, eta!. Fine-Needle Aspiration of Leiomyosarcoma. A Correlative Cytohistopathologlcal Study

of96 Tumors in 68 Patients. Dtogn Cytcpalhol 2003: 28(3): I 19-125. ~aoi B, Smith T A. Reith ID, et a!. RetrOperitoneal Leiomyosarcomas Una.sociated with the Gastrointestinal Tnoct. A

Clinieopathologic Analysis of 17 Cases. Mod Pmho/1999; 12(1):21-2&. Micttineo M. Sariorno-Rikala M. Sobin Ui. et aL Gastrointcslinal Suomal Thmo<s and LeiOm)'OS8lCO!llaS in the Colon. A

Clinicopathololic. Immunohistochemical, and Molecular Genetic Study of« Cases. Am J Surg Patho/2000; 24(10):1339-1352.

Case No. 7, Accession No. 2.9601

Arcadia • Oiant cell tumor of tendon sheath Bakersfield • Oiant eel! tumor of tendon sheath

April 2004

Baldwin Park CKnlser Perroanenrel • Local teoosynovial giwlt cell tumor (gillnt cell tumor of tendon sheath} (I); Oiwtt cell tumor ( I} fontana. CKajser l'ermanente) • Giant ceiJ tumor of tendon shOO Hayward!Fremopt • Giant cell tumor of tendon sheath (nodular tenosynovitis) [&RYAll Beach CSoyth Coa.<t Medjgll Center) - Giant cell tumor of tendon shcalh Lons Beach • Nodular tenosynovitis (8) Mol!!!1l!in view IE! Camino Pathology Group\ • Oiaot cell tumor of tendon sheath Qaldand (J(alp PqmaneOJel · Oiant cdl tumor oftendon sheath (6) Oranse !Omose Gounrv Pa!holo!!Y Medical Gmypl - Giant cell twnor of tendon sheath Sacnunen!D rue Oaris Medical Center) • Oiant cell tumor oftcodon sheath Sao Dicxo !Naya! M9diea! Center) • Oiant cell tumor of tendon sltealh San Frageiq CUniyer:;jN ofCaJifomial - Giant <:ell tumor of tendon sheath

CTrR. April2004 "Minutes" (Sub!cription A) II

Santa Rosa I Santa Rosa Memorial Hospilall - Giant cell rumor of tendon sheath Venrum - Giant cell rumor of tendon sheatb Alaska (Alaska Natjye Medical Center) • Giant cell twnor of IA:ndon sheath Colorado !Eyenzrgo\ - Giant cell tumor of tendon sheath Colorpdo !Lutheran Medical Center\ - Oiant cell tumor of tendon shcalh Florida IBoptjSJ HQ;!pjtal\ • Giant cell tumor of '"'don sheath Florida !Munroe Regional Medical Center\ • Tenosynovial giant cell tumor Florida Cia) Jahns) • Giant cell tumor oftcndoo sheath Florida. <Winter ijpyeo Hospital\ - Oianl cell MFH Illinois CBurr Rldicl • Giant cell tumorofiA:ndon sheath Ulinois CEva.ns;on Ho$nirnll - Giant cell tumor of tendon sheatlllnodular tenosynovitis lndjgna <Howard Communitv Hnsnitnll - Giant cell twnor of tendon sheath Louisjopn (Louisiana State University Medical Cent.erl - Giant cell tumor MnrvlWld CN!!IIqgnl Nayol Medical Center\ • Giant cell tumor of tendon sheath Mess•MuSCUS fBetksbire MedjeaJ Center) - Giant cell tumor orcendon sheath Massachusetts CNcw England Medical Center Residents! - Giant cell tumor oflendon sheath MichillM (Oakwood Hosoi!llll - Giant cell tumor of tendon sheath Michjgan CSt Jo.gh Mercv llospitall - Tenosyno\·ial giant cell tumor Minnesota Cfairvjew Southdalc H!l§!!ilall • Giant celltwnor of tendon sheath Nebn><k• CCo;iab!OQ !Jnjyrnity School of Medicine Residenl5) • Gianteell tumor of tendon sbeatb New Jmey COvglooJc llospitall • Giant ocJJ tumor of tendoo ~ CO<lSistent with increased mitotic: activity New Voris CLono !sloru! Jewish Homj!a!\ • Giant eel! rumor of tendon sheath New York fNmau llnjyrnjty Medical Center) • Giant eel! tumor New Voris. New Yorl< • Tenosyoovial giant ocJJ tumor New Yor!s fNY Presbyterian Hosoitall - Giant cell tumor of tendon sheath New York (Stony Dmok Univ..,.ilV Hosoital Residents! - GiWit eel! tumor of tendon sheath Nonb CaroliAa{Mouglftjn Ao;a Pathology\ • Giant cell tumor of tendon sheath ( 4) Ohio (McCullough-Hyde Memorial Hospjl!!)l - Giant cell rumor tendon sheath Pennsvlvanjo (Allegheny General Hosoilall • Giant cell tumor oftcndon sheath Pennsylyoolo <Conemaue.h Memorial Medical Center> .. Giant celltumoroftendon sheath Pennsylynnla l!.cblgb Valley Ho.mitall - Giant eel! tumor of tendon sheath Pennsylywlia IYJ>rls Hospital) • Giant cell rumor oftcndon shctt!h (7) Bhode Island fBI tlospltal Residents! - Giant cell rumor of tendon sheath Texas CLubb9ckl • Giant cell tumor of tendon sheath Texas CProPath Associates\ • Giant cell rumor of tendon sheath (2) IexM !San Amonlo\ • Giant cell rumor of tendon sheath (loca!!U<I tenosynovial giant cell tumor) Texas CScoq &. Wbjtc Memorial Hospj181l - Giam cell tumor TCl!!!S CUnjymjty oCTcxas Medical Bmnch • Giant cell tumor of the IA:ndon sbeatb Wvomjpa CGrqpbriq VaJiey Medical Center) • Plexlform fibrous bistiOC)'IOma Australia fNoab Oycen.•land Patholo!M - Giant cell tumor of tendon sheath Austtalia !Royal Pdncc Alfred Hosoitall - Giant eel! rumor of tendon sheath canada Cfoo!hllls MedlcBI Center} - Giant cell tumot or tendon sh«th Hong Kong (Hong Kono Baptist Hospilall - Tenosyoovial giant cell tumor Italy CNW}Ies Nnyal Medical! • Giant cell rumor oftcndoo sheath Jopan. Chjba • Tonosynovial giant cell rumor, locall:ecd type Netherlands. Am!lerdnm • Tenosynovial giant cell tumor, localized typ<l (nodular tenol>')'llovitis) Oatar CHnmqd Mcdjcnl Comorntionl - Giant cell tumor of tendon_ shcuth Saudi ArabjA. Albnssn • Giant cell rumor of tendon sheath Saydj Ar8bia IK!qo Khalid Unlyorsitvl • Giant cell tumor of tendon sheath

case 7 • DiaenosiJ: Localized tenosynovial giant cell tumor (giant cell tumor of tendon sheath), finger

T-Y8800, M-40000

Case 7 · .References: Ritora T. Yamamoto T. Akisue T, eta!. Multicentric Localized giant Cell Tomour oflhe Tendon Sheath. Th·o Separate Lesions at

Diff'erent Sit .. in a Finger. Br J DenntJJo/2002; 147(2):403-405. Al-Qanan MM. Giant Cell Tumours of Tendon Sheath. Classification and Recurrence Rale. J Hand Surg 2001 ; 26( 1):72-75.

12 CTTR. Apri12004 "Minute•" (Subscription A)

Looi KP. Low CK and Yap YM. Pigmented Villonodular Synovitis of the Hand in tile Asian Populmion. Hand Surg 1999; 4(1):81· 8S.

Galllani J, Oassiani G. Vnlmori A, et al. Giant Cell Tumor of Tendon Sehath. A Light and Electron Microscopic Study. J S11bmicrosc Cytol Patho/2000; 32(1 ):69· 76.

Cavaliere A, Sidon! A and Bucciarelli E. Giant Cell Tumor or Tendon Sheath. lmmunoblstochemical Study of20 Cases. Tl•morl 1997; 83(5):841-846.

Uribwu U and Levy VO. lnltaOSSeOUSGrowth of Giant Cell Tumors of !be Tendon Sheath (I ""''iud Nodular Tenosynovitis) of the Digits. Report or IS Cases. J Hand Surg 1998; 23(4):732-736.

Cue No. 8, Aceession No. 29652

AlSidia • Leiomyosarcoma Ba!sersfield • Leiomyosarcoma ll!!ldwin Park !Kaiser Pennancntel • Leiomyosarcoma, high srode (I); Leiomyosarcoma (I) t'ontano (Kaiser Permanentel - Pleomorphic rhabdomyosarcoma HoyWA!'d/Fremont • Pleomorphic rhabdomyoS4TCOma 4roma Beach CSouJh Coa:;t Medical Center\ • Myofibrosareoma vs. rhabdomyosarcoma vs. leiomyosarcoma Long Beacb • Leiomyosan:oma (8) MoWJtain Vlc:w (E) Ctmjno Pa!hology G!l!l)pl • Pleomorphic leiomyosarcoma Qakland (J(aiser PermMcntel - Leiomyosarcoma (6) Orange (Oranee County fathology Medical Grouol · Leiomyosarcoma Sneramcnlo !UC Davis Medical Center\ • Leiomyosarcoma San DieM CNaval Mcdjcnl Center\ · Pleomorphic rhabdomyo~orcoma San francisco aJniveahy ofCalifomial - Pleomorphic rhabdomyosarcoma

Apri12004

San11 Rosa !Sanll Rosa Mcmorial HOS!!ilall • Pleomorphic rhabdomyosarcoma (I); Rhabdomyosarcoma (I); Leiomyosarcoma ( J) YC!lllllJ • Rhabdomyosarcoma i\lllka !Alaska Native Mqljca! Center) • Leiomyosarcoma(2); Triton tumor (I) Colorado CBvcr!Q'CCnl • Pleomorphic rhabdomyosarcoma Colomdo <Lutheran Mcdltul eeorerl · J>Jeomorphic rhabdomyosnrcomn f lorida <Baptist Ho:rnito!l • Pleomorphic rhabdomyosarcoma (2); Rhabdomyosarcomn (2); Malignant f1 brous histiocytoma vs.

rhabdomyosarcoma (I) fJgri<!a (Munroe Rc¢on.a! Mqljca! C<nrg\ • Malignant fibrous histiocytoma Florida !Ta!lah \ • Adult pleomorphic rhabdomyosarcoma florida (Winter Haven Hmpita1) - Leiomyosarcoma I!!lnojs !Burr Ridge) • Leiomyosarcoma tl!!noj& (Evanston liosnila!l • Rhabdomyosarcoma. pleomorphic lndiona CH!!Wll!!! Commypjtv Hospital! · Rhabdomyosarcoma l..ouiJ:jana fl..ouisian!l SJ&te University MedicaJ Center> - Pleomorphic rhabdomyosarcoma Muyland !NIIjO!!AI Nayal Medical C<ntq\ • Rhabdomyosarcoma (8); Malignant fibrous histiocytoma (2) MNsocbusens !Berlcsh!Jl! Medical Center) • High J!111de sarcoma with muscle differentiation Momehusetts !New gog! and Medical Center Residents) - Leiomyosarcoma MlchiMn (Qakwood Hosnilall • Leiomyosarcoma M!ch!m !St. Joseph Mqcv Hospital\ · I..clomyosarcoma Mjnnewca (fairview Soytbdal• HOS!!illlll • Rhabdomyosarcoma NMp,s cogghton lJnjymitySdlool ofMqdjd$ R§ldet\LSl • Leiomyosarcoma New Jersey COyerJogk Hospital) - Leiomyosarcoma New York CLone Island Jewish Hospjta!} · High J!111de sarcorna consistent with leiomyosarcoma New York (Nassau Un!ysrsjtv Medical Center> - Rhabdomyosarcoma New Yori<. New Yodc • Favor high grade leiomyosarcoma; DDx: Muscle differentiation in a malignant pcripbetal nerve sl1eaJh

tumor New X ode: !NY Prcsblll<riM Hosoita!\ • Pleomotpltic rhabclomyosarcoma New York !Stony Bmok !lnjymitv Hospilal Rg!dcntsl • Leiomyosarcoma Nonb Carolina (Moumajo M:afatho!oJ!Yl • leiomyosarcoma (4) Obig !McCullough· Hyde Memorial HospitJU · Lciomyosarcomn l'rnosvlvania !Allegheny General Hosnlta!l • Pleomorphic mubdomyosarcoma Pennsvlvania!Conemnuoh Memorial MqljcaJ Center) - Pleomorphic rhabdomyosarcoma Pcno.<ylvania(Lehie.h Valley H9S!lita!l • Mali8JlADI fibrous histiocytoma

CTrR, Aj>ril 2004 "MinUI<$" (Subscription A) 13

Pennsy!yanla !York Ho•niflll) • Lciomyosan::oma (7) Rhode Island IR! Hosnj!al Residents) · Ma!ignMt Triton tumor (malignant peripheral nerve sbC31h tumor with 11Wxlomyoblastic

dilfem'ltiation) Texas C!.ubl>ockl • Leiomy~ma TcXliS <ProPath MmiJ!W · Rhabdomyosatt:Oma (2) Texu <San Antonio) .. Pleomorphic rhabdomyosarcoma Texas IScou & Wblte Memorial Hospifllll · Leiomyo""""'ma Texas CUniYct:!i'Y ofic= Medical Branch • Leiomyosarcoma Wyoming !Gn;epbriq Valley Medical Center) • Adult pleomorphic mabdomyosarcoma Au:;tra!ia CNorth Oueens!and Pathology) • Rhabdomyosarcoma Austmlis CRoya! Prince Alfred Hosnitall • MPNSTffriton tumor vs. pleomorphic leiomyosarcoma Q_nnada CFAAthil!s Mcdjcal Center) .. Ma1ignant Triton tumor Hong Kong I Hong Kong Baptist Hospiflll) • Rhabdomyosarcoma Italy CNap!cs Nayal Medical) · Leiomyosarcoma Japan. Chiba • Rhabdomyo.arooma, pleomorphic type NethefiMds Amsterdam .. Leiomyosarcoma Oatar ffinroad Medical Corporation) · Leiomyosarcoma Saudi AmbiA. Nhwa - Leiomyosarcoma Saudi Ambia CKjns J(halid University) • Leiomyosan::oma

Case 8 - Diagnosis: Leiomyosarcoma of soft tissue, back

T·Y 1100, M-88903

Case 8 - References: S!rubi~ KM and Skubitz AP. Differential Gene Expression in Lciomyo,.,.,.,ma Ca~cer 2003; 98(5): 1029·1 038. Hornick JL and Fletcher CO. Criteria for Malignancy in Nonvisural Smooth Muscle Tumors. Ann Diagn Patho/2003; 7( I ):60-66. Noguchi T, Dobo.shl Y, Minebara H, et al. involvement ofCyc!lns In Cell Proliferation and Their Clinical Implications in Soft

Tissue Smooth Muscle T\lmors. Am J Patlto/2000; 156(6):2135·2147. Farshid. Q. l'rndhan M, Goldblum J, eta!, Leiomyosarcoma 'of Somatic Son Tissues. A Tumor of Vascular orisln with Multivariate

Anal}'llls of Outcome in 42 Cases. Am J Surg Patho/2002; 26( I): 14-24. Miyajima K. Oda Y, Oshiro Y, eta!. Clinicopathological Progno!;tic Factors in Soft Tissue Leiomyosarcoma. A Multivariate

Analysis. flittopatho/2002; 40(4):353-359.

Case No. 9, Accession No. 29110

Ottl!liA . Poorly differentiated sarcoma(? MFH) Bakersfield • Maligllant fibrohistiocytOma Baldwin P!l!1c CKaj$<( Pqmancntc) • High grme sarcoma, NOS (2) Fonhlna <K•iw Pmnan<ntel · Peripheral malignant nerve sheath tumor Hayward/Fremont • MPH vs. poorly differentiated sarcoma w/ osteoclo.sts Lagunn Qencb !Soytb Coa.<;t Medical Center> • Malignant fibrous histiocytoma Lona peach • fibrosarcoma (8) Mountain Ylcw CE! Camino Pathology Gmuol • Malignant fibrous histiocytoma Oakland !Knlser Pennanen!e) - Pleomorphic high grade sarcoma consistent with malignaot fibrous h istioeytomn (6) Orange !Oranaa County Pftlbology Medical Group) • Ma!ignrull fibrous histiocytoma Sacoocotg !UC pavjs Me<iical C'.<:nterl . High grade sarcoma favor malignant fibrous histiocytoma

April 2004

San Dieso CNayal Mcdjca! Center! • High grade sarcoono. favor pleomorphic malignant fibrous histiocytoma; 2'" choice molignant peripheral nerve sheath tumor

San f!!l!!Cisco aJniYCC'lty ofCalifomial • Pleomorphic undifferentiated sarcoma Santa Rm !Santa Rosa Memorial Hospilllll • Malignant librou3 histiocytoma (I); Sarcoma consistent with malignant fibrou3

histioctyoma ( I); Ma!ignaot fibrous histiocytoma. storitl>rmlpleomorphic type (I) ~ - Malignant fibrous histiocytoma A]aska (Aias!sa Nulve Medjca! Center! • Malignant fibnous histiocytoma, StOriformfp!eomo<pbic (2); Ma!ignaot sebwannoma (I) Colorac!o CEv'""""") • Pleomorpbie malignant fibrous histiocytoma Colorado l!.uthemn Medical Center) • Malignant 6bnous histiocytoma

14 CTI'R, Apri120()4 "Minutes" (SubS<>ription A)

Floric!a (Ran!ist Hospital\ • Dedifferentiated liposarcoma (I); Undilfercntiatcd sarcoma (possible dedifferentiated liposarcoma) (I); Higb grade sarcoma, NOS (I); High grade, sarcoma (2)

Elori4a <Munroe Regional Medical Center> • Malignant fibrous histiocytoma Florjda (Tallahassee\ • Malignant fibrous histiocytoma Florida (Winter Haven Hosoilal\ - Fibrosarcoma Illinois CBuq Ridae\ • Malignant peripheral nerve sheath tumor Dlinois (Evanston Hospital\ • Malignant fibrous histiocytoma Indiana <Howard CommuniiY Hospital) • Malignant scbwanno0\8 Louisiana CL.oujsjana State Universitv Medical Center) - t-1alignant peripheral nerve sheath tumor Marvland <Na!jonal Naval Medical Center\ • Malignant fibrous histiocytoma (5); Malignant pedphe;ral nerve sheath tumor (4);

DedlfTere.ntiated liposarcoma ( t) Massachusetts (Berkshire Medical Center) . Malignant peripheral nerve sheath tumor Massachusetts <New England Medical Center Residents\ • Undifferentiated high grade pleomorphic sarcoma Michjggn COakwnod Hospital\ • Higb grade pleomorphic sarcoma Michigan CSt. Joseoh Mercv HOS!!ita\l · Malignant fibrous histiocytoma Minnesota (fairview Southdate Hospjta!) • Malignant fibrous histiocytoma Nebraska £Creighton University School ofMedicinl} Resjdentsl - High grad~ sarcoma vs. liposarcoma New Jersey (Overlook Hospital) · Soft tissue sarcoma, NOS New York (Long Island Jewish Hospital) • High grade sarcoma, malignant fibrous histiocytoma New York (Na«au University Medical Center\ · Malli:ll@.lll fibrous histioc)10ma New York. New York • favor pleomo,.Phic S(()riform malignant fibrous histiocytoma New York fNY Presbyterian Hospital) • Extra·~eletal osteosarcoma_ New Yorll IS!Ony Brook !Jnjversitv Hosoital Residents\ • Pleomorphic liposarcoma North Carolina (Mountain Area Pathology) . Fibrosarcoma vs. malignant fibrous histioc)1oma (I); Pleomorphic sarcoma (I); Higjl

grade fibrosarcoma ( !); High grade sarcoma? malignant peripheral nerve sheath tumor (I) Ohjo (MeCulloug!tHyde Memorial Hospital) · Fibrosan:oma Pennsylvania (Allegheny Geneml Hospital\ • Spindle cell sarcoma, possible peripheral nerve sheath tumor Pennsvlyan!a <Conemaugh Memorial Medical Center\ • Malignant peripheral nerve sheath tumor Pennsvlvania (Lehigh Valley Hospitall • Malignant fibrous histiocytoma Pennsvlvania !York Hosoilall · Poorly differentiated sarcoma (5); Sarcoma, NOS (I); Pleomorphic sarcoma (I) Rbode Island IR! Hospital Resident•\ • Malignant peripheral nerve sheath tumor Texa.• ILubbocl<\ • Neurofibrosan:oma Texas IProPath Ass9cjates) · Malignant fibrohistioc)1oma (2) Texas CSan Antonio) • Pleomorphic higjl grade sarcoma. (MPH) Texas (Scott & White Memorial ~""l>itall • Higb grade pleomorphic sarcoma (MFH) Texas <University ofiexas Medjcal Branch • Malignant fibrous histioc)1oma Wyoming (Qreephrier Valley Medical Center\ • Adult fibrosarcoma Australia (North Queensland Pathology\ · Malignant fibrous histioc)1oma Austra!jaiRoval Prince Alfred ·Hospi!Jll) - Giant cell variJ!nt malignant fibrous histiocytoma vs. malii:ll@.lll melanoma Canada IEoothllls Medical Center) • Malignant fibrous histioc)1oma Hong Kong <Hong Kong Baptist Hospital) • Spindle cell sarcoma Italy <Naples Naval M!ldjcal\ . Pleomorphic storiform millignant fibrous histiocytoma Jaoan. Cbiba · Malignant peripheral nerve sheath tumor Ne!herland.s. Amsterdam • Sarcoma, NOS (?) Oatar IHa.mad Medical Coroorationl · High grade sarcoma,l!\alignant 6brous histiocytoma (4); Malignant peripheral nerve sbcalh

tumor (3) Saudi Arabia. Alhassa • Malignant fibrous histiocytoma Saudi Ambia <King Khalid University) • Fjbrosarcoma

Case 9 -Diagnosis: High grade pleomorphic sarcoma (with phenotype of so-called "MFH''), back

T-YIIOO, M-88023

Case 9 - References: Miwa K, Nakamura J:l. Fukui H, eta!. A Resected Case ofMalignant fibrous Histiocytoma oftbe Chest Wall. Kyobu (iekll 2003;

56(9):742-746. Osanai T, Yamakawa M, Suda A, et al. Metamorphosed Fibroblasts and Their Relation to tbe Histogenesis of Malignant Fibrous

Histiocytoma in Experimental Murine Model. Hlstol Histopatho/2000; 15(3):697-705.

CITR, April2004 "Minutes" (Subscription A) 15

Case No. 10, Accession No. 24073

A1a!1iJ • Atypical lipoma (well-diffen:ntialed liposarcoma) Bake!$ficld • Pleomorphic lipoma

April 2004

Bnldwjo Pnt!c !Kaiser Peqnnnentel • Atypical lipomatous tumor (well-differentiated liposarcoma) (I): Well-<liJlerentiated liposarcoma (I)

fontana CKaiscr Permanentel - Pleomorphic lipoma Hoywnrd!fremont - Pleomorphic lipoma Lagupa Beach CSouth Coast Medical Ceptcrl - Pleomorphic lipoma Lon• Bcoch - Liposarcoma, low grade (8) Mountain View CE! Camino PaJboJogy Gmuol • Pteomorpltie lipoma 0o1:1an4 CKai:;er PennAne1\tel • Pleomorphic lipoma (6) Omose COmogc Countv Pathology Medical Group) - PleoiiiOfJlhic lipoma S!IC!!I!DenJo OJC Qavjs Me!lica! Center! - Pleomorphielipoma San Qjego !Naval Medical Center) • Pleomorphic lipoma vs. atypical lipomatous tumor San Frapcisco IUniversitv ofCalifom!a) • Pleomorphic lipoma Santa Rosn !Santa Rosa Memotiol Hgspi!all • Atypical lipoma (wcll-ditTcrcntlated liposarcoma) (I); Pleomorphic lipoma (2) Ylmlum • Pleomorphic lipoma Al!l$ka (Aias!sa Native MC<!lcal Center> - Pleomorpblc lipoma Co!Qfildo CEvergreenl • Well-differentiated liposarcoma Colorado <Luthcnm Modica! Center) - Well-differentiated liposan:oma Florida CBwtjSL HOS!?ilall - Liposarcoma (2): Pleomorphic lipoma (3) florida (Mwuoe Regional Medical Center) - Pleomorphic lipoma Florida ITallal!asseel • Pleomorphic lipoma Flods!a CWintcx Haven. Hosoiblll • Well-diffen:ntiated liposarcoma l!!lngis CBurr Ridael - Pleomorphic lipoma f!Hnoj; <Evanston •losoitall • Pleomorphic lipoma !nd!ann !Howard Community Hosp!ta!l • Atypical lipoma Loulslflnn fLouisjana.State lJnjycrsitv Msdjcal Centcrl -- AtypicaJ lipoma Mnrv!and !National Naval Medical Comer) - Atypical pleomorphic lipoma (7}; Well-differentiated liposarcoma (3) MIISlacbuseti' @crkshlre Medical CcpJcrl - Pleiomorphic lipoma M!!SaChusens <New Ensland Me!llcal Center ResjdepJS) - We!l-<lifl'en:ntiatod liposarcoma, adipocytic Michj!lOQ !Oakwood ijospitaJ) - Atypical lipoma MichjRM !SL Josenh Mercy Hospital) • Atypical lipoma Wnll£lllfA (fairview Southdllle !f!!!!Qj!AI\ • Pleomorphic lipoma Nebwlsa CCrti$lon Univmity School gfMC<!icine Resident<) • Atypical lipoma New Jcaey IQver!ook Hospital! - Liposarcoma. well-differentiated New vorts !Long Island Jcwi3h Hospj!Qil - Pleomorphic lipoma New Yortc. CNassan tlni"versjw Medjeal Ct<ntcr> - Pleomorphic lipoma Now Ygrk. New York • Pleomorphic lipoma (If this lesion issuperncla!) New YoQ; !NY Prt:sbytcrian Ho~niln!l • 111eomorphic lipoma New York <Stony Bmok Uniyersitv Homjtpl Residents) .. Pleomorphic lipoma Ngnh Carolina (MouoJAip Area Pathology) - Pleomorphiclipoma ( 4) Objo IMeOJJJou@-Byde Mernotia) Hgspilall - Atypical lipoma Penosvlyaoja IAI!cghcny Gencn!J HO!!!!jtall - Ploomorpblc lipoma Penpsylyaoja <Conem8!Jgb Memorial Me!llcai Center! - Atypical lipoma Penpsylyania !Lcbi•h Vatlev Hn<pjJA!l - Pleomorphic lipoma Ptnnsy!vanja (York Hospital) • Atypical (pleomorphic) lipoma (4); Atypical lipoma (3) Rhode Island IR! HOS!?ital Resida!ls} - Pleomorphic lipoma Texas 1Lubb9ckl • Pleomorpble lipoma TcxQS !ProPath Associates) • Pleomorphic lipoma (2) Texas <San Antonio! - Atypical lipomatous twnor (weil·differenliated liposarcoma) Texa.< (Scou & Wbite Memorial HospiJal\ • Pleomorphic lipoma TcxM Nnjycrsity of Texas Medis;o.l Brpncb • Pleomorphic lipoma Wyomipa <Gn:cnbder Valley Me!lica! Center> • Atypical lipomatous tumor AUSVJ!jaiNO!!h Oueen$1aod Pa!holosyl • Atypical lipoiOAlOtJS tumor

16 CTIR, April 2004 "Minutes" (Sub$cription A)

AliS!TA]IaiRoval Prince Alfred Hospita!l • PleolllO<PhiC lipoma Cwnda (foothills MediCAl Centerl • Atypical Upomatous tumor Hona Kong CHon• Kona Baptist Hospitall • Atypical!ipomntous tumor/well-differentiated !iposarcomn IJi>ly !Nanles Naval Medical! • Pleomorphic lipoma lalllln. Chiba - Pleomorphic lipoma Nghedand& ArMtf;rd•m - Pleomorphic lipoma Y.itb floret cells OAIIC CH8llllld M«<ica! Corponuionl • Pleomorphic lipoma Saudi An!bia. A!hassa • Wcll-differcntinted liposarcoma Saudj Arabia (King Kholid Universjivl - Atypical lipOma

Cm 10- Diagnosis: Pleomorphic lipoma. anterior chest waU

T·Y2130, M-88500

Case 10- Refe.rences: MentZ<! T. Cutaneous Lipomatous Nenphtsms. Semin Diagn Pntho/2001; 18(4):25()..257. Qui !lou Land Coindrc JM. Newly Desclbed Adipo~1ic Lesions. Semin Diagn Pat/rot 2001; IS(4):238-249. Dlaz-Cascajo C, BorQhl S, eta!. Pleomorphic Lipoma with PseudopapillaJY StNCIUn:s. A Pleomorphic Counterpart of

Pscudoaogiomatous Spindle Cell Lipoma. Hlstopo!hol 2000; 36(5):475-476. TbiNmala S. Desai M and Kannan V. Diapslie Pitfalls in Fine Needle Aspiration Cytology of Pleomorphic Lipoma. A Case

Rcpon. Acta Cyto/2000; 44(4):635~56.

CTTR. Apnl 2004 "Minutes" (SubsaipOO> A) t7