' -..
CALIFORNIA TUMOR TISSUE REGISTRY
"GASTROINTESTINAL PATHOLOGY"
Study Cases, Subscription A
November 2007
California Tumor Tissue Registry c/o: Department of Pathology and Hum110 Anatomy Lorna Linda University School of Medicine 11021 Campus A'•eoue, AR 335 Lorna Linda, California 92350 (909) 558-4788 FAX: (909) 558-0188 E-mail: [email protected] Web page: www.c!tr.org Web site & Case of the Month: www.cttr.org Target audience: Practicing pathologists and pathology residents.
Goal: . To acquaint the panicipant with the histologic features ofa variety of benign and malignant neoplasms and tumor-like conditions.
Objectives: The. panicipant will be uble to recognize morphologic features of a variety of benign and malignant neoplasms and rumor-like conditions and relate those processes to pertinent references in the medical literature.
Educational methods and media: Review ofrepresentative glass slides with associated histories. Feedback on consensus diagnoses from participating pathologists. Listing of selected references from the medical literature.
Principal faculty: Weldon K. Bullock, MD Donald R. Chase, MD
CME Credit: Lorna Linda University School of Medicine designates this continuing medical education activity for a maximum of2 hours of Category I ofthe Physician's Recognition Award ofthe American Medical Association. CME credit is offered for the subscription year only.
Accreditation: Lorna Linda University School of Medicine is accredited by the Accreditation Counci l for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians.
2 Study Cases, November 2007, Subscription A Contributor: LLUMC Pathology Group (mp) Case No. 1 - November 2007 A Lorna Linda, CA
Tissue from: Small bowel Accession #30652
Clinical Abstract: A 74 year old woman had a past history of endometrioid adenocarcinoma of the vagina. At a follow-up visi t, a I 0.0 em proximal jejunal mass was discovered.
Gross Pathology: A 277 gram, 11 x I I x 6 em mass was attached to a 3 em length of small bowel. The well circumscribed white whorled mass appeared to arise from the bowel wall and did not involve the mucosa. The cut surface showed no necrosis or cystic degeneration. , Special Studies: Negative: CD 34, CD11 7, SIOO Positive: Desmin (strong), Smooth muscle actin (focal)
Contributor: Robert Zuch, M.D. Case No. 2 - November 2007 A Baldwin Park, CA
Tissue from: Stomach Accession #30593
Clinical Abstract: A 49 year old man presented with nondescript abdominal pain. A gastric biopsy was performed with subsequent gastric resection.
Gross Pathology: The gastrectomy specimen had an intact mucosa Detached from the gastrectomy specimen, but submitted with it, was a 1,835 gram, 22 " I 9 x I I em mass. The cut surface was a variegated white-tan.
Special Studies: Strongly positive: CD34, CD117 Negative: Desmin
Sl\tdy Case.s. November 2007, Subscription A 3 Contributor: LLUMC Pathology G roup (mp) Case No.3 - November 2007 A Lorna Linda, CA
Tissue from: Stomach Accession #30708
C linical Abstract: A 79 year old woman presented with upper GI bleeding and was found to have an abdominal mass. Radiographic studies showed a lobulated mass involving the fundus ofthe stomach with central cys ti c change.
Gross Pathology: This 6 x 3 x 3 em portion of stomach was attached to an I I x 7 x 3 em spleen. A 6 x 5 x 4 em mural-based nodule extended from the stomach and had a central pale gelatinous area.
Special Studies: Positive: CD 117
Contributor: LLUMC Pathology Group (ec) Case No. 4 - November 2007 A Lorna Linda, CA
Tissue from: Liver Accession #30576
Cliniclll Abstract: A 35 year old man was found to have a li ver mass. lie had no history of cirrhosis.
Gross Pathology: This 16 x 13 x 8 em partial liver resection contained an I 1.7 x 10.0 x 6.5 em solitary, well circumscribed yellow-white mass with a lobulated cut surface. The cut surface showed foci of hemorrhage and necrosis.
4 Study Cases, November 2007, Subscription A Contributor: Lester Thompson, M.D. Case No. 5 - November 2007 A Woodland Hills, CA
Tissue from: Right ovary Accession #30595
Clinical Abstract: A 65 year old woman presented with right lower quadrant abdominal pain. Ultrasound showed a heterogeneous mass in the right ovary.
Gross Pathology: The 8.5 gram ovary was fi1111 with a gray-tan lobulated but smooth surface. The cut surface was edematous and focally hemorrhagic.
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Contributor: Gu.Wermo Acero, M.D. Case No.6 - November 2007 A Ojai, CA 93023
Tissue from: Gallbladde•· Accession #30491
Clinical Abstract: A 72 year old woman was in good health until the evening ofThank sgiving dinner, when she developed right upper quadrant pain. She denied weight loss or systemic symptoms. Radiographs showed gall stones and a possible mass at the tail of the pancreas. At surgery, the pancreas was normal.
Gross Pathology: The 8 x 3.5 em gallbladder had numerous calculi and a 2 em indurated gray area at the neck.
Study Cases, November 2007, Subscription A 5 Contributor : Lester Thompson, M.D. Case No.7 - November 2007 A Woodland Hills, CA
Tissue from: Gallbladder Accession #30602
Clinicnl Abstract: An 87 year old man presented with an acute abdomen. ACT showed a liver lesion which yielded pus on aspiration. Gallstones were noted, along with a thickened gallbladder wall.
Gross Pathology: The resected gallbladder was received in multiple fragments, accompanied by a single 4 em diameter calculus.
Contributor: Rose Akin, M.D. Case No.8 - November 2007 A Fresno, CA
Tissue from: P ancr eas Accession #30767
Clinical Abstract: A 29 year old woman was found to have an abdominal mass.
Gross Pathology: The 75 gram, 8 x 7 x 4.2 em specimen included the tail of the pancreas and a portion of stomach. Within the pancreas was a 6.5 x 5.0 x 4 em lobulated mass with a variegated cut surface showing focal hemorrhage and necrosis. ·
6 Study Cases, November 2007, Subscription A Contributor: Edgar Fischer, M.D. Case No.9 - November 2007 A Albuquerque, NM
Tissue from: Stomach Accession #30411
Clinical Abstract: A 53 year old man presented with non-specific ttpper Gl tract symptoms and was found to have a 10 em mass in the proximal stomach.
Gross l'athology: A 10 x I 0 x 4.5 em exophytic mass v.>as present in the proximal stomach, near the gastro esophageal junction.
Contributor: Ujvala Sawkar, M.D. Case No. LO - November 2007 A National City, CA
Tissue from: Cecum Accession #30570
Clinical Abstract: A 73 year old man complained of sudden onset of acute abdominal pain, without accompanying nausea or vomiting. The right lower quadrant was tender to palpation.
Gross Patboloey: A 32 em long portion of colon, terminal ileum and appendix included an 8 x 7 x 3 em ulcerated mass in the cecum.
Special Studies; Positive: Keratin, CEA Weakly positive: CK7, CK20, Chromogranin Negative: Synaplophysin
Study Cases, November 2007, Subscription A ·1 ',;:;:; CALIFORNIA November, 2007 'IVMOR Tissut: RWISTRY \!,!;, Study Cases, Subscription A roup answers due: December 7th) Finalized minutes will be mailed and POSted on the website by the Ist week of December
NAME: S\JIV\'1 ~ w \ EO l 'tA DATE:_ ___.:O:L_fc_C...~.o,_~0~3.::.,..1-,.,Jr.,..,.l.IO....J .) C...:3-;I:., - STUDY GROUP {IF Al'I'Y):______
EVALUATION: Please circle the best response.
~ I. Technical slide quality: Very Good Average Below Average 2. Did the slides adequately depict the case? All did Most did few did 3. Were the case histories adequate? Usually Sometimes Never
General comments:______
DIAGNOSES: . Case Ill (Accession #30652) __...:;L;_ t(,:_'_l :::.O_Il)__:_\ _,_0=---"'- fiL-______
Case 112 (Accessio11 #30593) _____G=-- \...:S."'--'\'------
Cfl,ve #4 (Accessioll #30576) ___\;\.:...:..l<( ;;...~..;.t(fl...-.,;f \J:w...(->.9_,L..;.t ..::(J..:.l_,.~\-L-~{-fl:..J,.,;.I\..,:(;..:., .:.:~'>.:::17.,;..rr>_,fl.~.-___ _
Case 115 (Accessio11 ii30595) ___~,:: (__1.:..,;_.JC.;..'L.=-:.£_r.J_:f>:_:}:_:(I~~:.__:C:..!.Jf]'------
Case #6 (Accession #30491)
Case H7 (Accession #30602)_--!Jlfd~O..lSc!.r-l:.:li~C~'Y\..!..l..!.\..:~-"':..:.;V:....:.;tv'..J((fLLl..______
Case 118 (Aues~" #30767)_....::,0::.;N:.:..~.{ ~.!.I '(.!..--..:.' .:_• _:L:...._:(;:,__JI)"---~_:)~,~-.__:_?_\.!.~:..::.L ~·I)'-!./~~c:.A..u.~~~..!.I.Jf\L!:l'\:1__L_
Case 119 (Acces,vlo" #304 I J) __.,_P\:.::; O...;~c.:N'-'U"---5"-"0._.v...,llr"'"-o.:..:;w.Dl.....,~.:,__,(....Lef\U2Q"-(-"\ "i>i.l1>.ll,!CmC!.I.:f>r~-. ___
Case ff I 0 (Acc<.$sio11 #30570) ___T'f _~_v _n .i.(__:__N O..:.lX..=...:.I\ _11_:_\\.,___C...:A...:______
California Tumor Tissue Registry Objectives: Participants will be able to: c/o Lorna Linda University I) Recognize morphologic features oro variety of benign and School of Medidnc/Dcpa11ment of Pathology malignant neoplasms and tumor-like conditions 11021 Crunpus Avenue, AH 335 2) Relate those processes to pertinent references in the medical l-<>ma Linda, CA 923 50 literature FAX: (909) 558·0188 FACSIMILE TRANSMITTAL SH EET
TO: CTTR FROM: STUART SWIEDLER FAX: 415-382-7889
COMPANY: DATE: 12/03/07
FAX NUMBER: 909-558-0 188 TOTAL NO. OF PAGES INCLUDING COVER: 2
NOTES/COMMENTS:
November Study Cases attached.
Smart J. Swiedler, M.D., Ph.D. Sr. Vice President, Clinical Affairs BioMarin Phannaceuticallnc. 415-506-6706 (Phone) 415-382-7889 (Fax) sswiedler(ti)brnrn.com ********************* *** 'fX REPORT *** ******************'**
TRANSMISSION OK
TXIRX NO 1900 RllCIPlENT ADDRESS 190955&0188 DESTINATION Ill ST . 'riME 12/03 15:34 TIME USll 00 ' 24 PAGES SENT 2 RESULT OK
FACSIMILE TRANSMITTAL SHEET
TO: CTTR FROM: STUART SWIEDLER FAJ{:415-382-7889
COMPANY: DATE: 12/03/07
FAX NUMBER: 909-558-0188 TOTAL NO. OF PAGES INCLUDING COVER: 2
NOTES/COMMENTS:
November Study Case$ attached.
Stuart J. Swiedler, M.D., Ph.D. Sr. Vice President, Clinical Affairs BioMarin Phannaceutical Inc. 415-506-6706 (Phone) 415-382-7889 (Fax) [email protected] CALIFORNIA TUMOR T ISSUE REGISTRY
GASTROINTESTINAL PATHOLOGY
Minutes - Sctbscription A
November, 2007
SUGGESTED READING (General Topics from Recent Literature):
Influence of the HIPAA l'rivacy Rule on Health Research. Ness RB. JAMA 2007; 298:2 164·21 70. Percentage of Gleason Panem 4 and 5 Predicts Survival After Radical Prostatectomy. Cheng L, Davidson DO, et al. Cancer 2007; 11 0: 1967·1972. Squamous Cell Carcinoma of the Bladder. A Clinicopathologic Analysis of 45 Cases. Lagwinski N, Thomas A, ct al. Am J Surg Patho/2007; 31:1777- 1787. Hospital Lymph Node r;xamination Rates and Survival After Resection for Colon Canc-er. Wong SL, Ji ~1 . et al. JAMA 2007; 298:2149-21 54. Cytology of Nonneoplastic Occupational and Environmental Disel~Se$ ofthe Lung and Pleura. Laucirica R and Ostrowski ML. Arch Paihol Lab Med2001; 131:1700-1708.
California Tumor Tissue Registry c/o: Department of Patho lo~:,ry and Human Anatomy Lorna Linda University School of Medicine 11 02 1 Campus Avenue, AH 335 Lorna Linda, California 92350 (909) 558-4788 FAX: (909) 558-0188 E-mail: c!!!@!inkline,corn Web site & Case of the Month: www.cttr.org FILE DIAGNOSES
CTTR Subscription A November 2007
Case 1: Leiomyoma, small bowel T -67 I 00, M-80 I 03
Case2: Gastrointestinal stromal tumor, malignant, stomach T-63000,M-96103
Case3: Gastrointestinal stromal tumor of uncertain 11}alignant potential, stomach T-63000, M-88903
Case 4: Hepatocellular carcinoma, low grade, liver T-56000, M-81703
Case 5: Metastatic signet ring adenocarcinoma (Krukenberg tumor), ovary T-87000,M-84903
Case6: Adenocarcinoma, gallbladder T-57000, M-81403
Case7: Adenocarcinoma (mucinous), gallbladder T-57000, M~ 8 L403
Case 8: Solid pseudopapillary tumor, pancreas T-77100, M-80103
Case 9: Adenosquamous carcinoma, stomach T-63000, M-85603
Case 10: Neuroendocrine carcinoma, cecum T-67100, M-80103
2 CTTR, No"embu 2007 "Minutes .. (Subscription 1\) Case No. 1, Accession No. 30652 Novem ber 2007
Alameda (Alameda Counrv Medical Center} • i.,eiomyoma Claremont • !.,eiomyoma Hayward-Fremont • Smooth muscle tumor of uncertain malignant potential Los Angeles (ABC Laboratories> • !.,eiomyoma Long Beach CYA Hospital) • Leiomyoma Monterey Peninsula
CTrJt November 2007 ''Minutes" (Subscription A) Canada {Shcrbrooke University Hospital) - Leiomyoma Hong Kong CHong Kong Baptist Hospital) - Leiomyoma Hong Kong {Kwong Wah Hospital) - Leiomyoma Ireland (Keqy General Hospitall - l eiomyoma Japan (Asashi General Hospital) - Gastrointestinal stromal tumor, low grade Japan (Kvoto University Hospital) - Leiomyoma Oman (Khoula Hospitall - Leiomyoma Puerto Rico CUniversity of Puerto Rico) - Leiomyoma The Netherlands Amstelveen - Leiomyoma small bowel United Kingdom (Oxford Studv Group) - Leiomyoma
Case 1 - Diagnosis: Leiomyoma, small bowel T-67100, M-80103
Case I - Refere nces: Nagi B, Venn3 V~ Vaiphei ·K, et al. Primary Small Bowel Tumors. A Radiologic--Pathologic Corrclution. Abdom lmagirzg 200L~ 26(5):474-480. Ludwig OJ and Traverso LW. Gut Stromal Tumors and Their Clinical Behavior. Am J Surg 1997; 173(5): 390-J94. Gill SS. Heuman DM and Mihas AA. Small intestinal Neoplasms. J Clin Gastroemero/200 I; 33(4):267-282. Vallaeys JH, Cuvelier CA, Bekaert L. et al. Combined Leiomyomatosis of the Small intestine and Colon. Arch Pat hoi Lab M•d 1992; 116(3):281-283.
Case No. 2, Accession No- 30593 N()vcmbcr 2007 Alameda (A lameda County Medical Center) - Gastrointestinal stromal tumor, malignant Claremont - Gastrointestinal stromal tumor Hayward-Fremont - Gastrointestinal stromal tumor, high grade Los Angeles CABC Laboratories) - Gastrointestinal stromal tumor, grade TI-ITI/IJJ Long Beach CVA Hospital) - Malignant gasn·ointcstinal stromal tumor Monterey Peninsula CCommunitv Hospital) - Gastrointestinal stromal tumor (malignant features) Mountain View CEI Camino Hospital) - Malignant GI stromal tumor Oakland - Gastrointestinal stromal tumor Orange crrR. November 2007 "Minutes'' (Subscrip1ion A) Marvland CNatjonal Naval Medjcal Center) - Gastrointestinal stromal tumor, high risk Massachusens (Berkshire Medical Center) - Gastrointestinal stromal tumor Michigan {Pathology Services of West Michigan) - Malignant gastrointestinal stromal tumor Minnesota (Fairy jew Ridges Hospital) - Gastrointestinal stromal tumor, high risk Missouri (MissoUri Delta Medjcal Center) - Gastrointestinal stromal tumor Mis souri-Kans!IS City Cfruman Medical Cen)crl - Gastrointestinal stromal tumor Nebraska (Creighton Universjrv) - Malignant gastrointestinal stromal tumor (G!Sl) Neyada (Sunrise Hospital) - Gastrointestinal stromal tumor New Mexico. Albuquerque • Gastrointestinal stromal tumor, malignant New York CECMC\ - Gastrointestinal stromal tumor (GIST), high risk category New York (Stony Brook University Residents) - High risk (malignant), gaSTrointestinal stromal tumor New Yoris CS\JNY Downstate Medical Center) - Gastrointestinal stromal tumor. high risk, malignant New York !Wes)cbester Medico! Center) - Malignant gastrointestinal stromal tumor Ohio CMcCulloug!l-Hyde Memorial Hosoitall - Malignant gastrointestinal stromal tumor Pennsylvania (Conemaugh Hospilall - Gastrointestinal stromal tumor, malignant/GANT Pennsvlvania CSJ. Elizabeth Health Center) - Gastrointestinal stromal tumor, malignant Texas. Crvstal Beach - Gastrointestinal stromal tumoJ Texas, Lubbock - Malignant gastrointestinal stromal rumor Texas !San Antonio Christus Saota Rosa Children's Hosojtall - Gastric gastrointestinal stromal tumor, malignant Texas (ScoU & White Hospital) - Malignant gastrointestinal stromal rumor Washinf!!on. DC • Gastrointestinal stromal mmor West yirginia (Greenbrier Valley Medical Center) - GaStrointestinal stromal tumor Australia (Royal Hobart Hosojta!l - Gastointcstinal stromal tumor (malignant i.e. high risk of aggressive behavior) Australia (Sulljvon Nicolaides Pathologv) - Gastrointestinal strOmal tumour Canada (Pasqua Hospjtal) - Gastrointestinal stromal tumor, probably malignant Canada CSherbrooke Vniversitv tiosPim!l - Gastrointestinal stromal tumor Hong Kong CHong Kong Baptist Hospital) - Gastrointestinal stromal rumor, malignant t!ong Kong (Kwong Wah Hospitall - Gastrointestinal stromal tumor, high risk Ireland (J{errv General Hospitall - Gastrointestinal stromal tumor Japan CAsashj General Hospita!l • GastrOintestinal stromal tumor, high grade J.i!nun (Kyoto Un jyersitv Hospital) • Gastrointestinal stromal tumor, malignnnt (high grade) Oman (Khoula Hospital) - Malignant gastrointestinal stromal tumour Puerto Rico CUnjyersity of Puerto Rico) - Malignant gastrointestinal stromal tumor The Netherlands. Amstelveen - Gastrointestinal stromal tumor United Kingdom (Oxford Study Group) - Gastrointestinal stromal tumor with high malignant potential Cm 2-Diagnosis; GastrOintestinal stromal tumor, malignant, stomach T-63000, M-96103 Case 2 .. References: Pork SH, Kim MJ, Kwon J, ct al. Solitary Fibrous Tumor Arising from Stomach. CT Findings. Ynnscl Mcd J 2007; 48(6): 1056- 1060. Demllltco RP. gold JS, Saran L, e1 a!. Tumor Mitotic Rate, Size, and L Cnse No. 3, Accession No. 30708 November 2007 Alameda (Aiamel!a Counrv Mcdjcal Center) - Gastrointestinal stromal tumor, GANT variant Claremont - Gastrointestinal stromal tumor Hayward-Fremont - Gastrointestinal stromal tumor C'rrR. NO\'ember 2007 "Minute$" (Subscription A) ; Los Angeles (ABC Laboratories} - Gastrofntestinal stromal tumor, low grade Long Beach CV A Nospi!all - Gastrointestinal stromal tumor, unknown malignant potential Monterey Peninsula CCornmunitv Nospitall - Gastroi.ntestinal stromal tumor Mountain View CEI Camino Nospftall - Gl stromal rumor Oakland - Gastrointestinal stro!llal rumor Oranee COranee Countv Pathology Medical Group - Gastrointestinal stromal rumor Oxnard CSt. John's Regional Medical Center) - Gastrointestinal srromal tumor (I); Gastrointestinal stromal tumor, probably benign (I) San Diego - Gastrointestinal stromal tumor San Diego (NavarMedical Center) - Gastrointestinal stromal tumor San Diego (Scripps Clinic) - Gastrointestinal srromal tumor, favor benign Sail Francisco CUCSF} - Gastrointestinal stromal tumor, low risk Santa Barbara - Gastrointestinal stromal tumor Santa Rosa (Santa Rosa Memorial Nospital) - Gastrointestinal stromal tumor (GIST) {3) Sonoma (Sonoma Valley Nospital} - Gastrointestinal srromal tumor, high risk Woodland Nills - Gastrointestinal stromal tumor Alabama (Baptist Medical Center} - Gastrointestinal stromal tumor Alabama, Mt Olive - Gastrointestinal stromal tumor, high malignant potential Florida (Jackson Memorial Hospital) - Gasrrointestinal stromal tumor Georgia - Gastrointestinal stromal tumor Illinois (Burr Ridge) - Gastrointestinal stromal tumor, benign Illinois (Heartland Regional\ - Gastrointestinal stromal rumor (of uncertain malig_nant potential) Illinois, Oak Brook - Gastrointestinal stromal rumor, low malignant potential Illinois (Mac Neal Hospital) - Gastrointestinal stromal tumor, stomach Indiana (St. Joseph) - Gastrointestinal stromal rumor (4) Kansas CCvtocheck Labora!Qrv. LLQ - Gastrointestinal stromal tumor, intermediate risk ( I); Neural sheath tumor ( 1) Kentucky (University of Louisville) - Gastrointestinal stromal tumor, intem1ediate risk Maryland (National Nayal Medical Center) - Fibromatosis, imraabdominal Massachusetts (Berkshire Medical Center) - Epithelioid GIST with secondary amylidosis Michigan (Patholoev Services of \Vest Michigan) - Gastrointestinal stromal tumor Minnesota (Fairview !Udges.Hospitall - Gastrointestinal stromal tumor, high risk Missouri (Missouri Delta Medical Center) - Scbwannoma Missouri-Kansas Citv 6 CITR. November 2007 "Minutes··· (Subscriplion A) Japan Cas• 3-Diagnosis: Gastrointestinal stromal rumor of uncertain malignant potential. stomach T-63000, M-88903 Gas: 3 · RcrerepceJ· Nada R, Vaiphei K, Singh R. et oL Gastrointestinal Stromal Tumors the Assessment of Malignant Potential. Indio,. J l'atl>ol Microbio/200 I; 44(4):393-397. Gu M, Ghafari S, Nguyen PT. ct al. Cytologic Diagnosis of Gastrointestinal Stromal Tumors ofthe Stomach By Bndoscopic Ultrasouod-Guided Fine-Needle Aspiration BiopSy. Cytomorphologic and lmmunohi Case No. 4, Accession No. 30576 November 2007 Alameda {Alameda County Medical Center) - Hepat CITR. Noventber '2007 ••MinU1cs" (Subscription A) 7 Maryland CNattonal Naval Medical Center) - Fibrolamellar hepatocellular carcinoma Massachusetts (Berkshire Medical tenter) - Fibrolamellar carcinoma Michigan !Pathology Services of West Michigan) - Hepatic adenoma Minnesota (fairview Ridges Hospital\ " Hepatocellular carcinoma, tibrolamellar Missouri (Missouri Delta Medical Center) - Hematoma vs. pelosis hepatitis Missouri-Kansas .City Cfruman Medical Center) - Poorly differentiated hepatocellular carcinoma Nebraska (Creighton University) - Hepatocellular carcinoma, fibrol~mellar variant Nevada (Sunrise Hospital) - Fibrolamellar hepatocellular carcinoma New Mexico. Al buquergue - Hepatocellular carcinoma, fibrolamcllar type New York (ECMC) - Fibrolamellar hepatocellular carcinoma New York (Stony Brook University Residents) - Aepatocellular carcinoma New York (SUNY Downstate Medical Center) - Fibrolamellar hepatocellular carcinoma New York (Westchester Medical Center) - Hepatocellular carcinoma Ohio (McCullough-Hyde Memorial Hospital) - Hepatoma Pennsvlvania (Conemaugh Hospital) - Hepatocellular carcinoma Pennsylvania (St. Eli7-abeth Health Center) - Hepatoma/hepatocellular carcinoma Texas. Crystal Beach - Hepatocellular adenoma Texas Lubbock - Lari1ellar carcinoma Texas (San Antonio Christus Santa Rosa Children's Hospital) - Heptocellular carcinoma Texas (Scott & White Hospital) - Hepatocellular carcinoma Washington. DC - Hepatic adenoma West Virginia (Greenbrier Valley Medical Center} - Well-diffe(entiated hepatocellular carcinoma Australia Case 4 - Diagnosis: Hepatocellular carcinoma, low grade, liver 'f-56000, M-81703 Case 4 .. References: Kitay-Coheny, Amiel A, Ashur Y, et al. Analysis of Chromosomal Aberrations in Large Bcpntocellular Carcinomas by Comparative Genomic I'Jybridi:anion. Cancer Genet Cytogenet 2001; 13 1(1):60-64. LiD, Mallocyi and Sntomu.rn S. AFP-L3 A New Generation of Tumor Marker for Hepatocellular Carcinoma. Clln ChimA era 2001; 313(1-2);15-19. Koo SH, Jhrn CH, Kwon KC. et aJ. Ge.netic Alterations in Hepatocellular Cl!fcinoma and Intrnhcpatic Cholangiocurcinoma. Cancer Genet Cyto..;enet 2001; 130(1 ):22-28. Bergsland EK. Molecular Mechanisms Underlying the Development of Hepatocellular Carcinoma. Semin Onco/2001; 28(5):521- 53 I. Little SA ~nd Fong Y. Hepatocellular Carcinoma. Current Surgical ManagcmcnL Senuit Onco/2001; 2.8(5):474-486. Case No. 5, Accession No. 30595 No-vern ber 2007 Alameda (A lameda County Medical Center) - Metastatic signet ring cell adenocarcinoma, (Krukenberg tumor) Claremont - Krukenberg tumor Hayward-Premont - Me~1static signet ring carcinoma(? gastric origin) 8 CTI'R, No\'cmbcr 2007 "Minute$.. (SubS(; ripti(Jn A) Los Angeles CITR, November 2007 -Minu1cs- (Subscription A) 9 Hong Kong (Kwong Wah Hospital) - Krukenberg's tumour (metastatic signet ring cell carcinoma) Ireland (Kerry General Hospital) - Krukenberg tumor ofovary Japan (Asashi General Hospital) - Fibroma with minor sex cord elements Japan (Kyoto Universitv Hospital\ - Metastatic signet ring cell carcinoma {Krukenberg tumor) Oman CKhoula Hospital) - Metastatic signet-ring carcinoma Puerto Rico (University of Puerto Rico) • Signet ring adenocarcinoma/metastatic The Netherlands. Amstelveen - Metastatic mucinous adenocarcinoma United Kingdom (Oxford Study Group) • Metastatic mucinous adenocarcinoma, ovary (Krukenberg) Case 5 ~ Diagnosis: Metastatic signet ring adenocarcinoma (Krukenberg tumor), ovary T-87000, M-84903 Case 5 .. References: Yook JH, Oh STand Kim BS. Clinical Prbgnostic Factors for Ovarian MetnstMis in Women with Gastric Cancer. Hepatogastroenter.ology 2007; 54(75):953-959. Young RH. From Krukenberg to Today. The Ever Present l'robtems Posed by Metastatic Tumors in the Ovary. Part fl. Adv Allat Pmho/2001; 14(3): 149-177. Lerwill MF and Young RH. Ovarian Metastases of Intestinal-Type Gastric Carcinomn. A Clinicopnthologic Study of 4 Cases with Contrasting Features to Those of the Krukenberg Tumor. Ari• J Surg 2006; 30(1 I): I 382· I388 . Kakushima N_, Kamoshida T, Hirai s. ct al. Early Gastric Cancer with Krukenberg Tumor and Review ofCases e>flntramucosaJ Gastric Cancers with Kmkenberg Tumor. J Gastroenttro/2003; 38( 12): 11 76- 11 80. Lashgari M, Behmaram B, Hoffman JS, ct al. Primary Biliary Carcinoma with metastasis ofthc Ovary. Gyneco/ Onco/ 1992; 47(2):272-274. Case No. 6, Accession No. 30491 November 2007 Alameda (Alameda County Medical Center) - Adenocarcinoma Claremont - Poorly differentiated adenocarcinoma, GB Hayward-Fremont - Adenocarcinoma, gallbladder, high grade Los Angeles Case 6- Diagnosi5: Adenocarcinoma, gallbladder T-57000, M-81403 Ca,~e 6 • References~ Krishnani N, Shuklo S, IVld Jain M. Fine Needle Aspiration Cytology in Xllllthogmnulomatous Cholecystitis, Gallbladder Adcnocarcinomo and Co-Existent Lesions. Acta Cyto 2000; Acta Cytoi44(4):S08-S t4. Alborcs-Saavedro J and Henson DE. Pyloric Gland MetAplasia with Pcrincuraltn\'asion of the Gallbladder. A Lesion That Can 13c Confused with Adenocarcinoma. Cancer t999; 86( 12):262$-2631. Naknshima H, Nngafuchi K, Sotoh H, ctal. Hepatold Adenocarcinoma of the Gallbladder. J /lepatobiliary Pancreat Surg 2000; 7(2):226-230. Nonh 1H, Pack MS, Hong C, ct al. f'rognostic Factoi'S for Adenocarcinoma of the Gallbladder. An Analysis of 162 Ca.•cs. Am S11"8 1998; 64(5}:437-440. CTIR, November 2007 ''Minutes'' (Subscription A) tt Case No. 7, Accession No. 30602 November 2007 Alameda (Alameda Countv Medical C~nter) - Adenocarcinoma .Claremont - Adenocarcinoma, GB Hayward-Fremont - Mucinous carcinoma, gallbladder Los Angeles (ABC Laboratories) - Adenocarcinoma Long Beach (VA Hospital) - Adenocarcinoma. Monterey Peninsula (Communitv Hospital) - Adenocarcinoma Mountain View (EI Camino Hospital) - Moderately differentiated adenocarcinoma Oakland - Adenocarcinoma Orange (Orange Countv Pathology Medical Group - Adenocarcinoma Oxnard (St. John's Regional Medical Center) - Adenocarcinoma (2) San Diego - Adenocarcinoma, gallbladder San Diego fNaval Medjcal eenterl - Adenocarcinoma, favor gallbladder primary San Diego (Scripps Clinic) - Adenocarcinoma San Francisco (UCSF) - Invasive adenocarcinoma Santa Barbara - Adenocarcinoma Santa Rosa (Santa Rosa Memorial Hospital) - Adenocarcinoma of gallbladder (I); Cystadenocarcinoma of gallbladder (2) Sonoma (Sonoma Valley Hospital) - Adenocarcinoma ofgallb ladder, well-differentiated Woodland Hi ll ~ - Adenocarcinoma Alabama (Baptist Medical Center) - Gallbladder adenocarcinoma Alabama. Mt Olive - Adenocarcinoma, favor metastatic Florida !Jackson Memorial Hospital) - Intestinal type of adenocarcinoma of the gallbladder Georgia - Adenocarcinoma with mucinous features Illinois (Burr Ridge) • Invasive cystadenocarcinoma, gallbladder Illinois (Heartland Regional) - Invasive adenocarcinoma, moderately diflllrentiated IJ!inois. Oak Brook - Well-differentiated adenocarcinoma Illinois (Mac Neal Hospital} - Cholangiocarcinoma, gallbladder lgdiana (St. Joseoh) - Adenocarcinoma (2); Chronic active cholecystitis ( I); Well-differentiated adenocarcinoma, intestinal type, invasive (I) Kansas (Cytocheck LaboratOQ'. LLC) - Adenocarcinoma of the gallbladder, gastric type (2) Kentucky CUniversitv ofLo uisville) - Mucinous adenocwcinoma Marvland (National Naval Medicai Center) - Invasive well-differentiated adenocarcinoma with intestinal features Massachusetts (Berkshire Medical Center) - Adenocarcinoma, intestinal type Michigan (patholoey Services of \Vest Michigan) - Adenocarcinoma Minnesota (fairview Ridges Hospital) - Adenocarcinoma, well-differentiated, invasive Missouri (Missouri Delta Medical Center) - Well-differentiated adenocarcinoma Missouri-Kansas City (Truman Medical Center) - Mucinous adenocarcinoma, favor gallbladder primary Nebraska (Creighton University).- Mucinous adenocarcinoma of gallbladder, well-differentiated Nevada (Sunrise Hospital) - Invasive-adenocarcinoma, mucinous type New Mexico, Albuquerque - Adenocarcinoma New York CECMC) - Adenocarcinoma with focal clear cell features New York CStonv Brook University Residents) - Well-differentiated adenocarcinoma New York (SUNY Downstate Medical Center) - Well-differentiated gallbladder adenocarcinoma New York (Westchester Medical Center) - Mucinous adenocarcinoma of gallbladder Ohio (McCullough-Hyde Memorial Hospital) - Adenocarcinoma Pennsylvania (Conemaugh Hospital) - Mucinous adenocarcii10ma Pennsylvania (St. ElizabeW1 Health Center) - Adenocarcinoma of gallbladder, moderately differentiated Texas. Crvstal Beach - Adenocarcittoma, gallbladder · ~ Lubbock - Adenocarcinoma Texas (San Antonio Christus Santa Rosa Children's Hospital) - Mucinous adenocarcinoma, gallbladder Texas (Scon & White Hospital) - Adenocarcinoma \Vashineton. DC - Jnvasive moderately differentiated adenocarcinoma West Yireinia (Greenbrier Valley Medical Center) - Well-differentiated adenocarcinoma Australia (Royal Hobart Hospital} - Moderately differentiated adenocarcinoma, gallbladder Australia (Sullivan Nicolaides Pathology) - Adenocarcinoma, gallbladder t2 C..'TTR. November 2007 ';Minutes" (SubscripliOn A) Canada (Pasqua Hospi!al) - Adenocarcinoma Canada Can 7- Diagnosis: Adenocarcinoma (mucinous), gallbladder T-57000, M-81403 cqy 7 . References: Pandey M, Pathnk AK, Gaulllm A, ct at. Carcinoma of the Gnllbladder. A Retrospootivc Review of99 Cases. Dig Di< Sc/200 I; 46(6): 1145-1151. Buisine MP, Devismc L, Degand P, etal Developmental Mucin Gene Expression in the Gastroduodenal Tract ond Acotossory Digestive Glnnd.• II. Duodenum and Liver, Gallbloddcr, and Pancreas. J Hilloch•m Cytochem 2000; 48(12):1667·1676. Yanagisawa N, Mikami T, Mitomi H, eta!. C044 Variant Ovcrexprc$sion in Gallbladder Carcinoma AS$ociated with 1'umor Dedifrerentiotion. Cancer 2001; 91(2):408-416. Yamaguchi K, Chijiiwa K, Saiki S, ct nl. Reliability of Frozen Section Diagnosis of Gallbladder Tumor for Det«:ting Carcinoma and Depth of Its Invasion. J Surg Oncol 1997; 65(2):132-136. Tsukoda K, Kurosnka l. Uchido K, et ol. Lymph Node Spread From Carcinoma of the Gallblodder. C01tctr 1997; 80(4):661-U?. Mizuno T. Eimoto T, Tnda T, ct al. Mucinous Tumor of the Gallbllldder with a Separate Nodule of Anaplastic Carcinoma. Arch Pathol L Case No. 8, Accession No. 30767 November 2007 Alameda C'ITR. November 2007 "Minutes" (Sul>scription A) 13 Illinois (Mac Neal Hospjtal) - Solid and pseudopnpillary rumor, pancreas Indiana (St. Joseph) - Acinar cell carcinoma (I}; Solid pseudopapillary rumor ( I}; Islet cell rumor ( I}; Endocrine carcinoma (I} Kansas CCVtocheck Laboratory. LLC) - Solid pseudopapillary rumor (I}; Islet cell tumor (I) Kentuckv CUniversitv of Louisville) - Solid pseudopapillary tumor of the pa.ncreas Maryland Cuo 8 - Diagnosis: Solid pseudopapillary tumor, pancreas T-77IOO,M-80l03 Case 8- References: . Tapia B, Ahrens W, Kenney B. el u!. Acinar Cell CarciiiOina vs. Solid Pscudopapillary Tumor of 1he Pancrc:L~ in Children. A Comparison of Two Rare and O•·crlappin~ Entities with Review ofthe literature. Pediatr Dcv Patho/2007; 13: 1 (l,pub ahoad of Print). Volkan Adsay N. Cystic J.,csions ofth~ !'ancre~. Mqd Parho/2007; J:S?I-93. Yu CC Tseng m, Yeh CN. ctal. C tinlcopa~tological Study of Solid and Pseudopapillary Tumor or Pancreas. Elmphnsis on Mognetie Resonance lmoging Findings. WorldJGastroenJtrD/2001; 13(12):181-JSIS. Hcmtlndez JM, Centeno BA and Kelley ST. Solid Pseudopapillary Tumors of the Pancreas. Case Pn:sentation and Review or the Litcra1ure. Am Sul'g 2007; 73(3):290-293. Bunurini G, Brighcnti A, Capelli P, ct at. ClinicaJ and Biological Behavior of Pancreatic Solid Pscudopapillary Tumors. Rcpon on 31 Consecutive Patients. J Surg Onco/ 2007; 9S(4):3M-310. 14 CrrR. November 2007 "Minutes" (Subscriptoon A) Case No. 9, Accession No. 30411 November 2007 Alame.da (Alameda County Medical Center) - Adenosqumous carcinoma Claremont - Poorly differentiated allenocarcinoma Hayward-Fremont - Mucoepidermoid carcinoma Los Angeles (ABC Laboratories) - Poorly differentiated adenosquamous carcinoma Long Beach NA Hospital) - Poorl)' differentiated adenocarcinoma Monterey Peninsula (Communitv Hospital) - Gastric adenocarcinoma Mountain View CEI Camino Hospital\ • Poorly differentiated adenocarcinoma (hepatoid features?) Oakland • Adenosquamous c.arcinoma Orange (Orange County Pathology Medical GrouR - Adenosquamous cell·carcinoma Oxnard (St. John's Regional Medical Center) - Squamous cell carcinoma (2) San Diego - Adenosquamous (mucoepidermoid) carcinoma San Diego (Naval Medical Center) - Undifferentiated gastric carcinoma with lymphoid stroma San Diego (Scripps Clinic) - Adenosquam·ous carcinoma San Francisco (UCSF) - Adenosquamous carcinoma Santa Barbara - High grade carcinoma Santa Rosa (Santa Rosa Memorial Hospital) - Adenosquamous cell carcinoma (3) Sonoma CTT'R, November 2007 •tMinutes" (Subscripdon A) 15 Australia (Sullivan Nicoiaides Pathology) - Adenosquamous carcinoma, stomach Canada (Pasqua Hospital) - Adenocarcinoma Canada (Sherbrooke Universitv Hospital) - A.denosquamous carcinoma Hong Kong (Honu Kong Baptist Hospital) - Poorly differentiated adenosquamous carcinoma Hong Kong (](wong Wah Hospital) - Adenosquamous carcinoma of the stomach Ireland (Kerrv General Hospital) - Carcinoma, ?adenosquamous Japan (Asashi General Hospital) • Adenosquamous cell carcinoma Japan (Kyoto University Hospital) - Adenosquamous carcinoma Oman (Khoula Hospital) - Adenosquamous carcinoma Puerto Rico (Universitv QI"Puerto Rico) - Adenosquamous/squamous cell carcinoma The Netherlands. Amste!yeen - Adenosquamous carcinoma United Kingdom (Oxford Srudy Group) - Carcinosarcoma, stomach Case 9 -Diagnosis: Adenosquamous carcinoma, stomach T-63000, M-85603 Cf!Se 9 - References: Lee \VA, Woo OK, Kim Yl, et al. P53, pl6, and RJ3 Expression in Adenosquamous and Squamous Cell CarcinoMas of the Stomach. Patliol Res Pract 1999; 195(11):747-752. Zaridze D, Borisova E, Mn.~imovitcb o, et al. Aspirin Protects Against Gastric Cancer. Resu lts of a Casc-Contro I Study from Moscow, Russia. lntJCancer 1999; 82(4):473-476. Mori ll, Watanabe A, Maekawa S, ct at. Adcnosquamous Carcinoma of the Remnant Stomach. Report of a Case. Surg Today 2000; 30(7):643-646. Sam Y. Shimozono T, Kawano s. ct nl. Gastric-Carcinosarcoma, Co-Existence of Adenosquamous Carcinoma and Rhabdomyosarcoma. A Case Report. Histopatho/2001; 39(5):543-544. Kitadai Y, Sasaki A, Ito M, eta!. Helicobacter Pylori Infection rnnuenccs Expression of Genes Related to An!liogencsis and ln\'asion in Human Gastric Carcinoma Cells. Blochem Biophys Res Commun 2003; 311 (4):809-814. Case No. 10, Accession No. 30570 November 2007 Alameda (Alameda Counrv Medical Center) - Poorly differentiated carcinoma Claremont - Poorly differentiated adenocarcinoma Hayward-Fremont - Medullary carcinoma Los Angeles (ABC .Laboratories) - Anaplastic small cell carcinoma with endocrine differentiation Lone Beach (VA Hospital) - Poorly differentiated adenocarcinoma with neuroendocrine differentiation Monterey Peninsula (Community Hosr..itill - Carcinoma, pot>rly differentiated vs. undifferentiated Mountain View (EI Camino Hospital) - Lymphoepithelioma-like carcinoma Oakland -Neuroendocrine carcinoma Orange (Orange County Pathology Medical Group - Adenocarcinoma Oxnard (St. John 's Regional Medical Center) - Neuroendocrine carcinoma (2) San Diego - Poorly differentiated carcinoma wiih endocrine fearures San Diego (Nayal Medical Center) - Neuroendocrine carcinoma San Diego (Scripps Clinic\ - Poorly differentiated neuroendocrine carcinoma San Francisco (UCSF\ - Adenocarcinoma, medullary panern Santa Barbara - Small cell neuroendO'crine carcinoma Santa Rosa (Santa Rosa Memorial Hospital) - Large cell neuroendocrine carcinoma(!); Neuroendocrine carcinoma (2) Sonoma (Sonoma Vallev Hospital} - Carcinoid rumor Woodland Hills - Adenocarcinoma Alabama (Baptist Medical Center\ - Poorly differentiated adenocarcinoma Alabama. Mt Olive - Medullary carcinoma Florida (Jackson Memorial Hospitall - Undifferentiated carcinoma of the colon Georgia - Poorly differentiated adenocarcinoma,? microsatell ite instabillty Illinois (Burr Ridge) - Carcinoid tumor Illinois t6 CTTR, November 2007 "Minu•es'' (Subsc(iption A) .Illinois Oak Brook - EC cell rumor ofcecum Illinois !Mac Neal Hospital) - Neuroedocrine carcinoma, cecum Indiana ($ 1. Joseph) - Carcinoid (3); Neuroendocrine carcinoma or adenocarcinoma with neuroendocrine differentiation (I) Kansas {Cy!ocheck Laboratory. LLC) - Poorly differentiated carcinoma (2) Kentucky {University of Louisville) - Neuroendocrine carcinoma vs. medullary carcinoma of colon Marvland (National Nayal Medical Center} - Invasive poorly differentiated carcinoma with neuroendocrine fean~rcs Massachuscus CBerkshjrc Medical Center} - Mixed neuroendocrine and adenocarcinoma Michigan (Pathology Services of West Michigan} - Undifferentiated carcinoma, cecum Minnesota Case 10 - Diagnosis: Neuroendocrine carcinoma, cecum T-67100, M-80103 Case I0 • References: Vonmeyer AO. Lubensky lA, Merino MJ, cl al. ConcordMCe of Genetic Al!mlions in Poorly Differentiated Colorectai Neuroendocrine Can:inomas and Associated Adenocarcinomas. Not/ Cancer hut 1997; 89(t9):1448-1453 . Soga J. Carcinoids of the Colon and Ileocecal Region. A Statistical Evaluation of 363 Cases Collected From the Litctature. J £xp C/in Cancer Res 1998; 17(2):139-148. Pon.ei·Gomes OM, Grimellus L, Johansson H, ct nl. Chromogranin A In Human Neuroendocrine Tumors. An lmmunohistochtmical Study with Region-Specific Antibodies. Am J Surg l'atho/25(1 0): 1261 -1 267. Cai YC. Danner B. Gliclanan J. et al. Cytokeratin 7 and 20 and Thyroid Transcription Factor l Can Help Distinguish PulmonllT)' From Gastrointestinal Carcinoid and Pan<:reatic Endocrine Tumors. lfwn Potho/2001; 32(10):1087-1093. Demellawy DE, Samkari A, Sur M, et at. Prim;uy Small Cell C CTTR. November 2007 "Minulcs'' (Subsctiplion A) t7 Wang L, Warner NE and Sherrod AE. Patlllogic Quiz Case. A 79-Year-Old Woman with a Black, Ulcerated Cecal Tumor and 3 Negative Guaiac Test Results. Medullary Adenocarcinoma of the Colon, Poorly Di!Terentiatcd. Arch Pathol Lab Med 2005; 129(1):113-114. 18 Cri'R, No\'emb-er 2007 ''Mintlles·• (Sub$cription A)