Case of the Week
- Details
Case History
A 75-year-old man presents with a maxillary sinus mass. Immunostains are negative for keratins, desmin, Sox10, MUC4, Stat 6 and p63. The only positive immunostain is shown.
- Reactive stromal spindle cell proliferation
- Osteosarcoma
- Biphenotypic sinonasal sarcoma
- Solitary fibrous tumor
- Details
Case History
A 67-year old woman with a history of bilateral breast cancer (2000), cervical cancer (1980) and recently diagnosed diffuse large B cell lymphoma admitted for chemotherapy. Pretreatment work-up showed increased serum creatinine of 6.7 mg per dL (baseline 1.0). Renal biopsy showed diffuse interstitial edema associated with diffuse expansile interstitial cellular infiltrate associated with frequent mitosis and apoptosis and acute tubular injury with tubulitis (Fig a, b & c). No glomerular lesions were present. Immunofluorescence and electron microscopy studies were unremarkable.
Which of the following is most appropriate initial immunohistochemical panel for the diagnosis?
- CD20, CD3 and Pan-CK
- CD20, LCA and GATA-3
- LCA, GATA and p16
- CD20, Ki67 and Pan-CK
- Details
Case History
Placenta from a 38-year-old female delivered at 37 weeks. Maternal history of gestational hypertension and preeclampsia. Gross exam revealed a dark subchorionic placental nodule.
The findings are characteristic of:
- Focal chorangiosis
- Chorangioma
- Chorangiocarcinoma
- Villous infarct
- Laminated intervillous hematoma
- Details
Case History
80-year-old female with post-menopausal bleeding and 5.5 cm polypoidal mass in the endometrium.
What is the best diagnosis?
- Endometrial stromal sarcoma
- Serous carcinoma
- Mixed Mullerian tumor/carcinosarcoma
- Leiomyosarcoma
- Details
Case History
Gastric biopsy in an 80-year-old female.
What is the best diagnosis?
- H. pylori gastritis
- Autoimmune gastritis
- Iron-pill gastritis
- Doxycycline-associated gastritis
- Details
Case History
A 95 y/o male, non-smoker, with hx of ocular pemphigoid on immunosuppressants. 4 cm left level 4 mass, firm and fixed without tenderness to palpation.
What is the best diagnosis?
- Metastatic squamous cell carcinoma
- Metastatic prostatic adenocarcinoma
- Metastatic papillary thyroid carcinoma
- Metastatic renal cell carcinoma
- Details
Case History
A 67-year-old male presents with a parotid mass associated with facial pain and cervical adenopathy. Fine-needle aspiration and core needle biopsy are performed and representative sections are shown.p63 immunostain is negative.
Which stain is expected to be diffusely positive?
- SOX10
- Androgen receptor
- p40
- Calponin
- Details
Case History
A 58-year-old woman presents with a new left upper quadrant breast mass. The tumor cells show SOX10 positivity.
What additional stain would help reach the diagnosis?
- Pancytokeratin; IDC grade 3
- P63; Metaplastic Carcinoma
- Melan-A; Metastatic Melanoma
- CK7; Adenoid Cystic Carcinoma
- Details
Case History
A 56-year-old female with a right upper lobe lung nodule.
Which of the following is true regarding this lung neoplasm?
- Usually centrally located
- It has a bad prognosis
- EGFR mutation and ALK rearrangement are usually absent
- CDX2 and CK20 are negative
