Case of the Week

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

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

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

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

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

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

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

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