II~ CALIFORNIA TUMOR TISSUE REGIST RY
"SOFT TISSUE PATHOLOGY"
Study Cases, Subscription A
January 2001
California Tumor Tissue Registry c/o: Department of Pathology and D uman A natomy Lolllll Linda University Stbool ofl\tedicine J 1021 Campus Avenue, AH 335 Loma Linda, California 92350 (909) 558-4788 FAX: (909) 558-01 88 E-mail: [email protected] Tanret audience: Practicing pathologists and pathology residents.
Goal: To acquaint the participant with the histologic features ofa variety of benign and malignant·neoplasms and tumor-Uke conditions.
Ob!eellves: ·The participant will be able to recognize morphologic features ofa variety of benign and malignant neoplasms and tumor-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 eonsensus diagnoses from participating pathologists. Listing ofselected references from the medical literature.
Principal facultv: Weldon K. Bullock, MD Donald R Chase, MD
CMECredlt: Lorna Linda University School ofMedicine designates this continuing medical education activity for up to 2 hours of Category r of the Physician 's Recognition Award of the American Medical Association. CME credit is offered for the subscription year only.
Accreditation: Lorna Linda University School of Medicine is·accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians.
2 Stt1dy Cases, January 2001 , Subscription A . .... Contributor: Sung Shin, M.D. Case No.1 - January 2001 ,.. • Fontana, CA ' Tissue from: Left shoulder Accession #29045
Clinical Abstract: For three months this 39-year-old Hispanic male experienced an enlarging mass in lhe posterior aspect of his left shoulder. He reported chronic discomfort, unaffected by movement and some tingling in hls left arm. cr scan ofthe upper lhorax revealed a mass occupying lhe majority ofthe left deltoid muscle.
Gross Pathology: The 206 gram encapsulated mass was 12.0 x 8.5 x 6.0 em and bad a homogenous tan-white whorled cut surface.
Contributor: Farooq Ali, M.D. Case No. 2 - .January 2001 Ventura, CA
Tissue from: Right thumb Accession #28723
Clinical Abstract: This 30-year-old male tolerated a growing mass on the volar aspect ofhis right thumb for four years. X-rays demonstrated calcific deposits and a soft tissue mass.
Gross Pathology: The 11 gram, 4.0 x 4.0 x 3.5 em mass consisted ofshiny white lobular, cal.cifted cartilaginous tissue and was covered by a transparent membranous white connective tissue capsule. •• Contributor: Philip Gruskin, M.D. Case No. 3 - January 2001 # Lynwood, CA
Tissue from: Rectovaginal septum Accession #28608
Clinical Abstract: Approximately one year after a normal vaginal delivery, this 31-year-old Hispanic female complained of dyspareunia and was found to have a mass in the rectovaginal septum.
Gross Pathology: The 25 gram rubbery, blue-tan portion oftissue was 4.0 x 4.0 x 3.0 em. The cut surfuce was solid tan-white to pink:.
Contributor: Mark Janssen, M.D. Case No.4 - January 2001 Anaheim, CA
Tissue from: Small bowel Accession #28449
Clinical Abstract: After two weeks ofabdominal pain, this 28-year-old nulligravida female was found, by ultrasound, to have an 18 em diameter multicystic mass. The clinical expectation was that of an ovarian mucinous cystadenoma. At exploratory laparotomy a multicystic mass of the small bowel and mesentery was found.
Gross Pathology: Attached to the mesentery was a 16.0 x 11.0 x I 0.0 ern variegated red-brown mass lined by apparent wrinkled capsular tissue with focal areas of fibrinous adhesions. The mass contained variable-sized interconnecting cystic/vascular structures ranging from 4 em to less than 0.2 em, some filled with blood or blood-tinged fluid. Contributor: LLUMC Pathology Group (mra) Case No. 5 - January 2001 Loma Linda, CA
Tissue from: Right inguinal region Accession #28854
Clinical Abstract: A 42-year-old male presented with a mass in his right inguinal region and thigh.
Gross Pathology: The I ,350 gram specimen included a well circumscribed I 0.0 x 9.5 x 8.5 ern firm yellow-tan mass with areas of hemorrhagic mucinous and serous cystic change.
SPECIAL STUDTES: Desmin negative S-100 negative Vimentin 4+
Contributor: K. Greg Peterson, M.D. Case No. 6 - January 2001 Sioux Falls, SD
Tissue from: Abdominal waU Accession #28621
Clinical Abstract: This 78-year-old male developed bowel obstruction and was discovered to have a right abdominal wall mass.
Gross Pathology: The 1891 gram well circumscribed tumor was 25.0 x 17.0 x 7.0 em and had a lobular yellow cut surface with variable areas offirmness and foci of hemorrhage. Contributor: LLUMC P11thology Group (rlc) Case No. 7 - January 2001 Loma Linda, CA
Tissue from: Right forearm Accession #29007
Clinical Abstract: While being followed for some umelated problems, this 89-year-old male suggested removal of a bothersome but non-painful lump on his right forearm. It had been present for I 0 years and had not increased in size.
Gross Pathology: The 15.3 gram pink-tan soft tissue mass was 4.5 x 3.0 x 2.6 em, surmounted by a 5.0 x 1.1 em ellipse oftan skin.
SPECIAL STUDIES: Desmin positive Keratin negative S-100 negative
Contributor: Gerald Dalgleish, M.D. Case No. 8 - January 2001 Simi Va.Uey, CA
Tissue from: Right groin Accession #28882
Clinical Abstract: Multiple rapidly growing masses developed in the right groin of this 39-year-old male, and lymphoma was suspected. There was no significant past medical or fumily .history.
Gross Pathology: Two ovoid shaped segments oftissue had smooth surfuces and were 2.0 em in greatest diameter. Cut surfuces were solid pale yellow.
SPECIAL STUDIES: S-1 00 strongly positive Contributor: Thomas Heinz, M.D. Case No. 9 - J anuary 2001 Orange, CA
Tissue from: Right leg Accession #28514
Clinical Abstract: After 1 Y. years of pain in the right lower extremity, this 74-year-old male submitted to an extensive work-up. An MRI scan ofthe ankle area revealed a soft tissue mass posterior to the tibia and anterior to the Achilles tendon. After biopsy, a below the knee amputation was performed.
Gross Pathology: About 3 em from the medial malleolus was a 7.6 x 5.2 x 3.8 em variegated pale tan to yellow tan tumor. The tumor was contiguous with. the tibial nerve, was partially circumscribed and did not invade adjacent bone.
Contributor: Gary N. Pontrelti, M.D. Case No. 10 - J anuary 2001 Tanana,CA
Tissue from: Left upper ann Accession #28435
Clinical Abstract: For about 10 years this 61-year-old male had noticed a mass in his left upper ann. ft became painful and was excised.
Gross Pathology: The 3.3 x 2.0 x 0.9 em skin ellipse with subcutaneous tissue included a 2.1 em white tan nodule. CALIFORNIA TUMOR TISSUE REGISTRY
SOFT TISSUE PATHOLOGY
Minutes - Subscription A
January 2001
SUGGESTED READING (General Topics from Recent Literature):
Primruy Desmoplastic Small Cell Tumor ofSo ft Tissues and Bone of the Hand. Adsay V, Cheng J, Athanasian E, et al. Am J Swg Patho/1999; 23(11 ): 1408-14 13. Functional Outcome in Patients Treated with Surgery and Irradiation for Soft Tissue Throours. Bell R, O'Sullivan B, Davis A, ct al. J ofSurg Onco/48:224-231 . Objective Criteria May As.~ist in Distinguish ing Necrotizing Fnsciitis from Nonnecrotizing Soil Tissue Infection. Wall DB, de Virgilio C. BlackS, e1 al. AmJ ofSurg2000; 179:17-20. The Microbiology of Necrotizing Soft Tissue Infections. Elliott 0, Kufern JA, Myers AM, et al. Am J Surg 2000; 179:361-366.
California Twnor Tissue Registry c/o: Department of Pathology and Human Anatomy L01na Linda University School of Medicine 11021 Campus Avenue, AH 335 Lorna Linda, California 92350 (909) 558-4788 FAX: (909) 558-0188 E-mail: cttrUL!inkline.com Case of the Month: www.llu.edu/llu/cur/cotm Web Page: www.cttr.org FILE DIAGNOSES
CTTR Subscription A January 2001
Case 1: C~llagenous fibroma (desmoplastic fibroblastoma), shoulder T-Y2300, M-88100
Case2: Soft tissue chondroma, thumb T-Y8810, M-92200
Case3: Aogiomyofibroblastoma T -68070, M-91600
Case 4: O.vernous lymphangiomyoma, mesentery
CaseS: Fibrosarcoma, inguinal region T-Y7000, M-88 103
Case 6: Well-differentiated liposarcoma, abdomen 'f.Y 41 00, M-88503
Cg~e 7: Pleomorphic ~iomyosarcoma.• forearm T-Y8500, M-88903
Ca.so 8: Cellular Schwaonoma, groin (Note: Not all slides showed both Anto11i A and Antoni B regions .. .. drc) T-Y7000, M-95600
Cose9: Epithelioid malignant peripheral nerve sheath tumor, leg (Note: Tumor wns S- 100 +, HMB45 -. Dcsmin -, CAM52 -) 1'-Y9400, M-95600
Superfieiulleiomyosareoma, arm T-Y8000, M-88903
2 C1,.K.. January 200 I "'Minulcs•• (Subscr1pc i-on A) Case No. 1, Accession No. 29045 January 2001
Mountnio View ffi1 Camjno l'athoJngy Group) - Fibromatosis B!lkmfie!d • Extra-abdominal fibromarosis Havward/Fn:mgn! · Collagenous fibroma (dc:smoplasclc fibroblastoma) (4) Qmnoe aJC! Medical Center &esjden§l · Collagenous fibroma (desmoplastic fibrnb!ascoma) Oakland CKujscrl · Collngcnous (sc!crooing) fibroma (3) Vcnlura (l/ni!abl · Extru-abdominal fibromatosis (2) Sanm Rosa • fnlmmuscul:it co!lagcnoma (3) Long Bench • Fibroma (6) Snn Dicup (Naval MediC(tl Center) • Collagenous fibroma Bav Areo • Collagenous fibroma (3} Monterey !'ark CC.arficld Medical Ceruql · Extra-abdominal desmoid Mommy CCommunitv tn1l!! ofMomgey Penimul11) • Filmna Santa a•m . Desmopl~t~!ic fibroma (collaga.ous fibroma) (6) Sncrnmcmp cue Davi ~) · FibromalOsis Ala. C'fTit January 200 I "Mimucs•· (Subscriptiun A) J OlA.GNOSl S: Collagenous fibroma (desmoplasllc fibrobla.rtoma), sboulder T-Y2300, M881 00 RllfERENCf.$: Jana JG. Jung HH, Sub KS, et al. Do$mopl,.,tic Fibroblasloma (Collagenous Fibroma). AmJ Dumatopatho/1999; 21(3)~56-258. Mieuinen M, Fetsch JF. Collagenous Fibroma (OcsmoplMtic Fibrobla11oma). A OinicopathologicAnalysis o£63 Cos~ ofa Distinctive Soft Tissue Lesion with Stella!e-Shsped Fibrobla:.1s. Hum PaJiu>l 1998; 29(7):676-682. Hasegawa T, Shimoda T. liirobashi S. ct al. Collascnoos Fibroma (Do$moplastic Fibroblasloma). Rcporl of Four Cases and Review of the Literature. Arch Pathol W Med 1998: 122(5)>1SS-460. tlvWlS HL De.•moplastic FibroblMtomn. A Report ofSeven Cases. AmJS rug Pat hoi 1995: 19(9):1077-1081. Case No. 2, Accession No. 28723 January 2001 MounuUp View CEI Camino Pa!ho!ogy GtouPl - E> 4 CITR. January 2001 ··Mmules" (SII~SC:r iption A) New Ygrk DIAGNOSIS: Son tissue chondroma, thumb T-Y8810, M-92200 REFERENCES: ~lumphrey:< S, l'ambaki•n H. eta!. Sol\ 'lis.wc Chondroma. A Study of 15 Tumours. Histopathology 1986; 10(2): 147-159. O'Malley MJ, Faller GT and Craig CC. Extraskele!al Choodromu oftl>C Foot. Orthopedics 1996; 19(3):256-258. Dagum AD and Sampson SP. Enchoodroma Protuberons. A case Report J llandSurg 1998; 23(2):338-341. Del Sill"""" JL, Tom: BA. Miller RJ. Extraslreletal chor1droma of the hand. Case report and review of!he litc:rnl.-e. C/in Onhop (U.S.) May 1990, (254):147-152. Case No. 3, Accession No. 28608 J a nuary 2001 Mountain Vjew CEI Camino Pathology Group) • Anaiomyofibrob!astoma l!,akersficld • Abdominal fibromatosis Hayward/Fremoot • Ansiornyofibroblostoma (4) Orange CUC! Medical Cooter Residents) • Angiomyolibrobla"omu Oakland CKaj;;er) • Angiomyxoma (3) Venuw C!lnilabl - Pelvic fibromatosis (2) Santa Rosa - Spiodle ecllliporua (I); Benign 6bromyxoid tumor (I); Benign mcscnchymal hamartoma (I) Long flcnch • Fibroma (6) S!!!J Diesq !Naval Medjg!l C.cntql - Aggressive angiomyxoma Bav .w · Cellular angiofibroma (3) Monterey l'wk (Garf~eld Medical Cemql • Myxofibroma Monterey {Community Hospital ofMonterev Penill.11dnl - AngiOI'ibrQmn Sanm O!l!!l • Reactive myofi broblustic proliferation (6) Saaamento ClJC Davis) .. Aggrcssi\'1.! angiomyxomu Alaska IJ\ochorage) • Aggressh-e Mgiornyxorna Florida DIAGNOSIS: Aogiomyofibroblastoma T-6 8070, M·916QO REFERENCES: l' lctcbcr CO, Tsung WY. Fisher C, Lee KC, ct al. Angiom)'Ofibroblustoma of the Vulva. A Ocnign Neoplasm Distinct from Assrcssive Angiom)"Oma. Am .ISurg Patlwl 1992: 16(4):373-382. l...askin WB. FdSCh JF and Mostofi FK. Angiomyofibroblastoma like Tumor of the Male Genital Tract. Anal)•>is of II Cases with Comparison to Female AnJiomyofibtoblostoma and Spindle <&II Lipoma. Am J Surg PmhtN 1998; 22(1)~16. Laskin WD, Fetsch JF. Tava"OO!i FA. Angiomyo6broblll$1oma of the Pcmale Gcnitul Tract. Analysis of 17 c....,. Including a Lipomatous VnrionL Num l'alho/1991; 28(9): 1046- 1055. Ockncr DM, Sa)1ldi II, Swanson PE, el al. Oenital Angiomyofibrob!astoma. Comparison with Aggressi\'C Angiomyxomu wtd Other Myxoid Neoplasms ofSkin and Soft Trssuc. AmJ Clln PmhtN 1991; 107(1}:36-44. Case No. 4, Accession No. 28449 January 2001 Mountujn View q;1Ca mino rmttologv Groupl - Lymphangioma Rakers field · Mullicystic mcsolltelioma Havward/Fremqu • Angiomyolipoma ofsoft tissue (2); l,)mpbangioma (I}; Hemangioma (I) O@tsc CUC! Medical Center RcsidcnJSl - Lympbangiomyoma Oakland !Kaiser) • Lymphangioma (3) Venuq Cllnilab) • Venous hemangioma (2) Sanm R0$8 · fle:maogioma. A-V malfonnadon (I); Venous hem""8ioma(l); Cavernous hemangioma(!) l.ono Bc 6 CITR~ Jll1UII)' 2001 "'Manu1cs'" (Subsafpcto.n A) Monwrev Park (('Jllffield Medical \,enter) - Lymphangioma Monterey CCommunitv Hospital of Momen..>v Pi DI.AG NOSIS: Cavernous Iymphaogiomyomu, mesentery REFERENCES: Carpenter HA, Lancaster JR and Lee RA. Multilocular Cysts of the Peritoneum. Mqv.o Clin /'roc 1982; 57( 10):634-638. Uayn D and McCaughey WT. Pathology of the Peritoneum. A Review of$e lected Topics. Sembt Diagn Pa1ho/ 1991; 8:277-289. Ros I'R, Olmstead WW, Moser RP, Jr., et al. Mesenteric and Omental Cysts. ~Ustolog.ic ClassiJication with Imaging Correlation. Radiology 1987; 164(2):327-332. Bliss .Dl' Jr., Coffin CM, Bower RJ, c~ al. Mesenteric Cysts in Children. SJU'g 1994; 115(5):571-577. 7 CTTR1 Januar:y 2001 "'Minutes" (Subsc:-iplion A} Case No. S, Accession No. 28854 January 2001 Mountain View 8 C'ri'R. January 200t "Mioulcs" (Subscrip1ion i\) Pyeno Rioo DIAGNOSIS: Fibrosarcoma, inguinal region T-Y7000, M-881 03 REFERENCES: Oshiro Y, Fukuda T. and Tsuneyushi M. Fibrosan:oma Versus Fibromatoses and Cellular Nodular l'ascii1is. A Comparative Study ofTheir Pro1iti:mtive Activity Using Proliferating Cell Nuclear Aotigen, DNA Flow Cytomctry, Md pS3. Am J Surg Pot hoi 1994; 18(7):7 12·719. Scholleld DE. f'lctchor JA, Grier HE. et al. Fibrosarcoma in lnfunlS and Children. Application of New Techniques. Am .I Surg Patho/1994; 18(1 ): 14-24. Sub Cl L Ordone>. NO and Mackay B. Fibrosaroama. Observations on the Ullnl$ltUcture. Ultrartrua Pathbl 1993; 17(3-4):221 · 229. Case No. 6, Accession No. 28621 January 2001 Moontain View CE! Cwnino Pathology Group) • Well-differentiated liposarcoma Bokrofietd • Wcll-difTm.'ll!iated lipasarooma l1al'W8!l!/Fremont • Uposarcoma, wcll-diRerentiated (4) Orange !UCI Medical CA.11tq Resident;\) • Well-differentiated liposarooma OitkhUld CKaiserl . Wcll-difterentiated lipo.sarooma (3) VmhO CUnilaR) • Uposarcoma (2) San1a Rosa - Atypical lipomatous tumor if ~c:ial (!);Atypical lipoma (I); Upc>sar<:oma. NOS (1) Long Beach - Upoo.vcoma, well-difTerentimed (6) San Diego fNaYlll Medical C.cntcrl - Well-differentiated lipoma-like liposarcoma Blly Area • Well-diflerentiated lipostltOOma (atypical lipomatous tumor) (2); Atypicullipoma (I) Monterey Park IGarGcld Medical Center\ • Liposarcoma. low IJI'Ilde Monterey CCommunjty Hospita1 of Momen:y Peninsula) .. Liposarcoma Santa Clara - Wcll-difTcmaialed liposat'COOI8 (6) Sa•Il!!J1S!!IO QJC Davjs) · Arypicallipomatous tumor Alaska (Anehorncxl • Upo.saroomn (wciJ-difterentiatcd) f lqr!da ITa!lqha<;;ccl • Liposarcoma, well-dillcrentiated Elorjda (Winter Hoven tJooojlall • Wcll-difterenti3Ied liposarcoma florida CMunroc ReajO!!!ll Medical Cemql - WeiH!ifferentillled liposarcoma Gconzja !Piedmont 1-foopiud} - UJ>0$8l<'OOla Illinois (()upam: Pllihology Assocj!!!Ml • Liposarcoma, well-difTcn:ntitlled (2) Illinois CBurr Rjdqol • Uposarooma !lljnois CNorthwe CTTR. JaOlal)' 2001 'MU>Ut~· (S DIAGNOSIS: WeU-diiTerentiated liposarcom.o, abdomen T-¥4100, M-88503 REFERE.NCES: Lucas DR. 1\'ascimcntoAG, $arUay BK. et al. Well-Difl"c:n:ntialcd Uposarcxxno. Ma)'O Clinic Experience wirh S8 ea-. AmJ Clln Patllo/ 1994; 102(S):677-683. l.llgsr r and Goldblum JR. Wcii·Dilfcrcntiated Liposarcoma oflhe Retropcritoneum. A Clinioopnthologic Analysis of20 Cases, with Particular Attemion to tho Exterll of !,.ow-Grade Dediffcrcntlatiooc Mod Pa/ho/1991; 10(2):113-120. Sre Case No. 7, Accession No. 29007 January 2001 Moumujn Yiew (£1 Camino Pathology Gmunl - Leiomyosu.rcoma, high grade Bakers!lcld - Maligmuu fibrous histiocytoma Hamnrd/FromMJ - l.ciomyosarooma (4) Oran&e IIJCI Medical Center Residenrsl • Leiomyosarcoma Oa](hu)d (Kaiser) • LeiomyoSIIrcoma (3) Venruro (lJnilabl • Leiomyosurooma (2) Sanra RO!!!l - Curancous ldom)osarcoma (3) Long B DIAGNOSlS: Pleomorphic leiomyosarcoma, forearm T-Y8500, M-88903 REFERWCES: Micttincn M. lmm\UICimlCtivity for Cytokcratin and Epithelial Membrane Antig,:n in L.eiomyosarcomll. Arch Pathol Lab .lltd 1988; 112(6):617-640. Oust Case No. 8, Accession No. 28882 January 2001 Mountain View (E! Camino Pathology Group) • Neurofibroma !Jukersfield - Neurilemmoma l!uyward/Fremont • Bet1ign peripheral nerve sheadt tumor (3); Malignllllt periphcrul nerve she:uh tumor (I) Op)Jlge CTTR, JlOJUW)'2001 "Minutes" (Subtcriptioa A) II Oakland DIAGNOSl S: Cellular S.:bwan noma, groin (Note: Not all slides showed both Antoni A und Antoni B regions .... drc} T-Y7000. M-95600 12 CTTR., January 2001 "'Mh1utcs- (Subscuiption A} RF!FfiRilNCES; Casadel Gl', Scheitluwcr BW, Hirose T, ct al. Cellular Schwannoma. A Clinicopathologic DNA Flow C)tometric, and Proliferation Marker Srudy 70 Patienl$. C~r 1995; 75(S):II09-1119. Lodding P, Kindblom LG, Angcrvall L, and Sterunan G. Cellular SebwOMOma. A Clinieopa~hol ogic Study of29 Cases. Jlirchows Arch A Pat/to/ Anal Histopatlto/1990; ~16(3);2 37-24&. White W. Shiu MH. Resenblum MK, et al. Cellular S.:hwannocua. A Clinieopa~hologio Study of57 l'alieltLI and 58 Tumors. Cancer 1990; 66(6):1266-1275. Yu m 1, Sa<:k MJ, Balooh Z, etal. Difficulties in the Fine Needle Aspinuion (FNA) Dill{ljloois ofS.:hwanooma. Cyrop<#h 1999; 10(3);1&6-194. Case No. 9, Accession No. 28514 ,January 2001 Mounuun View (E! Coming PuthologyGroup) - Melaoomaofsoft partS (clear cell ""'coma) Bodcernficld - Malignunl periphe-ral nerve sheath mmor Hayward/fremooJ • Sarcoma, needs ipox (4) Orun&e CUCI Medical Center Rcsidco!Sl • Melanoma (6); MPNSf (2) Oakland Cri'R, J:tnua.ry200 1 "Minut ~" (Subscdption A) l3 New York (Long !slruu! lAAish Medical Ccmerl • Clear cell smooma North Caroljnu(Wa!se [1e>rest \Jnjycrsity Residents\ • Epithelioid MPNST Peonsyh'll!li• fLchig!J Valley Hn DIAGNOSIS: Epllbelioid ma6gnanr peripheral uirve sbealh tiiDlor, leg (Note: Tumor wa.~ S- 100 +, HMB45 ·, Ocsmin ·, CAM5.2 ·) T-Y9400, M-95600 RilfERENCBS: l)iCarlo EF, Wooclrufl' JM, Bansal M illld ErlandsOfl RA. 'llte Purely Epithelioid Malignant Peripheral Nerve Sheath Tumor . .Am J SurgJ>atho/!986; 10(7):478-490. Rasbridgc SM, Browse NL, Ttglle JR and Fletcher CD. Mol igJU~t~t Nerve Sheath Tumor Arising in a lkllign Aociont Schwannoma. fllstopmlwl 1989; 14(5):525-528. Hcm:ra GA. Reimann BE and Salinas JA. Malignant Scltwannoma Presenting as a Malignant Fibrous Histiocytoma. Ultrawuct Pathc/1982; 3(3):253-261. Dodd LG, Scully Sand Layfield U. Fine-Needle Aspi.r Case No. 10, Accession No. 28435 January ZOO I Mmmh1in View lEI Camjoo Pathology Groun} · Leiomyosarcoma, low gmde B;!Jsersfield • Piloleiomyoma flnyward/frcmoot • Dcnnal leiomyosarcoma (I); Dcnnalleiomyoma {2); AFX (1) Omnae IUCJ Medical Center Rcsjdcp[S} • Lclomyosarooma (7); Fibrosarcoma (I) Oaki!!Od 14 C'lTR..Janutl)' 2001 "'Minutes"' (Subscrip1Jon A) . . . n!jnojs CNonhwcslqn Memorial Hospital) - Dennallciomyosarcoma !OIVU (\Jolversitv of Iowa) - CuiJlJlcous leiomyosarcoma K•-ntucky !UnivcrnilY o[ Louisyjl!e Residents) - Al)pical fibroxwnhoma (superficial MFH) M!Uion DIAGNOSIS: Superfitial !eiomyosarcoma, a rm T-Y8000, M-88903 REI'f1RE NCES: Olh cr GF, Reiman HM, et al. Cutanecus and Subcutaneous l.eiomyosan:oma.. A Clinioopathological Review of 14 Cases \lith Reference to Antidesmin Staining and Nuclear DNA l'auems StudiO CT'I'It January 200 I •'Minute:!;"' (Subsaiplicm A) IS