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California Tumor Tissue Registry " CALIFORNIA TUMOR TISSUE REGISTRY California Tumor Tissue Registry c/o: Departme.nt of Pathology and Human Anatomy Lorna Linda University Sebool of Medicine 11021 Campus Avenue, AH 335 Lorna Linda, California 92350 (909) 824-4788 FAX: (909) 478-4188 CON"ntiDUTOR: WllllanoTalbert, M.D. CASE NO. 1 ·NOVEMBER 1995 Long Beach, CA TISSUE FROM: Sple<on ACCESSION #27748 CLINICAL ABSTRACT: This 77-year-old maJe. bad a 1-1!2 year history of a myelodysplastic syndrome, Ilea ted with blood transfusions for anemia. G.I. bleeding with tany stools and a hemoglobin of 5.21<d to admission about two weeks prior to his death. He became febrile. Blood and urine cullures were sterile. Renal failure developed. He became obtunded and died. He did not have a leukenlic peripheral blood picture. GROSS PATHO LOGV: Autopsy revealed a 1750 gram spleen with a splenic ''abscess•• which was partially ruptured and contained by surrounding tissue. CONTRIDUTOR: William Talbert, M.D. CASE NO. 2 • NOVE~ffiER 1995 Long Beach, CA TISSUE FROM: Lung ACCESSION 1127760 CLINl CAL ABSTRACT: This 23-year-old Asian female bad hemoptysis for two years. Chest film revealed a 1.0 em mass which grew to 4 em under observation. Iron deficiency anemia was diagnosed preoperatively, with a hemoglobin of 10.7 grams. Needle biopsy of the mass revealed tissue with the same diagnosis as that made on the resected specimen. A right upper lobe lobectomy was performed . GROSS PATROLOGV: The 120 gram lung was 12 x 7 x 3.5 em. A 3.5 em well-cireuonscribed nodule was near the bronchial margin. Other areas of the lung parenchyma appeared unremarkable. TI1e cut surface of tbe nodule was smooth, red-brown, and bloody. ClTR. November. t995 .. CONTRIDIITOR: Craig Zuppao, M.D. CASENO.J-NOVEMrnERl~S Loma linda, CA TISSUE FROM: Ovary ACCESSION #27778 CLINICAL ABSTRACT: During work-up for a myeloproliferative syndrome, this 66-year-old Caucasian female, gravida 6, para 2, ab 4, bed incidental fi ndings of a 6 em solid mass left ovarian on aCT scan. A CA-125 was 10. The chest x-ray was consistent with COPD and no metastasis. A pap smear was within nonnal limits 1 1/2 years ago. The patient has had a TAH 20 years ago for benign problems. A bilateral salpingo· oophorectomy was performed. GROSS PATHOLOGY: An 8.5 x S x S em firm nodular light un mass was adjacent to a 2.5 x 1.5 x 1.0 em light tan lobulated ovary. The mass bad a nodular yellow surface with interspersed white to light tan fibrous streaks. CONTRI BUTOR: J ozefKollin, M.D. CASE NO. 4 ·NOVEMBER 1995 Lukfwood, CA TISSUE FROM: Endometrial polyp ACCESSION #27781 CLINICAL ABSTRACT: This 40-year-old, G3, P2. Abl, caucasian female pJeSented with a 1·2 year history of heavy uterine bleeding. including the occasional passage of large blood clots. Physical examination showed a large pedunculated polyp apparently arising from the intrauterine cavity protruding from the cervix. The outline of the uterus was unable to be palpated due to the patient's obesity. A transvaginal intracavitary Jciomyomectomy and diagnostic dilatation and curellage were performed. GROSS I'ATHOLOGY: A grayish-white, whorled nodule was 3 x 2.7 x 2.6 em. On doss sectioning, it was again wborled and gr3yish·tan. No hemorrhage or necrosis was grossly idcnlified. CTill. NoV<mb<r, !995 CONTRIBUTOR: Steve Kargas, M.D. CASE NO. S • NOVDmER 1995 Los Angeles, CA TISSUE FROM: Placenta ACCESSION #27783 CLTNICAL ABSTRACT: This 38-year-old female underwent a vaginal delivery at38-weeks. The infant was live-bo.rn with APGAR scores of8 and 9. The molber's past medical history included a spontaneous abortion three years ago. GROSS PATHOLOGY: The 660 gram oval placenta was 23.Q x 16.5 x 2 em. A 7.0 x 6.4 x 3.5 em firm, multinodular mass was present at one edge of the placental disc, 2.5 em from the insertion of the umbilical cord. The fetal surface of this mass was blue-tan and glistening and was covered by the membranes. The maternal surface of this mass bad the appearance of the usual cotyledons. Cut sectiorung through the mass revealed deep red to black tissues with variegated areas of gray:tan. The mass was not sha!ply defined from the adjacent more normal appearing placenta. CONTRIBUTOR: Steve Kargas, M.D. CASE NO. 6 • NOVEIIiBER 1.995 Los Angeles, CA TISSUE FROM: Len chest wnU mass ACCESSION IIZ718S CLINICAL ABSTRACT: This 3 1 year-old non-smoking woman was found to have a le(l chest mas-s on a routine x-ray. The mass was removed from the chest wall through a left thoracotomy. GROSS PATHOLOGY: The 4.5 x 3.9 x 1.7 em ma.ss weighed !6.6 grams. The external surface was covered by a 0.2 to 0.4 em thick pink-white capsule. The cut surface of the mass was variegated with white areas of sclerosis, tan· yellow areas, focal areas of hemorrhage, and gelatinous foci. SPECIAL STAINS: S-100: positive CTIR. November, t995 CONTRIBUTOR: Steve Kargas, M.D. CASE NO. 7- NOVEMBER 1995 Los Angeles, CA TISSUE FROM: Colontrenuinal Deum ACCESSION 1127782 CLINICAL ABSTRACT: This 37-year-old Caucasian female bad a 3 1/2 year history of intract<~ble constipation. Approximately one year ago sbe underwent a sigmoid colectomy for redundant sigmo.id colon and a rectopexy for recbl prolapse. In spite of these, sbe rell!Jiined constipated. A detailed workup included small bowel transit study via barium swallow, hydrogen breath testing wbicb normalized after treatment with antibiotics for bacterial overgrowth, colonic transit, nuclear motility studies and anorectal manometry. A subtotal colectomy was perfonned. GROSS PATHOLOGY: The specimen consisted of a 53 em long portion of colon with an attached 2.0 em long portion of sll!JIII bowel. The colon bad a diameter nnging from S.S em near the cecal pouch to an average of 4.0 em throughout. The mucosa was velvety, gray-jNrple with the usual folds. Discrete lesions were not identified. CONTRIBUTOR: Samuel Yoshida, M.D. CASE NO. 8 • NOVEMBER 1995 Fresno, CA TISSUE FROM: Right kidney ACCESSION n7823 CLINlCAL ADSTRACf: The patient is a 68-year-old male who presented with diffuse abdominal pain. A cr scan revealed a solid hypovascular mass of the upper pole of tbe right kidney. The patient bad no voiding symptoms and no b.istory of any other urological problems. A surgical exploration found a 2.9 em tumor of the right kidney. A radical nephrectomy was performed. GROSS PATHOLOGY: The 176 gfam kidney was 11 x 6.5 x 3.5 em. A bulging tumor was present on tbe posterior aspect of the upper pole of the kidney. The 2.9 em tumor was well-<lemarcate and consisted o£ CocaUy hemonhagic tan-gray tissue. The tumor did not invade tbe renal pelvis or renal vein. CTTR. November, 199$ CONTRIBUTOR: Edward Aoosta, M.D. CASE NO. 9 ·NOVEMBER 1995 Sylmar, CA TISSUE Jo'"ROM: Small bowtl ACCESSION #27790 CLINlCAL ABSTRACT: During work-up for an abnonnal Pap smear, this 51-year-old Black was found to be anemic with a hemoglobin of7.5. Her hemoglobin continued to drop (5.7 gm) and she developed black tarry stools. CT scan showed multiple masses in the pelvis adjacent to small bowel and right hilar lymphadenopathy. Past medical history included a hysterectomy and bilateral salpingo-oophorectomy for uterine fibroids and a 12.5 em benign ovarian cyst. A partial resection of small bowel was performed for intractable Gltract bleeding. GROSS PATHOLOGY: A 38 em segment of small bowel had multiple ulcerated purple to red-brown submucosal masses ranging from 1.2 to 5.0 em in greatest diameter. Two masses appeared to have perforated, producing a localized peritonitis. SPECIAL STAINS: PAS (with and without diastase), Kl-1, Myoglobin, LCA, S-100, Actin HMB-45, PTAH, Mucin, Desmin: all negative Keratin, Vimentin, EMA: positive CONTRIDUfOR: Gary Poulrelli, M.D. CASE NO. 10 • NOVEMDER 1995 Veoturu, CA TISSUE FROM: Left shoulder ACCESSION #27766 CI.INJCAL ABSTRACT: This 41-year-old male presented with a 8.5 em cystic mass on the left shoulder, present for many years, and thought to be a sebaceous cyst. It had recently increased in size. The mass was excised . GROSS PATHOLOGY: Tbe 100 gram specimen consisted of a 8.0 x 7.5 x 5.0 em aggregate of soft, SOlllCWhat friable golden-yellow fatty tissue. CT!R, No¥<mbet, 199j CALIFORNIA TUMOR TISSUE REGISTRY SUGGESTED READING (General Topics from Recen~ Literature): National Cancer Institute Workshop. The Revised Bethesda System for Reporting Cervical/Vaginal Cytologic Diagnoses. Report of the 1991 Bethesda Workshop. Acta Cytol 36: 273-276. Bottles K, Reiter RC, Steiner AL, Zaleski S, et a). Problems Encountered with the Bethesda System. The UniversitY, oflowa &perience. Obstet Gynccol 1991;78: 410-414. Barth A, Brenner RJ, and Giuliano AE. Current Management of Ductal Carcinoma In-Situ. West J ofMed 1995; 163(4): 360-366 California Tum9rTissue Registry c/o: Department of Pathology and Human Anatomy Lorna Linda University School of Medicine 11021 Campus Avenue, AH 335 Lorna Linda, California 92350 (909) 824-4788 FAX: (909) 478-4188 CASE NO. 1, ACCESSION NO. 27748 NOVEMBER 1995 INLAND fRIVBRSTDE!SAN BERNARPINOl - Tuberculosis (3). LONG BEACH - Atypical mycobaelcrial splenitis (10). SAN DfEGO <Naval Medical Centerl - Acute splenitis with bacterial overgrowth (15); Whipple's Disease (1). SAN DIEGO (Oro"'mont Hospital) - Bacterial splenitis with ruprured abscess (4). MAl (1). SANTA BARBARA - Acid-fast bacterial abscess (3). SArffA ROSA • (A) Histiocytes with grmular cytoplasm, RIO MAl etc; (B) Reactive inflammation, subacute (1); MAl infection (1); MAl infection vs possible background of myeloproliferative syndrome (1).
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