'"o CALIFORNIA TUMOR TISSUE REGISTRY
"GENERAL PATHOLOGY"
Study Cases, Subscription A
March 2002
California Tumor Tissue R egistry d o: Department ofP athology and H uman Anatomy Lorna Linda University School of Medicine 11021 Campus Avenue, AH 335 Loma Linda, Cnli fo roia 92350 (909) 558-4788 FAX: (909) SSS-.0188 E-mail: cur~tlinkhnc.com Web page: "~'w .<.nr.ore Web site & Case oft'bc Month: www.crtr.org Target aodien Goal: To acquaint the participant with the histologic features ofa variety of benign and malignant neoplasms and tum?<·like conditions. Objectives: The participant will be able to recognize m'Orphologic features of a variety of benign and malignant neoplasms and ttunor-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 conseo.sus diagnoses from participating pathologists. Listing ofselected references from the medical literature. Principal faculty: Weldon K. Bullock, MD Donald R Chase, MD CMECredit: Lorna Linda University School ofMedicioe designates this continuing medical education activity for .up to 2 hours ofCategory 1 of the Pbysici'ao 's Recognition Award oflhe American Medical Association. CME credit is offered for the subscription year only. Accreditation: Lorna Linda University School ofMedicine is accredited by the Accreditation Council for Contiiluing Medical Education (ACCME) to sponsor continuing medical_cducation for physicians. Contributor: K. M. Hollis-Perry, M.D. Case No. 1 - March 2002 San Diego, CA Tissue from: Spleen Accession #29406 Clinical Ab~tract: Two years earlier, this 26-year-old male had had a melanoma of his scalp and had undergone radiation therapy and a parotidectomy with neck dissection. A follow-up CT showed a mass in the spleen. Gross Pathology: Within the 470 gram spleen was a 7.0 x 5.0 x 5.0 em soft gray-tao mass. SPECIAL STUDI ES (Outside facility): S-100 positive HMB45 positive Cytokcratin negative Contributor: Xuedong Wang, M.D. Case No. 2 - March 2002 Pasadena, CA Tissue from: Left testicle Accession #28978 Clinical Abstract: This 30--year-o ld male presented with a testicular mass. A radical orchiectomy was performed. Gros.~ Pathology: The 112-gram testicle with spermatic cord included a 6.5 x 4.5 x 4.0 em tan, firm mass replacing 95% ofth e testis. Contributor: Phillip C. Gordon, M.D. Case No. 3 - March 2002 Winter Haven, FL Tissue from: Right testicle Accession #29355 Clinical Abstract: This 56-year-old roale complained ofa large scrotal mass. A right radical orchiectomy was performed. Gross Pathology: The testicle measured 5.0 x 3.0 x 5.5 em and was replaced by dull gray-tan firm tissue with areas of necrosis. Contributor: Xuedong Wang, M.D. Case No. 4 - March 2002 Pasadena, CA Tissue from: Left breast Accession #29326 Clinical Abstract: For eight years, this 35-year-old female bad had a left breast mass, originally described as "tluid filled .." A recent mammogram exam showed the roass to be solid. An lumpectomy was performed. Gross Pathology: The 11 x 8.5 x 5.0 em ovoid portion of breast tissue contained a well-circumscribed fleshy soft pink-tan tumor measuring 7.0 x 6.5 x 4.5 em. Contributor: Mark Janssen, M.D. Case No. 5 - March 2002 Anaheim , CA Tissue from: Abdominal waU Accession #29291 Clinical Abstract: After two years ofgradually worsening intermittent abdominal pain, this 75-year-old male noted a non-tender mass on the right side of his abdomen. Physical exam showed a non-movable irregular mass over the rectus abdominis muscle. There were no hernias or lymphadenopathy. A CT showed the mass involved the lower abdominal wall and right rectus muscle. Gross Pathology: The 98 gram, 9.5 x 6.0 x 4.5 em specimen consisted of abundant skeletal muscle with a central, ill-defined fibrous mass admixed with muscle and adipose tissue. Contributor: John McGill, M.D. Case No. 6 - March 2002 Pasadena, CA Tissue from: Left groin Accession #29113 Clinical Abstract: Eight yelii"S after a hysterectomy for cervical carcinoma-in-situ, this 55-year-old female developed a left groin mass. Gross Pathology: The 64 gram. 7.5 x 5.0 x 4.0 em firm, ovoid, mass had a solid, pale pink whorled cut surfilcc. SPECIAL STUDIES (Outside faci lity): S-100 negative Vimentin positive Smooth muscle actin positive Desmin positive Contributor: Kenneth A. Franke~ M.D. Case No. 7 - March 2002 Glendale, CA Tiss ue from: Right parotid Accession #29154 Clinical Abstract: This 70-year-old female developed a mass in her right parotid gland. Gross Pathology: The 7.5 x 6.0 x 3.2 em right parotid specimen contained a 3.0 em in greatest dimension, firm indurated mass. Cont ributor: Phillip C. Gordon, M.D. Case No.8 - March 2002 Winter Haven, FL Tissue from: Right leg Accession #29354 Clinica I Abstract: A gradually enlarging soft tissue mass was removed from the right leg of this 38-year-old female. Gross l'athology: The multilobulated pink-tan, fatty tissue mass measured I 0.5 x 10.0 x 4.5 em and appeared well-encapsulated. Cut sections displayed a soft pink-brown parenchyma without hemorrhage or necrosis. Contributor: Kenneth A. Frankel, M.D. Case No. 9 - March 2002 Covina, CA Tissue from: Gallbladder Accession #29370 Clinical Abstract: Because ofchronic cholecystitis and cholelithiasis, this 70-year-old female w1derwent a laparoscopic cholecystectomy. Gross Pathology: The previously opened gallbladder was 9 x 3.8 em, with a wall that generally varied from 0.2 to 0.5 em in thickness. Visible on the mucosal surface were two dome-shaped slightly elevated nodules, one of which measured up to 1.2 em in diameter and the other measuring up to 1.3 em in diameter. Contributor: Robert H. Zucb, M.D. Case No. 10 - March 2002 Baldwin Park, CA Tissue from: Right distal femur Accessioa #29293 p inical Abstract: During a workup for a 6~mooth history of a painful, swollen knee, this 56-year-old female was found to have a mass occupying the majority of the distal femur with extension into the knee joint. Gross P athology: Within the resected distal femur was a 6.5 em gritty, lobulated, expansile mass with a glistening mucoid, translucent gray-white cut surface. The tumor extended onto the articular surface of the distal femur and into surrounding soft tissues. CALIFORNIA TUMOR TISSUE REGISTRY GENERAL PATHOLOGY Minutes - Subscription A March 2002 SUGGESTED .READING (('..,neral To·pics from 'Recent Literature): A Review of Tumor Suppressor Genes in Cutaneous Neoplasms with Emphasis on Cell Cycle Regulators. Smith KJ, Barrett 11.., Smith WF, et al. Am J of Derma/opatho/ 1998; 20(3):302-3 13. Tolerance and Autoimmunity. Mackay IR and Rosen FS. Adv in lmmunology200 I; 344(9):655-664. Cytologic Diagnosis ofDysplasia in the Alimentary Tract. Tambouret R, Pitman MB, and Wang l:lH. Sem in Diagn Patho/2002; 19(1):38-47. The Molecular Basis ofDysp lasia. Zukerberg L Sem in Diagtt Patho/2002.; 19(1):48-53. DisrnantUng the Germinal Center. Comparing the Processes of Transformation, Regression, and 'fragmentation ofth e Lymphoid.Follicle. Jones D. Adv in AtUII Pathr>/ 2002; 9(2): 129-13 8. California Tumor Tissue 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) 558-4788 FAX: (909) 558-0188 E-tnail : [email protected] Web site, Case of the Month and Monthly Case Diagnoses: www.cttr.org FILE DIAGNOSES CTIR Subscription A March 2002 Case 1: Metastatic melanoma, spleen T-07000, M-87203 Case2: Classic seminoma, testis T-78000, M-90613 CaseJ: Embryonal carcinoma. testis T-78000. M-90703 Cau 4: Pbyllodes tumor, breast T-04000, M-90213 Case 5: Abdominal fibromatosis (desmoid tumor) T-Y4100, M-76!00 Case 6: Myxoid vascular leiomyoma ("'angiomyoma"), groin T-Y7000, M-88900 Case 7: Metastatic poorly differentiated adenocarcinoma, possibly of acinic cell origin. lymph nodes of neck T-55100, M-85503 Case 8: Hibemoma, leg T-Y9400, M-88800 Case 9: Invasive adenocarcinoma, gallbladder T-57000, M-81403 Case 10: Chondrosarcoma, femur T-11710. M-92203 CIU~ No. I, Ac~ession No. 29406 March 2002 Bakqsfickl • Metastatic mclaooma Bay ArCl! • Mctastatic mclanoDUl (3) Havward!Fn:mont • Mewtatic melanoma !.on• 8each !La}sewoo Case 1 · Diagnosis: Metastatic melanoma, spleen T-07000, M-87203 Case I • References: Watabe K, Ito A, Asada H, et al. Structure, Expression and Chromosome Mapping ofMLZE, a Novel Gene Which is Preferentially Expressed in Metastatic Melanoma Celis. Jpn J Cancer Res 200 I; 92(2): 140-151. Kyzer S, Koren R, Klein B, ct a!. Giant Splenomegaly Caused by Splenic Metastases of Melanoma EurJ Surg Onco/1998; 24(4):336-337. Stultc H, Muller PH; d'Hoedt B, et a1. Ulttasouographic Diagnosis of Melanoma Meta.•tascs in Liver, Gallbladder and Splocn. J Ultrasound Mod 1989; 8(10):54 1·547. Hess U, Gross M, Lehner K, et al. Initial Diagnosis of Melanoma MetastaSis to the Spleen. Case Report of Follow-Up in AtypiC~~! Early Invasion of the Spleen. Rontgen !996; 49(2):23-24. German Vcrmess M. New Contrast Material improves DeteCtion ofLiver·and Spleen metastases. JAMA 1984; 251(6):707-708. Case No. 2, Accession No. 28978 March 2002 Bakersfield - Seminoma Bay Area . Seminoma (3) Havwardlfremont • Seminoma Long Beach !Lakewood Regional Medical Center) • Seminoma (5) Montcrev !Conununitv Hospital of Montcrev Peninsula) ~ Seminoma Monterey Park !Garfield Medical Center) • Seminoma, classic Oakland (Kaiser Permancnte) • Seminoma, Classical type (5) Orange /UCf Medical Center Re. 4 CnR. March 20;02 ''Minutes" (S\1bscripuon A) Florida Case 2-Diagnosis: Classic seminoma, testis T-78000, M-90613 Case 2 - References: Czaja JT and Ulbrigbt TM. Evidence for Transformation ofSeminoma to Yolk Sac Tumor, " ith Histogenic Considerations. Am J Clin J>mh<;l\99'2; 97(4):468-477. Friedman NB and Moore RA. Tumors of tho l'estis: A Report of922 Cases. Mil Siftg•Qn 1946:99:573-583. ' Kelty P, Frazier H, O'Connell K, ct a!. Genn Cell Testicular Cancer. 15 Year Review. J Surg Oneol !996; 62(1):3.0-33. CITR, Mardt 2002 "Minutes" (Subscription A) Case No. 3, Accession No. 29355 Marcb2002 Bakcisfield - Embryonal cace\noma Bav Area • Embryonal carcinoma (3) lleyward/Fremont - Embryonal carcinoma Lons Beach lk!lkewood ReSional Medical Center) - Embryonal carcinoma (5) Monterey (Community Hwoil!ll of Monterey Peninsula) - Embryonal carcinoma fi•vored (germ cell tumor) Monterey Park (Garfield Medical Center} - Embryonal carcinoma Q.alilluld !Kaiser Permancntcl - Embryonal carcinoma (S) Otllnge Florida CPatltology Aswsiates> 8 Yolk sac twnor Florida (Winter Haven Hospital) • Embryonal carcinoma ( I); Choriocarcinoma (I) Illinois ChiAAGQ - lntratubular germ cell neoplasia with genn cell tumor lllinois (Evanston HospitaD - Embryonal carcinoma lllinois (NOt!hwOslem Memorial Hospital) • Mixed germ cell tumor with embryonal and yolk sac Indiana Cfon Wa~ • Embryonal carcinoma, rigl>t testis Indiana (Howard Communitv Hospital\ - Embryonal carcinoma Louisiana CLoujsiana State Universitv Hospital> - Erobl)•Onal carc-inoma, testicle Marvland. Baltimoro • Embryonal carcinoma (would do PLAP stain) MiJ!Yland (Johns Hopkins Hospital Residen!Sl - Mixed uonscmanomatous germ cell tumor (12); Pure embryonal carcinoma (3) Marvlaod. Bethesda • Embryonal carcinoma vs. mixed S<'TID cell tumor Marvland fUnj yerni!y of Marvlandl - Embryonal carcinoma ~hyse\(S £Berkshire Medical <'.enter) - Embryonal carcinoma Massachusetts fBrigham & Women's Re:tidents(feUows) - Nonscminomatous genn cell lumor, predominantly embryonal carcinoma with a minor component ofy olk sac tumor Massachusetts (New England Medjcal Center Residents) • Mixed genu cell tumor, yolk sac and embryonal carcinorna Mi chi~an (Oakwood HO!QilDll • Embryonal carcinoma with intmtubular germ ocll neoplasm Ncbra"ka 6 CTTR, M:u-ch 2002. ''Minutes" {Sub~ription A) Texas. Victory_a ~ Embryonal carcinoma \\ith rare yolk-sac-like foci. testis WashingtOn. S!eilncom - Nonseminomatousgenn cell tumor, embryonal/yolk sac Washington. DC (Georeerown Universitv Hosnital) . Embryonal carcinoma West Virginia (Greenbrier Va! lev Me Case 3 - Diagnosis: Embryonal carcinoma, testis T-78000, M-90703 Case 3 - References: latza U, foss HD, Dutkop H, et ol. CD30 Antigen in Embryonal CarcinOma and Embryo~>enesis and Release of !he Soluble Molecule·. ttmJ Par/w/1995; 146(2):463-471. Bemey DM, Shamasb l, Peironi K, eta!, Loss ofCD30 E.xpression in Metastatic Embryonal Carcinoma. The EITeets ol' Cbemolherapy? Hisroparho/2001 ; 39(4):382-385, Assi A, Patett.' R, Fava C, et al. Fine-Neodlc Aspiration ofTcsticula• lesions. Report of I 7 Cases. Dfagn Cytopatho/2000; 23(6):388-392. Moul JW, McCarlhy WF, Femande~ EB, et al. Percentage of Embryonal Carcinoma an.d of Vascular lnvas.ion Predicts Palhological Stage in Clinical Stage INonseminomatous Testicular Cancer. Cancer Res 1994; 54(2):362-364. Case No. 4, Accession No. 29326 March 2002 Bakersfield - Phyllodes twnor, benign Bay Area - Phyllodes tumor, benign (3) Ravward/Fremont - PhyllodeS tumor Long Beach Clakewoo C'ITR, Murch 2002 "MinuJes" (Suhscripoon A) 7 Florida {Baptist Medical Center) • Pbyllodes twnor (l); l'byllodes tumor, probably benign ( 1); Cystosarcoma pbyllodes (2); Benign cystosru:ooma, PbyUodes (l) Florida (Munroe Regional Medical Center) • Cystosarcoma pbyllodes Florida (pathology Associates) • Benign phyUodcs tumor Florida (Winter Haven Hospital) • Benign phyllodes tumor(!); Pbyllodcs tumor (I) Dlinois. Chicago • PbyUodes tumor Ulinois IEvanstoo Hospital) • Pbyllodes tumor !Uinois Cpse 4 • D;a2nosis: Phyllodes tumor, breast T -04000, M-90213 Case 4 ·References: Reinfuss M, Mitus J Duda K, et al. The Trealmcnt and Prognosis of Patients with Phy!lodes Tumors of the Breast. An Aoalvsis of 170 Cases. Cancer 1996; 77(5}:910-!11 6. · 8 CITR. March 200'2 ••tvtinul<:s" (Subscription A) Hirnoka N, Mukai M, Hosada Y, et at. Phyllodcs tumor of the Breast ContaininS the lntracytopasmic Inclusions Bodies Identical with lnfantile Digitlll Fibromatosis. Am J Snrg Patho/ 1994; 18(5):506-5 1L Geisler DP, Boyle MJ, Malnark F, et al Phyllodes Tumors of the Breast. A Review of32 Cases. Am Snrg 2000; 66(4):360-366. Batlh RJ Jr. Histologic Features Predict Local Rec=ce After Breast Conserving Therapy of Phyllodes Tumors. Breast Cancer Res Treat 1999; 57(3):291-295. Case No. 5, Accession No. 29291 March 2002 Balrersfie!d - Abdominal fibromatosis BIIY Area - Nodular faseiitis/proliferative myositis (2); Fib19matosis, a~s i ve (I) Hayward/Fremont - Fibromatosis !,ong Beach (!.akew<>Od Regional Medical Center) - Desmoid tumor (5) Montcryy CCommunitv Hospital ofMontcrcv Peninsula) - Desmoid tumor Monterey Park (Garfield Modica! Center) • Abdominal dcsmoid tumor Oakland (."''TR, March 2002 " Minutes" (Suhscription A) 9 Pmpsylyania!Mqnoria) Medical Cquq Residemsl - Fibromatosis Puc:!lo Rito!UnjymjtyoCPuqtoRicol - Fibromatosis ofabdominal wall (dcsmoid type) Icx!l.t. Lubbock - Desmoid tumor Texas (Propath Services\ - Abdominal desmoid rumor (2) Ici!As (Scott & While Memorial HosojWl - Dcsmoid Texas. Yicwi• - Abdominal desmoid fibromatosis Wosbjogton. Sreilacom - Extra-abdominal fibromatosis WMhjn!!!pn DC IGeorge!Ql!n Uni\-qsitv HQ§J)iJal) - Dcsmoid fibromatoSis West yuginja (Gft Case 5. Diagnosis: Abdominal fibromatosis (desmoid tumor) I-Y4100, M-76100 Cw 5 • References: Reiuuno JJ, Hayry P, Ny~')'ri E, etal The Dcsmoid Turna< I. Incidence, Se•·, Age·, and Anatomical Distribution in the Finnish Population. Am J Clln J>othol 1982; 77(6):66S-684. Acker JC, Bos.scn E!H, tt nl, The Management ofDcsmoid Tumors lnt J Rndlat Oncol 8/o/ Phys 1993; 26(5):851-858. SbcrmM NE, Romsdahl M, EviUJS H, et al. Dcsmoid Twnors. A 20-Year Radiotherapy Experience. Jnr J Radial Oncol Bioi f'hys 1990; 19(1):37-40. Vuylstcke P, Kcus Rand Van-Oongen JA. Dcsmoid Tumours of!he Abdomintl Wall NethJ Surg 1991 ; 43(4):117-120. E'l!tein OM, Tagliabuc JR and Dc:sai RK. Abdominal Desmoids. CT Findings in 25 Patients. A1R Am J Roentgeno/1991 ; 157(2):275-279 Lopez R, Kemalyan N, Moseley HS, eta!. Problems 1n Dia!lJ)osis and Management of Dcsmoid Twnors. Am Surg 1990; 159(5):450-453. Case No. 6, Accession No. 29113 Marcb 2002 Blkersfie1d • Vascular leiomyoma B!IY Area • Leiomyoma (I); Leoomyoma of unccnoin potential (1): Post-opc 10 CTTR. Maid! 2002 "Munttes" (SUbl<:npooo A) Tustin • l<:iomyoma Ventura • Leiomyoma (3) Alabama IBMC Princeton) • uiomyo= Arkansa.< llJAMS) . Leiomyoma P;taware (Christiana Hospital> · Leiomyoma Plori!la C'l"'I'R, M~trcll 2002 ••Minu\J.'$'' (Subticri_pljo£1 A) It • Case 6- Diagnosis: Myxoid vascular leiomyoma ("angiomyoma"), groin T-Y?OOO, M-88900 Case 6 .. References: Kilpatrick SE, Mentzel T and Fletcher CD. Leiomyoma ofDeep Soli Tissue. Clinicopathologic Anal}~is of a Series. Am J Surg Patho/ 1994; 18(6):576-582. Fletcher CD, Kilpatrick SE and Mentzel T, The Difficulty in Predicting Behavior of Smooth-Muscle Tumors in Deep SoflT issue. Am.!SurgPatho/1995; 19(1):116-1 17, Tao LC and Davidson DO. Aspiration Biopsy Cytology ofSmooth Muscle Tumors. A C)1ologic Approach to the Differentiation Between Leiomyosarcoma and Leiomyoma. Acta Cyto/ 1993; 37(3):300-308. Bllrdi 6 , Johansson B, Pandis N, et al. Recurrent Chromosome Aberrations in Abdominal Smooth Muscle Tumors. Cancer Genet Cytogenet 1992; 62(1):43-4{;. Billings SO, Folpe AI and Weiss S W. Do Leiomyomas of Doep Soft Tissue Exist? An Analysis of Rigbly Differentiated Smooth Muscle Tumors of Deep Soft Tissue Supporting Two Distinct Subtypes. Am.! Surg Patho/200 1; 1134-1142. Case No. 7, Accession No. 29154 March 2002 Bakersfield • Poorly differentiated carcinoma BavArea - Lymph9CJ'ithelial carcinoma (1); Metastatic poorly differentiated carcinoma (l ); Metastatic carcinoma possibly from ooe nasophruynx, !ymphoepithelial type ( l) Hayv.·ard!Fremopt - Carcinoma ex mixed tumor \ 'S. metastatic nasopharyrlgeal carcinoma Long Jk.tch 12 C'ffR, March 2002 "Minutes" (Subscription A) M!ISS!lchusens Case 7 • Diagno•is: Metastatic poorly differentiated adenocarcinoma, possibly of acinic ceU origin, lympb oodes of neck Director's Note: Study set material was from regional lymph nodes, not the parotid gland (as the history implied), thus cl Consultation: Lawrence Weiss, M.D., City of Hope National Medical Center. "Poorly differentiated acinic cell adenocarcinoma.'' Case 7 - Refereoru: Abrams AM, Carnyn J, Scofield MH, ct al. Acinic Adenocarcinoma of the Major Salivary Glands. A Clinicopathologic Study of 77 Cases. Cancer 1965; 18:1.145-1 !62. CbaudbJy AP, Culler LS, Leifer{:, Cl al. Histogenesis of Acinic Cell CarcinolDl! of t!1e Major and Minor Salivary Glands. An Ultrustmc S111riy J Puthol 1986; 148(4):307-320. Warner TF, Seo IS, A7,en EA, eta!. lmmunohistoChemisl!)• of Acioic Cell Carcinomas and Mixed Tumors of Salivlll)• Glands. Cancer 1985; 56(9);212 1-2227. · Eii-Naggar AI(, 13atsokis JG, Luna MA, ct.al. DNA Flow Cytomcl!)• of Acinic Cell Carcinomas.of Major Saliva')' Glands. J /,arymgoiOtol 1990; 104(5):4 10-416. Hamper X. Mausch HE and Caselitz J, Acinic CeU Carcinoma of the Salivary Glands. The Prognostic Relevance of DNA .Cytophotomeuy in a Retrospective Shldyofloog.Dw-ation (1965- 1987). Oral Surg Oral Med Oral Pmho/ !990; 69(1):68-75. CTIR. Marcil 2002 ·~Minutes'' (Subscription A) lJ • Case No. 8, Accession No. 29354 Marcb2002 Bakersfield • Well-differentiated liposarcoma Bay Area • Hibcmoma (3) Havward/Frcmon\ · Hibcmoma Long Beach '14 C'ITR, March 2002 "Minl.ltcs•· (Subscription A) Wn. Case 8 - Diagnosis: Hibemoma, leg T-Y9400,~-88 800 Case 8 - References: Hull D. The Structure and FWlctiOn of Bro;.n Adipose Tissue. 8r Med Bull 1966; 22( 1):92-96. Merlino AF Md Pike RF. Hibemoma of the Thigh. A Case Report. J Bone Joint Surg 1973;55(2):406-408. Seemayer TA, Knaack J, Wang NS, et al. On the Ultrastructure ofHibcmoma. Cancer 1975; 36(5): 1785-1793. Furlong MA, Faoburg-Smith and Mieltincn M. The Morphologic Specll'Um ofHibemoma. A Clinioopatho!ogie Study of 170 Cases. Am J Surg Patho/200 I; 25(6):809-8 I 4. Gisselsson D, Hoglund M, Mertens F, et al. Hibemomas are Characterized by·Homozygo us Deletions in the Multiple Endocrine Neoplasia Type I Region. Metaphase Fluore~uce In Siru Hybridization Reveals Complex Rearrangements ·Not Dctc Case No. 9, Accession No. 29370 March 2002 Bakersfield - Adenocarcinoma of gallbladder Bav Area - Adenocarcinoma (3) Hayward/Fremont . Metaplastic carcinoma, gallbladder Long Beach CLakewooc! Re!rional Medical Center) • Adenocarcinoma (5) Monterey ICommunitv Hospital of Monterey Peninsula) - Adenocarcinoma of gallbladder Monterey Park Cii'R. March 2002 "Minu Case 9-.l>iagnosis: Invasive adenocarcinoma. gallbladder T-57000, M-81403 Case.9 - References: Albores·S"'!vedra J, Alcantra· Vazquez A, Cruz-Orti1. H, et al. The Precursor lesions of Invasive Gallbladder Carcinoma, Hyperplasia, Atypical Hyperplasia and Carcinomaln-Silu. Cancer 1980; 45(5):919-927. Sumiyoshi K, N~gai E, Chijiiwa K, et al, Pathology of Catcinoma of the Gallbladder. World J Surg 1991; 15(3):3 15-321. Yamaguchi K and Enjoji M Carcinoma of the Gallbladder. A Clinicopadtology of 103 Patients and a New!)' Proposed Staging. Cancer 19$8; 62(7):1425-1432. 16 ern(. Ma.:ch 2002 "Minutes" (Subscription A) North IH, Pa~ MS, Hong C, et al. Prognostic Factors for Ad~inoma of the Gallbladder. An Analysis of 162 Cases. AmS11rg 1998; 64(5):437-440. Pll!ldcy M, Pathak AK, Gautam A, et al. Carcinoma of the Gallbladder. A Rettospeetive Rcviewof99 Cases. Dig Dis Sci 2001; 46(6):lt45-J 151 . Case No. 10, Accession No. 29293 March2001 Bakersfield · Chondrosarcoma Say Area · Chondrosarcoma, low grade (3) Havward/Fremont • CbondrosarCOtllJ!, grade I, ncod x-rays Long Beach !LakewOod Regional Medical Center) • Low grade cbondrosaroomn (5) Montercv fCommunitv Hospital of Montercv Peninsula) • Chondrooarcoma Monterey Park CITR. March 2002 "Minute'" (Subocription A) 17 Puerto Rico CUniymitv ofPuctUl Rjeo) - Cbo~ grade l Texas Lublx!ck • Grade II, cbondrossrcoma Texas Cue 10. Diunosis: Chondrosarcoma, femur T-ll710, M-92203 Case I 0 - References: Palma SH, Gibbons CL aod Athonosou NA. The Pathology of Bene All~ J &me Joinr Surg Br 1999; 8L(2):333-335. Lee FY, Manlcin HJ, Fondren G, et 31. Choodrossrcoma of Bone. An Assessment of OutCOme. J Bone Joint Surg Am 1999; 81(3):326-338. Mnlawcr MM and Chou LB. Prosthetic Survivol lltld Clinical Results with Usc of Lnrgc-Scgmcnt Replnccmcnts in the Treatment of High-Grade Bone Sarcomas J Bone Joint S\~rg Am 1995; 77(8): 1154- t 16$. Bommer KK, R.nm>:y I and Mody D. Fine"Noedle Aspiration Biopsy in the Diagnc6is nod ManagC111C11t of Bone Lesions. A Study of 450Cases. Cancer 1997; 81(3):148-156. Rizzo M. Oben MA, HarreiSQn JM, ct al. Chondrossrcoma of Bone. Analysis of 108 Cases aod E\·aluation ofPr 18 CTTR, Mm:b 2002 "M.nutes" (S