International Surgical Pathology Conference 2024 – Case Images

These are slides to accompany International Surgical Pathology Conference 2024.

Tuesday, May 7

1GynA 77-year-old female presented with vaginal bleedingSlide 1
Slide 2
2GynA 62-year-old female found to have a widely metastatic tumor and a uterine mass Slide 1
3GynA 55-year-old woman presented with pelvic pain and a 15 cm uterine mass Slide 1
Slide 2
4Head/Neck38YOM with a left preauricular lesion.Slide 1
5Head/Neck13YOM with a left mandibular cyst.Slide 1
6Head/Neck55YOF with a left nasal mass. Slide 1
7GUA 91-year-old underwent excision of a left hydrocele sac, which revealed nests and cords of infiltrative epithelioid cells.  In focal areas, these cells were associated with an accompanying myxoid/desmoplastic stromal response. Slide 1 
8GUA 74-year-old female underwent a left partial nephrectomy for a 3.9 cm mass.  This tumor showed infiltration into the perinephric fat and metastatic involvement of the ipsilateral adrenal gland. Slide 1

Wednesday, May 8

10Bone/Soft Tissue 32-year-old male with mediastinal massSlide 1
11Bone/Soft Tissue 25-year-old male with lytic tibia massSlide 1
12Bone/Soft Tissue 87-year-old male with prior history of high-grade myxofibrosarcoma with multiple recurrencesH&E
13Derm13-year-old female history of left nasal obstruction and allergic rhinitis. For a year prior to presentation, patient reported headaches and snoring. A bump in the nose was noted by PCP who referred patient to ENT. A large, dark, fleshy, left nasal mass was noted and Imaging were performed followed by incisional biopsy. PDF
14DermA fast-growing nodule on a 37-year-old male left nasolabial fold skin, approximately 3 cm in size. No other relevant clinical information was noted. PDF
15Derm64-year-old male with history of widely metastatic epithelioid mesothelioma and malignant pleural effusion and disseminated abdominal disease, pathology was confirmed.Presented with a 1-month history of a raised lesion on the right ear that bled easily. Physical examination was significant for a violaceous polypoid papule with central hemorrhagic crust involving the right superior anti-helix.  PDF
18BreastFemale (65 yr) with a peri-prosthetic effusion 8 years following breast implant surgery.
19BreastFemale, 55 yr, with a breast mass.

Thursday, May 9

20PulmonaryA 65-year-old woman with a history of right breast cancer (2015) and left lower lobe pulmonary adenocarcinoma (2020) presents with a new 2.6 cm right upper lobe lung mass with hilar and mediastinal lymphadenopathy and multiple liver lesions. FNA of the liver lesion is provided.  Slide 1
21CytologyA 49-year-old woman presented to clinic with complaints of recurrent chest pain. CTA showed a right lower lobe lung mass with bulky ipsilateral hilar and mediastinal lymphadenopathy. Endobronchial ultrasound (EBUS)-guided fine needle aspiration was performed. A representative cell block is shown.  Slide 1
22CardiacA 66-year-old patient with a 4 cm PET-avid right atrial mass. A representative section of the surgically resected specimen is provided.  Slide 1
23Hempath * 61-year-old male who presented 4 years prior with relapsing polychondritis. 
* Prior BM biopsies had no definitive diagnosis, no clonal abnormality; presumably autoimmune-related.
* He has been treated with steroids and rituximab.
* He has become progressively transfusion dependent and refractory to therapy.
* CBC: Hb 7.4, MCV 109, WBC 6.9, plt 67. Differential: 85% PMN, 13% lymphs and 2% monocytes.
* A BM biopsy is performed and is from 5 years ago.
Slide 1 
24Hempath* 44-year-old female who has BRCA2 mutation and had “spots” on her skin for 15 years.
* She has no itching, rashes, ulceration or any other symptoms.
* CT scan is normal.
* CBC: Hemoglobin 11.7, MCV 99, platelet 247, WBC 5.8 with ANC 3.0.
Slide 1
25Hempath* 71-year-old female with a PMHx of diabetes mellitus type 2, hypertension, hyperlipidemia, and GERD.
* She was on vacation and developed progressive fatigue and somnolence associated with significant exercise intolerance.
* Her symptoms did not abate after several weeks and she appeared pale and exhausted to her family members, so she was taken to the emergency room.
* In the ER, her CBC showed hemoglobin 6.2 gm/dL, MCV 106, white blood cells 70.3K and platelets 55K.
* A bone marrow was performed.
Slide 1
26NeuroThis 52 year-old female patient presented after a fall. Head imaging studies revealed a heterogenous, peripherally-enhancing mass centered in the right parietal lobe.Slide 1 
27NeuroThis 19 year-old male patient presented with new-onset seizures. Head imaging studies revealed a large, heterogenous mass centered in the right fronto-temporal lobe, which is associated with prominent mass effect. Slide 1 
28NeuroThis 73 year-old male patient presented with headaches. Head imaging studies revealed a dura-based, homogenously enhancing mass overlying the left fronto-parietal lobe. Slide 1

Friday, May 10

32Endo35-year-old female with a history of multinodular goiter. Thyroid gland ultrasound revealed multiple nodules up to 4.6 cm. FNA of the largest nodule was suspicious for papillary thyroid carcinoma. Slide 1 
33Endo34-year-old female with a history of thyromegaly and a parathyroid adenoma. The parathyroid hormone levels were 202.1 (pre-op), 29.4 (5 minutes post), and 21.5 (10 minutes post). The weight of the parathyroid gland was 2.8 g at the time of frozen section.Slide 1 
34Endo74-year-old female with a history of cutaneous melanoma presented with a 3.6 cm nonfunctioning adrenal mass. Slide 1 
35GI Slide 1
36GI Slide 1
37Biomarker Slide 1