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CALIFORNIA TUMOR TISSUE REGISTRY

LOS ANGELES COUNTY - UNIVERSITY OF SOUTHERN CALI FO RNIA

PROTOCOL

FOR

MONTHL Y STUDY SLIDES

MARCH 19BB

GENERAL PATHOLOGY

CASES SUBMI TTED BY

SAINT VINCENT MED ICAl CENTE R, LOS ANGELES , CALI FORNIA

• • • • • • * • • • • • • • * * • • • + * • • • • • • • • • • • • • • • • • •

CONTRIBUTOR: Joseph N. Carberry , M. 0. MARCH 1968 - CA~l NO. 1 Los Angel~s. California

TI SS LI ( FROM: Spleen ACCESSION NO. 25071

CLINICAL ABSTRACT:

HiStj>.~: An Sl -year- ol d woman was admitted fo r vaguP abdominal pain, nausPa, vomi ting. diarrhea and recent loss of 20-25 pounds. She was taken t.o surgery for vago tOI1\Y and pyloropl~st_y.

SURGERY: (June 28 . 1983)

At surgery . the pa t ient had splenomegaly and abdomi nal lymphadenopathy. The spleen was removed, and t he abdominal lympn nodes biopsied .

GROSS PA THOLOGY:

The spleen weighed 470 grams and measured 16 x 9 x 8 em. The capsule showed irregu lar scarring . The cut 's urface was firm and mottled red. The perivascular tissue was especially f irm.

CONTRIBUTOR: Mary Beth Shwayder , M. 0. MARCH 1988 - CAS£ NO. ? Lo$ Ang~l~s. Ca l i forn ia

11 SSII[ fROM: NPr.k ACCE SS ION NO. 2S2S6

CLI NI CAL ABSTRACT:

H i~tory: A 20-yPar-old man pr~sented wi th recent onset of a r ight neck mass. The mass was in the supraclavicular region and was associ ated with pain in the right arm. Multiple ca fe-au-lai t spots were present on t he skin.

SURGERY: (May 10 , 1984)

The mass was removed with diff iculty, as i t was adherent to adjacent s t ruc turt>s .

~ROSS PATHQLOGY :

The specimPn consisted of 183 gram mass wh ich measured JO.S x 7 x 5 em. Thl' external surface was mottl ed red to ypllow. St>ctioning showed dt>nse , whorl ed t.an-wh itP tissue wi th f0ci of mucoi d degenerat ion.

CONTRIBUTOR: Mary Beth Shwayder , M. O. MARCH 1988 - CASE NO. 3 Los AngelPs, California

TISSUE FROM: Cauda pquina ACCESSION. NO. 25336

CLINICAL ABSTRACT:

Histo~: This 35-year-old white male presented with a severa l months' history of back pain.

Radiograph: Myelogram showed "a cystic mass" in the low tnoracic, upper lumbar region.

SURGERY: (October 1984)

A laminectomy with excision of tumor was performed. Operative findings were of multip le yel low-tan nodules measuri ng up to 0.9 em. in diameter attached to the nerve roots of the cauda equina and the filum terminale.

GROSS PATHOLOGY :

The specimen consisted of mutiple yellow- tan nodules ranging in size from 0.1 to 0.9 em. in diameter.

CONTR IBUTOR: Joseph N. Ca rberry , M. D. MARCH 1988 - CASE NO. 4 Los Angeles . Cal iforn ia

1JSSUE rROM: Right cerebellopont ine angl e ACCESSION NO. 26121

CL!Nl~AL ABSTRACT;

History : This 48-yPar-old man presented with progressi ve di zz iness . loss of balance , dysphagia , and frontal headache over a 7 month period.

Phys ical exami nat ion: Neurolog ic examinat ion revealed difficulty wi th t andem walking and a decreased corneal ref l ex on the r ight compared with the left . Speech and swallowing were normal.

SU RGERY: (June 2 3 . 1 g87)

A cran iotomy was performed. At surgE' ry, a l arge , poorly c ircumscr ibed, granula r grey tumor was present i n the right cerebellopontinE' angle . invol ving thP fifth , ninth , tenth and eleventh cranial nerves and e~tending to involve the brain ~tern .

GROSS PATHOLOGY :

The specimen consiStE'd of mu l tiple fragments of grey to pink tan papill ary tissue which aggrega ted to 7 grams.

CONTR lBliTOR : Joseph N. Carberry. M. D. MARCH 1988 - CASE NO. 5 Lo~ Angeles. Ca l iforni a

TISSUE fROM: Cerebellum ACCESSION NO. 26069

CLINICAL ABSTRACT:

History: This 28-year-old woman presented with a 3 w~eks' history of headachp, nausea. vomiting. dizziness and photophobia.

Radiographs: Head CT showed a .Posterior foHa tumor.

SURGERY: (August 21 , 1987)

A craniotomy with excision of the tumor was performed . Findings were of a grey pink tumor involving the midline and left hemisphere of the cerebellum. lt extend~d to the dura.

GROSS PATHOlOGY:

The specimen consisted of 14 gram, 6 x 3.5 x 2 em. mass with a thin rim of normal appeari ng cerebellar tissue attac.hed to one aspect. The mass was so l id, mott led pink and had a rubbpry consistency.

CONTRIBUTOR: Phillip Gru~kin , M. 0. lo~ Angeles, California

TISSUE FROM: lung

CLINICAL ABSTRACT:

MARCH 1988 - CAS£ NO. &

ACCESSION NO. 25558

Hi ~tory : Thi~ 55-year-old man presented with a 1 year's hi~tory of dyspnea on e~ertion aod pedal edema.

SURGERY: (Ju ly 1985)

A l eft pneumonectomy with e~c i~ion of a large pleura l mass wa~ perfomed.

GROSS PATHOLOGY:

The specim~n consisted of a 30 x 30 x 20 em , 9 ,600 gram firm , lobulated ma~s and separate enti re left lung , the medial aspect of whi ch showed a 10 x 9 em. depression wi th ~n i rregula r suface . The remaining pleural ~ur faces were smooth and gl i stening.

CONTRIBUTOR: Joseph N. Carberry, M. D. MA RCH 1988 - CAS£ NO. 7 Los Ang~l es , California

TISSUE rROM: Right external auditory canal ACCESSION NO. 21243

CLI NICAL ABSTRACT:

Hi story : This 72-year-old man presented with hearing loss and itching and swelling beh i nd the right ea r of 3 months' duration. He noticed a pulsatile sound in the right ear for the 2 months pr ior to presentation.

Phys ical examination: There was swelling and injecti on of the lower aspect of t he r ight externa l auditory cana l .

SURGERY: (Ma rch 7, 1975)

After bi ops.y, a middle fossa and mastoid removal of the right auditory canal was performed with right total parotidectomy and partial right ma ndibulectomy.

GROSS PATHOLOGY :

The specimen cons isted of a right parotid gla nd, attached skin , external auditory canal, mastoid bone and ramus of madibl e. An il l-dP fined. f irm white tumor was present involving the auditory canal and extending into both the maxillary bone and a portion of the parotid gland.

CONTRI8UTOR: Joseph N. C~rberry , M. D. MARCH 1988 - CAS[ NO. 8 Los Angel es , California

TISSU[ fROM: Thigh ACCESSION NO. 23918

CLINICAL ABSTRACT:

History: This 48-year-old woman presented with sudden onset of left lateral thigh pain and swelling.

~sical examination: Diffuse swelling was present in the left lateral thigh.

SVRG[RY: (May IS. 1980)

A wide excision of a mass in the left rectus femora l muscle was performed.

GROS~ PATHOLOGY:

The specimen consisted a 7 .!'> x 2.0 em. portion of skin. subcutaneous adipos~ tissue and underlying skeletal muscle . The skeletal muscle appeared infiltrated by yellow ad iposP tissue and portions of the subcutaneous fat showed soft brown to wh ite discolored areas. No discrete mass lesion was identified .

CONTRIBUTOR: Joseph N. Ca rberry, H. 0. MARCH 1988 - CASE NO. 9 Los Angeles, California

TISSUE FROM: Nasopharynx ACCESSION NO. 26067

CLI NICAL ABSTRACT:

History: This 88-year-old woman experienced right nasal stuff iness for 4 months.

Physical examination : A large fleshy mass was present occ lud ing the right nasal cavity.

Radiogra~h : CT scan revealed a large r ight nasal mass wi th bony erosion of the rightateral nasal wa ll.

SURGERY : (June 10 , 1987)

A wide excision of the tumor was per formed.

GROSS PATHOLOGY:

A 2. 6 x 2. 4 x 0.8 em. tumor was rece ived. The cut surfaces were firm, rubbery , pale yellow to white and semitranslucent.

CONTRIBUTOR: Joseph N. Carberry, M. 0. MARCH 1988 - CASE NO. 10 Los Angeles, Ca lifornia

TISSUE FROM: Brain ACCESSION NO. 26068

CLINICAL ABSTRACT:

His tory: Thi s 70-yea r-old Mexican female presented wi th sudden aphasi a and right-sided hemipl egia t wo weeks prior to admi ssion .

Physical examination: Vita l signs were normal. This wa s an acutely il l, dehydrated . lethargi c female, unabl e to spea k. Lungs were clear. Breast were normal. Cardiovascular exam revea led a systolic eject ion murmur. Abdominal and extremity exam normal. Neurologic exam revealed right sided hemiplegia.

Radiograph: Head CT scan revealed a large mass in the left fronto parietal area with evidence of midline shift and significant cerebral edema.

SURGE RY: (January 27 , 1986)

Craniotomy and removal of le f t frontal brain tumor.

GROSS PATHOLOGY:

Received was a 5 x 4.5 • 3 em. recognizable fragment of CPrebral tissue weighing 3Z grams and largely replaced by a mass. The tumor was pink and firm . rubbery in consistency . Prominent areas of necrosis were present. Margins were grossly involved.

CONTRIBUTOR: Joseph N. Carberry, M. 0. MARCH 1988 - CASE NO. 11 Los Angeles, Cali fornia

TISSUE FROM: Left thigh ACCESSION NO. 21267

CLINICAL ABSTRACT:

History: This 51-year-ol d obese . hypertensive, diabetic fema le presented with swelling of the left knee of approximately 9 months ' duration. The swell­ing persisted and increased . and became painful. She at first ignored the swelling. attributing it to in jury or phlebitis (which she had several episodes in the past).

Physica l examination: A 15 x 12 x 4 em. mass above the left knee.

Radiograph: X-ray showed a soft tissue mass with destructive bony changes over the lower femur.

SURGERY: (March 28, 1975)

Partial excision of the tumor of the left thigh and a biopsy of t he left femur was performed. The tumor was described by the surgeon as being wrapped around the anterior portion of the left femu r, sta rt ing above t he condyle and extending superiorly for ?0 em. All of the tumor could not be removed because of adherence to bone.

GROSS PATHOLOGY:

Received were specimens labelled "l eft t high tumor" and "bone from left femur". The tumor measuring 12 x 9.5 x 5.5 em. and consi sted of solid, fa intly lobulated , tan, fleshy tissue. Multiple small foci of slightly more yellow areas, 1-3 mm. were present. The bone biopsy was processed.

CONTRIBUTOR: ,Joseph N. Carberry, M. D. MARCH 1988 - CA SE NO. 12 Los Angel es. California

TISSUE FROM: Kidney ACCESSION NO. 24571

Cli NICAL ABSTRACT:

History: This 83-year-old female presented with asymptomatic hematuria. Urinary work-up showed tha t the blood was coming from the right kidney. Pyelo­gram showPd a pelvic mass.

SURGERY: (April 21 . 1982)

The patient underwent a right radical nephrectomy.

GROSS PATHOLOGY:

Received was a right kidney and ureter. hilar lymph nodes, and peritonea l tissue. From the inferior aspect of the lower pole was a 2 x 2 em. tan grey mass bulging from the cortical surface but not invading the capsule. On opening the renal pelvis, the pelvis was markedly dilated and contained two detached masses , each measuring 3 x 2. 5 x 2 em . One appeared to be blood clot and the other appeared to be blood clot and tumor. This tumor had a pink-gray color and a soft consistency and was quite hemorrhagic . A 2.5 em. polypoid hemorrhagic mass was attached to the lower pole of the renal pelvis and over t he previous ly desc r ibPd area . Hilar nodes contained matastatic tumor.

STUDY GROUP CASES FOR

MARCH 1988

CASE NO. 1 - ACCESSION NO. 25071

LOS ANGELES: Lymphoma - 3; hypersplenism - 1 FRESNO: Myeloid metaplasia - 8; forejgn body - 1; mastocytosis - 1 MARTINEZ: Systemic mastocytos is - 6 SAN BERNARDINO (INLAND}: Myeloproliferati ve disorder - 5; amyloidosis - 4 SEATTLE: Well differentiated lymphocytic lymphoma - 2; histiocytosis X - 2; mast cell disease - 2 LONG BEACH: Mast cell disease- 7 OHIO: Mast cell disease - 2 BAKERSFIELD: Congestive splenomegaly - 5; myeloid metaplasia - 1 OAKLAND: Castleman's disease- 6; chronic myelogenous leukemia - 4 SAN FRANCISCO: Fibrocongestive splenomegaly - 1; hairy cell leukemia - 1; infectious mononucleosi s - 1 VENTURA: Amyloidosis - 3 NORTH DAKOTA: Well differentiated lymphocytic lymphoma - 1

SPECIAL STAIN:

The Gei msa stain was positive in perimalphghian cluster of cytoplasmic cells.

CONSULTATION:

Thomas A. Webb, M. D., Deaconess Hospital, Indiana: Systemic mast cell disease, spleen and lymph node.

FOLLOW-UP:

She died in the nursing home sometime in 1985.

FILE DIAGNOSIS:

Mast cell disease, spleen

REFERENCES:

Gonella , J. s., Lipsey, A. I . : Mastocytosis Manifested by Hepato­splenomegaly. N. Eng. J. Med. 271:533, 1964.

Webb, Thomas A. , Li, Chin-Yang, Yam, Lung T.: Systemic Mast Cell Disease: A Clinical and Hematopathologic Study of 26 Cases. Cancer 49:927-938, 1982.

Lennert, K. and Parwaresch, M. R.: Mast Cells and Mast Cell Neoplasia: A Review. Histopathology 3:349-365, 1979.

Brunning, Richard 0. , et al. Systemic Mastocytosis Extracutaneous Mani­festations. Am J. Surg. Pathol 7: 425-438, 1983.

Klatt, E. C., Lukes, R. J . , and Meyer , P.R.: Benign and Malignant Mast cel l Proliferations: Diagnosis and Separatio~ Using a PH Dependent Toluidine Blue Stain in Tissue Section. Cancer 51:1119-1124, 1983.

Forni, Marco, Klatt, Edward C., Shaw, Seth T., Taylor, CliveR., Lukes, Robert J., and Meyer, Paul R.~ Immunohistochemical Characterizati on of Re­active and Neoplastic Mast Cells. Am. J. Clin. Pathol. 80:660-665, 1983.

CASE NO. 2 - ACCESSION NO. 25256 MARCH 1988

LOS ANGELES: Malignant schwan.noma with chondroid features - 7 FRESNO: Malignant schwannoma- 7; rhabdomyosarcoma- 1; malignant fibrohisto­cytoma - 1; liposarcoma - 1 MARTINEZ : Myxoid chondrosarcoma - 5; chondromyxoid fibroma - 2 SAN BERNARD INO (INLAND): Malignant schwannoma - 9 SEATTLE: Malignant nerve sheath tumor- 6 LONG BEACH: Myxoid liposarcoma - 7 OHIO: Neurofi broma - 2 BAKERSFIELD: Malignant triton t umor - 1; mal ignant neurogenic t umor- 2; mal ignant schwannoma - 2; chondrosarcoma - 1 OAKLAND: Neurofibrosarcoma - 5; neurofibroma - 5 SAN FRANCISCO: Mal ignant epi thel ioid schwannoma- '1 ; neurof ibrosarcoma - 2; sarcoma NOS - 1 VENTURA: Myxoid neurofibroma - 3 NORTH DAKOTA: Neurofibrosarcoma - 1

EM REPORT:

The cells of thi s sample appeared t o be of mesenc~ymal origi n and a few had vague suggesti ons of chondrocytic different iation, ·to include an eccentric nucleus and well developed reticulum wit h probable glycogen deposition. The presence of thick and thi n cytofil aments and basal lamina were , however, suggestive of possi bl e myocytic differentiation . Without t he demonstration of particulate glycogen and in the absence of a pericellular capsule, these cel ls coul d only be sai d to be those of a poorly differentiated sarcoma with a suggestion of chondro­cytic differentiation.

FOLLOW-UP:

The patient was further operated on for several benign neurofibromas fol low­ing the removal of t hi s malignant lesion. On March 21, 1986, he was again admi t ted t o the hospi t al for radical surgery of recurrent mal ignant nerve sheath tumor i n the same region in the ri ght neck as t he orignial specimen. Current ly the patient is alive and well .

FILE DIAGNOSIS:

Malignant schwannoma with chondroid fea t rues , neck

REFERENCES:

D'Agostino, A. N. , Sou le, E. H., Miller, R. H.: Sarcomas of t he Peripheral Nerves and Somatic Soft Tissues Associated with Mul t iple Neurof ibr omatosis (Von Reckl inghausen's Disease) . Cancer 16:1015, 1963.

Guccion, J. G. , Enzin9er, F. M. : Malignant Schwannoma Associated wi t h Von Reckl inghausen' s Neurofibromatosis . Vi rchows Arch. 383:43, 1979.

CASE NO. 3 - ACCESSION NO. 25336 MARCH 1988

LOS ANGELES: Myxopapillary ependymoma - 4; meni ngioma - 3

FRESNO: Myxo-papillary ependymoma - 9; chordoma - 1 MART INEZ: Myxopapillary ependymoma - 5; meningiomatosis - 2 SAN BERNARDINO (INLAND): Neurofibroma - 6; myxopapillary ependymoma - 3 SEATTLE: Hyalinized myxopapillary ependymoma - 7 LONG BEACH : Ependymoma - 7 OHIO : Chordoma vs. myxopapillary ependymoma - 1 BAKERSFIELD: Neurofibroma, pacinian variant- 1; meningioma, cauda equina - 5 OAKLAND: Myxopapillary ependymoma - 10 SAN FRANCISCO: Myxopapillary ependymoma - 1; neurofibroma - 3 VENTURA: Hyalinized meningioma - 3 NORTH DAKOTA: Hemangi oblastoma - 1

EM REPORT:

These findings were entirely consistent with meni ngi oma, regi on of cauda equina.

SPECIAL STAIN:

GFAP: Negative, consistent with monigeal origin.

FOLLOW-UP:

The patient was last seen in the neurosurgeon's office on February 1988 at which time the patient had minimal neurologic deficit consisting of slight loss o• sensation in one foot . He was otherwise doing well.

FILE DIAGNOSIS:

Myxopaillary ependymoma, filum terminale.

REFERENCE:

Sonneland, Paula R. L. , Scheithauer, Bernd W. and Onofrio, Burton M: Myxo­paillary Ependymoma. A Clinicopathologic and Immunocytochemical Study ~f 77 Cases . Cancer 56:883-893 , 1985.

CASE NO. 4 - ACCESSION NO. 26121 MARCH I988

LOS ANGELES: Choroid plexus carcinoma, low grade - 4; choroid plexus papilloma· 3 FRESNO: Choroid plexus papi lloma - 10 MARTINEZ: Choroid plexus papi lloma - 3; papillary ependymoma - 3; choroid plexus papillary carcinoma (rule out metastatic carcinoma) - 1 SAN BERNARDINO (INLAND): Choroid plexus papilloma - g SEATTLE: Choroid plexus carcinoma - 5; ependymoma - 1; metastatic adenocarcinoma - I LONG BEACH: Choroid plexus papilloma - 7 OHIO: Meningioma - 2 BAKERSFIELD: Choroid plexus papilloma - 6 OAKLAND: Choroid plexus tumor, probably carcinoma - 6; choroid plexus papilloma - 4 SAN FRANCISCO: Choroid plexus papilloma - 4 VENTURA: Choroi d plexus papilloma .- 3 NORTH DAKOTA: Choroid plexus papilloma - I

EM REPORT:

Compatible with choroi d plexus origin.

FOLLOW-UP:

The patient developed severe respiratory insufficiency post-operatively, requiring a tracheostomy and a ventilator. The patient could not be taken off the ventilator. He had several bouts of aspiration pneumonia and atelectasis, bouts of infection including sepsis due to pseudomonas and candida. The patient was discharged on I1/30/87 to Northr idge Rehabilitation Center. The respiratory insufficiency and dysphasia was thought to be secondary to marked brainstem dysfunct ion, post surgical.

FILE DIAGNOSIS:

Choroid plexus carcinoma, low grade, right cerebellopontine angle.

REFERENCES:

Lawrence, K. M.: The Biology of Choroid Plexus Papilloma and Carcinoma of the Lateral Ventricle in Viken, P. J., Bruyn, G. W. (eds.): Handbook of Clinical Neurology. Amsterdam, North Holland, 1974 , Vol. 17, pp. 555. (Less than 4i of choroid plexus papillomas occur in the cerebel lopontine angle).

·Bohm, E., Strang, R.: Choroid Plexus Papillomas. J. Neurosurg. 18:493, 1961.

Dog! ioni, Cla.udio et al: Choroid Plexus Tumors: I11111unocytochemtstry with Particular References to Coexpression of Intermediate Filament Proteins. Am. J. Pathol. 127(3):5I9-528, June I987.

Coffin, C. M., et al: Choroid Plexus Neoplasms : Clinicopathol ogic and Immunohistochemical Studies (10 Cases). Am. J. Surg. Pathol. 10(6):394-404, June 1986.

Anguilar , D. , Martin, J. M., 'Sneiros, J., Arjona, V., Lara, J . L. and Nogales, F: The Fine Structure of Choroid Plexus Carcinoma. Histopathology 7:939-946, 1983.

CASE NO. 5 - ACCESSION NO. 26069

LOS ANGELES: Medulloblastoma, desmoplastic variant - 7

FRESNO: Medulloblastoma - 10

MARCH 1988

MARTINEZ: Transitional meningioma - 2; whorled medulloblastoma - 5

SAN BERNARDINO (INLAND}: Medulloblastoma - 9

SEATTLE: Neuroblastoma (central PNET} - 7

LONG BEACH: Medulloblastoma - 7

OHIO: Medulloblastoma - 2

BAKERSFIELD: Medulloblastoma - 6

OAKLAND: Desmoplastic medul loblastoma - 4, medulloblastoma - 4; angioblastic menfngoma - 2

SAN FRANCISCO: Medul loblastoma - 3; malignant meningioma - 1

VENTURA: Medulloblastoma - 3

NORTH DAKOTA: Medulloblastoma - 1

EM REPORT:

The morphology of these cells was entirely consistent with the light micro­scopy impression of medulloblastoma.

SPECIAL STAIN:

Glial fibrillary acidic protein (GFAP}: There was definite staining of some of the cells in some fields but many of the cel ls did not stain.

FOLLOW-UP:

The patient was last seen 5/5/88 at which time she was doing well and may return to light work.

FILE DIAGNOSIS:

Desmoplastic medulloblastoma, cerebel lum.

REFERENCES:

Rubinstein, L. J. , Northfield, D. W. C.: The Medulloblastoma and the So­called "Arachnoidal Cerebellar Sarcoma". A Critical Re-Examination of a Naso­logical Problem. Brain 87:379, 1964.

Chatty, E. M., Earle, K. M.: Medulloblastoma. A Report of 201 Cases with Emphasis on the Relationship of Histological Variants to Survival. Cancer 28: 977, 1971.

CASE NO. 6 - ACCESSION NO. 25558

LOS ANGELES: Fibrous mesothelioma - 7

FRESNO: Fibrous mesothelioma - 10

MARTINEZ: Mesothelioma, fibrous - 7

SAN BERNARDINO (INLAND): Fibrous mesothelioma - 9

SEATTLE: Subpleural fibroma - 7

LONG BEACH: Fibrous mesothelioma - 7

OHIO: Fibrous mesothelioma - 2

MARCH 1988

BAKERSFIELD: Benign fibrous histiocytoma - 1; fibrous mesothelioma - 2; schwannoma, benign - 3

OAKLAND: Localized fibrous mesothelioma- 10

SAN FRANCISCO: Fibrous mesothelioma - 4

VENTURA: Fibrous mesothelioma - 3

NORTH DAKOTA: Fibrous mesothel ioma - 1

CONSULTATIONS:

Shu-Yuan Liao, M. D. -University of California; Irvine: Localized fibrous mesothelioma, pleura.

F. M. Enzinger, M. D. - AFIP: Fibrous mesothel ioma , pleura.

Michael Kos s, M. D., LAC-USC: Localized fi brous mesothelioma, pleura.

FOLLOW-UP:

Alive and well without recurrence of disease as of March 19B8 .

FILE DIAGNOSIS:

Fibrous mesothelioma, pleura.

REFERENCES:

Hernandez, F. J., Fernandez, B. B. : Localized Fibrous Tumors of Pleura. A Light and Electron Microscopic Study. Cancer 34:1667-1674, 1974.

Dervan, P. A. et al: Solitary (Localized) Fibrous Mesothelioma: Evidence Against Mesothelial Cell Origin. Histopathol. 10(8}:867-876, August 1986.

CASE NO. 7 - ACCESSION NO. 21243 MARCH 1988

LOS ANGELES: Ceruminous gland carcinoma - 7 FRESNO: Malignant oncocytoma - 3; ceruminous carcinoma - 5; acinic cell ca rei noma - 2 MARTINEZ: Poorly differentiated adenocarcinoma probably of ceruminous gland origin - 6; adenoca.rcinoma- 1 SAN BERNARDINO (INLAND): Adenocarcinoma with oncocytic change - 4; ceruminous adenocarcinoma - 3; acinic cell carcinoma - 2 SEATTLE: Ceruminous adenocarcinoma - 7 LONG BEACH: Adenocarcinoma - 7 OHIO~ Metastatic carcinoma, oxyphilic - 2 BAKERSFIELD: Carcinoma of apocrine gland - 5; mucoepidermoid carcinoma - 1 OAKLANO: Ceruminous carcinoma - 10 SAN FRANCISCO: Apocrine carcinoma (ceruminous) - 2; adenocarcinoma, NOS - 1; carcinoma, NOS - 1 VENTURA: Ceruminous adenocarcinoma - 3 NORTH 'DAKOTA: Ductal adenocarcinoma - 1

EM REPORT:

Some tumor cells formed duct-like structures in which microvilli covered luminal surfaces. In the cytoplasm there were often membrane-bound lipid-like droplets resembling lipofuchsin. Cisternae of the rough endoplasmic reticulum were often dilated. The ultrastructure of the tumor cells was similar to that described for ceruminous gland tumors (Cancer 2g:1169, 1972).

SPECIAL STAIN:

PAS with and without digestion positive for mucin and glycogen; AMP also positive.

FOLLOW-UP:

The patient was last seen in June 1g77 and x-rays showed a recurrence of the disease in bone. The patient was referred for radiation treatment. Un­fortunately due to storage problems the records have all been destroyed. The patient has not been seen within the last ~even years.

FILE DIAGNOSIS:

Ceruminous gland carcinoma, ear canal.

REFERENCES:

Wetli, C. V., Pardo, V., Mil lard , M., Gersten, K: Tumors of Ceruminous Glands. Cancer 29(5):I169-1178, May 1972.

Batsakis, John G., Hardy, George C., Nishiyama, Ronald H: Ceruminous Gland Tumors. Arch. Ottolaryng. 86, July 1967.

Cankar V., Crowley, H.: Tumors of Ceruminous Glands logical Study of Seven Cases. Cancer 17:67-75, 1964.

A Clinicopatho-

CASE NO. 8 - ACCESSION NO. 23918 MARCH 1988

LOS ANGELES: Infiltrating lipoma - 6; infiltrating hemangioma ·- 1

FRESNO: Intramuscular lipoma - 9, low grade liposarcoma - 1

MARTINEZ: Intramuscular lipoma - 7

SAN BERNARDINO (INLAND): Intramuscular ~ipoma - 9

SEATTLE: Intramuscular lipoma (with thrombophlebitis) - 7

LONG BEACH: Intramuscular lipom~- 7

OHIO: Intramuscular lipoma - 2

BAKERSFIELD: Lipoma, intramuscular- 6

OAKLAND: Intramuscular lipoma- 10

SAN FRANCISCO: Intramuscular lipoma - 4

VENTURA: Intramuscular lipoma- 3

NORTH DAKOTA: Intramuscular lipoma- 1

CONSULTATION:

Joe J. Lin, M. D. - St . Franci s Hospital, Kansas: Infiltrating angie­lipoma, thigh

FOLLOW-UP:

The patient alive and well, living in Hawaii and has no evidence of any residual problem or complaints, as of January 1988.

FILE DIAGNOSIS:

Intramuscular lipoma, thigh

REFERENCES:

Dionne, G. P., Seemayer, T. A.: Infiltrating Lipomas and Angiolipomas Revis.ited Cancer 33:732, 1974.

Kimdblom, Lars-Gunnar, Angervall, Lennart, Stener, Bertil and Wickbom, Ingmar: Intermuscular and Intramuscul ar Lipoma and Hibernomas. A Clinical, Roentgenographic, Histologic and Prognostic Study of 46 Cases. Cancer:33: 754- 762, 1974.

CASE NO. 9 - ACCESSION NO. 26067

LOS ANGELES: Schwannoma - 7

FRESNO: Neurilemmoma - 9; neurofibroma - 1

MARTINEZ: Schwannoma - 7

MARCH 1988

SAN BERNARDINO (INLAND): Neurilemmoma - 4; neurofibroma - 4

SEATTLE: Leiomyoma - 7

LONG BEACH: Leiomyoma - 6; schwannoma - 1

OHIO: Meningioma - 2

BAKERSFIELD: Benign schwannoma, nasopharynx - 6

OAKLAND: Schwanoma, nasopharynx - 6 ; fibrous meningoma - 2; leiomyoma - 2

SAN FRANCISCO: Neurilemmoma - 3; leiomyosarcoma - 1

VENTURA: Neurofibroma - 1; schwannoma - 2

NORTH DAKOTA: Leiomyosarcoma - 1

EM REPORT:

The ~rphology of these cells suggested they were derived from Schwann ce 11 s.

SPECIAL STAIN:

S-100: Positive

FOLLOW-UP:

Not available.

FILE DIAGNOSIS:

Schwannoma (neurilemmoma), nasopharynx

REFERENCES:

Rabitalle, Y., Seemayer , T. A. , Eldeiry, A.: Peripheral Nerve Tumors In­volving Paranasal Sinuses . A Case Report and Review of Literature. Cancer 35:1254 , 1975.

Bruner, Janet M.: Peripheral Nerve Sheath Tumors of the Head and Neck. Sem. Diag. Pathol. 4(2):136-14~, May 1987.

CASE NO. 10 - ACCESSION NO. 26068 MARCH 1988

LOS ANGELES: Glioblastoma multiforme - 7

FRESNO: Glioblastoma multiforme- 6; gemistocytic astrocytoma - 4

MARTINEZ: Astrocytoma, grade II - 2; astrocytoma,grade III - 4; glioblastoma multiforme - 1

SAN BERNARDINO (INLAND): Malignant astrocytoma - 3; glioblastoma- 3; mixed malignant glioma - 1; oligodendroglioma, grade III - 1

SEATTLE: Gl iobl astoma multiforme- 7

LONG BEACH: High grade astrocytoma (glioblastoma multiforme) - 7

OHIO: Glioma - 1; glioblastoma multiforme with sarcomatous component - 1

BAKERSFIELD: Astrocytoma, grade III, left frontal lobe- 6

OAKLAND: Glioblastoma, left frontal lobe- 10

SAN FRANCISCO: Astrocytoma - 3; glioblastoma - 1

VENTURA: Glioblastoma multiforme - 3

NORTH DAKOTA: Glioblastoma multiforme- 1

FOLLOW-UP:

In June 1986 the patient was hospitalized and stereotactic biopsy was performed which confirmed residual or recurrent tumor. The patient was still alive as of December 16, 1986.

FILE DIAGNOSIS:

Glioblastoma multiforme, brain

REFERENCES:

Fulling KH, Nelson J .S. Cerebral Astrocytic Neoplasms in the Adult. Contribution of Histologic Examination to the Assessment of Prognosis. Sem. Diag. Pathol. 1:152-163, 1984.

Burger, P. C.,· and Vollmer, R. T.: Histologic Factors of Prognostic Sig­nificane in the Glioblastoma Multiforme. Cancer 46:1179-1186 , 1980.

Burger, P. C. et al: Glioblastoma & Anaplastic Astrocytoma: Pathological Cri teria and Prognostic Implications - National Brain Tumor Study Group. Cancer 56(5):1106-1111. September 1, 1985.

CASE NO. 11 - ACCESSION NO. 21267 MARCH 1988

LOS ANGELES: Malignant lymphoma, large noncleaved foll icular center cel l type - 7

FRESNO: Malignant lymphoma, histiocytic - 9; osteoblastic osteosarcoma - 1

MARTINEZ: Malignant lymphoma, diffuse , large cell type- 7

SAN BERNARDINO {INLAND): Malignant lymphoma, large cleaved cell - 7; clear cell sarcoma - 1 SEATTLE: large cell lymphoma - 7

LONG BEACH: Sarcoma NOS - 4; high grade lymphoma - 3

OHIO: Lymphoma - 2 0

BAKERSFIEL D: Malignant lymphoma, l arge cell - 6

OAKLAND : Lymphoma - 10

SAN FRANCISCO: lymphoma - 3, sarcoma NOS - 1

VENTURA: High grade large cell lymphoma {?immunoblastic sarcoma) - 3

NORTH DAKOTA: ·Rhabdomyosarcoma - 1

CONSUL TAT! ON :

Paul Meyer, M. D. & Barbara Tindle, M. D.: large noncleaved follicular center cell lymphoma.

FOllOW-UP:

The patient was discharged and treated with post-op radiation and chemo­therapy consisting of Cytoxin and Oncovin. the patient developed a pathological fracture of the femur due to osteonecrosis. Patient was last seen in May of 1987 for a mass in the right axil la which turned out to be lipoma. There was no evidence of recurrence of the tumor.

FILE DIAGNOSIS:

Malignant lymphoma, large noncleaved cell, bone

REFERENCES:

Shoji , H., Miller, T. R.: Primary Reticulum Cell Sarcoma of Bone. Cancer 28:1234, 1971.

Boston, H. C., Jr., Dahlin, D. C., Ivins, J. C., et. al.: Mal ignant lymphoma (So-called Reticulum Cell Sarcoma) of Bone . Cancer 34 :1131, 1974.

Ostrows ki, Mary l., Unni, Krishnan K., Banks, Peter M., Shivers, Thomas C., Evans , Richard G., O'Connell , Michael J., and Taylor, William F: Malignant Lymphoma of Bone. Cancer 58 : 2~46-2655 , December 15, 1986 .

CASE NO. 12 - ACCESSION NO. 24571 MARCH 1988

LOS ANGELES: Wilm's tumor- 7

FRESNO: Embryonal carcinoma - 4; rhabdomyosarcoma - 2; transitional cell carcinoma - 1; Wilm's tumor- 2; undifferentiated carcinoma - 1

MARTINEZ: Transitional carcinoma with smal l cell component - 5; undifferentiated carcinoma of renal pelvis - 2

SAN BERNARDINO (INLAND}: Adult Wilm's tumor - 8

SEATTLE: PNET - 2; adult Wilm's tumor - 3; high grade transitional cell carcinoma - 2

lONG BEACH: Mixed transitional cell carcinoma and neuro-endocrine carcinoma - 6; carc1nosarcoma - 1

OHIO: Undifferentiated carcinoma - 2

BAKERSFI ELD: Wilm's tumor in an adult - 6

OAKLAND: Adult Wilm's tumor- 10

SAN FRANCISCO: Anaplastic transitional cell carcinoma - 2; sarcoma botryoides - 1; adult Wilm1s - 1

VENTURA: Undifferentiated carcinoma of the renal pelvis - 3

NORTH DAKOTA: Wilm's tumor - 1

FOLLOW-UP:

Patient died of her disease November 1982 in convalescent hospital.

FILE DIAGNOSIS:

Wilm' s tumor, kidney.

REFERENCES:

Beckwith, J. B., Palmer, N. F.: Histopathol ogy and Prognosis of Wilm's Tumor. Cancer 41:1937-1948, 1978.

D'Angio, G. J ., Beckwith, J . B., Breslow, N. E. , et. al.: Wilm's Tumors: An Update. Cancer 45(Suppl.):1791-1798, 1980.

Olsen , B. S., Bishoff, A. J.: Wilm's Tumor in an Adult. Cancer 25:21, 1970 .

Francis , D., Olsen, b. S.: Adult Nephroblastoma. Scan. J. Ural . Nephrol. 11:305, 1977.