Case of the Week
- Details
Case History
27-year-old female with incidentally discovered 9.4-cm left lobe liver mass on MRI. There is no underlying liver disease, and the background liver is non-cirrhotic. Serum AFP is normal. Hepatitis panel is non-reactive.
What is your best diagnosis?
- Focal nodular hyperplasia
- Fibrolamellar hepatol cl ca
- Hepatolcellular ca
- Cholangiocarcinoma
- Details
Case History
A 35-year-old with a unilateral pelvic mass.
What is the likely diagnosis?
- Endometrioid carcinoma
- Carcinoid tumor
- Sertoli–Leydig cell tumor
- Metastatic carcinoma
- Granulosa cell tumor
- Details
Case History
A 48-year-old male with facial flushing was found to have atypical cells in both the peripheral blood (<1%) and bone marrow (50% on aspirate differential). Based on the provided photos and flow cytometry, which of the following is the best diagnosis?
- AML with t(8;21)
- CML
- AML with inv(16)
- Mast cell leukemia (aleukemia variant)
Blood 
Aspirate
Flow 
Marrow Biopsy
- Details
Case History
A 58-year-old male with a liver and omental mass. Omental mass biopsy shows:
- Signet ring cell carcinoma
- Ex Goblet cell carcinoid/Goblet cell adenocarcinoma
- Epithelioid Hemangioendothelioma
- Angiosarcoma
EH ERG2 
EH Keratin
EH omentum 4x 
EH omentum 20x- Details
Case History
A 63-year-old female with uterine mass and postmenopausal bleeding
What is the diagnosis:
- High-grade serous carcinoma
- Carcinosarcoma
- Undifferentiated endometrial sarcoma
- Adenosarcoma with sarcomatous overgrowth
Uterine tumor 
Vimentin + 
CK LMW (CAM 5.2+) - Details
Case History
A mid 60’s-year-old male with metastatic prostate cancer presents with dysphagia and chest pain. An upper gastrointestinal endoscopy reveals few superficial esophageal ulcers, 27 to 32 cm. The biopsy findings shows in the Figure A (H & E, 20) and Figure B (high magnification, x40) and Figure C (polarizing microscopy). What is your diagnosis?
- Inadequate specimen
- Fungal esophagitis
- Pill esophagitis
- Foreign body
Fig. A: Endoscopic biopsy (H&E Stain, X20) 
Fig. B High magnification (x40) 
Fig. C: Findings under polarized light - Details
Case History
A 61 year-old man with no other significant medical history presents with a nasal region mass. The biopsy is shown. Which of the following is a documented risk factor for the lesion?
- Asbestos exposure
- Wood dust exposure
- Smoking
- HPV infection
- Details
Case History
28 year-old male with inguinal lymphadenopathy. IHC shows many CD15-, CD30+ large cells. CD20+ and CD3+ large cells seen. Background lymphocytes mostly T-cells with inverted CD4/CD8 ratio. Ki-67 elevated throughout infiltrate. EBER shows scattered + cells.
- EBV+ classic Hodgkin lymphoma
- Acute EBV infection (infectious mononucleosis)
- EBV+ PTCL
- EBV+ DLBCL, NOS
- Details
Case History
A 30 year-old man presents with progressive left side weakness. Imaging shows a right parietal lobe cystic lesion. Testing of the surgical resection specimen demonstrates negative IHC staining for IDH1 (R132H). FISH test is positive for 1p/19q codeletion. What is the next step?
- Sign out as diffuse astrocytoma, WHO grade II.
- Sign out as anaplastic oligodendroglioma, WHO grade III.
- Submit for sequencing (NGS) to confirm IDH status.
- Submit for fusion gene panel.