Case History

A 69-year-old woman presents with a thyroid mass. Representative sections of the thyroidectomy specimen are shown.

What is the most likely molecular abnormality?

  1.        BRAFV600E
  2.        BRAFK601E
  3.        RET/PTC translocation
  4.        TERT promoter mutation

HTT 10x HTT 20x HTT 40x 

Case History

45-year-old female presents with a ruptured hemorrhagic ovarian mass. The mass was received in fragments and measures 7.5 x 5.7 x 4.3 cm in aggregate. Grossly unremarkable fallopian tube is also present. IHC staining for inhibin revealed positive staining in the cells of interest & EMA was negative.

What is the diagnosis?

  1. Endometrioid adenocarcinoma, FIGO 3 
  2. High grade serous carcinoma 
  3. Low grade serous carcinoma 
  4. Granulosa cell tumor, adult type 

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Case History

A 67-year-old man with a history of hypertension, diabetes and chronic pancreatitis presented with diarrhea and acute renal failure with serum creatinine of 5.6mg/dL (baseline 1.1mg/dL).  A renal biopsy performed showed moderate acute tubular injury (PASH Fig:1) with multiple foci of calcium oxalate crystals (H&E Fig: 2 and H&E polarized: 3). IF and EM were negative.

What is the most common cause of oxalosis?

  1.       Ethylene glycol poisoning.
  2.       Excessive ingestion of oxalate rich diet.
  3.       Enteric hyperoxaluria.
  4.       Pyridoxine deficiency.

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Case History

Placenta at 21 weeks. Most likely diagnosis?

  1.       Choriocarcinoma
  2.       Complete Hydatidiform Mole
  3.       Partial Hydatidiform Mole
  4.       Placental Mesenchymal Dysplasia

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Case History

A 58-year-old-female with a persistent gastric ulcer presented to ER with acute abdominal pain and underwent total gastrectomy. During surgery, an enlarged lymph node was sent to frozen analysis and it was reported to be reactive. Grossly, a 2.7 x 2.5 cm perforated ulcer was noted on posterior gastric wall. The entire lesion was submitted for microscopic examination.

What is your diagnosis of this case?

  1. A. Perforated gastric adenocarcinoma
  2. B. Perforated gastric lymphoma
  3. C. Perforated stomach due to Sarcina Ventriculi
  4. D. Perforated stomach due to Staph aureus

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Case History

A 17-year-old young lady presenting with a pancreatic neck mass.

What is the most appropriate diagnosis?

  1. Nondiagnostic specimen
  2. Negative for malignant cells
  3. Atypical cells present
  4. Neoplastic cells present 

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Case History

A 34-year-old man with pancytopenia, mediastinal mass and splenomegaly. Bone marrow flow cytometry showed an abnormal population with this phenotype: CD45lo, cytoplasmic CD3-, CD19-, CD10-, CD34+, CD13heterogeneous, CD33 heterogeneous, HLA-DR+, TdT+, MPO-. What is the diagnosis?

  1. Acute myeloid leukemia
  2. T-Acute lymphoblastic leukemia
  3. Acute undifferentiated leukemia
  4. Mixed phenotype acute leukemia

 Question Photo 1 Bone marrow flow cytometry Question Photo 2 Bone marrow biopsy   

Case History

A 59-year-old male presents with heavy proteinuria, hypoalbuminemia and normal kidney function. No other significant medical history. The findings of the kidney biopsy are classic for this entity. What antibody is associated with this diagnosis?

  1. PLA2R
  2. ANA
  3. ANCA
  4. Anti-GBM

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Case History

A 35-year-old male presents with scrotal pain and a 1-cm testis mass is identified on ultrasound. A frozen section is performed. What is the diagnosis?

  1.       Leydig Cell Tumor
  2.       Seminoma
  3.       Embryonal Carcinoma
  4.       Spermatocytic Tumor

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Case History

A 71-year-old female presents to an ENT for a soft palate mass. A biopsy is performed.

This neoplasm most often arises in the:

  1.        Parotid gland
  2.        Submandibular gland
  3.        Sublingual gland
  4.        Minor salivary glands

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