CALIFORNIA TUMOR TISSUE REGISTRY
"GASTROINTESTINAL PATHOLOGY" Study Cases, Subscription B
January 2003
California Tumor Tissue Registry c/o: Department ofPathology and Human Anatomy Lorna Linda University School of Medicine 11021 Campus Avenue, AH335 Lorna Linda, California 92350 (909) 558-4788 FAX: (909) 558-0188 E-mail: [email protected] Web site & Caseoftbe Month: www.cttr.org Target audience: 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.
Objectives: The participant will be able 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 of representative glass slides with associatedltistories. Feedback on consensus 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 of Medicine designates this continuing medical education activity for up to 2 hours ofCategory I of the Physician's Recognition Award of the American Medical Association. CME credit is offered for the subscription year only.
Accreditation: Loma Linda University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME} to sponsor continuing medical education for physicians.
2 Study Ca. Tissue from: Stomach Acces-sion #25447 Clinical Abstra.ct: A 66-year-old male had a two to three month history of malodprous eructations and stomach pains that were relieved by antacids. An upper GI series revealed a fundic ulcer. He underwent a Tadical total gastrectomy. Gross l)athology: Within the cardia was an 8.0 x 7.0 em fungating tumor with a 6 em diameter excavated ulcer. The tumor extended through the gastlic wall and was adherent to ·the hi tar region of the spleen. Cut sections showed a tllliform gray appearruic.e. Contributor: A.J. Rajala, M.D. Case No. 2 - January 2003 Santa Barbara, CA Tissue from: Gastro-esophageal junction Accession #20444 • Clinical Abstract: This 51-year-old female ha!l a three week history of abdominal pain. An upper GI series revealed an infiltrative process in the fundus of the stomach. Gastroscopy revealed a tumor protruding into the esophagus, which precluded the passing of the gastroscope beyond that point. She underwent a partial esophagogastrectomy. Gross Pathology: The resection specimen included a 7.3 em ulcerated fungating red-brown to gray tumor at the esophagogastric junction with induration extending·into the gastric wall. On the lesser curvature were masses of gray-yellow to white nodes. SPECIAL STUDIES: CD3 negative Synaptophysin negative CD20 negative Chromogranin negative CD45 negative CD79A negative Ki67 >40% positive CAM5.2 positive Cytokeratin positive NSE positive Kappa positive AE1/AE3 focally positive Lambda positive CD99 negative Cyclin Dl negative Study Cases, January 2003, Subscription B 3 Contributor: Jerome L. H eard, M.D. Case No. 3 - January 2003 San Diego, CA Tissue from: Mesentery Accession #21167 Clinical Abstract: Seven years after a subtotal colectomy for polyposis, this 31-year-old female presented with a rapidly enlarging abdominal mass. At surgery, the mass was present in the small bowel mesentery and extended from the pancreas to below the pelvic brim, and was considered inoperable. One year later she presented with bowel obstruction and perforation. Gross Pathology: The 18.0 x 15.0 x 6.0 em specimen was composed of multiple intestinal loops bound by dense fibrous adhesions and showing numerous aieas of perforation. The mesentery was infiltrated by a 6 x 4 em ill-defined yellow-gray mass. Contributor : C.O. Burdick, M.D. Case No. 4 - January 2003 Livermore, CA Tissue from: J ejunum Accession #21684 Clinical Abstract: For six to eight months, this 17-year-old male had intermittent episodes of severe abdominal pain accompanied with nausea and vomiting that lasted three to four days. Radiographic findings were consistent with intussusception. Gross Pathology: The I 0.0 em resected portion of the jejunum had a 7.0 x 5.0 em intraluminal nodular mass confmed to the mucosa. 4 S1udy Cases, January 2003, Subscriplion B Contributor: E.R. Jennings, M.D. Case No. 5 - January 2003 Long Beach, CA Tiss ue from: Stomach Accession #12412 Clinical Abstract: This is a 79-year-old male presented with mild epigastric distress. His physical examination was unremarkable. Initial radiographs showed no abnormalities but a repeat study one month later showed a thickening ofthe mid-third of the greater curvature of the stomach. Gross Pathology: The mucosal surface showed an 18.0 em polypoid, glistening tumor that involved most of the stomach. The gastric wall was thickened up to 1.5 em and was indurated. Contributor: Kenneth Frankel, M.D. Case No. 6 - January 2003 Covina, CA Tissue from: Small intestine Accession #29494 Clinical Abstract: This 79-year-old male presented with small bowel obstruction. Gross Pathology: Small bowel segments had multiple sites where firm white tumor infiltrated the full thickness of the wall, producing luminal narrowing. The mucosal surfaces at those sites were ulcerated with at least one area of full thickness perforation. The tumor masses, up to 2.5 em in diameter, appeared to undermine adjacent, uninvolved mucosa. SPECIAL STUDIES: CAM 5.2/AEI strongly positive CEA negative Yimentin strongly positive S IOO negative Calretinin focal positive C0117 negative Cytokeratin 5,6 focal positive CD34 negative Desmin negative Study Cases, January 2003, Subscription 8 Contributor: Jana Pindur, M.D. Case No.7 - J anuary 2003 Anaheim, CA Tissue from: Rectum Accession 1129197 Clinical Abstract: This female presented with bleeding from the rectum. Gross Pathology: A 6 em long portion of rectum was resected. Contributor: J.A. Arcellana, M.D. Case No.8 - .January 2003 Livermore, CA Tissue from: Liver Accession 1119897 Clinical Abstract: This 77-year-old chronically ill male had a history of hemoptysis and pneumonia for over two to three months. Despite antibiotic lherapy, he deteriorated and died. An autopsy was performed. Gross Pathology: The 2200 gram liver contained multiple irregular, ill-defined firm gray-white areas, 7.0 to 8.0 em in diameter, on both external and cut surfaces. 6 Srudy Cases, January 2003, Subscriplion B Co ntributor: Livia Ross, M .D. Case No. 9 - January 2003 Oakland, CA Tissue from: Sm11U intestine Accession #20889 Clinical Abstract: With a long history of alcoholic liver disease with cirrhosis and iron deficiency anemia, this 34- year old male expired following a lengthy hospitalization for sepsis, hepatic coma and G.l. tract bleeding. An autopsy was performed. Gross Pathology: Throughout the length of the small intestine were multiple solid 'pea-sized' submucosal red nodules, found singly and in clusters. Contributor: Roy L . Byrnes, M.D. Case No. 10 - .January 2003 Laguna Beach, CA Tissue from: Pancreas Accession #20494 Clinical Abstract: Shortly after a normal delivery of a healthy infant, this 25-year-ol d female noticed a lump in her left upper abdomen. She underwent an exploratory laparotomy for abdominal mass. Gross Patholozy: The tail of the pancreas contained a 25.0 em diameter cystic mass, containing clear viscid gray white fluid and subloculations from I to 6 em in diameter. Srudy Cases, January 2003, Subscription B 1 CALIFORNIA TUMOR T ISSUE REGISTRY "GASTROINTESTINAL PATHOLOGY" Minutes - Subscription B January,2003 SUGGESTED READING (General Topics from Recent Literature): Primer on Medical Genomics Part II: Background Principles and Methods in Molecular Genetics. Tefferi A, Wieben ED, Dewald GW, et al. Mayo Clin Proc. 2002 Aug; 77(8):785-808 Primer on Medical Genomics. Part III: Microarray Experiments and Data Analysis. Tefferi A, Bolander ME, Ansell SM, et al Mayo Clin Proc. 2002 Sep; 77(9):927-940. Multicystic Mesothelioma. An Analysis ofPatho1ogic Findings and Biologic Behavior in 37 Cases. Weiss SW, Tavasso1i FA. Am J Surg Pathol. 1988 Oct; 12(10):737-746. Gleason Score on Biopsy: Is It Reliable for Predicting the Final Grade on Pathology? Lattouf JB, Saad F. BJU Int. 2002 Nov; 90(7):694-8; discussion 698-699. Absolute Risk of a Subsequent Abnol.lllal Pap Among Oncogenic Human Papillomavirus DNA Positive, Cytologica lly Negative Women. Castle PE, Wacholder S, Sherman ME, et a!. Cancer. 2002 Nov IS; 95(1 0):2145-2151. California Tumor Tissue Registry c/o: Department of Pathology and Human Anatomy Loma Linda University School of Medicine 11021 Campus Avenue, AH 335 Lorna Linda, California 92350 (909) 558-4788 FAX: (909) 558-0188 E-mail: [email protected] Web site & Case of the Month: www.cttr.org FILE DIAGNOSES CTTR Subscription B January 2003 Case 1: High grade B-celllymphoma, stomach T-63000, M-95903 Case 2: Small ceU (neuroendocrine) carcinoma, gastro-esophageal junction T-62000, M-8041/3 Case 3: Mesenteric fibromatosis, likely Gardner's syndrome related T-64200, M-76100 Case 4: Hamartomatous polyp with heterotopic gastric mullosa, jejunum T-65100, M-75630 Case 5: Poorly differentiated adenocarcinoma with signet ring cell features (linitis plastica) T-63000, M-8142/3 Case6: Malignant mesothelioma, peritoneum T-Y4400, M-9050/3 Case 7: Aberrant vascular proliferation consistent with angiodysplasia, rectum T-68000, M-74850 Case 8: Angiosarcoma, liver T-56000, M-912013 Case 9: Kaposi's sarcoma, small intestine T-64000, M-9140/3 Case 10: Mucinous cystic tumor (cystadenoma), pancreas T-59000, M-8470/0 2 CITR. J.anwuy 2003"Minutes• (Subscription S) Case No. 1, Accession No. 25447 January 2003 Emndjdo · Lymphoma Glend81e • Lymphoma Lorna Upda - Lymphoma. Hodgkin's MnslaJO Nosemjte Pathology Medical Grouo) - High jiT&delymphoma <>oooe rucr Medical Center Resi Case I - Diagnosb<: High grade B-ceU lymphoma, stomach T-6JOOO,M-9590J Cag 1 .. References: Ko YH. Han JJ, Noh JH, et al. Lymph Nodes in Gastric B-ccll Lymphoma: Panem of !nvolVC1ll01lt and Early Histological Changes. HutopaJ/ri)/Qgy. 2002 Jun; 40(6):497-504. Skacel M. Paris PL. Pcttay JD, et al. Diffuse Large B-cell Lymphoma of the Stomach: Assessmem of Microsatcllitc Instability. Allelic Imbalance, and Trisomy ofChromosomes 3, !2, and 18. Diagn Mol Pathol. 2002 Jun; 11(2):75-82. CTTR, J•nu:vy l003 "Minutes" (Subsoriptioo B) 3 K~ Y, Nakamwa T, Suzuki T, et al. Clinical Relevance ofTelomaase Acdvi!y in Primary Gastric l-ymphoma. Gastric Cancer. 2000 Sep 29; 3(2}:57~2. Mafune Kl, Tanaka Y, Suda Y. et al. Outcome of PalieniS with Non-Hodglcin's l-ymphoma of lhe Scomach After Gastm:tomy: Clinicopathologic Study and Reclassification According to the Revised European-American l-ymphoma Classification. Gastric Cancer. 2001;4(3}: 137-143. Gretschel S, Hunerbein M, Foss HD, et al. Regression of High-gmde Gastric B~ell Lymphoma Afier Eradication of He/icobacter pylori. Endoscopy. 2001 Sep; 33(9}:805-807. Case No. 2, Accession No. 20444 January 2003 Escondido ~ SmaiJ ee11 careinoma Glendale • Neuroendocrine carcinoma Lorna Linda - Anaplastic carcinoma Mode!IQ (Yosemite Pathology Medical Gmon> · Poorly differentiated c81'Cinoma with neuroendocrine differentiation Omnge CUCJ Medical Cen~tr Residents) .. Neuroendocrine ea.rciooma Sacmmento CUC Davis Mcc!jcal Center) - Poorly differcntipted carcinomA with neuroendocrine feature Alabama CCWllljnebam Pa!hology. l.l.C) • Small ~II carcinoma Arizpna - Undifferentiated carcinoma n!d!ia.na.~~l'o~rt~W~a!'!n~c~-~~~i1=~1· n!om~a,~eso~p~ha{l0-gastric- Neuroendocrine junction carcinoma • Poorly differentiated carcinoma (6}; Poorly differentiated carcinoma with coe: 4 CTTR, January 2003"'Minulcs- (Subscriptioa B) Cue 2 - Diagnosis: Small cell (neuroendocrine) carcinoma, gastro-e.opbageal junellon T-62000, M-804113 Cw 2 · References: KimUill H. Konishi K, Kaji M, e1al. Highly Aggre..,ivc Behavior and Poor Prognosis ofSmal l Cell Carcinoma in the Stomach: Flow Cytomttric and Immunohistochemical Analysis. Oneal Rep. 1999 Jul-Aug; 6(4):767-772. MatSUi K, lin XM, KilllgliW8 M. et aL Clinicopalholoeic features of neuroendocrine carcinomas of the stomach: appraisal ofsmall cell and large cell variants. Arch Patht>I!Ab Mtd. 1998 Nov; 122(11):1011>-1017. Kanahara T, Hirckawa M, Nakamura E, ct al. Cytology of Ascitic Fluid in a Patient with Gastric Small Cell Carcinoma. Acta Cytol. 2000 Sep-Oct; 44(5):929-930. Takaku H, Oka K, Naoi Y, et nl. J>rinwy Advanced GIL'I tric Small Cell Carcinoma: A Case Report and Review of the Literatw'e. Am J Ga.ttroenterol. 1999 Muy; 94(5): 1402-1404. Cast No. 3, Accession No. 21167 January 2003 Escondida - Fibromatosl$ Glend!!le - Mesenteric fibromatosis Lorna Ljns!a - Sclerosing peritonitis Modcstp CYoscmice Pathology Medical Grotto) - Fibtomatosis O[ftnpe CUCI Medical Center Resjdentsl - Fibromatosis Sacramento C1TR. Janu.uy 2003 "Mirunrs• (Subocriprion B) Japan (Hamamatw Unjyersity School of Medicine) .. Abdominal desmoid Japan ISaiseikai Shiga Hospital) - Intraabdominal fibromatosis Puerto Rico CtJniversitv of Puerto Rico) - Jntraabdominal fi bromatosis Oatar CHamad Medjca! Comoratjon - Mesenteric fibromatosis Spain IPoliclinico Vigosal - Mesenteric fibroJilatosis The Netherlands. Am.stelveen - GastroIntestinal Stromal Tumor (GIST) Case 3 - Diagnosis: Mesenteric fibromatosis, likely-Gardner's syndrome related T-64200, M-76 100. Case 3 - References: Burke AP, Sobin LH, Shekitka KM. Mesenteric Fibromatosis. A Follow-up Study. Arch PathoJ Lab Med. 1990 Aug; 11 4(8}:832- 835. Rcmmele W, Muller-Lobeck H; Paulus W. Primary Mesenteritis, Mesenteric I'ibrosis and Mesenteric Fibromatosis. Report of Four Cases, Pathology, and Classification. Pathol Res Pract. 1988 Dec; 184( 1):77-85. Clark SK, Smith TO, Katz DE. et al. Identification and Progression ofa Desmoid Precursor lesion in Patients with Familial Adenomatous Polyposis. Br J Surg. 1998 Jul: 85(7):970:973. Middleton SB, Phillips RK. Surgery for large Intrn-Abdominal Desmoid Tumors: Report of Four C~s . Dis Colon Rectum. 2000 Dec; 43(12):1759-1762; discussion 1762-1763. Yantiss RK, Spiro IJ, Compton CC, et al. Gastrointestinal Stromal Tumor Versus Intra-Abdominal Fibromatosis of the Bowel Wall: A Clinically Important Differential Diagnosis. Am J Surg Pathol. 2000 Jul; 24(7):947-957. Case No. 4, Accession No. 21684 January 2003 Esco·ndido · Aeterotopic gastric mucosa Glendille - Pemz-Jesl\er's polyp J,.oma Ljnda - Well differentiated adenocarcinoma Modesto CYooemite Pathology Medical Group) - Peutz-Jegher's p61yp Orange IUCI Medical Center Residents) • Ectopic-gastric mucosa Sacrnmerilo CUC Davjs Medjca! eeD!erl - Ectopic gastric polyp Alabama !Cunningham Pathology, LLCl - Meckel's diverticulum Arizona (Phoenix Memorial Hospital) .. Tubulovillous adenoma Arlg!nsas (IIAMS. Depth of Pathology) - Gastric heterotopia, polypoid, jejunum COlorado. Denver .. Adenoma Florida !Monroe Regional Medical Center) - Heterotopia gastric polyp Florida 6 CTTR. January 2003 .. Minutos" (Subscri ption 8) Texas. San Amonjo - Meekcl's diverticulum Texas !Scolt & White Hosoitall - Hamanomatous polyp (Peutz-Jegher's polyp) Utah !St. Mark's Hosojta!l - Hamartomatous polyp W!!Shinmon, DC - HamartomatoUS polyp Canada !CUSE. She flewimontl - Juveoile polyposis, compatible Canada !foothjl!s HQ!pjqll - Polypoid gastric he!eroropia Jaoan. Chiba - Heterotopic gastric mucosa Japan !Gypma UniY"Qjtvl - Juvenile polyp Japan CHamama!§u University School of Medicine\ - Ectopic fundic mucosa Janan Case 4 - Dlam osi§: Hamartomatous polyp with heterotopic gastric mucosa, jejunum T-65100, M-75630 - Case 4 - References: Sone Y, Nelwlo S, Takeda I, eta!. Solitary Hamartomatous Polyp ofPeutz-Jeghers Type in the lejunwn Resec~ed Endoscopically. Go.strolntut Endosc. 2000 May; 51(5):6~22. Cho Gl, Bcraquist K, Schwanz AM. Peutz-lcghcrs Syndrome and the Hamartomatous Polyposis Syndromes: Radiologic-Pathologic Cotrelation. Radiographies. 1997 May-Jun; 17(3):785-791. Hizawa K, lic!a M. Ma~>umoto T, et al. Neoplastic Transfonnation Arising in Pcutz-Jeghers Polyposis. Dis Colon Rtctllm, 1993 Oct; 36(10):953-957. Bujanc!a L. Beguirlstain A, Villar JM, et al. Gastric Adenocarcinoma in Hamanomatous Polyp in Peutz-Jcghers Syndrome. Gaslro•nterQ/ Hrpotol. 1996 Nov; 19(9):452-455. Case No. 5, Accession No. 12412 January 2003 ~ - Sisnet ring carcinoma Glendale - Signet ring cell carcinoma Loma Linda p Anaplastic carcinoma -linitis plastica Modesto CYofiemitg Pathology Medical Group) - Signet ring carcinoma Orange (UCl Medjc;al CenJer Residents) - Poorly differentiated adenocarcinoma diffuse type (signet ring oell) Sacramento CUC payjs M CTfR. January 200J .. Minu1es" (Subscription B) 7 Pennsylvania !Allegheny General H!ll!pjtal\ • Gastric carcinoma. signet ring cell type Pennsylnoja (Magee Women's Hosoj!.l!l • Poorly differentiated adenoc:at<:inoma- signet ring Pennsylyanja !Memorial Medical Centcrl • Poorly diffen!llti&Ied adenocan:inoma with signet ring type PennsyJvMia. Pit!Sbwgh • Poorly differentiated signet cell ad Ca•e 5 - Diagnosis: Poorly differential adenoearclJioma with signet ring cells (linitis plastica) T-63000, M-814213 Ca. Case No. 6, Accession No. 29494 January 2003 Ecmpdjdo . Epithelioid leiomyosarcoma Glendg)e • Diffuse $3J'COmatoid mes01helloma Lomqlindn · GI stromal tumor (vs .. carcinoma) Modesto CITR, JanU31)' 2003"Mlnutos• (Subscript;on B) Nebras!sa CGOO Case 6 • DiagnMis: l\faligrumt mesothelioma, peritoneum T-Y4400. M-9050/3 C!!Se 6 • Relerences: Stefnnini OF, Foschi FG, Marsigli L, A Rare Case of Peritoneal Mesotheliomn in a Male with Ascites. Am J Gastroenterol. 1994 Dec; 89(12):2257-2259. Anderson JH, Stewatl CJ, Hansell DT, et al. Peritoneal Mesothelioma. Postgrod Med J. 1990 Oct; 66(780):866--868. Sebba& 0. Sug;ubaker PH. Peri!oncal Mt$0thelioma Prcposa1 fo; a Staging System. Ew J Surg Oncol. 2001 Apr; 27(3):223-224. Sebbag G. Yan H. Slunookler BM, et al Results orTreatment of33 Paricms with Peritoneal Mesothelioma. Br J Surg. 2000 Nov: 87(11):1587-1593. Gtntiloni N, Febbraro S, Barone C, eta!. Peritoneal Mesolllelioma in Recurrent Familial Peritonitis. J Clin Gastroenterol. 1991 Jun: 24(4):276-279. Cook OS, Attanoos Rl, , Jnlloh SS, et al. 'Mucin-Positive' Epithelial Mesothc.liomn oft!•• Peritoneum: An Unusual Diagnostic Pitfall. Histopathology. 2000 lu1;37( I ):33-36. Case No. 7, Accession No. 29191 January 2003 E.•oondido • Solitary n:ctal ulcer G!eodgle - Inflammatory fibroid polyp Lomu Linda - Ulcers wilh gra,nulation rissue ModL-.!O( Yosemite Pa!hOIOQ' Medical Group\ - Solitary reclal ulcer syndrome Orani< cuq Medical Cemcr Residents) - Solitary I'CCI31u lcer S)ndrome Sacramento fUC Davjs Medjcal Center\ • Hemangioma Alabam• {Cunningham Pathology. LLQ - Angiomatosis Ari21lna {Phoenix Memorial Hosoitall - "Solitary" rc<:tal ulcer syndrome ArJsanw CUAMS, Qepth g[Pathology\ • Arteriovenous malformation, rectum Colomdo. Denver - Vascular malformation flpdda CTl'R, JMU3r)' 2003 "Minuces" (Subscription B) 9 Maryland CNJH- P!!!boloayl - AVM {Arteri~venous malformation) Maryland Cue 7 - Diagno.•is: Aberrant vasoular proliferation eon.sistent with angiodysplasia, rtttum T-68000 , MC 74850 Case 7 - Referenw: Hochter W, Weingan J, Kuhner W, ct aL Angiodysplasia in the Colon and Rtctum. Endoscgpi< Morphology, Localisation and Froquency. Endoscopy. 1985 Sep; 17(5):182-185. Duray PH, Marcal JM Jr, LiVolsi VA, et al. GasD'Oioteoti""l Angiodysplasla: A Possible Component of Von Wjl!ebraod's Disease. Hum Pothol. 1984 Jun; I 5(6):539-544. Marcuard SP, Weinstock JV. Gastrointestinal Angiodysplasi• in Renal Failure. J Clin Gartroenterol. 1988 O Case No. 8, Accession No, 19897 J anuary 2003 Escondjdo • Hepotocellular carci_noma Glendale - HCC (lt 10 CTTR, Janu31)' 200J"Minutes" (Subscription 8) Florida (Monroe Regional Medical Center) - Hepatoc<:llu!or carcinoma l'!orida !Winter Haven Hosnitall - Epithelioid bemangioendothelioma Georgia. Decatur - Cho!angi2CalCinoma Indiana, fort Wavne - Hemangioendothelioma, liver Illinois (Marion Memodal Hospital> - Epithelioid hemangioendothelioma Kansas ICoffi>vvillc Regional Medical Center) - Angiosarcoma, Liver Morv!and !NIH - Pathology) - Aogiosaicoma !>faalan d !National Naval Medical Center) - Angiosarcoma (5); Hepatocellular carcinoma (3); Hepatocellular carcinoma/ch Case 8 -Diagnosis: Angiosarcoma, liver T-56000, M-9120/3 Ca.«e 8 - References: Fulcher AS, Sterling RK. Hepatic. Neoplasms: Computed Tomography and·Magnetic Resonance features. J Clin Oastroenterol. 2002 Apr; 34(4):463-471. Koyama T, fletcher JG, Johnson CD, et al. Primary Hepatic AngiosarcoOUI: Findings at CT and l'vfR Imaging. Radiology. 2002 Mar; 222(3):66H73. Guy CD, Yuan S, Ballo MS. Spindle-Cell Lesions of!he Liver: Diagnosis by Fine-needle Aspiration Biopsy. Diagn Cytopatho/. 2001 Aug; 25(2):94-100. Tannapfel A, Wcibrauch M, Beoicke M, et al. pi61NK411-Alteration.' in Primary Angiosarcomaofdte Liver. J Hepatol. 2001 Jul; 35(1):62-67. Case No. 9, Accession No. 20889 January 2003 Escondido - Kaposi's sarcoma Glendale - Kapost's sarcoma Lom.li.!Jruli - Angiosarcoma (Kapo.•i's) CITR, Januruy 2003 "Mlnutes" (SubS<:ription B) t l Modesto CYosemho Pathology Mcc!ical Qrounl • Angiod)'1plasia Qrange IUCI Medical Center Residents) - KS (Kaposi's sarcoma) Sacramento rue Oayis MedjcaJ Center> · Kaposi's sarcoma Alabama CGunnjn!!h.am Pathology.LLCl · Kaposi's san:oma AriZOIIA Cf'boenjx Memorial HosoitaD • Kaposi's sarcoma Arkansas IUAMS Qepth of Pathology) • Kaposi's san:oma, small intestine Colomdo. Pmm • GIST (Oastro lnlestinal Stromal Tumor) Florida !Monroe Reoiooa! Medical Center) · Kaposi's san:oma Florida (Winter Haven Hospjyll · Angiomatosis Georaia. Dccanrr . Kaposi's sarcoma lndiona. Foa Wayoe • Kaposi's sarroma, small bowel Illinois (Marjon Memorial Hospitall - Kaposi's sarcoma KWM CCoffeyyWe Regional Modieal Cepter) - Angioleiomyoma Marvland CN!tl • Pa]holoayl • Spindle cell hemangioma Maryland {NI!joOII! Naval Medical Center) • Kaposi's SllJ'COJno (9) Maryland CUniyeahy ofMarv!aod Residency Program) • Kaposi's :Jatcoma Massachl.sttts CBricl1an1 & Women·s Hospita1. Residems/fellgwl - Kaposi's sarcoma Michigan (Spectrum tleahh) • Kaposi's sarroma Mjchigan CSL Jo51!ph Mercy HospjtaJl - Kaposi1 S sarcoma Mjnnesora (United Hospitall .. Angiosarcoma MississiPpi CUnjyeajty ofMjujssiooi Medical Center> - Kaposi's sarcoma Nebras!ca COood Samaritan Hosojtall · Kaposi's san:cma New Mexico (Uojymity of New Mexico) - Kaposi's sattOma New Yod< fN&SSOu Unjyysity Medical Center Groop) • Kaposi's sarcoma, small intestine New Yod< iWestches]q Mc!lical Ceow> · Kaposi's san:oma, small intestine Qbjo(Medjeal Co!!eoe of Ohio Residents) · Kaposi's san:oma Oklahoma Case 9 - Dia]l!!o! j.: Kaposi's sarcoma, small intestine T-64000, M-9140/3 Ca.'"' 9 • References: Kaplan IE, Masur H. Holmes KK. Guidelines For Preventing Opportunistic Infections Among HIV-Infected Persoos.. 2002. Recommendations ofThe U.S. Poblic Health Service and the Infectious Diseases Society of Amonca. MMWR Recomm Rep. 2002 Jun 14; SI(RR-8):1-52 Moses A V, Jarvis MA, Raggo C,et al. Kapos~s Sareoma-Associated Herpesvirus-loduced Upregulation of the c-kit Proto-Oncogene, as Idemified by Gene Expression Profiling. is Essential for the Tf'II1Sformatioo ofEn 12 CTTR. January 2003·'Minults" (Subsc:ription B) DePond W, Said JW, Tasaka T, et aL Kaposi's Sarooma-Ass~iated Herpesvirus and Human Herpesvirus 8 (KSHV/HHV8) Associated Lymphoma of the Bowel. Report of Two Cases in HIV-Poslrive Men with Secondary Effusion Lymphomas. Am J Surg PatiJol. 1997 Jun; 21(6):719-724. Chetty R, Pillay SV. Coexistent Gastric MALT Lymphoma and Kaposi Sarooma in an HlV Positive Patient. J Clin Pathol. 1999 Apr; 52(4):313-316. Case No. 10, Accession No. 20494 January 2003 llscon~ido - Mucinous eys~adenoma Glendale - Mucinous cystadenoma L:oma Linda - Cys~adenoma pancreas Modesto (Yosemite Pathology Medical Groupl - Mucinous cystic tumor Orange (!JCl Medical Center Residents) - Mucinous cystic adenoma Sacramento CUC DayjS Medical Center) - Panc.:eatic muc-inous neoplasm Alabama (Cunningham Pathology. LLCl - Benign mucinous cystic tumor Arizona !Phoenix Memorial HO.pi!BI\ - Mucinous cystBdenoma with focal moderate dysplasia Adglnsas.(UAMS Deoth of Pathology) - Mucinous cystadenoma, pancreas Colorado, Denver - Cysladenoma Florida (Monroe Regional Medical Center) - Mucinous cystic tumor probable borderline florida CWimer Haven Hospital) .. Cystadenoma Geo!llia, Decatur - Mucinous cystic neopla.'m (cystadenoma) of pancreas Mucinous cystadenoma - Mucinous cystic tumor, pancreas !!!!!!!!!!!!i!~M~uc!;in!o!uls!cy!s~!Bid!c~n o~m~~a,~pian;cre~ascystadenoma cystic neoplasm (9) - Mucinous cystadenoma !Massachusetts (Brigham & Women's HospjJ!!I. &esjdentslfe!lowl1 - Mucinous cystic neoplasm Michigan (Soectrum Health) - Borderline mucinous cystic tumor Michigan CSt. Joseph Mercy Hospital) - Mucinous cystic neoplasm (adenoma) Minnesota CUnUed Hospjtall - Mucinous cystic tumor- adenoma Mfssissiopi crtR. Jaou:uy 2003 ,.Minutes" (Subscription B) IJ Case lO - Diagnosis: Mucinous cystic tumor (cystadenoma), pancreas T-59000, M-8470/0 Case I 0 - References: Yamaguchi K, Tanaka M. ln~raductal Papillary-Mucinous Tumor of the Pancreas: A Historical Review of the Nomenclature and Recent Controversy. Pancreas. 200 I Jul; 23(1 ): 12-9. Papillary-Mucinous Tumor (IPMT) of the Pancreas. Hepatogastroenterology. 2001 Jul-Aug; 48(40):962-966. Nagasaka T, Nakashima N. Problems in Histological Diagnosis of Intraductal Papill31)•-Mucinous Tumor (IPMT). · HepotogastrfJenterology. 2001 Jul-Aug; 48(40):972-976. Madura JA, Wiebke EA, Howard TJ, et al. Mucin-Hypersecreting Intraductal Neoplasms of the Pancreas: A Precursor to Cysiic Pancreatic Malignancies. Surgery. 1997 Oct; 122(4):786-792; discussion ?92-793. Terris B, Ponsot P, Paye F, et al. Intraductal Papillary Mucinous Tumors of the Pancreas Confined to Secondary Ducts Show Less Aggressive Pathologic Features as Compared with Those Involving the Main Pancreatic Duct Am J Surg Pathol. 2000 Oct; 24(10):1372-1377. AdsayNV, Klimstra OS, Compton CC. Lesions ofThc <;:ystic Pancreas. Introduction. Se.min Diagn Pathnl. 2000 Feb; f7(1):1-6. ) 14 CITR, 1anllaty 2003"'Minutes•• (Subseriplion B)