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?

  1.       Asbestos exposure
  2.       Wood dust exposure
  3.       Smoking
  4.       HPV infection 
 Question Photo 1   Question Photo 2   Question Photo 3
 

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.

  1.       EBV+ classic Hodgkin lymphoma
  2.       Acute EBV infection (infectious mononucleosis)
  3.       EBV+ PTCL
  4.       EBV+ DLBCL, NOS 

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?

 

  1.        Sign out as diffuse astrocytoma, WHO grade II.
  2.        Sign out as anaplastic oligodendroglioma, WHO grade III.
  3.        Submit for sequencing (NGS) to confirm IDH status.
  4.        Submit for fusion gene panel.

Case History

22-year-old man with visual field deficit. Suprasellar mass resected which showed nuclear expression of beta-catenin. 

 

  1.        Anaplastic meningioma, WHO grade III
  2.        Adamantinomatous craniopharyngioma
  3.        Erosive basosquamous carcinoma
  4.        Pilomatrix carcinoma

Case History

A 25-year-old man presented with right lower extremity erythema and right ankle pain. Basic laboratory investigations showed serum creatinine of 3.5 mg/dL, uric acid of 10 mg/dL and 3+ proteinuria.  All serological workup was negative.  Renal biopsy performed showed globally sclerotic glomeruli (PASH, Fig A), segmentally sclerotic glomeruli (Jones silver, Fig B) and multiple foci of amorphous, faintly crystalline material surrounded by narrow zone of inflammatory cells and fibrosis in the tubulointerstitium (H&E, Fig C), consistent with microtophi. IF and EM were unremarkable.

Based on LM findings, which of the following gene may be mutated?

  1.        APOL-1
  2.        VHL
  3.        UMOD
  4.        ACTN4