COLUMNS. Diagnostic Exercise: Epithelioid Hemangiosarcoma Mimicking Metastatic Prostatic Neoplasia in a Dog
|
|
- Polly Daniel
- 5 years ago
- Views:
Transcription
1 COLUMNS Vet Pathol 46: (2009) DOI: /vp.08-VP-0245-L-DEX Diagnostic Exercise: Epithelioid Hemangiosarcoma Mimicking Metastatic Prostatic Neoplasia in a Dog S. SHOR, S. C. HELFAND, E. GORMAN, AND C. V. LÖHR Department of Clinical Sciences (SS, SCH), and Veterinary Diagnostic Laboratory in the Department of Biomedical Sciences (EG, CVL), College of Veterinary Medicine, Oregon State University, Corvallis, OR Abstract. A 10-year-old intact male Labrador Retriever dog was euthanized because of rapid deterioration after suffering from mild chronic cough, hematuria, acute blindness, ataxia, and lethargy. Clinical examination revealed blepharospasm and hyphema, with clear discharge from the right eye; a firm mass in an enlarged right testicle; a mass in the irregularly enlarged prostate; and nodules in the left kidney, liver, and spleen detected by abdominal sonography. Cytologic evaluation of fine needle aspirates from the prostate, testis, and kidney comprised large, clustered or individualized, anaplastic cells that lacked convincing tissue differentiation. Necropsy examination revealed an irregularly enlarged prostate with dark tan to red zones and multiple, discrete, beige to dark red nodules that ranged from 0.5 to 6 cm in diameter in the lung, liver, left kidney, right testis, colon wall, stomach wall, and brain. On histologic examination, discrete nests of anaplastic carcinoma-like tumor cells were found in sections of all affected organs. Results of immunohistochemical examination revealed widespread expression of von Willebrand factor and the absence of cytokeratin in neoplastic cells. The diagnosis was metastatic epithelioid hemangiosarcoma, primary site unknown. Cytokeratin; dogs; epithelioid; hemangiosarcoma; immunohistochemistry; von Wille- Key words: brand factor. History, Gross Findings, and Laboratory Results A 10-year-old intact male Labrador Retriever dog was referred to the Veterinary Teaching Hospital (VTH) at Oregon State University (OSU) for evaluation of a thoracic mass. The dog had a 1-month history of mild coughing, intermittent hematuria, acute right ocular pain, and lethargy. A physical examination revealed blepharospasm and hyphema, with clear fluid discharge from the right eye; a firm mass 1 cm in diameter within an enlarged right testis; and an irregularly enlarged prostate. An abdominal ultrasonographic examination confirmed an irregularly enlarged prostate with a cm mass, and nodules in the liver, spleen, and left kidney that measured from 1.2 to 4 cm in diameter. A blood count and biochemistry profile were within normal limits. Urine was brown and turbid and contained many red blood cells (RBC) (.100 cells/hpf) and white blood cells (20 30/hpf), with normal ph level ph 7, and specific gravity. Cytologic examination of fine needle aspirates was performed on samples 548 obtained by ultrasound guidance from the prostatic mass, prostatic parenchyma, left kidney mass, and the mass in the right testis. The sample from the prostatic mass contained numerous clustered or individualized neoplastic cells, with a background of RBCs (Fig. 1), scattered leukocytes, and necrotic cellular debris (Fig. 1). Individual neoplastic cells were large and typically contained 1 3 round nuclei with multiple prominent, bizarre nucleoli. They were surrounded by a variable amount of eosinophilic cytoplasm with relatively distinct borders. Most cells contained small, discrete cytoplasmic vacuoles, with a few cells containing 1 2 large vacuoles. Marked anisocytosis and anisokaryosis were present, and mitotic figures were rare. In some fields, cohesion was identified, but this was not a consistent finding. Similar aggregates of neoplastic cells were present in the samples from the right testis and the left kidney. The sample from the solid portion of the prostate was consistent with benign prostatic hyperplasia, and the sample from the spleen was suggestive of nodular lymphoid hyper-
2 Vet Pathol 46:3, 2009 Diagnostic Exercise 549 Fig. 1. Anaplastic cells in the aspirate from the prostatic mass occasionally show cohesion. Wright s Giemsa stain. Fig. 2. Prostate; dog. The prostate is severely enlarged by a mottled beige brown mass (arrow). Fig. 3. Prostate; dog. Epithelioid tumor cells are arranged in solid lobules, are large, and have pleomorphic, vesicular nuclei with marked anisokaryosis and frequent, often bizarre, mitotic figures. HE. Fig. 4. Prostate; dog. Epithelioid tumor cells show faint-to-strong cytoplasmic staining for vwf (aka factor VIII-related antigen). Labeled for vwf by immunohistochemistry. Fig. 5. Prostate; dog. Cytokeratin expression was not observed in epithelioid tumor cells, although the resident ductular epithelium is intensely stained. Labeled for AE1/AE3 by immunohistochemistry.
3 550 Shor, Helfand, Gorman, and Lo hr Vet Pathol 46:3, 2009 plasia. Palliative treatment that consisted of an appetite stimulant and pain medication was provided. The dog was euthanized 1 week after presentation at the VTH because of rapid deterioration associated with development of anorexia, acute bilateral blindness, and generalized ataxia, and was submitted for necropsy to the Veterinary Diagnostic Laboratory at OSU. At gross necropsy, the 25-kg Labrador Retriever dog was in moderate body condition and good postmortem condition. Muscle mass was reduced and adipose stores minimal. A mottled beige to red soft mass that measured cm was located in the left caudal lung lobe. Multiple similar nodules that ranged in size from 0.3 to 1 cm in diameter were scattered throughout all lung lobes. There were a few red-black soft masses up to 0.5 cm in diameter that were located at the mesenteric insertion of the colon and in the stomach wall. Half of the left kidney was replaced by a mottled beige-gray to red, slightly firm, cm mass, and multiple liver lobes had similar masses up to 4.5 cm in diameter (Fig. 2). The prostate gland was irregularly enlarged, some areas were spongy and beige, other areas were soft and mottled red-beige (Fig. 2). The muscular layer of the urinary bladder wall was thickened to 8 mm. The right testis had a solitary, soft, mottled black-beige mass 1 cm in diameter, and there was hyphema of the right eye. The brain had multiple, randomly distributed, small, discrete, hemorrhagic foci that varied from 0.1 to 0.3 cm. The spleen had a small number of roughly spherical, beige-red, subcapsular, soft nodules up to 1 cm in diameter. Differential Diagnoses Based on clinical findings of an enlarged prostate with a mass and masses in other organs, and the presence of anaplastic neoplastic cell with cohesion on cytology in the aspirate taken from the prostatic mass, a metastatic anaplastic carcinoma, possibly of prostatic origin, was the primary differential diagnosis. Cytologic features did not, however, completely rule out the possibility of a poorly differentiated sarcoma. The gross necropsy appearance was more suggestive of metastatic hemangiosarcoma (HSA) based on the dark red color of the disseminated lesions, although a primary site was not identified. Immunocytochemistry was not done and could have provided valuable information about the phenotype of the neoplastic cells. Microscopic Findings Routine HE stained sections of masses from the lung, spleen, prostate, kidney, liver, colon, and testis, and sections taken from the brain, and right eye were examined by light microscopy. The prostate had solid clusters of anaplastic cells infiltrating the prostatic interstitium and vasculature and replacing prostatic parenchyma. Tumor cells were large, polygonal to round to ovoid, had large, vesicular nuclei, with moderate anisokaryosis and multiple nucleoli (Fig. 3). Mitotic figures were common and often bizarre (Fig. 3). The surrounding prostatic tissue had prostatic epithelial hyperplasia and mild prostatitis. Solid aggregates of large anaplastic cells penetrating vascular walls were present within multiple pulmonary arterioles, whereas other masses effaced alveoli. Mild hemorrhage was also present. Anaplastic cells formed solid, multilobular masses in the kidney, liver, colonic wall, and testis that were supported by delicate fibrous but highly vascular stroma and associated with massive hemorrhage in the liver, colon, and testis, and large areas of necrosis in the kidney. The right eye contained appreciable amounts of degenerate erythrocytes and fibrin in both chambers. The iris was focally expanded by a multilobular, solid mass composed of anaplastic cells morphologically identical to those seen in other organs that was associated with severe hemorrhage. The lesions in the brain consisted of solid nests of anaplastic neoplastic cells that occluded arterioles and were associated with extensive perivascular hemorrhage. The nodules inthespleenpresented,onhistologicexamination, as nodular lymphoid hyperplasia. The histopathologic presentation as anaplastic epithelioid neoplasm supported the clinical and clinicopathologic diagnoses but was not consistent with the gross presentation of the neoplasm. Therefore, further characterization of the neoplastic cells by immunohistochemistry was pursued. Immunostaining was performed on an autostainer (Dako Autostainer Universal Staining System) with Nova red chromogen (Vector Laboratories, Burlingame, CA) and Mayer s hematoxylin counterstain (Sigma, St. Louis, MO). Microscopic sections were high temperature antigen retrieved with BD Retrieval A solution (Dako, Carpinteria, CA). Rabbit anti-human von Willebrand factor (vwf aka factor VIII-related antigen; Dako, diluted 1 : 400) and wide spectrum cytokeratin (WSS; Dako, diluted 1 : 500) antiserum and monoclonal mouse anti-human cytokeratin antibody (AE1/AE3; Dako, diluted 1 : 200) were used. Normal canine skin served as a positive control, and serial sections of neoplastic tissue were incubated with nonimmune serum to serve as negative controls. Neoplastic cells in all lesions
4 Vet Pathol 46:3, 2009 Diagnostic Exercise 551 from all examined locations had faint-to-strong cytoplasmic staining for vwf (aka factor VIIIrelated antigen, Fig. 4). Neoplastic cells in serial sections of the same tissues did not express cytokeratin, whereas adjacent resident epithelium was strongly positive (Fig. 5). Diagnosis: Metastatic epithelioid hemangiosarcoma. Discussion Canine HSA is a malignant neoplasm of vascular endothelial origin that represents about 5% of all noncutaneous primary malignant tumors and 12% to 21% of all mesenchymal neoplasms in this species. 8,9 HSA presents in 2 topographic distribution patterns: visceral and cutaneous. For visceral HSA, the spleen is the most common primary site, but it can occur as a primary tumor in many other organs. Typically, visceral HSAs are very aggressive, with rapid and widespread metastasis through the hematogenous route. 6,8,9 On histologic examination, visceral HSAs comprise vascular spaces lined by elongated, plump, anaplastic endothelial cells. Identification of vascular spaces in tumors with highly cellular stroma differentiates HSA from other sarcomas. 6 Confirmation of endothelial differentiation historically used staining of histologic specimens with various types of lectins. 1 The current gold standard used in veterinary anatomic pathology for assigning endothelial histogenesis to cells is positive expression of vwf (aka factor VIIIrelated antigen) and/or positive expression of CD31 (aka PECAM-1, platelet endothelial cell adhesion molecule) assessed through immunohistologic (IHC) techniques. 3,10 Although we did not examine CD31 expression in the cells of this report, the ubiquitous vwf staining was highly supportive of an endothelial cell origin for the malignancy in this dog. A histologic variant of HSA, epithelioid (histiocytoid) HSA, is rarely reported in the veterinary literature and may pose a diagnostic challenge on histopathologic and cytologic examination because of epithelial-like morphology of the cells that comprise this tumor. 4,11 This variant was reported in the dog, horse, and cow. 2,5,11 Epithelioid vascular tumors in humans are positive for at least one of the commonly used vascular markers (i.e., vwf, CD31, CD34). 7 A percentage of these tumors in humans is positive for cytokeratin on immunohistochemistry and has been shown to have ultrastructural features of epithelial cells. 7 A recent immunohistologic study showed that epithelioid vascular tumors in domestic animals stain for at least one of two used vascular markers (vwf, CD31), whereas none stained for cytokeratin (AE1/ AE3). 2 In most of the reported cases in the dog, the primary lesions were located in the dermis, subcutis, skeletal muscle, spleen, heart, or lung, and the tumors were locally aggressive, with metastasis chiefly confined to the regional lymph nodes without systemic dissemination. 2,5,11 In the dog of this report, there was no evidence of cutaneous involvement or history of the surgical removal of skin masses, and the epithelioid HSA was present and widely disseminated in numerous tissues, including some previously unreported locations (e.g., prostate, testis, kidney, liver, and brain). The clinical presentation (i.e., irregular prostatomegaly) and the widespread metastases of a malignancy with epithelial features mimicked prostatic carcinoma. The case reported here illustrates the potential for epithelioid HSA to present with a confusing constellation of clinical and pathologic findings and underscores the need to pursue IHC studies of anaplastic cells to confirm the histogenesis of epithelial HSA. Acknowledgement We thank Kay Fischer for excellent technical assistance. References 1 Augustin-Voss HG, Smith CA, RM. Lewis: Phenotypic characterization of normal and neoplastic canine endothelial cells by lectin histochemistry. Vet Pathol 27: , Bertazzolo W, Dell Orco M, Bonfanti U, Ghisleni G, Caniatti M, Masserdotti C, Antoniazzi E, Crippa L, Roccabianca P: Canine angiosarcoma: cytologic, histologic, and immunohistochemical correlations. Vet Clin Pathol 34:28 34, Ferrer L, Fondevila D, Rabanal RM, Vilafranca M: Immunohistochemical detection of CD31 antigen in normal and neoplastic canine endothelial cells. J Comp Pathol 112: , Gross TL, Ihrke PJ, Walder EJ: Hemangiosarcoma. In: Veterinary Dermatopathology. A Macroscopic and Microscopic Evaluation of Canine and Feline Skin Disease, 1st ed., pp Mosby-Year Book, Inc., St. Louis, MO, Machida N, Arimura T, Otagiri Y, Kiryu K, Oka T: Epithelioid haemangioendothelioma of the lung in a dog. J Comp Pathol 119: , Robinson WF, Maxie MG: Vascular neoplasms. In: Jubb, Kennedy, and Palmer s Pathology of Domestic Animals, Volume 3, ed. Maxie MG, 5th ed., pp Saunders Elsevier, St. Louis, MO, Rosai J: Angiosarcoma. In: Ackerman s Surgical Pathology, ed. Rosai J and Ackerman LV, 8th ed., vol. 1, p Mosby-Year Book, Inc., St. Louis, MO, 1996
5 552 Shor, Helfand, Gorman, and Lo hr Vet Pathol 46:3, Smith AN: Hemangiosarcoma in dogs and cats. In: The Veterinary Clinics of North America, Small Animal Practice, ed. Mitchell BE, pp WB Saunders, Philadelphia, PA, Thamm DH: Hemangiosarcoma. In: Withrow and MacEwen s Small Animal Clinical Oncology, eds. Withrow SJ and Vail DM, 4th ed., pp Saunders Elsevier, St. Louis, MO, Von Beust BR, Suter MM, BA. Summers: Factor VIIIrelated antigen in canine endothelial neoplasms: an immunohistochemical study. Vet Pathol 25: , Warren AL, Summers BA: Epithelioid variant of hemangioma and hemangiosarcoma in the dog, horse and cow. Vet Pathol 44:15 24, 2007 Request reprints from Dr. Christiane V. Löhr, Veterinary Diagnostic Laboratory in the Department of Biomedical Sciences, College of Veterinary Medicine, Oregon State University, Magruder Hall Room 105, Corvallis, OR (USA). christiane. lohr@oregonstate.edu.
Disorders of Cell Growth & Neoplasia. Histopathology Lab
Disorders of Cell Growth & Neoplasia Histopathology Lab Paul Hanna April 2010 Case #84 Clinical History: 5 yr-old, West Highland White terrier. skin mass from axillary region. has been present for the
More informationCase Scenario 1: Thyroid
Case Scenario 1: Thyroid History and Physical Patient is an otherwise healthy 80 year old female with the complaint of a neck mass first noticed two weeks ago. The mass has increased in size and is palpable.
More informationAlmost any suspected tumor can be aspirated easily and safely. Some masses are more risky to aspirate including:
DOES THIS PATIENT HAVE CANCER? USING IN-HOUSE CYTOLOGY TO HELP YOU MAKE THIS DIAGNOSIS. Joyce Obradovich, DVM, Diplomate, ACVIM (Oncology) Animal Cancer & Imaging Center, Canton, Michigan Almost every
More informationNeoplasms of the Canine, Feline and Lemur Liver:
Neoplasms of the Canine, Feline and Lemur Liver: Classification and Prognosis Annual Seminar of the French Society of Veterinary Pathology John M. Cullen VMD PhD DACVP North Carolina State University Primary
More informationFORELIMB SWEAT GLAND ADENOCARCINOMA IN A CAT
I: 2047-2051 ISSN: 2277 4998 FORELIMB SWEAT GLAND ADENOCARCINOMA IN A CAT ABEDI G 1, HESARAKI S 2, ASGHARI A 1* 1: Department of Clinical Science, Science and Research branch, Islamic Azad University,
More informationA case of giant cell tumour of soft parts in a horse Francesco Cian 1, Sarah Whiteoak 2, Jennifer Stewart 1
A case of giant cell tumour of soft parts in a horse Francesco Cian 1, Sarah Whiteoak 2, Jennifer Stewart 1 1 Animal Health Trust, Newmarket, UK 2 608 Equine and Farm Vets, Rowington, UK Signalment: Horse,
More informationCytology of NeoPlasia
PEEr reviewed Cytology of NeoPlasia An Essential Component of Diagnosis Anne Barger, DVM, MS, Diplomate ACVP Cytology is a quick, easy, and inexpensive diagnostic tool. It is commonly used for the diagnosis
More informationDiplomate of the American Board of Pathology in Anatomic and Clinical Pathology
A 33-year-old male with a left lower leg mass. Contributed by Shaoxiong Chen, MD, PhD Assistant Professor Indiana University School of Medicine/ IU Health Partners Department of Pathology and Laboratory
More informationNote: The cause of testicular neoplasms remains unknown
- In the 15- to 34-year-old age group, they are the most common tumors of men. - Tumors of the testis are a heterogeneous group of neoplasms that include: I. Germ cell tumors : 95%; all are malignant.
More informationCanine Histiocytic Disorders DR. MEREDITH GAUTHIER, DVM DACVIM (ONCOLOGY) OCTOBER 29, 2015
Canine Histiocytic Disorders DR. MEREDITH GAUTHIER, DVM DACVIM (ONCOLOGY) OCTOBER 29, 2015 Canine Histiocytes! Cells derived from CD34+ stem cells and blood monocytes! Macrophages! Dendritic cells (DC)!
More informationLymphoma. Types of Lymphoma. Clinical signs
Lymphoma Lymphoma is a tumour originating from lymphoid tissue, either nodal (lymph ) or extranodal (thymus, spleen, mucosa, conjunctiva, or skin-associated lymphoid tissue). It is one of the most common
More informationXIII. Tumours of the liver and biliary system
XIII. Tumours of the liver and biliary system V. PONOMARKOV 1 & L. J. MACKEY 2 In this histological classification of liver and gall bladder tumours the tumour types largely correspond to those found in
More informationKidney Case 1 SURGICAL PATHOLOGY REPORT
Kidney Case 1 Surgical Pathology Report February 9, 2007 Clinical History: This 45 year old woman was found to have a left renal mass. CT urography with reconstruction revealed a 2 cm medial mass which
More informationWhat s Your Diagnosis?
What s Your Diagnosis? Courtney S. Wait Signalment: 11 year old FS Labrador Retriever Presenting Complaint/History: The patient presented to the referring DVM for inappetance, vomiting, lethargy, and anorexia.
More informationSESSION 1: GENERAL (BASIC) PATHOLOGY CONCEPTS Thursday, October 16, :30am - 11:30am FACULTY COPY
SESSION 1: GENERAL (BASIC) PATHOLOGY CONCEPTS Thursday, October 16, 2008 9:30am - 11:30am FACULTY COPY GOAL: Describe the basic morphologic (structural) changes which occur in various pathologic conditions.
More informationWhat s your diagnosis? Malori Marotz. Squirt, an 8month old mix breed puppy. History:
What s your diagnosis? Malori Marotz Squirt, an 8month old mix breed puppy History: The owner obtained squirt at 12 weeks of age. The owner reported that Squirt was passing soft stools lately and he is
More informationCanine Cutaneous Melanoma
Canine Cutaneous Melanoma By Elizabeth Downing Clinical Advisor: Dr. Angharad Waite, VMD Basic Science Advisor: Dr. Cheryl Balkman, DVM, DACVIM Senior Seminar Paper Cornell University College of Veterinary
More informationPathology of the Hematopoietic System. Case studies
Pathology of the Hematopoietic System Case studies Shannon Martinson, September 2015 Signalment: 9 yr-old MC cat Case Study 1 History: Cat had been anorexic and developed bleeding in the eyes Physical
More information2015 Descriptive Vet Path Course. Histo Exam #3 KEY
2015 Descriptive Vet Path Course Histo Exam #3 KEY Test 3, Slide 1 Tissue from a guinea pig. MORPHOLOGIC DIAGNOSIS: Heart: Multifocally and randomly (1 pt), within the left and right ventricular myocardium
More information(Iteceived for publication December 3, 1915)
TRANSPLANTABLE SARCOMATA OF THE RAT LIVER ARISING IN THE WALLS OF PARASITIC CYSTS G. L. ROHDENBURG, M.D., AND F. D. BULLOCK, M.D. From Colurnbia University, George Crocker Special Re-search Fund, F. C.
More informationA Canine Case of Complex Carcinoma of the Mammary Gland with Metastasis to the Axillary Lymph Node
A Canine Case of Complex Carcinoma of the Mammary Gland with Metastasis to the Axillary Lymph Node Kenjiro Hashimoto 1), Atsushi Kawabata 1), Tamio Ohmuro 2), Kinji Shirota 1, 3) * 1) Research Institute
More informationCase: The patient is a 62 year old woman with a history of renal cell carcinoma that was removed years ago. A 2.4 cm liver mass was found on CT
Case: The patient is a 62 year old woman with a history of renal cell carcinoma that was removed years ago. A 2.4 cm liver mass was found on CT during follow- up. ALT, AST, Alk Phos and bilirubin were
More informationNormal Morphology. Anatomic Considerations. Normal Urothelial Histology and Cytology
1 Normal Morphology Anatomic Considerations The urinary tract can be divided into three regions: the kidney; the calyces, pelves and ureters (upper collecting system or upper tract); and the bladder and
More informationCase Presentation. Maha Akkawi, MD, Fatima Obeidat, MD, Tariq Aladily, MD. Department of Pathology Jordan University Hospital Amman, Jordan
Case Presentation Maha Akkawi, MD, Fatima Obeidat, MD, Tariq Aladily, MD Department of Pathology Jordan University Hospital Amman, Jordan The 25th Annual Congress of the ADIAP The 8/11/2013 1 5th International
More informationGross appearance of nodular hyperplasia in material obtained from suprapubic prostatectomy. Note the multinodular appearance and the admixture of
Tiền liệt tuyến Tiền liệt tuyến Gross appearance of nodular hyperplasia in material obtained from suprapubic prostatectomy. Note the multinodular appearance and the admixture of solid and microcystic areas.
More informationNormal thyroid tissue
Thyroid Pathology Overview Normal thyroid tissue Normal thyroid tissue with follicles filled with colloid. Thyroid cells form follicles, spheres of epithelial cells (always single layered in health, usually
More informationNUCLEAR MORPHOMETRY IN RELATION TO METASTASES IN CANINE SPONTANEOUS CUTANEOUS SQUAMOUS CELL CARCINOMAS
Trakia Journal of Sciences, Vol. 8, No. 1, pp 74-78, 2010 Copyright 2009 Trakia University Available online at: http://www.uni-sz.bg ISSN 1313-7050 (print) ISSN 1313-3551 (online) Original Contribution
More informationMalignant Peripheral Nerve Sheath Tumor
C H A P T E R 120 Malignant Peripheral Nerve Sheath Tumor Currently, malignant peripheral nerve sheath tumor (MPNST) is the most commonly used generic name for the neoplasms known in the past as neurosarcoma,
More informationScience & Technologies A RETROSPECTIVE STUDY OF CANINE SKIN ROUND CELL TUMOURS
A RETROSPECTIVE STUDY OF CANINE SKIN ROUND CELL TUMOURS Radostin Simeonov Department of General and Clinical Pathology, Faculty of Veterinary Medicine, Trakia University, Stara Zagora, Bulgaria, e-mail:
More informationPROGNOSTIC TESTING INTO FELINE CUTANEOUS MAST CELL TUMOURS
Vet Times The website for the veterinary profession https://www.vettimes.co.uk PROGNOSTIC TESTING INTO FELINE CUTANEOUS MAST CELL TUMOURS Author : Melanie Dobromylskyj Categories : Vets Date : October
More informationCase 2. Dr. Sathima Natarajan M.D. Kaiser Permanente Medical Center Sunset
Case 2 Dr. Sathima Natarajan M.D. Kaiser Permanente Medical Center Sunset History 24 year old male presented with a 3 day history of right flank pain, sharp in nature Denies fever, chills, hematuria or
More informationPapillary Lesions of the Breast A Practical Approach to Diagnosis. (Arch Pathol Lab Med. 2016;140: ; doi: /arpa.
Papillary Lesions of the Breast A Practical Approach to Diagnosis (Arch Pathol Lab Med. 2016;140:1052 1059; doi: 10.5858/arpa.2016-0219-RA) Papillary lesions of the breast Span the spectrum of benign,
More informationPathology of the Hematopoietic System - Lab.
Pathology of the Hematopoietic System - Lab http://people.upei.ca/smartinson/ Shannon Martinson, September 2015 Case #1 Signalment: 96 kg gilt History: Pig from minimal disease herd. Sudden death Case
More information2 to 3% of All New Visceral Cancers Peak Incidence is 6th Decade M:F = 2:1 Grossly is a Bright Yellow, Necrotic Mass with a Pseudocapsule
GENITOURINARY PATHOLOGY Kathleen M. O Toole, M.D. Renal Cell Carcinoma 2 to 3% of All New Visceral Cancers Peak Incidence is 6th Decade M:F = 2:1 Grossly is a Bright Yellow Necrotic Mass Grossly is a Bright
More informationAtypical Palisaded Myofibroblastoma of Lymph Node: Report of a rare case.
ISPUB.COM The Internet Journal of Pathology Volume 10 Number 1 Atypical Palisaded Myofibroblastoma of Lymph Node: Report of a rare case. V Kinnera, R Nandyala, M Yootla, K Mandyam Citation V Kinnera, R
More informationSEBACEOUS NEOPLASMS. Dr. Prachi Saraogi Clinical Fellow in Dermatology
SEBACEOUS NEOPLASMS Dr. Prachi Saraogi Clinical Fellow in Dermatology Sebaceous neoplasms Sebaceous adenoma (Benign) Sebaceous carcinoma (Malignant) SEBACEOUS ADENOMA Benign tumours composed of incompletely
More informationPresentation material is for education purposes only. All rights reserved URMC Radiology Page 1 of 98
Presentation material is for education purposes only. All rights reserved. 2011 URMC Radiology Page 1 of 98 Radiology / Pathology Conference February 2011 Brooke Koltz, Cytopathology Resident Presentation
More informationCLINICAL AND PATHOLOGICAL ASPECTS IN 2 CASES OF CANINE MASTOCYTOMA
CLINICAL AND PATHOLOGICAL ASPECTS IN 2 CASES OF CANINE MASTOCYTOMA C. MURESAN 1, P. BOLFA 2, C. CATOI 2, A. GAL 2, M. TAULESCU 2, F. TABARAN 2, A. NAGY 2 1 Emergency Hospital, 2 Discipline of Pathology
More informationEpithelial tumors. Dr. F.F. Khuzin, PhD Dr. M.O. Mavlikeev
Epithelial tumors Dr. F.F. Khuzin, PhD Dr. M.O. Mavlikeev Epithelial tumors Tumors from the epithelium are the most frequent among tumors. There are 2 group features of these tumors: The presence in most
More informationCYTOLOGY OF THE LIVER
CYTOLOGY OF THE LIVER Maxey L. Wellman, DVM, PhD, DACVP (Clinical Pathology) Professor, Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
More informationEpithelioid Variant of Hemangioma and Hemangiosarcoma in the Dog, Horse, and Cow
Vet Pathol 44:15 24 (2007) Epithelioid Variant of Hemangioma and Hemangiosarcoma in the Dog, Horse, and Cow A. L. WARREN AND B. A. SUMMERS Department of Biomedical Sciences, College of Veterinary Medicine,
More informationNeoplasia 2018 Lecture 2. Dr Heyam Awad MD, FRCPath
Neoplasia 2018 Lecture 2 Dr Heyam Awad MD, FRCPath ILOS 1. List the differences between benign and malignant tumors. 2. Recognize the histological features of malignancy. 3. Define dysplasia and understand
More informationACCME/Disclosures ALK FUSION-POSITIVE MESENCHYMAL TUMORS. Tumor types with ALK rearrangements. Anaplastic Lymphoma Kinase. Jason L.
Companion Meeting of the International Society of Bone and Soft Tissue Pathology The Evolving Concept of Mesenchymal Tumors ALK FUSION-POSITIVE MESENCHYMAL TUMORS Jason L. Hornick, MD, PhD March 13, 2016
More informationOcular Neoplasia What s Common? What s New? Richard R Dubielzig
Ocular Neoplasia What s Common? What s New? Richard R Dubielzig Orbit 288 6% Tumors of the globe make up 3225 out of 6110 total neoplasms = 53%. Tumors of the conjunctiva make up 1192 out of 6110 total
More information21/07/2017. Hobnail endothelial cells are not the same as epithelioid endothelial cells
UPDATE IN CUTANEOUS VASCULAR S DERMATOPATHOLOGY SESSION BELFAST PATHOLOGY JUNE 21/2017 Dr E Calonje St John s Institute of Dermatology, London, United Kingdom THE FAMILY OF VASCULAR S WITH EPITHELIOID
More informationHISTOPATHOLOGY. Shannon Martinson
HISTOPATHOLOGY Shannon Martinson March 2013 Case #1 History: 8 year old beagle Neck pain for the past couple of weeks Paresis, followed by paralysis developed over the past few days Gross Description courtesy
More informationCase Report A Rare Cutaneous Adnexal Tumor: Malignant Proliferating Trichilemmal Tumor
Case Reports in Medicine Volume 2015, Article ID 742920, 4 pages http://dx.doi.org/10.1155/2015/742920 Case Report A Rare Cutaneous Adnexal Tumor: Malignant Proliferating Trichilemmal Tumor Omer Alici,
More informationCase # nd Annual SEVPAC May 17, Kathy-Anne Clarke
Case # 10 42 nd Annual SEVPAC May 17, 2014 Kathy-Anne Clarke Google images Babu Babu is 10 year old spayed female French Bulldog Chronic weight loss over 4 months Febrile and lethargic at the referring
More informationXX. Tumours of the nasal cavity *
XX. Tumours of the nasal cavity * H. STONZI 1 & B. HAUSER2 Tumours of the nasal cavity are rare in domestic animals, most cases occurring in the dog. Epithelial tumours are the most common type in carnivores
More informationEndometrial Stromal Tumors
Endometrial Stromal Tumors WHO Categories: Endometrial Stromal Nodule (ESN) Endometrial Stromal Sarcoma, low grade (LGESS) Endometrial Stromal Sarcoma, high grade (HGESS) Undifferentiated Uterine Sarcoma
More informationBladder Case 1 SURGICAL PATHOLOGY REPORT. Procedure: Cystoscopy, transurethral resection of bladder tumor (TURBT)
Bladder Case 1 February 17, 2007 Specimen (s) received: Bladder Tumor Pre-operative Diagnosis: Bladder Cancer Post operative Diagnosis: Bladder Cancer Procedure: Cystoscopy, transurethral resection of
More informationWhat s Your Diagnosis? Signalment: Species: Canine Breed: Golden Retriever Sex: Female (spayed) Date of Birth: 04/01/99
What s Your Diagnosis? Signalment: Species: Canine Breed: Golden Retriever Sex: Female (spayed) Date of Birth: 04/01/99 Presenting Complaint: Acute onset of lethargy Vomited twice (partially digested food)
More informationNormal endometrium: A, proliferative. B, secretory.
Normal endometrium: A, proliferative. B, secretory. Nội mạc tử cung Nội mạc tử cung Cyclic changes in endometrium.. Approximate relationship of useful microscopic changes. Arias-Stella reaction in endometrial
More informationUncommon pattern in soft tissues epithelioid sarcoma
Romanian Journal of Morphology and Embryology 2005, 46(3):229 233 Uncommon pattern in soft tissues epithelioid sarcoma CARMEN ARDELEANU 1, 2), MARIA COMĂNESCU 3), VIOLETA COMĂNESCU 4), F. ANDREI 1) 1)
More informationAsadi-Amoli et al Adenocarcinoma of RPE Iranian Journal of Ophthalmology - Volume 19, Number 4, 2007
Adenocarcinoma of Retinal Pigment Epithelium Clinically Diagnosed as Malignant Melanoma; A Case Report with Unsystematic Review of Literature Fahimeh Asadi-Amoli, MD, 1 Hedyeh Moradi, MD 2 Mohammad-Taher
More informationProliferative Epithelial lesions of the Breast. Sami Shousha, MD, FRCPath Charing Cross Hospital & Imperial College, London
Proliferative Epithelial lesions of the Breast Sami Shousha, MD, FRCPath Charing Cross Hospital & Imperial College, London Amman, November2013 Proliferative Epithelial Lesions of the Breast Usual type
More informationRespiratory Pathology Lab 2: Lung. Shannon Martinson,
Respiratory Pathology Lab 2: Lung Shannon Martinson, 2017 http://people.upei.ca/smartinson/ Case 1 Signalment: 9 month old DSH cat History: Poor doer with stunted growth One month of lethargy one day the
More informationFinancial disclosures
Mesenchymal Neoplasms with Melanocytic Differentiation By Konstantinos Linos MD, FCAP, FASDP Bone, Soft Tissue and Dermatopathology Assistant Professor of Pathology Dartmouth-Hitchcock Medical Center Geisel
More informationOutline 11/2/2017. Pancreatic EUS-FNA general aspects. Cytomorphologic features of solid neoplasms/lesions of the pancreas
ENDOSCOPIC ULTRASOUND GUIDED-FINE NEEDLE ASPIRATION CYTOLOGY OF PANCREAS Khalid Amin M.D. Assistant Professor Department of Laboratory Medicine and Pathology University of Minnesota Outline Pancreatic
More informationDiseases of the breast (1 of 2)
Diseases of the breast (1 of 2) Introduction A histology introduction Normal ducts and lobules of the breast are lined by two layers of cells a layer of luminal cells overlying a second layer of myoepithelial
More informationCellular Neurothekeoma
Cellular Neurothekeoma Scott W Binder, MD Pritzker Professor of Pathology & Dermatology Sr. Vice Chair Director, Pathology Clinical Services Chief, Dermatopathology Geffen/UCLA School of Medicine Clinical
More informationA 42-year-old woman with a liver mass
April 2016 Case of the Month A 42-year-old woman with a liver mass Contributed by: Natalia I. Rush, MD, Resident Physician, Indiana University School of Medicine, Department of Pathology and Laboratory
More informationOncocytic carcinoma: A rare malignancy of the parotid gland
ISPUB.COM The Internet Journal of Pathology Volume 8 Number 2 Oncocytic carcinoma: A rare malignancy of the parotid gland K Mardi, J Sharma Citation K Mardi, J Sharma.. The Internet Journal of Pathology.
More informationUNUSUAL OCULAR HODGKINʼS-LIKE LYMPHOMA IN A DOG
Bulgarian Journal of Veterinary Medicine, 2019 ONLINE FIRST ISSN 1311-1477; DOI: 10.15547/bjvm.2241 Case report UNUSUL OCULR HODGKINʼS-LIKE LYMPHOM IN DOG Summary M. KHORDDMEHR 1, S. JROLMSJED 2, J. SHRFI-HELN
More information57th Annual HSCP Spring Symposium 4/16/2016
An Unusual Malignant Spindle Cell Lesion to Involve the Breast Erinn Downs-Kelly, D.O. Associate Professor of Pathology University of Utah & ARUP Laboratories No disclosures Case 39 y/o female with no
More informationSynchronous squamous cell carcinoma of the breast. and invasive lobular carcinoma
Sentani K et al. 1 Letter to the editor Synchronous squamous cell carcinoma of the breast and invasive lobular carcinoma Kazuhiro Sentani, 1 Takashi Tashiro, 2 Naohide Oue, 1 Wataru Yasui 1 1 Department
More informationTinh hoàn
Tinh hoàn Tinh hoàn Tinh hoàn Tiền liệt tuyến Tiền liệt tuyến Mào tinh hoàn Mào tinh hoàn Túi tinh Túi tinh Túi tinh Túi tinh So-called cystadenoma of seminal vesicle. Gross appearance of granulomatous
More informationMedullary Thyroid Carcinoma. This case was provided by Treant Hospital, Bethesda, Hoogeveen, The Netherlands
Medullary Thyroid Carcinoma This case was provided by Treant Hospital, Bethesda, Hoogeveen, The Netherlands ADS-01504 Rev. 001 2016 Hologic, Inc. All rights reserved. Overview Medullary Thyroid Carcinoma
More informationNeoplasia literally means "new growth.
NEOPLASIA Neoplasia literally means "new growth. A neoplasm, defined as "an abnormal mass of tissue the growth of which exceeds and is uncoordinated with that of the normal tissues and persists in the
More informationA 25 year old female with a palpable mass in the right lower quadrant of her abdomen
May 2016 A 25 year old female with a palpable mass in the right lower quadrant of her abdomen Contributed by: Paul Ndekwe, MD, Resident Physician, Indiana University School of Department of Pathology and
More informationCanine Liver Eneku Wilfred Bovine Pathology
2012-1-3 Canine Liver Eneku Wilfred Bovine Pathology Contributor: New Mexico Department of Agriculture Veterinary Diagnostic Services Signalment: 5 month old male Weimaraner dog (Canis familiaris) History:
More informationImmunohistochemical Evaluation of Necrotic Malignant Melanomas
Anatomic Pathology / EVALUATION OF NECROTIC MALIGNANT MELANOMAS Immunohistochemical Evaluation of Necrotic Malignant Melanomas Daisuke Nonaka, MD, Jordan Laser, MD, Rachel Tucker, HTL(ASCP), and Jonathan
More informationTitle. Author(s)KANAGAWA, Hiroshi; ISHIKAWA, Tsune; KAWATA, Keiichir. CitationJapanese Journal of Veterinary Research, 13(1): Issue Date
Title A CASE OF CANINE TESTICULAR SERTOLI CELL TUMOR Author(s)KANAGAWA, Hiroshi; ISHIKAWA, Tsune; KAWATA, Keiichir CitationJapanese Journal of Veterinary Research, 13(1): 11-1 Issue Date 1965-03 DOI 10.14943/jjvr.13.1.11
More informationCase Report Tumor-to-Tumor Metastasis: Lung Carcinoma Metastasizing to Thyroid Neoplasms
Hindawi Publishing Corporation Volume 2015, Article ID 153932, 5 pages http://dx.doi.org/10.1155/2015/153932 Case Report Tumor-to-Tumor Metastasis: Lung Carcinoma Metastasizing to Thyroid Neoplasms Shiuan-Li
More informationHemangioendothelioma with a Prominent Lymphoid Infiltrate Mimicking Follicular Dendritic Cell Tumor: Report of a Case
Journal of Cancer Research Updates, 2013, 2, 135-139 135 Hemangioendothelioma with a Prominent Lymphoid Infiltrate Mimicking Follicular Dendritic Cell Tumor: Report of a Case Justin Kerstetter 1, Mia Perez
More informationCYSTIC TUMORS OF THE KIDNEY JOHN N. EBLE, M.D. CYSTIC NEPHROMA
Page 1 CYSTIC TUMORS OF THE KIDNEY JOHN N. EBLE, M.D. Department of Pathology & Laboratory Medicine Phone (317) 274-4806 Medical Science A-128 FAX: (317) 278-2018 635 Barnhill Drive jeble @iupui.edu Indianapolis,
More informationJOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH How to cite this article : PAI K,GUPTA A.INTRAVASCULAR EPITHELIOID HAEMANGIOMA OF TEMPORAL ARTERY: A DIAGNOSTIC DIFFICULTY Journal of Clinical and Diagnostic
More informationRENAL CELL CARCINOMA 2 to 3% of All New Visceral Cancers Peak Incidence is 6th Decade M:F = 2:1 Grossly is a Bright Yellow, Necrotic Mass with a Pseud
GENITOURINARY PATHOLOGY Kathleen M. O Toole Toole, M.D. RENAL CELL CARCINOMA 2 to 3% of All New Visceral Cancers Peak Incidence is 6th Decade M:F = 2:1 Grossly is a Bright Yellow, Necrotic Mass with a
More informationUniversity Journal of Pre and Para Clinical Sciences
ISSN 2455 2879 Volume 2 Issue 1 2016 Metaplastic carcinoma breast a rare case report Abstract : Metaplastic carcinoma of the breast is a rare malignancy with two distinct cell lines described as a breast
More informationFNA of Thyroid. Toward a Uniform Terminology With Management Guidelines. NCI NCI Thyroid FNA State of the Science Conference
FNA of Thyroid NCI NCI Thyroid FNA State of the Science Conference Toward a Uniform Terminology With Management Guidelines Thyroid Thyroid FNA Cytomorphology NCI Thyroid FNA State of the Science Conference
More informationHistopathology of Melanoma
THE YALE JOURNAL OF BIOLOGY AND MEDICINE 48, 409-416 (1975) Histopathology of Melanoma G. J. WALKER SMITH Department ofpathology, Yale University School ofmedicine, 333 Cedar Street, New Haven, Connecticut
More informationPATHOLOGY OF LIVER TUMORS
PATHOLOGY OF LIVER TUMORS Pathobasic, 31.05.2016 WHO Classification Approach to a Liver Mass Lesion in a patient with chronic liver disease? Lesion in a patient without chronic liver disease? Malignant
More informationSynchronous Multicentric Osteosarcoma in the Canine Axial Skeleton: a Report of Two Cases
173 Case Report Synchronous Multicentric Osteosarcoma in the Canine Axial Skeleton: a Report of Two Cases Matheus V. L. Moreira 1, Juneo F. Silva 1, Jankerle N. Boeloni 1, Natalia M. Ocarino 1, Rogéria
More informationCase Report Tumor-to-Tumor Metastasis: Lung Carcinoma Metastasizing to Thyroid Neoplasms
Case Reports in Pathology Volume 2015, Article ID 153932, 5 pages http://dx.doi.org/10.1155/2015/153932 Case Report Tumor-to-Tumor Metastasis: Lung Carcinoma Metastasizing to Thyroid Neoplasms Shiuan-Li
More informationSynonyms. Nephrogenic metaplasia Mesonephric adenoma
Nephrogenic Adenoma Synonyms Nephrogenic metaplasia Mesonephric adenoma Definition Benign epithelial lesion of urinary tract with tubular, glandular, papillary growth pattern Most frequently in the urinary
More informationNeoplasia part I. Dr. Mohsen Dashti. Clinical Medicine & Pathology nd Lecture
Neoplasia part I By Dr. Mohsen Dashti Clinical Medicine & Pathology 316 2 nd Lecture Lecture outline Review of structure & function. Basic definitions. Classification of neoplasms. Morphologic features.
More informationSalivary Glands 3/7/2017
Salivary Glands 3/7/2017 Goals and objectives Focus on the entities unique to H&N Common board type facts Information for your future practice Salivary Glands Salivary Glands Major gland. Paratid. Submandibular.
More informationPitfalls in thyroid tumor pathology. Prof.Valdi Pešutić-Pisac MD, PhD
Pitfalls in thyroid tumor pathology Prof.Valdi Pešutić-Pisac MD, PhD Too many or... Tumour herniation through a torn capsule simulating capsular invasion fibrous capsule with a sharp discontinuity, suggestive
More informationPathological Classification of Hepatocellular Carcinoma
3 rd APASL Single Topic Conference: HCC in 3D Pathological Classification of Hepatocellular Carcinoma Glenda Lyn Y. Pua, M.D. HCC Primary liver cancer is the 2 nd most common cancer in Asia HCC is the
More informationBREAST PATHOLOGY. Fibrocystic Changes
BREAST PATHOLOGY Lesions of the breast are very common, and they present as palpable, sometimes painful, nodules or masses. Most of these lesions are benign. Breast cancer is the 2 nd most common cause
More informationInternational Journal of Veterinary Science
International Journal of Veterinary Science www.ijvets.com P-ISSN: 2304-3075 E-ISSN: 2305-4360 editor@ijvets.com CASE REPORT Histiocytic Sarcoma with Visceral Spread Resembling Metastasizing Poorly Differentiated
More informationDIAGNOSTIC SLIDE SEMINAR: PART 1 RENAL TUMOUR BIOPSY CASES
DIAGNOSTIC SLIDE SEMINAR: PART 1 RENAL TUMOUR BIOPSY CASES Dr. Andrew J. Evans MD, PhD, FACP, FRCPC Consultant in Genitourinary Pathology University Health Network, Toronto, ON Case 1 43 year-old female,
More informationCINtec p16 INK4a Staining Atlas
CINtec p16 INK4a Staining Atlas Rating Rating Positive The rating positive will be assigned if the p16 INK4a -stained slide shows a continuous staining of cells of the basal and parabasal cell layers of
More informationCerebral Parenchymal Lesions: I. Metastatic Neoplasms
Chapter 4 Cerebral Parenchymal Lesions: I. Metastatic Neoplasms After one has reasonably ruled out the possibility of a nonneoplastic diagnosis (see Chap. 3), one is left with considering a diagnosis of
More informationReview of the AP Part II Practical Examination. Dr David Clift Co Chief Examiner
Review of the AP Part II Practical Examination Dr David Clift Co Chief Examiner General Remarks The part II practical examination involved 15 cases which were presented with sufficient clinical data to
More informationPrinciples of Surgical Oncology. Winnie Achilles Tierklinik Hollabrunn Lastenstrasse Hollabrunn
Principles of Surgical Oncology Winnie Achilles Tierklinik Hollabrunn Lastenstrasse 2 2020 Hollabrunn boexi@gmx.de The first surgery provides the best chance for a cure in an animal with a tumor Clinical
More informationIntroduction. Results. Discussion. Histopathologic and immunohistochemical findings. Results. conclusions,
1/5 2/5 Carcinoma distinctive carcinoma. form erysipeloides (CE), metastasis. which clinically Itfrom has resembles been termed erysipelas, is an uncommon, but may extend It164 toclassically back, presents
More information!! 2 to 3% of All New Visceral Cancers.!! Peak Incidence is 6th Decade!! M:F = 2:1
!! Kathleen M. O Toole, M.D.!! 2 to 3% of All New Visceral Cancers!! Peak Incidence is 6th Decade!! M:F = 2:1!! Grossly is a Bright Yellow, Necrotic Mass with a Pseudocapsule 1 !!Conventional RCC! Clear
More informationCytology of Neoplasms that Occur on the Limbs Rick Alleman, DVM, PhD, DABVP, DACVP
Cytology of Neoplasms that Occur on the Limbs Rick Alleman, DVM, PhD, DABVP, DACVP I. Introduction The purpose of this material is to provide information that may be useful in the identification of tumors
More informationGeneral physical examination was unremarkable. No history of previous ocular problems.
AQUEOUS HUMOUR FROM A DOG H Ferreira 1, E Scurrell 2, J Bass 3, K Salmon 4 1: Axiom Veterinary Laboratories, Newton Abbot, UK 2: CYTOPATH Limited, Ledbury, Herefordshire, UK 3: Finn Pathologists, Weybread,
More information