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* * * * * * * * * * * * * * * * * * * * * * * * * * CALIFORNIA TUMOR TISSUE REGISTRY LOS ANGELES COUNTY - UNIVERSITY OF SOUTHERN CALIFORNIA MEDICAL CENTER
PROTOCOL For MONTHLY STUDY SLIDES
JUNE 1976
MYOENDOMETRIAL TUMORS PART I
* * * * * * * * * * * * * * * * * * * * * * * * * * CONTRIBUTOR: Roy L. Brynes, M.D. JUNE 1976 - CASE NO. 1 South Coast Community Hospital South Laguna, California ACCESSION NO. 21178
TISSUE FROM: Uterus
CLINICAL ABSTRACT:
This 83 year old Caucasian female was seen for a complaint of vaginal bleeding. of one week's duration. Six months previously she had a similar problem, but a pelvi c exam disclosed a large benign polyp, which was removed. The PAP smear at that time was negative. A pelvic exam on this admission showed r edundant vaginal mucosa, making visualization of the cervix imposs i ble. A D&C on frozen read as 11 "sarcoma •
SURGERY: (December 1974)
A hysterectomy and bilateral salpingo-oophorectomy were performed.
GROSS PATHOLOGY:
The uterus wei ghed 200 gr ams and measured 10 x 42 x 3.5 em . The serosa was smooth, but a massive pedunculated irr egular tumor protruded into the endcmetrial cavum. The endometrial cavum measured 6.5 x 4.5 x 4.0 em., was soft gray-whit e with encephaloid features. It was also ulcerated and hemorrhagic in one area, and was attached by a broad stalk to the anterior fundus, rather high near the apex. The tumor had a pushing border with little gross invasion of the subjacent myometrium.
FOLLOW-UP:
This pat ient underwent a cholecystectomy February 1976, and at that time no recurrence was present. The patient was last seen April 1976, with no evidence of recurrence. CONTRIBUTOR: J. R. Craig, M.D. JUNE 1976 - CASE NO. 2 Saint Luke Hospital Pasadena, California ACCESSION NO. 21333
TISSUE FROM: Uterus
CLINICAL ABSTRACT:
Thir, 67 J"t':a.r old female complained of spotting and occasional heavy flow of l to 2 months f duration. She also had occasional left lower ab dominal pain and dysuria. There were no other complaints besides easy fatigP.l:ility. A PAP smear 3 months preYious was negative. On physical examination a huge irregular pelvic mass, which reached the umbilicus, was palpated. It was most pronounced on the right. The IVP showed dilatation of the upper ureter and renal pelvis. The barium enema was negative. The tentative diagnosis was a large uterine fibroid.
SURGERY: (March 1975)
A hysterectomy with a right salpingo-oophorectomy was performed.
GROSS PATHOLOGY:
The total specimen weighed in excess of 1000 grams. It measured 18 x 14 x 10 em., and externally was multilobulated and wrinkled with necrotic tumor subjacent. The myometrium contained multiple smooth muscle tumors measuring 2 to 6 em. in diamter as well as the large necrotic, creamy white hemorrhagic tumor, which extended from the myometrium to within a few millimeters of the serosa. The bulk of the tumor was located anteriorly near the endocervical area.
FOLLOW-UP:
The patient is thriving on Depo Provera. The pelvic exam was negative in March 1976. CONTRIBUTOR: Robert E. Wybel, M.D. JUNE 1976 - CASE NO. 3 Greater Bakersfield Memorial Hospital Bakersfield~ California ACCESSION NO . 20676
TISSUE FROM: Uterus
CLINICAL ABSTRACT:
This 67 year old female developed postmenopausal bleeding while on estrogen therapy,vhich ·she had been taking f or some time. On physical examination the uterus vas atrophic. However, peculiar whit ish mucoid material was curetted from the uter ine cavity~ not from the cervix.
SURGERY: (March 1974)
A hysterectomy, right salpingo-oophorectomy, left oophorectomy and partial omentectomy were performed.
GROSS PATHOLOGY:
The uterus weighed 53 gms., 7.5 em. long and vas sounded to 6.5 em. At the fundus it was measured at 4~ 1 x 2.5 em. The entire endometrial cavity was fill ed with a degenerated appearing , tan, polypoid, irregular mass which measured 4.5 x 3.0 x 1.2 em. On section, it was mottled yellowish gray white with a generally extremely soft consistency, but did have firm areas. There was only superficial infiltration of the underlying myometrium. At the junction of the upper end of t he cervix and the lower uterine segment, t here was a 1.0 em. diameter out pouching into the l eft lateral aspect of the uterine wall and a portion of t he tumor projected i nto the defect. FOLLOW-UP:
The patient was seen on December 2 , 1975 and was free of any significant di sease. CONTRIBUTOR: E. G. Edwards, M. D. JUNE 1976 - CASE NO . 4 Santa Ana Community Hospital Santa Ana, California ACCESSION NO. 19101
TISSUE FROM: Uterus
CLINICAL ABSTRACT:
This 78 year old female noted vaginal bleeding over a period of several months, increasing in severity. An endometrial curetting was performed, yielding about 60 gms. of hemorrhagic gray tissue fragments, which were rather large, measuring up to 5 em.
SURGERY: (March 1971)
A hysterectomy and bilateral salpingo-oophorectomy were performed.
GROSS PATHOLOGY:
The specimen consisted of a large uterus with ce~vix, weighing 225 gms. and measuring 10.5 x 8~5 x 8.0 em. The serosa was smooth and on sectioning the myometrium and anterior wall were markedly thinned, measuring at most 0.8 em. In the endometrial cavity was a large necrotic tumor, yellow-red on secti on, which measured 7 x 4 x 4 em.
FOLLOW-UP:
This patient was seen in 1974 and physical examination, including a PAP smear, was negative. CONTRIBUTOR: Francis Buck, M.D. JUNE 1976 - CASE NO . 5 Los Angeles County Hospital Los Angeles, California ACCESSION NO. 11713
TISSUE FROM: Uterus
CLINICAL ABSTRACT: This G III, P I, 20 year old female delivered a normal full term male infant on September 17, 1959. The placenta was unremarkable. One month later, vagianl bleedfng necessitated a curettage. Products of conception were seen. Two weeks later, persistent vaginal bleeding again necessitated hospitalization. A positive pregnancy test was obtained a week lat er. On November 24, 1959 she was admitt ed to LACH in shock with profuse vaginal bleeding. She was st abilized and transfused. Physical examination revealed abdominal pain. Uterine curettage and culdoscopy were perf ormed. On the next day profound shock again developed and an emergency laparotomy was performed. A large ruptured cyst of the right ovary and an intra-abdominal hemorrhage were found. The left ovary also appeared cystic and the uterus was enlarged to the size of a two months' gestati on. A right salpingo-oophorectomy and a left ovarian cystectomy were performed.
Laboratory and X-ray reports: · Urinary HCG titer, using animal assay, ) was found greater than 10,000 but less than 40,000 I.U. per liter. A post laparotomy chest x-ray revealed bilateral metastatic nodules.
SURGERY: (December 12, 1959)
A hysterectomy and a left salpingo-oophorectomy were performed. GROSS PATHOLOGY:
Hemorrhagic, friable necrotic tumor was found in the uterus and fallopian tube.
FOLLOW-UP:
Postoperative (2 1/2 weeks) gonadotrophin levels were reported as being between 40,000 and 200,000 I. U. Methotrexate therapy was begun and levels were less than 10,000 on January 4, 1960. Within 5 weeks after institution of therapy, the assays were negative until September of 1961. At that time the assays were reported as over 1,000 but under 10,000 I. U. per liter. Chest radiographs in 1961 and 1966 were negative as was t he serum HCG. In 1974 a 2 em. left breast mass, read as intraductal papillomatosis, was removed. CONTRIBUTOR: Avram Jacobson, M.D. JUNE 1976 - CASE NO. 6 Beverly Glen Hospital Los Angeles, California ACCESSION NO. l8515
TISSUE FROM: Uterus
CLINICAL ABSTRACT:
This 34 year old female was admitted with a history of vaginal bleeding and not feeling well. She was a gravida III, para II with a delivery expected in about 4 months. The two previous deliveries were normal. No fetal heart tones were heard and examination of the abdomen revealed an enlarged uterus. The pelvic radiograph revealed no fetal parts. However, chest radiograph revealed 2 rounded nodules in the ·lung fields. The first HCG titer was greater than lOl,OOO I.U.
SURGERY: (February 1970) • An abdominal hysterecto~ was performed.
GROSS PATHOLOGY:
The specimen consisted of a 15 x lO x 7 em. uterus. The endo metrial cavity was filled with grape-like struct ures, measuring ) around 1 em. Areas of the tissue were yellowish and somewhat lobulated. FOLLOW-UP:
Following surgery she received Methotrexate for 5 days but was soon r eadmitted with a history of chest pain. Another chest radiograph re vealed additional pulmonary metastases. The HCG was greater than 23,000 but less than 34,650 I.U. She received 2 more courses of Methotrexate with resultant decrease in HCG to less than 1,000. The final chest radiograph showed some resolution of the pulmonary metastases. CONTRIBUTOR: Donald Alcott, M.D. JUNE•I 1976 - CASE NO. 7 Santa Clara Co . Hospital San Jose, California ACCESSION NO. 14603
TISSUE FROM: Endometrium
CLINICAL ABSTRACT:
History: This 72 year old gravida II, para II Caucasian female was approximately 20 years postmenopausal. In June 1964, a diagnostic D&C was performed because of intermittent vaginal spotting. The microscopic report included chronic endocervicitis, chronic endometritis and senile atrophy of the endometrium. The clinical diagnosis was that of cervical stricture and uterine procidentia. The patient was followed for 15 months during which time her symptoms recurred. Green purulent material re accumulated within the uterine cavity, which on culture grew anaerobic streptococci.
SURGERY: (September 1965)
An elective hysterectomy was performed.
GROSS PATHOLOGY:
The uterus measured 8.5 x 5 x 3 em. and showed a normal external surfacf The cervix measured 3.2 em. in length. The os was patulous and the canal was now patent. The myometrium measured up to 2.5 em. in thickness. The fundal endometrium showed numerous discrete and confluent yellow-orange bosselations. The cut surface revealed similar foci, extending into the superficial myometrium.
FOLLOW-UP:
The patient expired on February 2, 1969 from a myocardial infarction. No autopsy was performed. CONTRIBUTOR: Ronald Mihata, M.D. J UNE 1976 - CASE NO. 8 Riverside Community Hospital Riverside, California ACCESSION NO . 19837
TISSUE FROM: Uterus
CLINICAL ABSTRACT:
This 39 year old Caucasian female sought medical assistance concerning a one year history of heavy prolonged menstrual periods with pelvic pain and dyspareunia. On physical examination; pertinent findings were limited to the pelvic exam which revealed a "grapefruit size uterus".
SURGERY: (June 1972)
An abdominal hysterectomy was performed. .. GROSS PATHOLOGY: The specimen consisted of a 205 gm. symmetrical uterus, the anterior serosa of which showed adhesions. The only other abnormality was a 3 em. white whorled nodule in the left wall.
FOLLOW-UP:
Postoperative course was uneventful and she was last seen by her gynecologist in July 1972 and then lost to follow-up. CONTRIBUTOR: S. M. Rabson, M.D. JUNE 1976 - CASE NO . 9 Mission Hospital Huntington Park, California ACCESSION NO. 13397
TISSUE FROM: Uterine cavity
CLINICAL ABSTRACT:
This 26 year old Caucasian female underwent premature (25th week) delivery of an infant that lived 6 hours. Fourteen months previously s·he had undergone a normal pregnancy delivery of a healthy child.
GROSS PATHOLOGY:
The specimen was found by the attending physician. It was slightly adherent to and easily separated from the maternal surface of the placenta. The latter, when examined later, showed no anomalies. The tumor ovoid (9 em. diameter) composed of fleshy, kidney-like, deep pink to pale tan tissues in which were well demarcated yellow areas of necrosis. CONTRIBUTOR : J. R. Craig, M.D. JUNE 1976 - CASE NO. 10 Saint Luke Hospital Pasadena·, California ACCESSION NO . 21817
TISSUE FROM: Uterus
CLINICAL ABSTRACT:
This 75 year old femal e was first seen with a slight painless bloody vaginal discharge of 6 months' duration. The patient had taken Methyl- · test osterone Premarin for the prior 8 years but had discontinued this at t~e onset of spotting. Physical examination revealed a well developed lady, appearit~ younger than her stated age. Pelvic exam showed cystocele and r ectocele with a small cervix and uterus which was tender and smooth , to palpation. A PAP smear disclosed atypical cells, aft er which an endo metrial biopsy was perf ormed.
SURGERY : (January 1976)
A total abdominal hysterectomy and left salpingo-oophorectomy were performed.
GFOSS PATHOLOGY:
The specimen consisted of a t otal ut erus weighing 47 gms. and measuring 7.5 em. x 3 em. x 2 em. Externally it was smooth and filled with a light tan, soft, slightly mucoid material, which involved the uterus circum ferentially down to the endocervical canal. In one area it penetrated the myometrium to i ts outer one third. The exocervix showed stellate scarring. The left tube and ovary were normal •
FOLLOW-UP:
Postoperative course was smooth. As of March 29, 1976 the patient was doing well. CONTRIBUTOR: William E. Cowell, M.D. JUNE 1976 - CASE NO. 11 Tri-City Hospital Oceanside, California ACCESSION NO. 17234
TISSUE FROM: Uterus
CLINICAL ABSTRACT:
This 67 year old Caucasian female presented with intermittent vaginal bleeding and a 30 pound weight loss over the previous 5 months. Abdominal examination disclosed a smooth but lobulated mass arising in the pelvis to just below the umbilicus. Bimanual pelvic examination reconfirmed this, but the origin of the mass could not be determined. However, the cervix seemed free of involvement.
SURGERY: (November 1967)
The patient underwent a hysterectomy, right salpingo-oophorectomy, and a partial small bowel resection.
GROSS PATHOLOGY:
The specimen consisted of a very large uterus, measuring 21 x 13 x 7 em ., with a couple of loops of small bowel densely adherent to a nodular. mass that was protruding from the uterine fundus. The stroma of the fundus and much of the cervix appeared to be almost completely replaced by a friable foul smelling pink tan tumor which grew into the endometrial cavity and into the myometrium.
FOLLOW-UP:
The patient expired on April 27, 1968. CONTRIBUTOR: W. K. Bullock, M.D . JUNE 1976 - CASE NO . 12 Saint Luke Hospital Pasadena, California ACCESSION NO. 20472
TISSUE FROM: Uterus
CLINICAL ABSTRACT:
This 53 year old. Caucasian female has a history of spotting off and on for the 3 months prior to admission. She had a past history of ab normal uterine bleeding with a D&C in 1969 and 1971. Both were r ead as "endometrial polyps". On physical examination, although the patient was obese, the uterus was felt to be premenopausal size without palpabl e irregularities.
, SURGERY: (February 1973)
A hysterectomy and bilateral salpingo- oophorectomy were performed.
GROSS PATHOLOGY :
) The specimen consisted of a 100 gram uterus with a hJ~erplast ic endo metrium. On the dome 1vas a bulge which when sectioned had an encapsulated whorled white smooth muscle appearing tumor. The endometrial cavity was completely filled by a tan moist, slightly papi llary endometri um, and measuring up to 0.6 em. thick. On sectioning, it did not appear to extend into t he underlying muscle.
FOLLOW UP:
She was seen in April and was doing well. STUDY GROUP CASES
For
JUNE 1976
CASE NO. 1 ACC. NO. 21178 CONTRIBUTOR: Roy L. Brynes, M.D.
LOS ANGELES: Mixed mesodermal tumor of uterus - 16
SAN FRANCISCO: Malignant mix~d mullerian tumor, heterologous t ype - 18
~ CENTRAL VALLEY: Malignant mesodermal tumor - 7; malignant mixed mesodermal tumor - 1; endometrial stromal sarcoma - 2 a OAKLAND: Malignant, mixed mesodermal tumor, heter ologous t ype - 14; pure heterologous tumor, rhabdomyosarco~a - 1
WEST LOS ANGELES: Undifferentiated sarcoma of uterus - 3; carcinosarcoma - 1
INLAND (SAN BERNARDINO) : Endometrial stromal sarcoma- 8; epit helial leiomyosarcoma - 2; mixed mullerian tumor - 1; and sarcoma NOS - 1
OHIO: Sarcoma, probably l eiomyosarcoma
SAC~ffiNTO: Mixed sarcoma and adenocarcinoma uterus (Carcinosarcoma) - 14
RENO: Endometrial stromal sarcoma - 13; malignant mesenchymal tumor - 3
HAWAII: Endometrial stromal sarcoma - 3
FitE DIAGNOSIS :
Malignant mi xed mullerian tumor, heterologous type, uterus 1829-8953 CASE NO. 2 ACC. NO. 21333 CONTRIBUTOR: J. R. Craig, M.D.
LOS ANGELES: Anaplastic carcinoma - 7; rhabdomyosarcoma - 1; malignant mixed mesodermal - 3; malignant NOS - 1
SAN FRANCISCO: Epithelioid leiomyosarcoma - 18
CENTRAL VALLEY: Malignant mesenchymal tumor - 6; malignant mixed mesodermal tumor - 5
OAKLAND: Pure homologous tumor, leiomyosarcoma - 14; pure sarcoma, NOS -1
WEST LOS ANGELES: Anaplastic carcinoma of uterus - 1; mesenchymal ~ sarcoma - 1; pleomorphic leiomyosarcoma - 2
INLAND (SAN BERNARDINO): Endometrial stromal sarcoma- 4; mixed mesodermal sarcoma - 3; anaplastic adenocar cinoma - 3; and sarcoma NOS - 1
OHIO: Undifferentiated malignant neoplasm, possible undifferentiated carcinoma endome trium
SARC~ffiNTO: Stromal sarcoma - 1; leiomyosarcoma - 8; sarcoma NOS - 2; myosar coma - 1
RENO: Myogenic sarcoma - 3; malignant mesenchymal tumor - 3
HAWAII: Malignant mesenchymomal tumor, rhabdomyosarcoma - 3
FILE DIAGNOSIS:
Leiomyosarcoma, uterus 1829-8893
X-File: Anaplastic carcinoma, uterus 1829-8018 ...
CASE NO . 3 ACC. NO. 20676 CONTRIBUTOR: Robert E. Wybel, 11.D .
LOS ANGELES: Well differenti ated mucinous adenocarcinoma - 16
SA-~ FRANCISCO: Mucinous carcinoma of endometrium - 18
CENTRAL VALLEY: Low grade mucinous adenocarcinoma - 7 (endometrial - 4; endocervical 3); a typical adenomatous hyperplasia (origin not specified) - 4
OAKLAND: Adenocarcinoma, endometrial type - 15; hyperestrinism - 1
WEST LOS ANGELES: Well differentiated secretory adenocarcinoma - 4
~NLAND (SAN BERNARDINO): Atypical endometrial hyperplasia- 5; mucinous adenocarcinoma - 3; endocervical adenocarcinoma - 2; clear cell carcinoma - 1; iatrogenic hyperplasia - 1
OHIO: Endometrial adenocarcinoma, low grade, "secretory" variant
SACRAMENTO: Endometrial hyperplasia - 3; well differentiated adeno carcinoma - 10; in situ endocervical adenocarcinoma - 1
RENO: Mucinous adenocarcinoma - 6
F.l~WAII: Secretory adenocarcinoma of the endometrium
FILE DIAGNOSIS: Well differentiated (low grade) mucinous adenocarcinoma, uterus 1829-8483 CASE NO. 4 ACC. NO. 19101 CONTRIBUTOR: E. G. Edwards, M.D.
LOS ANGELES: Malignant mixed mullerian tumor - 16
SAN FRANCISCO: Malignant mixed mullerian tumor, heterologous type - 18
CENTRAL VALLEY: Carcinosarcoma - 9; malignant mixed mesodermal tumor - 1; · sarcoma botryoides - ~
OAKLAND: Malignant, mixed mesodermal tumor, heterologous type - 16
WEST LOS ANGELES: Carcinosarcoma arising in polyp - 4
INLAND (SAN BERNARDINO): Carcinosarcoma- 12
OHIO: Carcinosarcoma, endometrium
SACRAMENTO: Carcinosarcoma - 14
RENO: Mixed mesodermal tumor - 6
HAWAII: Carcinosarcoma (malignant mixed mullerian tumor) - 3
FILE DIAGNOSIS:
Malignant mixed mullerian tumor, heterologous type (malignant mixed mesodermal tumor), uterus 1829-8953 CASE NO. 5 ACC. NO, 11713 CONTRIBUTOR: Francis Buck, M.D .
LOS ANGELES : Choriocarcinoma - 16
SAN FRANCISCO: Choriocarci noma - 18
CENTRAL VALLEY: Choriocarcinoma - 11
OAKLAND: Choriocarcinoma - 16 rffiST LOS ANGELES: Choriocarcinoma - 4
INLAND (Sk~ BERNARDINO): Choriocarcinoma- 12
OHIO: Choriocarcinoma
SACRAMENTO: Choriocarcinoma - 14
RENO: Choriocarci noma - 6
HAWAII: Chorioc~rcinoma - 3
FILE DIAGNOSIS:
Choriocarcinoma, uterus 1829-9103 CASE NO. 6 ACC . NO. 18515 CONTRIBUTOR : Avram Jacobson, M.D.
LOS ANGELES: Chorioadenoma destruens - 16
SAN FRAJ~CISCO: Trophoblastic disease, NOS - 17; choriocarcinoma - 1
CENTRAL VALLEY: Choriocarcinoma with mole - 6; hydatidiform mole with metastases, and decidual reaction - 5
OAKLAND: Choriocarcinoma - 16
WEST LOS ANGELES: Mali gnant mole and leiomyoma - 1; invasive mole and leiomyoma - 2; metastasizing mole and leiomyoma - 1
INLAND (SAN BE&~ARDINO): Choriocarcinoma with intravenous leiomyo ma tosis - 9; chorioadenoma - 2
OHIO: Malignant chorioma (slide c/w syncytial endometritis; gross findings and clinical details suggest 'correct diagnosis more 1~. ly chorioadenoma destruens or choriocarcinoma)
SACRAMENTO : Choriocarcinoma - 4; chorioadenoma destruens - 7; invasive hydatidiform mole - 2
RENO: Choriocarcinoma - 6
HAWAII: Chorioca~cinoma arising in invasive hydatidiform mole and intra venous leiomyomatosis - 3
FILE DIAGNOSIS :
Choriocarcinoma with hydatidiform mole, uterus 1810-9101
X-File: Chorioadenoma destruens, uterus 1810-9101 CASE NO, 7 ACC. NO . 14603 CONTRIBUTOR: Donald Alcott, M.D.
LOS ANGELES: Xanthogranulomatous endometritis - 16
SAN FRANCISCO: Xanthogranulomatous endometritis plus adenomyosis - 18
CENTRAL VALLEY: Adenomyosis with xanthomatous endometritis - 19; stromal lipoidosis - 2
OAKLAND: Xanthogranuloma - 16
WEST LOS ANGELES: Xanthomatous endometitis and adenomyosis - 4
INLAND (SAN BERNARDINO): Xanthogranuloma- 6; clear cell carcinoma- 3; and adenomyosis - 1
OHIO : Adenomyosis
SACRAMENTO: Xanthomatous endometritis - 14 ) RENO: Adenomyosis with xanthomatoid reaction - 5; clear cell carcinoma - 1 HAWAII: Adenomyosis with endometrial xanthomatosis - 2; stromal endo metriosis - 1
FILE DIAGNOSIS:
Xanthogranulomatous endometitis, uterus 1829-4404 ..
CASE NO. 8 ACC. NO •. 19837 CONTRIBUTOR: Ronald Mihata, M. D.
LOS ANGELES: Adenomatoid tumor - 16
SAN FRANCISCO: Benign mesothelioma - 18
CENTRAL VALLEY: Adenomatoid tumor - 8; vascular leiomyoma - 3
OAKLAND: Adenomatoid tumor (mesothelioma) - 16
WEST LOS ANGELES: Adenomatoid tumor of uterus - 3; lymphangioma of uterua - 1
INLAND (SAN BE&~ARDINO): Adenomatoid tumor (mesothelioma) - 12
OHIO: Adenomatoid tumor
SACRAMENTO : Adenomatoid tumor - 12; lymphangioma - 2
RENO: Adenomatoid tumor - 6
HAWAII: Adenomatoid tumor 3 )
FILE DIAGNOSIS: Adenomatoid tumor (mesothelioma) and adenomyosis, uterus 1829-9050
REFERENCE: Taxy, Battifora, Oyasu: Adenomatoid Tumors: A Light Microscopic, Histochemical, and Ultrastructural Study. Cancer:34:306-316, 1974. CASE NO. 9 ACC. NO. 13397 CONTRIBUTOR: S. M. Rabson, M.D.
LOS ANGELES: Chorangioma - 16
SAN FRANCISCO: Chorangioma - 18
CENTRAL VALLEY: Chorio-angioma or angiomyxoma - 11
OAKLAND: Chorangioma (hemangioma) - 16
WEST LOS ANGELES: Placental hemangioma - 3; ancient retained placental ~ tissue - 1
INLAND (SAN BERNARDINO) : Chorioangioma- 12
OHIO: Chorioangioma, placenta
SACRAMENTO: Chorioangioma - 14
RENO: Placental hemangioma - 6
HAWAII: Hemangioma - 2; hemangioendothelioma - 1
FILE DIAGNOSIS:
Chorioangioma, uterus 1829-9120 CASE NO. 10 ACC. NO. 21817 CONTRIBUTOR: J. R. Craig, M.D.
LOS ANGELES : Adenocarcinoma of variable differentiation - 10; adena squamous carcinoma - 2
SAN FRANCISCO: Adenocarcinoma of endometrium with foci of clear cells and poor differentiation plus adenomyosis - 18
CENTRAL VALLEY: Adenocarcinoma of endometrium - 9; adenosquamous carcinoma - 2 ·- OAKLAND: Adenocarcinoma, moderately differentiated - 16 WEST LOS ANGELES: Adenocarcinoma of endometrium - 4
INLAND (SAN BERNARDINO): Endometrial adenocarcinoma- 9; adena squamous carcinoma - 2; secretory carcinoma - 1
OHIO: Adenocarcinoma, endometrium with variable differentiation
SACRAMENTO: Grade 4 adenocarcinoma of the endometrium - 14
RENO: Poorly-differentiated adenocarcinoma - 4; adenosquamous carcinoma - 2
HAWAII: Endometrial adenocarcinoma - 3
FILE DIAGNOSIS:
Adenocarcinoma with variable differentiation, uterus 1829-8143 CASE NO. 11 ACC. NO. 17234 ' CONTRIBUTOR: William E. Cowell, M.D.
LOS ANGELES: Adenosquamous carcinoma- 4; mixed mesodermal- 5
SAN FRANCISCO: Malignant mixed mullerian tumor, homologous type - 18
CENTRAL VALLEY: Carcinosarcoma - 7; adenocarcinoma with adenomyosis - 4
OAKLAND : Adenocarcinomas moperately well differentiated - 15; adenoacanthoma - 1
WEST LOS ANGELES: Adenos quamous carcinosarcoma - 4
INLAND (SAN BERNARDINO): Endometrial adenocarcinoma- 9; carcinosarcoma- 2
OHIO: Adenocarcinoma, endometrium with focal squamous differentiation
SACRAMENTO: Adenocarcinoma - 1; carcinosarcoma - 10; adenocarcinoma and leiomyosarcoma - 1
RENO: Adenocarcinoma - 6
} HAWAII: Malignant mixed mullerian tumor (adenoca and leiomyoma)
FILE DIAGNOS IS:
Malignant mixed mullerian tumor, homologous type (carcinosarcoma), uterus 1829-8953 CASE NO. 12 ACC. NO. 20472 CONTRIBUTOR: W. K. Bullock, M.D.
LOS ANGELES: Adenocarcinoma of endometrium, non-invasive - 16
SAN FRANCISCO: Adenocarcinoma of endometrium with xanthomatous stromal cells - 18
CENTRAL VALLEY: Endometrial adenocarcinoma in situ - 11
OAKLAND: Adenocarcinoma, well differentiated - 16
WEST LOS ANGELES: Adenocarcinoma of endometrium - 4
INL~~ (SAN BERNARDINO): Endometrial adenocarcinoma - 9; adenocarcinoma in situ - 2; atypical endometrial hyperplasia - 1
OHIO: Adenocarcinoma, endometrium
SACRAMENTO: Adenocarcinoma endometrium - 14
RENO: Adenocarcinoma - 6
HAWAII: Adenocarcinoma of endometrium arising in cystic and adenomatous hyperplasia - 3
FILE DIAGNOSIS:
Adenocarcinoma in situ, uterus 1829-8142
COMMENT:
Special stains: PAS positive material in lumen but not in cytoplasm.