03/07/2010 - São Paulo, 03/07/2010

DIAGNÓSTICOS

Diagnoses

1. Case  Drut 
– A 6 month old boy presented with a solid, cystic cerebral mass interpreted as an abscess. 
- Infantile desmoplastic ganglioma
(Synaptophysin, chromogranin: positive)

2. Patocito – Hospital Aliança 
– Girl, 7 y/o. Headache. A cerebral ventricular tumor. Ependimoma? Neurocytoma?
- Atypic teratoid-rhabdoid tumor 
( Vim, EMA, Actin positive, AE1-AE3 focal; K-67=7%; chromogranin negative)

3. FMUSP –    
– SP 10/9088
 – Man, 46 y/o. The patient was admitted to the emergency room with difficulty to talk and sleepiness CT: A voluminous, expansive mass in the left temporo- parietal region. 
- Multiform glioblastoma with granular cells
(GFAP, S-100, EMA positive)

4PUC-Campinas   
– B10-093 – Man, 45 y/o, Pain in the left eye for 5 months which evolved to proptosis. A well-demarcated, whitish nodule was resected, measuring 2.5 x 2.0 x 1.0 cm.
- Low grade mucoepidermoid oncocytic carcinoma of the lacrimal gland
( 35BH11, 34BE12, Ck7, p63, K67 = 5%)
( Pulitzer et al, 1987; Paulino et al, 1999)

5. Ribeirão Preto – USP   
– 
Woman, 50 y/o Nasal obstruction and presence of a naso-sinusal mass.
A polypoid, whitish, fibro-elastic fragment was resected, measuring 8.5 x 5.5 x 3.5 cm and weighing 54g.
- Solitary fibrous tumor 
(Bcl2, CD34, CD99, 1A4, Vim positive; S-100 negative) 

6. Case Suster
– SS09-9880
 – 35 y/o man with a history of radiation therapy to the neck for Hodgkin lymphoma is seen for the development of a large (10 cm) soft tissue mass.
- Malignant peripheral nerve sheath tumor, post-radiation (S-100 & Bcl2, focal;     SMA, EMA, CD34 negative).

7. HBH 
– IM968/08 – 
Woman, 46 y/o, Nodule in the superior lobe of the thyroid.
  - Spindle-cell variant of follicular adenoma of the thyroid ( TTF1, thyrogloblin positive) 
(Amer J Surg  Pathology, 2004)
(case will be shown in the next meeting)

8. Salomão & Zoppi
– IHO110-559 – 
Boy, 10 y/o. A 2.6 cm in diameter tumoral was in the right lobe of the thyroid.
- SETTLE
(AE1-AE3, 35BH11, 34B12, p63 positive);
(TTF1, thyroglobulin negative)
(Amer J Surg Pathology 33:1179.2009)

9. Rio Preto  
– B09-24344
 – Boy, 4 y/o. Voluminous mass in the anterior mediastinum. Gross features: a nodular, well–demarcated lesion, measuring 19 x 14 cm, made up by a homogeneous, granular, whitish tissue 
- Tubulo-papillary tumor consistent with congenital mesothelioma
(AE1-AE3 focal, p63 focal, calretinin & D2-40 positive)
(Case seen in consultation by Dr. Miguel Reyes–Mujica)

10. AC Camargo    
– 
Girl, 3 y/o. Coughing and persistent fever. CT: A voluminous mass in the inferior pulmonary lobe.
- Pleuro-pulmonar blastoma.

11. Lab. Macro & Micro – Florianópolis 
– B09-28260
 – Man. 35 y/o. Renal transplantation. Renal dysfunction and malaise. After a graft biopsy, the graft was resected.
- Tx renal, Adenovirosis: extensive necrotizing granulomatous inflammation
( IHC positive multifocally for adenovirus)

12. CIPAX
– 
Boy, 12 y/o. Lesion in the dorsum of the right foot. The specimen revealed a whitish nodule surrounded by the subcutaneous tissue.
- Hybrid schwannoma/ perineurioma

13. UNESP – BOTUCATU  
– A2309/10 – A male patient presented with a 0.1 cm in diameter nodule lesion in the skin of the glabella for 3 years.
The lesion was pearly, teleangiectasic and ulcerated.
- Cutaneous lymphadenoma (adamantinoid trychoblastoma)
( AE1-AE3 +; BerEp4 negative;C03+, CD20+, S100+)