09/05/2009 - Botucatu

DIAGNÓSTICOS

Diagnoses

1.  Hospital Aliança 
– AP170/09 – Male, 65 y/o. Cerebral tumor in the left parietal lobe. Glioma?
– Metastasis of Melanoma (MM excised from the skin 5 years ago, S-100 and HMB45 positive; GFAP, EMA, AE1-AE3 negative; Ki67: 40%)

2. Basque country – Case (Dr. José Lopez)
– B07/19557 – 
Female72 y/o. Tumor in the cerebellum. 
 Cerebellar liponeurocytoma, WHO grade II (GFAP, synaptophysin, chromogranin positive)

3. Lab. Salomão & Zoppi
– AP0109-11557 – 
Male, 61 y/o. A soft tissue tumor in the thoracic region. An oval tumoral mass, measuring 6.7 x 4.8 x 2.6 cm, whitish, glistening at the cut surface and firm-elastic was excised.
 Desmoplastic fibroblastoma (collagenous fibroma)
   (Vim, 1A4 positive) (Miettinen & Fetsch; Human Pathol 29:676-82, 1998)

4. Case sent by Dr. Michael den Bakker
– H08-1250
 – Male, 15 y/o. Tumor in the parotid gland.
– NUT midline carcinoma (NMC)
  (EBER, CD99 negative; NUT-BRD4 translocation; t-15;19)
  (French CA et al. Cancer Res 63: 304-07, 2003; J Clin Oncol 22: 4135-39, 2004)

5. Lab. Pathos Case  
– 
Female, 38 y/o. A 1 year-history of a nodule in the jugal mucosa adjacent to the inferior pole of the parotid.    
 Clear cell carcinoma (CK7 positive; GFAP negative)

6. H.C. Ribeirão Preto, USP
 Female, 24 y/o – Hepatosplenomegaly with hypoechoic lesions at the US examination. A wedge biopsy of the liver. 
 Initial liver bx: Mesenchymal hamartoma
 Two years later: Liver transplantation: Large B-cell lymphoma: CD20, CD9 positive; Ki67 = 70%
 In the follow-up: Lymphoma involvement of the small intestine (B-cell)
P.S. The case will be rediscuted in the next meeting: Congo-red for amyloid?; Lymphoma in the first bx?; In situ hybridization for EBV?

7. Basque country – Case (Dr. José Lopez)
– B08/20825 – 
Male, 70 y/o. Tumor located in the left lung, lower lobe. The tumor measured 3.5 cm and had a whitish bilobated (endobronchial and intraparenchymatous) appearance. Two regional lymph nodes with metastases.
 Low grade mucoepidermoid carcinoma of the bronchial glands.

8. EPM
– B09/4498 – 
A woman, 55 y/o, was found to have several pulmonary nodules with no symptomatology. Two were resected. In September 1987, she was submitted to a hysterectomy which revealed several subserosal and intramural nodules up to 8.0 cm in diameter.
 Benign mestastasizing leiomyoma (The patient is alive and well. Unfortunately the hysterectomy material was not any longer available) 

9.  Dr. Sergio González  Case
– B438.423 – 
Female, 9 y/o. Presented with an abdominal tumor. Multiple peritoneal nodules at the laparotomy.
 Peritoneal gliomatosis associated with an ovarian immature teratoma (1250 g) (GFAP positive)

10.  Suster’s Case 
–SS-C08/18690 
– Male, 32 y/o – Left renal cell cancer. 
 PNET of the kidney (primary) (CD99, enolase positive; S-100, TdT, WT1 negative; t (11;22); Trisomy of the 7 chromosome) 

11.  UNICAMP
– Male, 21 y/o. Skin lesion in the scalp measuring 4.5 x 3.0 x 0.5 cm.
– Acute lymphoblastic leukemia (B phenotype)
(CD20, CD10, TdT, CD43, Bcl2 positive; CD5, Cyclin, CD23, negative) (Bone marrow not involved) (Am J Clin Pathol 115: 868-75, 2004)

12.  UNESP, Botucatu – Case (CD)
– 
Female, 36 y/o. Fever, asthenia, microcytic and hypochromic anemia, lymphocytopenia, hepatosplenomegaly. Lymphoproliferative disease? Gaucher??
– Hanseniasis (leprosy) (Ziehl-Nielsen positive; a skin lesion positive)