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CALIFORNIA TUMOR TISSUE REGISTRY
California Tumor Tissue Registry c/o: Department ofPathology and Human Anatomy Lorna Linda University School of Medicine 11021 Campus Avenue,.AH 335 Lorna Unda, California 92350 (909) 824-4788 FAX: (909) 478-4188 Tamet·auilience: Practicing pathologists and pathology residents.
Goal: To acquaint the participant with the histologic features of a variety of benign and malignant neoplasms and tumor-like conditions.
Objective: The participant will be able to recognize morphologic features of a variety ofbenign and malignant neoplasms and tumor-like conditions and relate those processes to pertinent references in the medical literature.
Educational methods and media: Review of representative glass slides with associated histories. Feedback on consensus diagnoses from participating pathologists. Usting of selected references from the medical literature.
Principal faculty: Weldon K. Bullock, MD Donald R. Chase, MD
CMECredit: The CITR designates this activity for up to 2 hours of continuing medical education. Participants must return their diagnoses to the CITR as documentation ofparticipation in this activity.
Accreditation: The California Tumor Tissue Registry is accredited by the California Me TISSUE FROM: Retroperitoneum ACCESSION #27853 CLINICAL ABSTRACT: , This 63-year old Hispanic female presented with a history of frequent bowel movements and some pelvic discomfort. Examination found a rectal mass. CT scan revealed an 8.0 em retroperitoneal mass displacing the rectum and vagina to the left side. The mass was resected. GROSS PATHOLOGY: The specimen consisted of portions of yellow-gray, focally hemorrhagic soft tissue from 0.5 to 3.4 em in diameter. SPECIAL STAINS: Vimentin: positive in spindled elements/rare positive in polygonal elements Keratin: positive in polygonal elements/negative in spindled elements Desmin: negative HCG: negative CONTRIBUTOR: Ernesto Rivera, M.D. CASE NO. 2 - APRIL 1997 Delano, CA TISSUE FROM: Right hip ACCESSION #27844 CLINICAL ABSTRACT: This 71-year-old female presented with a one year history of an enlarging mass in the right hip. She denied any history of trauma. CT scan showed a subcutaneous mass without invasion of muscle or underlying tissue. The mass was excised. GROSS PATHOLOGY: The 41 gram specimen consisted of a 6.0 x 4.8 x 3.0 em smooth surfaced oval mass with an overlying 4 em long elliptical piece of skin. The cut surface was soft, gelatinous, pale brown without areas of hemorrhage or necrosis. CONTRIBUTOR: Philip G. Robinson, M.D. CASE NO.3 • APRIL 1997 Boynton Beach, FL. TISSUE FROM: Thigh ACCESSION #27845 CLINICAL ABSTRACT: This 86-year-old male presented with a six month history of a mass in his distal left thigh. An excisional biopsy was performed. GROSS PATHOLOGY: The specimen consisted of a 4.2 x 2.5 x 2.5 em elliptical fragment of pale tao skin through which could be seen a bluish firm area which measured 3.5 x 2.0 x 2.3 em. Cut sectioning through the underlyllig tissue revealed a gelatinous center. SPECIAL STAINS: S-100 negative CONTRIBUTOR: Mark Janssen, M.D. CASE NO.4 • APRIL 1997 Anaheim, CA TISSUE FROM: Sigmoid colon ACCESSION #27856 CLINICAL ABSTRACT: This 50-year-old obese female presented with a two year history of crampy abdomin·al palm, diarrhea, occasional decreased bowel movements, and occasional clot-like blood per rectum. She denied any nausea or vomiting. Barium enema studies showed a filling defect in the distal sigmoid colon which was felt to be an extraluminal process. Colonscopy showed a 5.0 em diameter mass atlS.O em, producing severe luminal narrowing. A low anterior colon resection was performed. GROSS PATHOLOGY: The 14.0 em long segment of colon had a 5.0 em long region where the mucosa was thickened and distorted. The wall in this area was up to 2 em thick and indurated. CONTRIBUTOR: Mar k Janssen, M.D. CASE NO. 5 • APRIL 1997 Anaheim, CA TISSUE FROM: Suprnclavicular ACCESSION #27857 CLINICAL ABSTRACf: This 51-year-old male smoker presented with a ten week history of a growing supraclavicular mass. The mass was firm, moveable, and non-tender. A left supraclavicular biopsy was performed. GROSS PATHOLOGY: A 4.0 r3.5 x 2.0 em portion of soft'tan tissue contained a tan slightly nodular area measuring up to 2.0 em. The mass "shelled out" at the time of biopsy. CONTRIBUTOR: Douglas A. Kahn, M.D. CASE NO. 6 • APRIL 1997 Sylmar, CA TISSUE FROM: Thyroid ACCESSION #27842 CLINICAL ABSTRACf: This 34-year-old Hispanic female presented with a suspicious thyroid nodule. Following an FNA, a total thyroidectomy was performed. GROSS PATHOLOGY: The left and right lobes of thyroid were submitted separately. The 18 gram left lobe was 4.0 x 4.0 x 3.0 em. Sectioning revealed almost complete replacement by homogenous gray-tan, firm tumor with only a thin.rim of brown thyroid parenchyma. The right lobe was grossly unremarkable. CONTRIBUfOR: Lorna linda Pathology Group (ric) CASE NO.7 - APRIL 1997 Lorna Linda, CA TISSUE FROM: Right chest wall ACCESSION #27836 CLINICAL ABSTRACT: This 50-year-old male had a liposarcoma in the right thigh, diagnosed 6 years earlier. It had been treated with radical excision of the quadriceps, intra-arterial Adriomycin and 6500 rads of radiation. Four years later he had a left flank mass excised. He now presents with a 5 em diameter right lower lung/chest wall mass. An excisional biopsy was performed. GROSS PATHOLOGY: The 93.5 gram, 9.0 x 5.0 x 4.0 em specimen included a central3.5 x 3.0 x 3.0 em firm white-tan well-circumscribed mass. The cut surface was somewhat nodular. CONTRIBUfOR: Lomo Linda Pathology Group (rlc) CASE NO. 8 • APRIL 1997 Lorna Linda, CA TISSUE FROM: Right kidney ACCESSION #27837 CLINICAL ABSTRACT: This 49 year-old male presented with an episode of hematuria. KUB, IVP and cr scan revealed a 7·8 em diameter renal mass in the lower pole. A radical nephrectomy was performed. GROSS PATHOLOGY: The 783 gram, 7.0 x 5.0 x 5.0 em kidney had a 8.0 x 7.0 x 6.0 em soft brown and white-tan partially necrotic mass involving the lower pole. CONTRIBUTOR: Lorna Linda Pathology Group (ao) CASE NO. 9 • APRIL 1997 Lorna Linda, CA TISSUE FROM: Small bowel ACCESSION #28040 CLINICAL ABSTRACT: This51-year-oldmale presented with bowel obstruction. A partial small bowel resection was performed. GROSS PATHOLOGY: The specimen consisted of a 270 gram, 17.0 x 4.0 x 3.0 em segment of small bowel with an attached)5.0 x 4.0 x 3.0 em portion of mesentery. The bowel wall was diffusely thickened to 0.7 em. CONTRIBUTOR: Douglas Kahn, M.D. CASE NO. 10 • APRIL 1997 Sylmar, CA TISSUE FROM: Omentum ACCESSION #27822 CLINICAL ABSTRACT: This 69 year-old female presented with increased abdominal girth, weakness and fatigue. The CA-125 was 825. Cytology on ascitic fluid showed malignant cells. Work-up for a primary was negative. Hysterectectomy, bilateralsalpingo-oophorectomy and omentectomy were performed. GROSS PATHOLOGY: The omentum was a 30.0 x 20.0 x 3.0 em irregularly-shaped portion of yellow and red-brown ·firm fibroadipose tissue. The ovaries and fallopian tubes·showed atrophic changes. The uterus ha:d atrophic endometriuq~ and benign adenomyosis. CALIFORNIA TIIMOR TISSUE REGISTRY SUGGESTED READING (Gcnenl Topics from Recent Utenturc): Apoptosis. Cummings MC. Winterford CM and WalkerNI. Am J. Surg Pathol 1997; 21(1): 88-101. An Infectious Etiology for Wegener's Granulomatosis? Adv in Anatom Pathol 1997; 4(1): 52. Empiricism and Wegener's Granulomatosis (Editorial). DeRcmce RA. N Engl JMcd 1996; 335: 54-SS. Trime01opri.J.n SulfameUlo,azole (Co-Trimo~le) For the Prevention of Relapses of Wegener's Granulomatosis. (Dutch Co-Trinlo~le Wegener Study Group) Stegeman CA, Travaert 1WC, DeJong PE and Kallcnberg CGI\1. N. Eng J Mcd 1996; 335: 16-20. Unbuffered Formalin Negates HPV DNA Detection by Polymerase Chain Reaction in Laryngeal Papillomas. Adv in Anat Pathol1997; 4(1): 53. Detection of Human Papilloma virus in Routinely Processed Biopsy Specimens from Laryngeal Papillomas. Evaluation of Reproducibility of Polymerase Chain-Reaction and DNA in situ Hybridization Procedures. Acta Otolaryngol 1996; 116: 627-632. Tumor Angiogenesis as a Predictor ofTumor Agg11:ssiveness and Metastatic Potential in Squamous Cell Carcinoma of the Head and Neck. Carrnu RL, Barnes EL, Snyderman CH, Petruz.clli G, et al In vas Metas 1996; 15: 197-202. California Tumor Tissue Registry c/o: Department ofPathology and Human Anatomy Lorna Linda University School ofMedicine 11021 Campus Avenue, AH 335 Lorna Linda, California 92350 (909) 824-478 FAX: (909) 478-4188 CASE NO. 1, ACCESSION NO. 27853 APRIL 1997 INLAND auyER$1DEISAN BERNARDINO! - Chondrosarcoma, possible malignant chordoma (I); C=inosarcoma (!). BAKERSfi'ELD CCenuaJ VaUev Studv Grouo> - High grade transitional cell catcinoma. cAMARILlO DIAGNOSIS: CARCINOS,U.COMA, RETROPERlTONEUl\1 TY4600/l\189803 FOLLOW-yp: 111e patient was treated with radical pelvic exenteration followed by local radiation therapy, colostomy. One year later tlte patient was found to have a duct carcinoma of!he brcasl Tumor m01phology was di.ffercnt from the retroperitoneal neoplasm. EEI'IZRENCES: Lauchlun SC. Conccpllllll Unity orthe Mullerirut 'rumor Group. Cancer 1968; 22: 601-610. McGrath PC. Retroperitoneal Sarcomas. Seruin Surg Oncol 1994; 10: 364-368. lshikunl H, Kumagai F, Yoshika T. CarcinQilai" INLAND CRJVERSIDE/SAN BERNARDINO\ • MaligMnt fibrous histiocy1oma (I); Pleomorphic liposarcoma (I). BAJ DTAGNOSTS: DEDIFFERENTlATED LIPOSARCOMA (MIXED LIPOSARCOMA WITH WELL DIFFERENTiATED AND PLEOMORPIDC COMPONENTS); RIGBT HIP TYJSOO/M88S13 REfERENCES: Fletcher CD, Ackerman M, Dal Cin P, de WeAver L, et 81. Correlation Between Clinicopathological Features and Karyotype in Lipomatous Twnors. A report of 178 Cases from Chromoso!U$ and Morphology (CHAMP} Collaborative Group. Am J Pathol (US) 1996; 148(2}: 623~30. Kilpatric SE, Doyon J, Peter FM, et a1. n,c Clinicopathologic Spectrum of Myxoid und Round Cell Liposttrcoma. A StudyofSS Cases. Cancer 1996; 77: 145().1458. CASE NO. 3, ACCESSION NO. 27845 APRIL 1997 INLAND CRI\FERSIDE/SAN BERNARDINO> - Myxoid malignant fibrous histiocytoma (I); Carcinosarcoma (I). BAKERSFIELD DTAGNOSIS: MYXOMA, THIGH TY9100/M88400 REFERENCES: I-fushimoto H, Tsuneyoshi M, Daimatu Y, ct al. lntramuso:ulot Myxoma. A Clinicopatholosie,lnununohistocbemical and Elcclron Microscopic Study. Cancer 1986; 740-747. · MieUinen M, Hockersted! K, Reitarno J and 'fottCI'lllllnS. h1trarnusculW' Myxoma-A Clinicopathological Study of Twenty-Three Cases. Am 1 Clin Pnthol 1985; 84: 265-272. AllcnPW. Myxoid TwnorofSoi\T1$SUe. PathoiAnnual l,Potlll980; 133-192. CASE NO. 4, ACCESSION NO. 27856 Al'lUL 1997 INLAND CRIVERSIDEISAN BERNARDINO) - Endometriosis (2) BAKERSFIELD DIAGNOSIS: ENDOMETRIOSIS, COLON T67000/M76500 FOLLOW-UP; In the year following surgety, she has had episodes of pyelonephritis, secondary to endometriosis associated ureteral obstruction and endometriosis of !he liver, identified through nllraSOnography. REFERENCES: Panganiban W, Coronog JL Endometriosis of the In~ and Vermiform Appendix. Dis Colon Rectum 1972; 15: 253-262. Gray LA. The Manllgcment of Endometriosis Involving the Bowel. Clin Obstet Oynecol 1966; 9: 309-330. CASE NO. 5, ACCESSION NO. 27857 APRIL1997 INLAND CRI\IERSIDEISAN BEBNARDINOl - Myxosarcoma (I); Lipoma "ilh myxoid change (myxolipoma). BAKERSFIELD DIAGNOSIS: MYXOID LlPOSARCOMA, LEFT SUPRACLAVICULAR REGION TYOG20/88523 FOLLOWUP: Additional liposarcomatous masses were found to involve the left retroporitoneum and right submandibular region. REFERENCES: Gollcgc 1, FisherC IUld Rhys-Evans PH. Head Wid Neck Lipo=m•. Cancer 1995; 76(6): JOSI-1058. McCulloch TM, Maliclski KH; McNutt MA. Head and Neck Liposarcoma A Histc>pathologic Re-E,.,luation of Reported Cases. Arch Otoiar)ngol Head Neck Surg 1992; 118(10): 104S-t049. (76 ca.scssinee 1911). Stewart MG, Schwartz MR. Alford BR. Atypical and Mali@JlaJlt Lipomatous Lesions of the Head and Neck. Arch Otolnryngol He:~d Neck Surg 1994; 120(10): 1151-1155. CASE NO. 6, ACCESSION NO. 27842 APRIL 1997 INLAND £RIVERSIDE/SAN BEBNARD!NO> - Papillary carcinoma. thyroid (I); Papillary carcinoma, till cell variaru ( 1) . BAKERSFIELD - Papillary carcinoma CAMARILLO DIAGNOSTS: PAPILLARY CARCINOMA, THYROID T96000/M80503 REFERENCES: Gilliland FD, Hunt WC. Morris OM. Key CR. Prognostic Factors for Thyroid Carcinoma. A Population Based Study of 15,698 Cases from the Surveillanoc, Epidemiology and End Rcsulis (SEER) Prosrnm, 1973-1991-Cancer 1997; 79(3): 564-513. • cady B, Rossi R An Expanded ViewofRisl;..()roup Definition in Differentiated Thyroid c.utcers 1988; Sursery; 104: 947-953. . Bisi H. Fernandes VSO, Asato De camargo RY, ct a!. Tite Prevalence of Unsuspec~ Thyroid Pathology in 300 Sequentilll Autopsies, with Speci4l Reference to Incidental C&rcinoma. Cancer 19&9; 64: 18&8-1893. CASE NO. 7, ACCESSION NO. 27836 APRIL 1997 INLAND CRJYERSIDE/SAN BERNARQINOl - Metastatic lipasarcoma (I); Dedifferentiated lipasarcoma (I). BAKERSFIELD (Central Valley Study Grouo> - Malignant fibrous histiocytoma. CAMARILLO (Alviso Group) - Malignant fibrous histiocytoma. VENJ1JRA CUnilabl - Fibrosarcoma (2). PLEASANTON/FREMONT • Metastatic liposarcoma. LONG BEACH • .Malignant fibrous histiocytoma (3); Sarcoma, NOS (3). OXNARD CS!. Johns Regional Ctrl - High grade sarcoma c/w librosarooma. SAN DIEGO (Naval Medjcal Center! - Dedifferentiated lipasarcoma (20). SANTA BARBARA CCouagel - .Malignant solitary fibrous tumor. SANTA CLAM DIAGNOSIS: DEDIFFERENTIATED LIPOSARCOMA (MFB PHENOTYPE), CIIESTWALL TY2150/M88513 REFERENCES: Deitos AP, Mentzel T, Newman CD. Spindle CeO Liposarcoma. A Hitherto Unrecognized Variant of Liposarcoma. All Anlllysis ofSix Cases. Am J Surg Pntholl994; t8(9): 913-921. KnloAC, Neibcrg OE, Van Oinkl RJ, el al. Detection of Local Recurrence ofSoil Tissue Sarcoma with Positron Enunission TomooJilphy Using(ISF) fhD'odeoxy Glucose. Surg Oru:ol1997; 4(1): 57~3. Faber LP, Somc:B J,and Tanpleton AC. Chest Wall TumO INLAND CR!VERSIDEISAN BERNARDINO> - Renal cell carcinoma (I); Papillary renal ceU carcinoma (I). BAKERSFIELD - Renal cell adenocarcinoma CAMARILLO IAiyiso Grouo> - Carcinoma, kidney, clear and wbular variety. VENJURA DIAGNOSIS: PAPILLARY RENAL CELL CARCINOMA, RIGHT KIDNEY T71010/M83J23 REFERENCES; JWJker K, Schlichter A, Jwlker V, Knofel B. eta!. Cytogcnic, H.iSt0]>3Utologic und lnununologic Studies ofMultifocnl Renal Cell Carcinoma. Cancer 1997; 79: 975-981.. · Guinan P, Fronk W, Soffrum R nnd Rubenstein M SU!ging and Survival of Patients "i.lh Renal Cell Cnrcinoma. Semin Surg Oncoll994'; 10: 47-50. . Fulmnan SA, Lasky LC and Limas C. The Prognostic SignifiC INLAND CRIVERSIDEJSAN BERNARDrNO • Ganglioneuroma (I); Dilfuse ganglioneuromatosis (I). BAJ{ERSFIELD ICentrnl Valley Study Group) - Diverticulum wi!h ulcer. CAMARJ'LLO !Alviso Group) - Ganglioneuroma. yENTIJRA CUnilab) - Crohn's enteritis (2). PLEASANTON/FREMONT - Ganglioneuroma. LONG BEACH - Hyperplasia of myenteric plexus(? Neurofibromatosis ? MEN 2B) (6). QXNARD 1St. Johns Regional Medical Ctrl - Crohn's disease wi!h hyperplasia of neural elements. SAN DIEGO CNaval Medical Ctrl - Neuronal dysplasia wi!h secondaiy inflammatory changes (17); Neuronal dysplasia and Crohn's disease (3). SANIA BARBARA !Cottage) - Wlarnmatory bowel disease (Crohn's) "ith ganglioneuroma. SANTA CLARA DIAGNOSIS: INTESTINAL GANGUONEUROMATOSrS, DrFFUSE TYPE, SMALL BOWEL T640001MS4600 REFE&ENCES: • Monln:sor E. Tacano C, Nifosi F, INLAND DTAGNOSIS: PAPILLARY SEROUS ADENOCARCINOII1A OF PERITONEUM TY44 00/M84603 REfERENCES: Licchlon SC, TIIC Secondary MuUorian System-Revisited. lnt J Gnec.ol !'athol t994; 13(1): 73-79. Miyaishi 0, Kenvchi I, SaiJII Sand Solo T. Autopsy Case of Serous Papillary Carcinoma of Peritoneum with Distant Mctastases but No Peritoneal Dissemination. G)'l<'COI Oncol 1994; SS(3): 443-452. Botti fora H, McCaughey WTE. Atlas of Tumor PathologyThtrd Series Foscicle IS. Tumors of !he Serosal Membranes. Armed Forces Institute of Pa!hol, Washington, DC 199S.