18/08/2007 - São Paulo - E.P.M (UNIFESP)

DIAGNÓSTICOS

1. A220-1 – Rio Preto - IAPC
49 y/o woman. Dyspepsy and adinamy. Endoscopic examination showed enantematic pangastritis and mild atenuation of mucous folding. Gastric antrum and corpus biopsy.
Diagnosis: Auto-immune gastritis: atrophy, focal neuro-endocrine cellular proliferation; involvement of the body section; positivity for auto-antibodies (parietal cells)

2. A220-2 – Marília
LB2006/5831
 – 95 y/o, woman. Parotid tumor: 4.6 cm in  diameter, filled up with a red or creamy liquid.
Diagnosis: Papillary cistadenocarcinoma of the parotid (Am. J. Surg. Pathol. 20:1440-47, 1996).

3. A220-3 – Belo Horizonte
67 y/o woman. Pulmonary, 1.0 cm in diameter nodule (left superior lobe).
Diagnosis: Pneumocytoma (Sclerosing hemangioma) plus focal tumorlet (CK, EMA, TTF1 positive) (synaptophysin positive = tumorlet).

4. A220-4 – EPM
B07/10592
 – 14 y/o, boy Retro-orbital mass Clinical diagnosis: Cystic lymphangioma vs schwannoma. At the operation, the procedure had to be suspended due to a frank hemorrhage. 
Diagnosis: Alveolar soft part sarcoma (PAS positive; Desmin , vimentin positive; TTF3 negative: unreliable antibody (case see in consultation by Dr. Christopher Fletcher).

5. A220-5 – UNESP - Botucatu
B3567/07
 – 81y/o man. Scrotal mass.
Diagnosis: Aggressive solitary fibrous tumor (dedifferentiated) - CD34, vimentin positive; 1A4, S-100 negative)

6. A220-6 – Salomão & Zoppi
AP06/51700
 – 75 y/o woman. Retroperitoneal mass, excised with the hypothesis of an adrenal tumor: multiloculated, cystic, 6.2 x 3.2 x 2.5 cm mass, with a gelatinous, brownish liquid.
Diagnosis: Retroperitoneal bronchogenic (foregut) cyst (J. Chin. Med. Assoc. 69:538-542, 2006).

7. A220-7 – DAPHC - FMUSP
B07/11870 – 19y/o boy. Tumor in the left frontal lobe.
Diagnosis: Desmoplastic low grade astrocytoma = Gliofibroma (S-100, GFAP, vimentin positive; Ki 67 = 1% positivity; EMA and neuron markers negative).
Gliofibroma with extensive calcified depositsClin Neuropathol. 2003 Jan-Feb;22(1):14-22.

8. A220-8 – Porto
H04/627 – 53 y/o woman. Tumor at the basis of the frontal lobe.
Diagnosis: Papillary meningioma, grade III (EMA positive; CAM 5-2 negative).

9. A220-9 – Fleury
AP15584A-07 – 16. y/o boy. A 3 weeks-history of fever, cervical lymphadenomegaly and splenomegaly.
Diagnosis: Infectious mononucleosis (EBV positive; CD15 negative; CD20, CD138, CD30, CD3, CD4, CD8 positive either in follicular or paracortical area) (the reactive lymphadenomegaly regressed spontaneously).

10. A220-10 – Patocito - Bahia - Hosp. Aliança
AP1598/07
 – 72 y/o man. Tumor in the right testis. 
Diagnosis: Spermatocytic seminoma (PLAP, Ckit, Ki67 positive) (Pathol. Case Review, 2005).

11. A220-11 – Hospital A.C. Camargo
66 y/o woman. A polypoid, infiltrating, 2.6 cm mass in the uterine body. The mass involves the parametrium, tissues around the tubes and the ovaries.
Diagnosis: Metastatic lobular carcinoma of the breast (Estrogen, progesterone receptor, mamaglobin, BRST 2 positive) (a lobular carcinoma was later on detected in both breasts).

12A220-12 – EPM 
B07/9491 – 23 y/o, woman. Left ovary: 110g, 7.5 x 6.5 cm. Lobulated external surface. At cut surface, yellow tissue with whitish areas. 
Diagnosis: Follicular lymphoma, grade II, primary of the ovary (LCA, CD10, Bcl2, Bcl6, Ki67 positive) (Am. J. Surg. Pathol. 291:512, 2005; Mod. Pathol. 14: 1093, 2001)

13. A220-13 – USP - Ribeirão Preto
The case (images) will be sent later 
Diagnosis: Melanocytic nevus (choroid) plus fibrovascular membrane-post-retinal detachment).