Case History

A75-yer-old old female with PMHx of lung SCC& fibrosarcoma of the groin. Now with new liver & lung lesions. Liver biopsy shows sclerotic matrix (areas reminiscent of osteoid), medium-size cells with eosinophilic cytoplasm. 
What is the diagnosis?
A.    Cholangiocarcinoma
B.    Scirrhous HCC
C.    Sclerosing epitheloid fibrosarcoma
D.    Metastatic osteosarcoma

1234

Case History

A 64-year old woman with no medical history presents with leukocytosis (Fig 1). Flow shows blasts with this phenotype: CD19+, CD10+, CD45lo, CD34+, CD20-/lo, nTdT+, cMPO-. FISH study shows 93.5% of the cells have the t(9;22)(q34;q11.2) resulting in BCR/ABL1 gene fusion.

What is the diagnosis?

  1. Chronic Myeloid Leukemia, BCR-ABL1-positive, in blast phase
  2. T-Acute lymphoblastic leukemia with t(9;22) (q34.1;q11.2); BCR-ABL1
  3. B-Acute lymphoblastic leukemia with t(9;22) (q34.1;q11.2); BCR-ABL1.
  4. Mixed phenotype acute leukemia with t(9;22) (q34.1;q11.2); BCR-ABL1 

PBS

Case History

The patient, a 57-year-old female, was found to have 15.5 cm unilateral right adnexal mass. No evidence of extraovarian/peritoneal involvement was seen intraoperatively. The right ovarian tumor consisted of a multiloculated cyst with smooth inner lining. There were no ovarian surface involvement identified grossly. Representative microscopic images are shown. Immunohistochemical studies are pending. Based on the H&E appearance, the most likely diagnosis is:

  1.        Mucinous cystadenoma
  2.        Mucinous borderline tumor
  3.        Seromucinous borderline tumor
  4.        Secondary ovarian involvement by mucinous tumor of lower gastrointestinal tract origin
  1. Image 1442 Image 1445 Image 1457

Case History

This is a biopsy of a sinonasal mass in a 58-year-old man.

  1.       Esthesioneuroblastoma
  2.       Poorly differentiated squamous carcinoma
  3.       Sinonasal undifferentiated carcinoma (SNUC)
  4.       NUT carcinoma
  1. SNUCC4x SNUCC40x

Case History

A 12-year-old boy presented with a lytic lesion in the epiphysis of the proximal tibia with sclerosis at the periphery on imaging. A biopsy was performed.

  1.      Giant cell tumor of bone
  2.      Solid variant of aneurysmal bone cyst
  3.      Giant cell-rich osteosarcoma
  4.      Chondroblastoma
  1. CB

Case History

An 81-year-old female with a skull base tumor. Which ancillary test will clinch the diagnosis?

  1.       s100 protein expression
  2.       MART1 expression
  3.       Artginase expression
  4.        An immunostain for INI-1
  1. Picture6Picture7 Picture8 Picture10

Case History

A 36-year-old HIV+ male with left retroperitoneal adenopathy. Prior h/o sepsis and negative excisional biopsy. What is the diagnosis?

  1.      Metastatic carcinoma
  2.      Lymphoproliferative neoplasm
  3.      Infectious lymphadenidits
  4.      HIV lymphadenitis
  1. Picture1Picture2 Picture3 Picture4

Case History

A 35-year-old female with multiple cutaneous lesions that show these histopathologic features. This patient should be screened for a germline mutation of which gene and will likely develop which types of tumors in addition to the one displayed here?

  1.         BHD, renal cell carcinoma, fibrofolliculoma, trichodiscoma
  2.         PTCH1, basal cell carcinomas, medulloblastoma
  3.         SDHB, pheochromocytomas, paragangliomas
  4.         FH, renal cell carcinoma, uterine leiomyomas
  1.  Fig 1Fig 2 Fig 3

Case History

A 74 -year-old woman with a clinical history of dementia dies at home. The family wishes to clarify the history of dementia. An autopsy shows cortical atrophy and ventriculomegaly. Based on the 3 images taken from sections of frontal lobe, what is the most likely diagnosis?

  1.        Dementia with Lewy Bodies
  2.        Vascular dementia
  3.        Alzheimer dementia
  4.        Frontotemporal dementia
  1.   Fig 1 NeocortexFig 2 NeocortexFig 3 Neocortex

Case History

A 79-year-old Caucasian male was diagnosed with CLL in 8/2011. His CT revealed splenomegaly and some borderline enlarged nodes. One in the left axilla was 1.4cm. In January, 2017, his CT showed mild progression of his nodes. The largest one was left external iliac lymph node 3.4 x 1.2 cm, with a 1.4 cm increase over 13 months. In March 2019, he developed cough, chest X-ray reveal bronchial changes.  In several month, he also developed peritoneal fluid.

What is the diagnosis?

A: Reactive mesothelial cells

B: Lymphoma

C: Melanoma

D: Mesothelioma

  1.   pic1pic2pic3pic4