SB 6331 (scanned slide available) Keith Duncan; Mills-Peninsula Hospital 52-year-old male with painful right parotid mass.

Transcription

1 SB 6331 (scanned slide available) Keith Duncan; Mills-Peninsula Hospital 52-year-old male with painful right parotid mass.

2

3

4

5

6

7

8

9

10

11

12 SB 6332 Shyam Raghavan/Don Born; Stanford 77-year-old male with right occipital bone mass.

13 77 year old male with a right occipital bone mass. The mass is heterogeneous in appearance with cystic changes and some enhancement measuring 2.9 x 1.8 x 2.7 cm

14 Low power

15 Medium power

16 High power

17 CK7

18 SMA

19 ERG

20 CD31

21 SB 6333 Jeffrey Cloutier/Yaso Natkunam; Stanford 74-year-old HIV-negative male with 6 months of intermittent fevers, night sweats and fatigue, and cervical and axillary lymphadenopathy. FNA biopsy showed reactive lymphoid hyperplasia. Underwent excisional biopsy.

22

23

24

25

26 CD34

27 CD123

28 Kappa ISH

29 Lambda ISH

30 SB 6334 Matthew Koo/Yaso Natkunam; Stanford 75-year-old male with intra-abdominal mass.

31 Clinical History Denied abdominal pain, weight loss or anorexia, or bone pain No known history of immunosuppression or immunodeficiency No known prior history of hematolymphoid malignancy

32 Radiography CT scan (3/12/2018): Low anterior pelvic mass (4.5 x 3.8 cm), compatible with adenopathy, immediately anterior to the right external iliac Other adenopathies: External iliac, right (2.3 x 1.4 cm) External iliac, left (shotty) Retroperitoneal Pericaval, right (2 x 1 cm)

33 H&E (2x)

34 H&E (10x)

35 H&E (40x)

36 H&E (60x)

37 HHV8 (4x)

38 CD21 (4x)

39 SB 6335 Sharon Wu; El Camino Hospital 83-year-old male with anemia since 2017, treated with iron and B12, no h/o bleeding, GI work-up negative. Worsening anemia within past 3 months requiring blood transfusion. Peripheral smear: normochromic normocytic anemia, absolute neutropenia, absolute lymphopenia, mild thrombocytopenia, no evidence of hemolysis, dysplasia, or blasts. Bone marrow bx performed.

40 Medical History Anemia since early 2017, treated with iron and B12 supplementation No history of bleeding GI workup unrevealing Worsening of anemia within past 3 months requiring blood transfusion

41 Peripheral blood smear Normochromic normocytic anemia Absolute neutropenia Absolute lymphopenia Mild thrombocytopenia No evidence of hemolysis, dysplasia or blasts

42 CBC WBC 2.5 K/uL RBC 2.41 M/uL Hb 7.5 g/dl Hct 22.1% MCV 92 fl RDW 12.7% Plt 131 ANC 1.1 K/uL ALC 0.8 K/uL Neutrophil 45% Lymphocyte 30% Monocyte 21% Eosinophil 3% Basophil 0%

43 Other Clinical Labs Ferritin Iron Iron binding Iron % sat Vitamin B12 Folate 457 (H) 103 (nl) 200 (L) 52 (H) 955 (H) 12.8 (nl)

44

45

46

47

48

49

50

51

52

53 SB 6336 (scanned slide available) Nicholas Ladwig/Sarah Umetsu; UCSF 44-year-old G2P2 female with an intrauterine pregnancy. 32-week ultrasound showed 5cm uterine mass most suggestive of a succenturiate lobe. She underwent normal spontaneous vaginal delivery of male infant. Immediately following delivery of placenta, 6.8cm mass was delivered, which was entirely separate from both infant and placenta.

54

55

56

57

58

59

60

61

62

63

64 SB 6337 (scanned slide available) Daffolyn Rachael Fels Elliott/Sarah Umetsu; UCSF 55-year-old male with h/o allogeneic stem cell transplant for AML. He initially presented with abdominal pain and diarrhea. He was treated for C.difficile but diarrhea persisted. One month lateral he presented with symptoms of bowel obstruction and underwent left hemi-colectomy.

65

66

67

68

69

70

71

72

73

74

75

76 SB 6338 Jeffrey Cloutier/Christine Louie; Stanford/Palo Alto VA 73-year-old male with lymphoplasmacytic lymphoma recently started on rituxan and bendamustine. After two rounds of treatment, developed itchy erythematous lesions on bilateral legs highly suspicious for erythema nodosum.

77

78

79

80

81

82

83

84 SB 6339 Caroline Temmins; Santa Clara Valley Medical Center 41-year-old male with recently emigrated with Philippines with 1-year h/o itchy non-painful rash on face and arms. No systemic symptoms, no loss of sensation over the rash.

85

86

87

88

89

90

91 SB 6340 Andrew Bandy/John Moretto; CPMC 53-year-old male presented with GI bleeding, underwent endoscopy and found to have >100 colon polyps. Patient later developed ischemic bowel and underwent colectomy.

92 53 year old man presented with GI bleeding, underwent endoscopy and found to have >100 colon polyps. Patient later developed ischemic bowel and underwent colectomy.

93

94

95

96