14/04/2007 - Botucatu

DIAGNÓSTICOS

1. A218-1 – UNESP Botucatu - B3985/06
*
 A 7 y/o girl with the diagnosis of SLE for 2 years, under immunosuppressive regimen. She developed an acute abdominal episode and an abdominal US revealed heterogenous splenic nodules, up to 3 cmin diameter. She underwent splenectomy (143 g; infarct areas of 3.8 cm in diameter) and died one day afterwards.
Diagnosis – Hemophagocytic syndrome associated with systemic erythematous  lupus. (Nodular areas were infarcts) 
 

2. A218-2 – UFTM – Uberaba -    B06/4233
*
 33 y/o HIV positive woman. Pain and a nodular lesion in the posterior side of the left knee. Local trauma 3 years ago.
Diagnosis – Fibrous – histiocytic lipomatous hemosiderotic lesion.CD 34 positive.Calponin focally positive.A possible trauma-related lesion. 

 3. A218-3 – Salomão & Zoppi -    IHQ106/466
*
 41 y/o woman. Cervical tumor.
Diagnosis –Diffuse large cell B-cell lymphoma AE1-AE3, CD15, CD3, EMA, S-100, negative.  LCA, CD20 dot , CD30 dot positive.Note striking tumoral sinusal involvement (Histopathology 2005; 46; 241; Mod. Pathol. 2000; 13:223). 

 4. A218-4 – INCA 
* 8 y/o boy. Anemia, fever, diarrhea, generalized lymphadenomegaly. A 6 cm in the diameter mass in the 5th left costal arch.
Diagnosis – Angiomatoid fibrous histiocytoma Desmin, CD68, EMA positive. EWS-AT F1-CREB1 fusion. (USCAP, 2007: Abstract 31). 

 5. A218-5 – Hospital Aliança – Patocito Bahia - AP 1080/04
*
 12 y/o boy. A destructive tumor in a lombar vertebra.
Diagnosis – Solid aneurismal bone cyst.(Cancer 15: 2278, 1983; Cancer 71: 729, 2003).

6. A218-6 – Bauru -    B06/3291 
* 52 y/o woman. Intradural tumor. Schwannoma? 
Diagnosis – ParagangliomaSynaptophysin, chromogranin, NSE positive; S-100+ in sustentacular cells; Ki67 low; GFAP negative.There were some neuron-like cells which raised the hypothesis of gangliocytic paraganglioma (Mod. Pathol. 1988; 1:126). 

 7. A218-7 – Michal Michal - AP07/1506 
* 13 y/o girl. An 8 cm tumor on both lateral quadrants of the left breast.  
Diagnosis – Fibro-epithelial tumor of the breast with digital fibromatosis-like inclusions like formation. (Actin, calponin; vimentin, desmin, positive). (Hiraoka N et. al. Am. J. Surg. Pathol. 1994; 18: 506; Bittesini L et. al. Am. J. Surg. Pathol. 1994; 18: 296-301). 

 8. A218-8 – PATMED – Uberaba - B897/07 
* 34 y/o woman. Endometrium. Irregular genital bleeding US:   Endocervical polip, implanted high in the cervix.Multiple, brownish, elastic, irregular fragments, weighing 4.9 g and measuring 3.5 x 3.0 cm.     
Diagnosis – Müllerian adenosarcoma (Human. Pathol. 1990; 21:363). 

 9. A218-9 – Hospital do Câncer – A. C. Camargo -    BA6/7717 
* 27 y/o man. Testicular tumor.  
Diagnosis – Large cell calcifying Sertoli cell tumor (S-100, vim positive; inhibin negative). 

 10. A218-10 – CENAPA - B06/8541 
* 46 y/o woman. Submandibular nodule (microslide) with a synchronous nodule in the parotid gland.  
Diagnosis – Epithelial myoepithelial carcinoma (AE1-AE3 positive in ductal structures; calponin, S-100 positive in mesenchymal cells; Ki 67>10%). 

 11. A218-11 – Suster - S06/43205
* An 80 y/o man who presented with a soft tissue mass on his foot, measuring 8,0 cm in the greatest dimension.
Diagnosis – Parachordoma (S-100, EMA, CAM5.2 positive) Adv. Anat. Pathol 200: 7: 141).(P.S.Dr.Chris Fletcher has informed that parachordoma is now essentially a “dead term”.They are indistinguishable from myoepithelioma tumors.The term will probably be deleted in the next version of WHO blue book) 

 12A218-12 – Pathos - B99/25031 
* 53 y/o woman. Nodular lesion in the perianal region. Hamartoma?       
Diagnosis – Deep aggressive angiomyxoma   

 
13. A218-13 – HBH/ Hosp. Felício Rocho - B7074/06 
* 45 y/o, woman. A hepatic nodule suggestive of hemangioma.
Diagnosis – Epithelioid angiomyolipoma of the liver (PECOMA) HMB45 positive; CK negative.

14. A218-14 – Drut    
A 10 month-old boy with a liver tumor. Alpha-fetoprotein negative. FNA negative for neoplastic cells.
Diagnosis – Mesenchymal hamartoma (Human Pathol. 2002; 33: 236; J. Ped. Surg. 2005; 40:1681) 

 15. A218-15 – Esther Oliva - OCS 646 
* Man 50 y/o. On gross examination, there was a large tumor, involving the renal pelvis and renal parenchyma. Next to the mass, in the renal pelvis and upper ureter, there was a striking fine papillarity covering extensively the mucosa (microslide from this area).
Diagnosis – Villous adenoma with high grade dysplasia. Association with urothelial carcinoma grade 3 and cystic ureteritis. (Pathol. Res. Pract. 2001:197:507).