April 2020 — Gastroenterology & Surgical

14 year old female presents with an abdominal/mesenteric based mass as resected.

Image A

Image B

Immnohistochemical stains demonstrate strong cytokeratin AE1/AE3 (A) and trypsin (B) positivity within the tumor cells. Synaptophysin is negative while chromogranin is focally and weakly positive in the malignant population. B-catenin fails to show nuclear expression. The tumor cells are negative for SALL4, KIT, SF1, OCT4, NUT and inhibin. INI1 and BRG1 are retained.

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Photo of Stefan Brettfeld, D.O. Stefan Brettfeld, D.O.
Fellow, Surgical Pathology
Mayo Clinic
Photo of Rondell P. Graham, M.B.B.S. Rondell Graham, M.B.B.S.
Consultant, Anatomic Pathology
Mayo Clinic
Associate Professor of Laboratory Medicine and Pathology
Mayo Clinic College of Medicine and Science
@rondell_graham

April 2020 — Gynecological

50 year old woman underwent hysterectomy for a 4.8 cm mass involving the cervix and lower uterine segment.

The tumor cells had the following immunoprofile: AE1/AE3 (-), Desmin (-), SMA (+), h-Caldesmon (+), S100p (-), Tyrosinase (-), HMB45 (+), Melan A (+), TFE3 (+).

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Hong Jiang, B.Med.
Fellow, Surgical Pathology
Mayo Clinic
J. Kenneth Schoolmeester, M.D.
Consultant, Anatomic Pathology
Mayo Clinic
Assistant Professor of Laboratory Medicine and Pathology
Mayo Clinic College of Medicine and Science

April 2020 — Gastroenterology

A middle-aged man presented with multisystem manifestations, including diarrhea and abdominal pain, unintentional weight loss and hypoalbuminemia, chronic heart failure, seronegative spondyloarthropathy, and diffuse lymphadenopathy. In the past, he had been treated with secukinumab, methotrexate, and prednisone for seronegative spondyloarthropathy, without significant improvement. The following photomicrographs are from the duodenal biopsies.

HE x 100
HE x 400
PAS x 200

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Burak Tekin, M.D.
Resident, Anatomic and Clinical Pathology
Mayo Clinic
Photo of Roger Moreira, M.D. Roger Moreira, M.D.
Consultant, Anatomic Pathology
Mayo Clinic
Assistant Professor of Laboratory Medicine and Pathology
Mayo Clinic College of Medicine and Science

April 2020 — Neuropathology

An 18-year-old man presented with progressive headaches, left face and tongue sensory change, and gait imbalance for four months. He had no significant past medical or family history. Magnetic resonance imaging (MRI) of the brain revealed a 4.7 x 4.4 x 3.9 cm right lateral ventricle mass, extending medially to compress the third ventricle and causing obstructive hydrocephalus. A gross total resection of the tumor was performed.

T1 post-contrast axial MRI demonstrates a well circumscribed, multilobulated strongly enhancing mass within the right lateral ventricle compressing the foramen of Monro (arrow).
The tumor consists of fascicles and sheets of spindled cells (A) admixed with large, ganglion-like cells with glassy cytoplasm, vesicular nuclei and prominent nucleoli (B).
Tumor cells show diffuse S100 protein (A) and TTF-1 (B) immunoexpression.

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Photo of Maria Adelita (Adelita) Vizcaino Villalobos, M.D. Maria Adelita Vizcaino Villalobos, M.D.
Resident, Anatomic Pathology/Neuropathology
Mayo Clinic
@astroade
Photo of Caterina Giannini, M.D., Ph.D. Caterina Giannini, M.D., Ph.D.
Consultant, Anatomic Pathology
Mayo Clinic
Professor of Laboratory Medicine and Pathology and Neurosurgery
Mayo Clinic College of Medicine and Science
@CaterinaGianni7
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This post was developed by our Education and Technical Publications Team.