30/06/2012 - São Paulo - ICESP - A245

DIAGNÓSTICOS

Diagnoses of the Cases


1. São Luiz, Maranhão - Pablo (case from previous meeting)
-   Epithelioid sarcoma, distal type.

2. B HORIZONTE (BH): 70y/o woman. Tumor in the nasogenian sulcus, depressed and painfull.
-   Microcystic adrenal carcinoma (CK7, CK15, CK903-34BE12, CD10 positive).

3. ICESP: Woman 73 y/o Pedunculated lesion in the skin of the right cervical region.
-   Carcinosaroma (metaplastic carcinoma/ Basal-cell carcinoma with osteosarcomatous transformation) Ca (Am J Surg Pathol).

4. Case HIAE (Einstein): slides not sent 
-   Crystal toring histiocystosis (CSH)

5. Case Hosp. Brigadeiro – Hosp. of TX: Man. 46 y/o. Renal Tx. Pulmonary nodules.
-   Histoplasmosis (Tx patient)

6. Case Sta. Maria – IMH 12086: Woman, 66 y/o, Endometrial thickness. A curettage revealed endometrial hyperplasia with no atypia. In the follow-up: endometrial hemorrhage, weight loss, fetid secretion and left retroperitoneal adenomegaly.
-   Pleomorphic, undifferentiated uterine sarcoma with osteoclast – like giant cells (CD10+ focal; Caldesmon, Desmin, CK negative).

7. Salomão & Zoppi: IH1412-707: Man, 45 y/o. A tumor in the cupula of the urinary bladder measuring 2.8 x 1.8cm.
-   Inflammatory myofibroblastic tumor (Actin, AE1 – AE3, Alk+; ki-67 = 20%; S.100, Desmin, C kit -).

8. Case Porto: Woman, 69 y/o. Hepatic nodule (2.1 cm in diameter).
-   Intrahepatic  sporadic schwannoma 
-   (S-100 +, Ki-67 low; CD34, CD117, SMA -). 

9. ASPEN: Man, 71 y/o. Right cervical submandibular lymph node. Good general condition. No additional signs or symptoms.
-   Malignant neoplasia of uncertain histogenesis, rich in plasmatic cells (case see in consultation by  Dr. John Chan).
-   (IHC negative for melanoma, carcinoma, HIV negative, EBER+, CD138. MUM1, BOB 1 +). 

10.  HC – FMUSP: Man, 40 y/o. AIDS treated with retroviral drugs for two years. Now after a year with no treatment, the patient developed multiple skin lesions, generalized lymphadenomegaly and fever. A cervical lymph node bx was undertaken. 
-     B-cell large cell lymphoma associated with multicentric Castleman disease (positive for HHV – 8), (Ki-67 high, CK 138 negative).

11. Ribeirão Preto (Smear): 82 y/o, man. Patient with dementia. A pelvic mass was detected.  An abdominal CT revealed an abscess in the psoas region.  In the follow up: fever, an infectious leukogram, leukocyturia and death. During the autopsy, a 18 cm in diameter, well demarcated, yellowish, necrotic mass was detected in the region. Smears were performed from the lesion.
-    Diffuse anaplastic lymphoma of large cells Alk + (CISH ++, CD30+, SMA +).

12. UNESP: Woman, 50 y/o. Headache. Abdominal pain, tachycardia. Pressure: 46 x 22 mmHg. Respiratory insufficiency and death.
-    Vasculitis secondary to silicone implants (data from the autopsy).

13.  Hosp. Aliança: Ox, 2 y/o. Death after a bilateral orchiectomy (castration). A microslide  from  the heart obtained during the autopsy.
-    Sarcocystosis.

 14. IAMSPE: Woman, 27 y/o. GIII. PI. AI. A term newborn with 3 and 8 Apgar developed respiratory discomfort and died at Day 51.
-     Andersen disease (glicogenosis type IV).