CALIFORNIA TUMOR TISSUE REGISTRY

Genitourinary System Study Cases, Subscription B

May,2008

California Tumor Tissue R egistry c/o: Department of Pa thology and Human Anatomy

Loma Linda University School of Medicine 11021 CamJ>US Avenue, AH 335 Lorna Linda, California 92350

(909) 558-4788 FAX: {909) 558-0188

E-mail: C!tr@linklinc.com Web site & Case oft he Month: www.cttr.org

Target audience: Practicing pathologists and pathology residents.

Goal: To acquaint the participant with the histologic features of n variety of benign and

malignant neoplasms and rumor-like conditions.

Objectives: The participant will be able to r,!)cognize morphologic features of a variety of benign

and malignant neoplasms and tumor-like conditions and relate those processes to pertinent references in the medical literature.

Educational mer hods and media: Review of representative glass slides with associated histories. Feedback on consensus diagnoses from participating pathologists, Listing of selected references from the medical liferarure.

Principal facultv: Donald R. Chase, MD

CME Cred i!: Loma Linda University School of Medicine designates this continuing medical

education activity for up to 2 hours of Category l of the Physician's Recognition Award of the American Medical Association.

CME credit is offered for the subscription yea.r only.

Accreditation: Loma Linda University School of Medicine is accredited by the Accreditation

Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians.

Studv Ca•es. Mav. 200&· !';toh.,rinoinn F\

Contributor: Lester Thompson, M.D. Case No. 1 - M ay, 2008 Woodland Hills, CA

Tissue from: Prostate Accession #30547

Clinical Abstract: A 64-year-old man presented with difficulty urinating. On workup, he was found to have an

elevated PSA.

Gross Pathology: The cut surface of the resection specimen showed multiple nodules.

Contributor: Philip Robinson, M.D. Cnsc No. 2 - May, 2008 Boynton Beach, FL

Tissue f rom: P rostate Accession # 28967

Clinical Abstract: AS 1-year-old man presented with urinary retention. TURP, followed by a radical retropubic

prostatectomy with bilateral pelvic lymph node dissection, were perfonned.

Gross Pathology: The prostate weighed 113 grams and measured 7.2 x 8.3 x 5.5 em. Cut sectioning revealed

gray surfaces with a mucinous quality. The lwnen of the attached seminal vesicle was distended by mucus.

Soecial Studies: Negative: PSA.

Study Cases, May, 2008; Subscription B 3

Contributor: LLUMC Pathology Group (pw) Lorna Linda, CA

Tissue from: Urinary bladder

C linical Abstract:

Case No. 3 - May, 2008

Accession #30503

A 45-year-old woman with presented with complaints of frequent dysuria and urinary incontinence at night for a s ix-month duration. The patient denied gross hematuria. Cystoscopy revealed a solid tumor in the bladder neck.

Gross Pathology: T he 9.0 x 7.0 x 4.5 em urinary bladder had a 6.0 x 5.5 x 2.5 em fungating mass extending from

and invading into the anterior wall.

Cont ributor: Lester T hompson, M.D. Case No. 4 - May, 2008 Woodland Hills, CA

T issue from: Kidney Accession #30402

C linical Abstract: Because of difficu lty urinating and hematuria, this 75-year-old man was worked up and an

abdominal mass was identified with an enlarged kidney and hydronephrosis.

Gross Pathology: A 5.5 x 6.0 em papillary mass was identified within the renal pelvis, resulting in marked

dilation of the renal pelvis. The ureter was uninvolved.

Study Cases, May, 2008; Subscription B 4

Contributor: W m. Michael Green, M.D. Case No. S - May, 2008 Oxnard, CA

Tissue from: Kjdney Accession #30552

Clinical Abstr act: A 39-year-old man presented with complaints of gross hematuria. CT scan revealed a large left

renal mass.

Gross Pathology: The 900 gram, 19.0 x 12.5 x 11 .0 em specimen included a markedly distorted kidney with a

12.5 em diameter fleshy, tan, necrotic, hemorrhagic tumor.

Contributor : Catherine O dell, M.D. Case No. 6 - May, 2008 Riverside, CA

Tissue from: Bladder ch ips Accession #30297

Clinical Abstract: A 60-year-old man was found 10 have a bladder tumor.

Gross Pathologv: The transurethral resection specimen consisted of mul tiplc portions of rubbery finn tan to tan­

red tissue weighing 60 grams and measuring 9.0 x 8.0 x 3.5 em in aggregate.

Special Studies: Positive: Negative:

CAM 5.2/AE-1, Yimentin,p63. S-100, CD45, CK7, CK20, PSA, HPAP, CDX2, ITF-1 , SMA, Desmin, Ber-EP4, CD34/QBEND-10, CD31, Synaptophysin.

Study cases, May, 2008; Subscription B 5

Contributor: J ohn McGiU, M.D. Case No. 7 - May, 2008 Pasadena, CA

Tissue from: Right testis Accession #30145

Clinical Abstract: A 43-year-old man presented with swelling in the right scrotum. There was no associated pain,

nor any known injury. Ultrasound revealed a dominant right intratesticular mass, and a smaller, undefined, hypoechoic lesion Y.-ithin the left testis. HCG was elevated at 29MIU/ml. Alpha fetoprotein was normal. Alkaline phosphatase was elevated at 153 (normal 27- 142). Glucose was also slightly elevated.

Gross Pathology: The 380 gram right testicle measured ' l 3.0 x 8.0 x 8.0 em. Serial sectioning revealed complete

replacement by an 11.5 x 8.0 x 7.0 em gray-tan tumor.

Contributor: David M. Lawrence, M.D. Case No. 8 - May, 2008 Sao Luis Obispo, CA

Tissue from: Left testis Accession #30548

Clinical Abstract: A 63-year-old man had noted a mass in his lefl testicle for several years. An increase in size

had brought him to his primary care physician for treatment.

Gross Pathology: The 9.9 x 7.1 em enlarged testis revealed virtual replacement by a 7.7 em diameter gray-white

soft tumor. Most of the tumor bad a uniform gray-white appearance, although a few foci of hemorrhage were present.

Study Coses, May, 2008; Subscriplion B 6

Contributor: Donna Kell, M.D. Case No. 9 - May, 2008 Santa Barbara, CA

Tissue from: Testis Accession #3033 7

Clinical Abstract: At the age of 2 months, a baby boy w;~snoted by his pediatrician to have a testicular mass. At

that time, the family refused surgery or further treatment. By age 20 months, the testicular mass had gro~>.'ll tO I 0 em. In addition, masses were identified in the abdomen, and bilateral lungs. AFP (serum) measured 27,000, and serum beta HCG was 25. The patient expired two weeks after undergoing an orchiectomy.

Gross Pathology: The 295 gram, 11.0 x 8.5 x 6.5 cni encapsulated tumor had a pink, fleshy and diffusely

mucinous cut surface vrith areas of translucency, cystic areas, small areas of hemorrhage, and a peripheral 3.5 em area of chalky yellow necrosis. The majority of the identified tunica albuginea was replaced by tumor, with no normal residual testis remaining, and extension into the spermatic cord.

Special Studies: Positive: Alpha Fetoprotein.

Contributor : L ester Thompson, M.D. Case No. 10 - May, 2008 Woodland Hills, CA

Tissue from: Scrotum Accession #30545

Clinical Abstract: An 88-year-old man presented with bilateral inguinal hernias and a right-sided scrotal mass.

The mass was removed during herniorrhaphy.

Gross Pathology: The specimen consisted of a 17.0 x 15.0 em mass. The cut surface was slightly myxoid with a

smooth, glistening surface.

Study Cnses, May, 2008; Subscriprion B 7

CALIFORNIA TUMOR T ISSUE REGISTRY

"Genitourinary System"

Minutes- Subscription B

May, 2008

SUGGF-STED READING (General Topics rrom Recent Literature):

FDA Rcgulution of Stem-Cell-Based Therdpics. Helme DG and Kessler DA. N Eng/ J Med1006; 355:1730-1735.

Systematic Four-Quadrant Biopsy Detects Barren's Dysplasia In More Patients Than Nonsyslematic Biopsy. Abela JE, Going J.l, et al. Am J Gastroentero/2008; 103:850-855.

The Biomarkers of Human Papillomovirus Infection in Tonsillar Squamous Cell Carcinoma. Molecular Basis and Predicting Favorable Outcome. Kuo KT, Hsiao CH. et al. Mod Patho/2008; 21:376-386.

Goblet Cell Carc inoid of the Appendix. A Specific Type of Carcinoma. Van Eeden S, Offerhaus GJ, et al. Histoporhol 2007; 5 I :763-7773.

Giant Cell Tumor of Bone Express p63. Dickson BC, Li SQ, e1 al. Mod Pcttho/ 2008; 21:369-375.

California Tumor Tissue Registry c/o: Department of Pathology and Human Anatomy

Lorna Linda University School of Medicine 11021 Campus Avenue, AH 335 Lorna Linda, California 92350

(909) 5 58-4 788 FAX: (909) 55&-0 188

E-mail: ctt r@linklinc.com Web si te & Case of the Month: www.cttr.org

FILE DIAGNOSES

(Preferably submitted on website at www.cttr.o rg. Click "su bscri1>1ions" , then "submit answers.")

Case 1:

Case 2:

Case 3:

Case 4:

Case 5:

Case 6:

Case 7:

Cnsc 8:

Cnsc 9:

CTTR Subscription B

Prostatic adenocarcinoma (Gleason's grade 3+3), prostate T-77 100, M-81403

Prostatic mucinous (colloid) adenocarcinoma T-28000,M-84803

Invasive high-grade urotheliA I carcinoma, bladder T-74000, M-81203

Papillary urothelial carcinoma, kidney T-71000, M-8 1303

Chromophobe renal cell carcinoma, kidney T-71000, M-83123

Sarcomato id carc inoma, bladder T-74000, M-80103

Classic semi noma, testis T-78000, M-90613

Sertoli cell rumor, sclerosing type, lCStis T-28000, M-86400

Mixed germ cell tumor with immature teratoma and yolk sac tumor, testis T-78000, M-90713

Case 10: Well-differentiated liposarcoma with sclerosis, scrotum

T-79400, M-90713

CTTR. May, 2008: .. 1\ihnutc.s'' (Subsc:nplion 8)

Case No. I - Accession No. 30547

Chatswonb • G Ieason Y., prostate cancer Costa Mesa <College Hosoilall • Adenocarcinoma, grade 3 of3 Escondido • Prostate carcinoma, Gleason's 3+3 Glendale • Adenocarcinoma, Gleason's 3+3 Lorna Linda. LLUMC • Adenocarcinoma of prostate, grad¢ I

May, 2008

Los Angeles (LACIUSC Medical Center) • Prostatic adenocarcinoma, Glc.uon's score • (3+3) and high-grade PIN Palo Alto • Prostate carcinoma San Diego CNaya l Medical Ccnu:rl · Prostatic adenocarcinoma (3+3~6) San Diego CUCSD) · Acinar type prostate carcinoma, Gle;uon's 3"'-3=6 Santa Rosa !Chrisms Santa Rosa Hospital) • Prostatic carcinoma, Gleason's 3+3 Woodland ~!jl!s (Woodland Hjlls Medical eemerl - Prostatic adenocarcinoma, Gleason's grade 3+ 3=6 Alabama (Cunningham Pathology. LLC} • Prostatic adenocarcinoma 3+3•6 Arkansas. Scarv . Prostatic adenocarcinomn, Gleason's score 6 Georgia. Dccan~r • Benign stromal hyperplasia/neoplasm Illinois (Hcanland Regional Medical eenter • lnvasive adenocarcinoma, Gleason's score 6 QUI of 10 Illinois (Lovola University Medjcal Center) • Adenocarcinoma of the prostate, Gleason's 6 (3+3) Kansas (CoCfeyville Regional Medical CeQ(cr) • Nodular hyperplasia and infiltrating adenocarcinoma (Gleason's

3+3=6) Tennessee (Wake Forest Unjversitv) · Prostotic adenocarcinoma (3+3+6) benign prostatic hyperplasia Kansas (Peterson Laboratorv Services) · Prostatic adenocarcinoma, 3+3, score 6 Marvland (Silver Sorines) • Adenosis of prostate Massachuscns (Beverlv Hosll.imll · Prostatic adenocarcinoma, Gleason's grade liN Michiean. Monroe - Prostatic adenocarcinoma (Gleason 's 3+3=6), background stromal and glandular hyperplasia Nevada CSunrjse Hospital) • l'roslatic adenocarcinoma, Gleason's grade 3+3• 6 New York. Horseheads • Prostatic adenocarcinoma New York <S1onv Brook University Hospital\ • Leiomyoma with prostatic adenocarcinoma (Gleason's 3+3) Ohio (Cleveland Clinic Foundation) · Low Gleason's score prostatic adenocarcinoma Ok lahomg !Ameripath Oklahoma) • Adenocarcinoma, Gleason's scor~ 6 (3+3) Orinda <Knjser PeJmanentQ) • Prostatic adenocarcinoma l'ennsylvanja !Conemaugh valley Memorial Hospital) · Prostatic cancer, Gleason's 6 (3+3) Pennsvlvania !Drexel University) · Prostate cancer, Gleason's score H3 Texas. Crvsta! Beach · Benign nodular hyperplasia, glandular and stromal (2) Texas Lubbock · Adenocarcinoma, Gleason's score 3+3•6 Texas !Scott & White H~Ji.Uill · Prostate adenocarcinoma (3+ 3~6) Wisconsin CSI , Mary Hosoiln!\ • Prostate adenocarcinoma, acinar type Canada {Unjycrsitv of Shcrbrookel • Nodular hyperplasia of prostate Ireland <UC!i Galwav) · Invasive prostatic adenocarcinoma, Gleason 's score 6 (3T 3) J.gp,an (Asashj General Hospital) • Well-differentiated adenocarcinoma a oan (Saisejkai Maebashi HosrumJl - Adenocarcinoma, Gleason's score 3+3 Saudj Arabia <K jng Abdulazi4 Medical Ci!Vl • Prostatic adenocarcinoma Spain IHospjw! Povjsa) · Adenocarcinoma of the prostate The Netherlonds, Amstelveen • Adenocarcinoma, Gleason's 3+3 and leiomyoma United Kingdom (John Radcliffe Hospital) • Prostatic adenocarcinoma

Cuse I ·Diagnosis: Prostatic adenocarcinoma (Gleason's grade 3+3), prostate

T-77100, M-81403

Case I · References: Billis A, Mcircllcs LR, et al. Extent of Prostatic Atrophy in Needle Btopsics and Serum PSA Levels. Is There an

Association? Uro/2007; 69(5):927. MacLennan GT, Eisenberg R, et al. The lnOuence of Chron ic lnfiammation in Prostatic Carcinogenesis. A 5-Year

Follow-Up Study. JUro/2006; 176(3):1012·1016. Kwak C, Ku JH, eta!. Effect of Subclinical Prostatic lnOammation on Serum PSA Levels in Men wit.h Clinically

Undetectable Prostate Cnncer. 2003; Uro/2003; 62(5):854-859.

CTTR. M21y, 2008: "Minutes" (Subscriplion B)

Abrahams NA, Bostwick OG, et al. Distinguishing Atrophy and High-Grade Prostatic lntraepithelial Neoplasia from Prostatic Adenocarcinoma With and Without Previous Adjuvant Hormone Therapy wilh the Aid ofCytokeratin S/6. Abrahams NA, Bostwick DO, et al. Am J Clln Patho/2003; 368-376.

Herawi M and Epstein Jl. Immunohistochemical Antibody Cocktail Staining {p63/HMWCK!AMACR) of Ductal Adenocarcinoma and Gleason Pattern 4 Cribriform and Non-Cribriform Acinar Adenocarcinomas of the Prostate. Hcrawi M and Epstein Jl . Am J Surg Patho/2001; 31(6):889·894.

Case No. 2 - Accession No. 28967

Chatswot1h . Colloid "signet" ring carcinoma/stomach/colon Costp Mesa (College Hospital) - Mucinous adenocarcinoma Escondido · Seminal vesicle carcinoma Glendale • Mucinous carcinoma, rule out bladder vs. colorectal primary Lorna Linda. LLUMC · Mucinous (colloid) adenocat·cinoma of prostate, WHO fascicle pl77 Los Angeles CLAQUSC Medjcal Center) • Semina) vesicle adenocarcinoma Palo Aho • Mucinous carcinoma with signer rings San Diego (Naval Medical Center) · Mucinous adenocarcinoma San Diego CUCSDI • Poorly differentiated mucinous adenocarcinoma. possibly metastatic Santa Rosa (Christus Santa Rosa Hospital\ • Prostate mucinous carcinoma

May, 2008

Woo<lland Hills !WOO<Iland Hills Me<lical Center) • Mucinous adenocarcinoma, focal signet ring features Alabama <Cunningham Pathologv, Lt.Cl - Mucin producing urothelial-typc carcinoma Arkansas, Seary • Mucinous adenocarcinoma consistent with seminal vesicle origin Georgja. Decatur .. Mucinous adenocarcinoma Illinois (Heartland Regional Me<fical Center · lnvasive mucinous adenocarcinoma, signet ring cell type Tllinois (Loyola Unjversity Medical Center) · Mucin-producing signet ring cell carcinoma Kansus (Coffeyville Regional Medical Center) · Mucinous adenocarcinoma, metastatic Tennessee !Wake forest Unjversi!V) • Mucinous (colloid) adenocarcinoma Kansas (Peterson Laboratory Services! - Signet ring carcinoma Maryland !Silver Springs> • Mucinous adenocarcinoma Massachusetts !Beyerlv Hospital\ • Signet ring cell adenocarcinoma Michigan. Monroe - Mucinous and signet ring adenocarcinoma Nevada !Sunrise HospitaD - Signet ring cell carcinoma New York. Horseheads - Mucinous adenocarcinoma New York !Stony [)rook Unjversi!V Hospital) - Mucinous colloid carcinoma, seminal vesicle Ohio (Cleveland Clinic Foundation) · Colloid adenocarcinoma Oklahoma (Amerjpath Oklahoma) - Mucinous adenocarcinoma, possibly metastatic from Gl tract Orinda (Kaiser Petmanente) • Mucinous adenocarcinoma Pennsylvania (Conemaugh Vallev Memorial Hospitall • Signet ring carcinoma with mucinous secretion Pennsylvania COrexel Unh•cr;si!V\ - Mucinous prostate ~~~r Texas. Crvstal Beach • Mucinous adenocarcinoma, probably seminal vesicle origin (2) Texas, Lubbock • Metastatic signet ring cell carcinoma Texa~ <Scon & While Hospitall . Signet l'ing cell adenocarcinoma Wisconsin (St .Mary Hospitall - Mucinous carcinomlllsignet ring cell carcinoma Canada !Universjtv of Sherbrooke) - Mucinous adenocarcinoma Ireland <UCH Galway) • Urachal carcinoma Japan (Asashi General Hospi!Jlll - Muci11ous adenocarcinoma Jaoan (Saiseikai Maebashi Ho;mital) • Mucinous carcinoma Saudi Arabia !King Abdulazjz Medical Cj!V\ - Prostatic mucinous adenocarcinoma SPain (Hospital Poyisa) • Mucinous (colloid) adenocarcinoma The Netherlands. Amstelvecn · Mucinous adenocarcinoma (metastatic) United Kinedom (John Radcliffe Hospitall • Mucinous adenocarcinoma

Case 2- Diagnosis: Prostatic mucinous (colloid) adenocarcinoma

T-28000, M-84803

CTTR~ May, 2008; "M1nu1cs' (Subscl ipuon R)

llirector's Note: The tumor was mostly contained within the prostate, with only a small ponion extending into surrounding tissue. The colon was reported as "normal". (drc)

Case 2 • Rcfcreng:s: Rhce AC. Olgac S, ct al. Muc.nous Adenocarcinoma of the Prostate. A Case Repon of Long-Term Disease-Free Survival end a

Review of the Uteraturc Uro/2004; 779-780. l.llnc BR. Mogi-01\llu;r.zi C, et al, Mucinous AdenoC(II'Cinoma of1hc Prostate Does Nol Confer Poor Prognosis, Vro/2006:

68(4):R25-830. O~unkoya AO ond Epstein ll Primary Mucin-Producing Uroth~lini-Type Adenocarcinoma of Prostate. Rcpon of IS Cases. Am J

Surg Patho/2007: 31 (9): I 323-1329 Adlc) BP. Maxwell K. Dahon DP. etal. Urotheliai-Type Adenocarcinoma of the Prostate Mimicking Metastatic Colorectal

Adcnocarcmoma. lnl Bra: J Uro/2006: 32(6):681-687.

Cnsc No. 3 - Accession No. 30503 May, 2008

Chatsworth - Poorly differentiated adenocarcinoma Costa Mesa (College Hospital> - Transitional cell carc inoma, high-grade Escondido - High-grade ur01helial carcinoma Glendale - Lymphoepithelial carcinoma Lorna Linda. !.LUMC - Transitional cell carcinoma ofblodder, grade IV Los Angeles (LAC/USC Medjcal Center) - Poorly d ifferentiotcd carcinoma, likely urothelial PQio Alto - Urcthelial cell carcinoma, high-grade San Diego (Naval Medical Center) • Invasive urothelial carcinoma San Dieeo CUCSDl - Invasive high grade urothelial carcinoma Santa Rosa CChristus Santa Rosa Hospital) - Urothelia! carcinoma, high-grade, invasive Woodland Hills (Woodland tljl!s Medical Center) - Poorly differentiated carcinoma, lymphoepithelioma-like variant t\ labama (Cunningham Pathology. LLC) - Invasive anaplastic transitional cell carcinoma Arkansas, Searv - High-grade invasive urothclial carcinoma Georgia, Deca1yr - Invasive urothelial carcinoma, high-grade Illinois CHeaniAnd Regional Medjcal Center - Invasive high-grade urothelial carcinoma Illinois (Lovola Universitv Medical Center) - Poorly differentiated carcinoma, favor urothelial Kansas (Coffevvi!le Regional Med ical Cemerl - Infiltrating urothelial carcinoma, high grade Tennessee <Wake Forest Uniycrs jtv) - Micropapillary urothelial carcinoma Kpnsas (Peterson l.aboratorv Services) - Invasive high-grade urothelial cu•·cinoma Marvland (Silver Sprines) - lnliltrating high-grade urolhelial carcinoma M!!Ssaehusens (Bcvcrlv Hospital) - Lymphoepithelial carcinoma Mjchtean, Monroe - High -grade transitional cell carcinoma Nevada {Sunrjsc Hospital} - Invasive high-grade urothelial carcinoma New York, Horseheads - High-grade invasive u•·othelial carcinoma New York !Stony Brook Unjversin• Hospital> - Giani and spindle cell c:arcinoma of bladder Ohio (Cleveland Clinic. Founda1jonl . Invasive urothelial carcinoma Oklahoma (Amerjpath Oklahoma) , Undifferentiated carcinoma, probably metastatic Orjnda (Kaiser Permanente) · High-grade urothelial carcinoma Pennsylvania (Conemaugh Valley Memorial Hospital) - Urothelial carcinoma, high-grade Pennsylvania (Drexel Universjrvl - Urothelial cell carcinoma, high-grade Texas , Crvstal Beach - Adenocarcinoma poorly differentiated urachal origin could be considered (2) Texas, Lubbock - Invasive high grade urothelial cell carcinoma Texas (Scon & Whjte Hospital! - Invasive high-grade urothelial carcinoma Wisconsin (St .Mat-v Hospital\ - High-grade urothclial carcinoma, invasive Canada CUniversjtv of Sherbrooke) - Invasive uro~1elia l carcinoma Ireland CUCH Galway) - High-grade invasive transitional cell carcinoma Jppan (Asashi General Hospital) - Urothetial carcinoma, high-grade lpoan CSaiseiknj Maebashi Horojtall - High-grade urolhelinl carcinoma Saudi Arabia (King Abdulazi7. Medical City) - Urothelial carcinoma, high-grade Spain (Hospital l'ovisal - High-grade urothelial carcinoma (lymphoepithelioma-like)

ClTR. May, l008: "Minllles- (Sub<crlption Bl s

The-Netherlands. Amstelveen - Grade 3, urothelial carcinoma United Kingdom (John Radcliffe Hospital\ - High-grade carcinoma, probably urothelial origin

Case 3 - Diagnosis: Invasive high-grade urothelial carcinoma, bladder

1'-74000, M-81203

Case 3 - References: Kakizoe T. Development and Progression of Urothclial Carcinoma Cancer 2006; 97(9):821-828. Cono JW, Yates DR, ct al, Behavior of Urothelial Carcinoma with Respect to Anatomical Location. J Uro/ 2007; 177(5): 1715-

1720.

Lopez-Belu:an A and Cheng L. Histologic Variants of Urolhclial Carcinoma. Differential Diagnosis and Clinical Implications. Hum Potho/2006; 3 7( 11): 1371-1388.

Samaratunga H. Fairweather P, Purdie D. Significance of Stromal Reaction Patterns in Invasive Urolhclial Carcinoma. Am J Clir: Patho/2005; 123(6):851-857.

Case No. 4 - Accession No. 30402

Chatsworth - Pelvic transitional cell carcinoma, grade Tl Costa Mesa (College Hospitall - Transitional cell carcinoma, high-grade, Esc-ondido - High-grade papillary urothelial carcinoma Glendale - High-grade papillary transitional cell carcinoma Loma Linda. LLUMC - Transil.ional cell carcinoma of bladder, grade Ill

May, 2008

Los Angeles (LAC/USC Medical Center) - Papillary urothelial carcinoma, grade I of3, of renal pelvis Palo Alto - Papillary urothelial cell neoplasm San Diego (Naval Medical Center) - Non-invasive urothelial carcinoma,. high-grade San Diego CUCSDl - Papillary urothelial carcinoma, high-grade Santa Rosa CChristus Santa Rosa Hospital) - Renal pelvis papillary urotrnelial carcinoma, high-grade Woodland Hills (Woodland Hills Medical Center) - Urothelial carcinoma Alabama (Cunningham Pathology. LLC) - High-grade papillary transitional cell carcinoma Arkansas Scary - Papillary non-invasive urothelial carcinoma Georaia. Decarur - Papillary urotl1eJi·a1 carcinoma of renal pelvis l.llinois (Heartland Regional Medical Center - Papillary urothelial carcin.oma, low-grade, without invasion Illinois (Loyola University Medical Center) - Urorhelial cell carcinoma Kansa< (Coffeyville Regional Medic,al Center) - Transil'ional cell carcinoma, renal pelvis Tennessee (Wake Forest Univetsitv) - High-grade urorhelial carcinoma of the renal pelvis Kansas !Peterson Laboratorv Servjces)- High-grade urothelial carcinoma, extending into collective ducts, non-invasive Marvland ISilver Sprinesl - Low-grade urothelial carcinoma Massachusetts (Beverly Hospitall - Papillary urothelial carcinoma, low-grade, non-invasive Michigan. Monroe - H igh-&'l'ade papillary transitional cell carcinoma Nevada (Sunrise Hospitail - High-grade papillary urothelial carcinoma, non-invasive New York. Horseheads - High-grade papillary invasive transitional cell carcinoma New York CSronv Brook University Hospitall - High-grade papillary urorhelial carcinoma, non-invasive Ohio (Cleveland Clin ic' Foundation\ - lnvasive urothelial carcinoma Oklahoma IAmeriparh Oklahoma) - Urothelial carcinoma, WHO grade 2 Orinda fKaiser Permanemel - High-grade papillary urorhelial carcinoma Pennsylvania (Conemaugh Vallev Memorial Hospital) - Papillary urothelial carcinoma, grade 2 Pennsylvania (Drexel Universirv) - Urothelial cell carcinoma, high-grade Texas . Crvsral Beach - Papillary transitional cell carcinoma Texas. ·Lubbock - Non-invasive papillary urothelial carcinoma Texas (Scott & White Hospital\ - Non-invasive high-grade papillary urorhelial carcinoma Wisconsin (St .Mary Hospital) - High-grade urothelial carcinoma, renal pelvis Canada CUniversity of Sherbrooke) - Low-grade papillary urothelial carcinoma 1reland (UCH Galway) - Invasive papillary urorhelial carcinoma, high grade Japan (Asash i General Hospital) - Urothelial carcinoma

6 CT"fR, May, 2008; ··r-.·1imlicf• (Subscription B)

Japan (Saiseikai Maebash i Hospital) - Urothelial carcinoma Saudi Arabia (King AbdulazizMedicaJ,Citvl - Papillary urothelial carcinoma, high-grade Spain (Hospital Povjsa) - Infiltrating urothelial carcinoma of renal pelvis The Netherlands. Amstelveen - Grade 2, urothelial carcinoma United Kingdom (John Radcliffe Hospital) - Invasive papillary urothelial carcinoma

Case 4 - Diagnosis: Papillary urothelial carcinoma, kidney

T-71000, M-81303

Case 4 - References: Whisnant RE, Bastacky Sl and Ohori NJ>, Cytologic Dingnosis of Low-Grade P~pillary Urothelial Neoplasms (Low Malignant Poli:ntial and Low-Grade Carcinoma) In the Contex< of the 1998 WHO/I SUP Classification, Diagn Cywpatho/2003; 28(4): 186-190, Lopcz.·Beltran A and CJleng L Histologic Variants of Urothclial Citrcinoma. Di fferential Diagnosis and Clinical Implications. H:tm

Parho/2006; 37( II ): I 371 -1 388. Romas D, Ruiz A, et aL Prognostic Value ol' Morphometry in Low-Grade Papillary Urothclial Bladder Neoplasms, Anal Q:ta/JI

Cyrol Histo! 2004; 26(5):·285-294, Jones TD and Cheng L, Papillary Urothelial Neoplaom of Low Malignant Potcntinl. Evolving Tcnninology and Concepts. J Uro/

2006: 175(6); 1995-2003,

Case No. 5 - Accession No. 30552

Chatswo11h - Oncocytic hypernephroma (RCC) Costa Mesa (College Hosp.i!ill - Clear cell carcinoma Escondido - Chromophobe renal cell carcinoma Glendale - Chromophobe renal cell carcinoma Lorna Linda, LLUMC - Clear cell carcinoma of kidney

May,2008

Los Angeles (LAC/USC Medical Center) - Conventional clear cell cardnoma, nuclear, grade 1 Palo A Ito - Renal cell carcinoma, Chromophil San Diego (Naval Medical Center) - Chromophil renal cell carcinoma ( I); Renal cell carcinoma with associated

neurob 1astoma ( 1) San Diego (UCSD) - Chromophobe renal cell carcinoma Santa Rosa (Chrisrus Santa Rosa Hospital\ - Renal oncocytoma Woodland Hills (Woodland Hills Medical Center) - Papillary renal cell carcinoma Alabama (Ctmningham Pathology. LLC) - Renal cell carcinoma, granular cell type Arkansas. Seary - Renal cell carcinoma, chromophobe type Georgia. Decamr - Papillary renal cell carcinoma Illinois (Heanland Regional Med ical Center - Chromophobe renal cell carcinoma, oncocytic'type illinois (Lovola University Medical Center) - Chromophobe renal cell carcinoma Kansas CCoffevville Regional Medical Center) - Renal oncocytoma Tennessee CWake Forest Uni versity) - Chromophobe renal cell carcinoma Kansas (Peterson LaboratorY Services) - Oncocytoma Maryland (Silver Springs) - Chromophobe renal cell carcinoma, eosinophilic variant M;~ssachusetts (Beverlv Hospital) - Chrom9phobe renal cell carcinoma, Fuhtman grade 1-2 Mich igan, Monroe - Renal cell carccinoma, clear and granular cell types, Fuhm1an grade 2 Nevada (Sunrise Hospital) - Chromophobe renal cell carcinoma, eosinoph ilic variant New York. Horseheads - Renal cell carcinoma New York (Stony Brook University Hospital\ - Oncocytoma Ohio (Cleveland Clinic Foundation) - Chromophobe carcinoma, eosinoph ilic variant Oklahoma (Ameripath,OJdahoma) - Sarcomatoid urothelial carcinoma Orinda (Kaiser Perrnanentel - Eosinophilic variant of chromophobe Pennsvlvania (Conemaugh Valley Memorial Hospital) - Renal cell carc inoma, clear cell type, grade 2 Pennsylvania (Drexel llniversirvl - Papillary renal cell carcinoma Texas,, Crystal Beach - Tumor with oncocytic fealures, A'granular cell carcinoma well-differentiated probable Texas, Lubbock - Clear c,ell carcinoma Texas (Scott & White Hospital) - Papillary renal cell carcinoma

C'TTR, May, 2008: "Mmmes .. (Subs:c.ription B) 7

Wisconsin CSt .Mary Hospital> • Renal cell carcinoma, chromophobe rype Canada (University ofSberbrooke) · Papillary renal cell carcinoma Ireland CUCH Galway) • Renal ceU carcinoma, oncocytoma variant Japan (Asashi General Hospitall • Renal cell carcinoma, clear cell type Japan CSaisejkaj Maebashi Hospital) • Chromophobe carcinoma Saudi Arabja CKjng i\bdulaziz Medical City) • Renal cell carcinoma, conventional type Soain CHospjtal Poyjsa) · Chromophobe renal ceU carcinoma The Netberlands. Amstelveen · Urothelial carcinoma, oncoeytic differentiation United Kjngdom (John Radcliffe Hospital) · Chromophobe renal cell carcinoma

Case 5- Ding nos is: Chromophobe renal cell carcinoma, kidney

'r-71000, M-83123

Case 5 - Rcfertnces: Li G, Oorthclcmy A, et ol. S IOOA I. A Powerful Marker to Dill'crentiote Chronnphobe Renal Cell Clll'<inoma from R<nnl

Oncocytamll, Nlsroparho/2007; 50(5):642·647, Memco L, Jh>ng J, et ol. Immunohistochemical Analysis for Cytokeratin 7, KIT, and PAX2. Value •n the Differcnllol Oiognos•s of

Chromphobc Cell Cascinoma. AmJCiin Parho/2001, 127(2):225·229. Wang HY Md Mills SE. KIT and RCC arc Useful in Distinguishing Chromphobe Renal Cell Carcinoma from the Granular Vl!l'iant

of Clcl!l' Cell Renal Cell Carcinoma. Am J Surg Patho/2005; 29(5):640-646. Katzman PJ and Sehwartz Jl. Chromophobe Renal Cell Can:inoma In a Child Case Repon and Rcvic" of the Literature Pt dtarr

O.V Patho/2001; 10(2):125.

Case No. 6 - Accession No. 30297

Chatsworth • Poorly differentiated adenocarcinoma (colloid) Costa Meso (College Hospital) · Urothclial cell c-arcinoma, sarcomaloid Escondido · Sarcomatoid carcinoma Glendale - Sarcomatoid ~·ansit ional cell carcinoma Lorna Linda, LLUMC • Anaplastic bladder carcinoma Los Angeles (LAC/USC Medical Center) • Sarcomatoid transitional cell carcinoma Palo Alto • Mucinous tubular and spindle cell carcinoma vs. sarcomatoid renal cell carcinoma San Djego fNaval Me<Jjcal Center) - Sarcomatoid carcinoma San Diego CUCSD> • Sarcomatoid carcinoma Santa Rosa (Chrjstus Santa Rosa Hospital) • Urinary bladder sarcomatoid carcinoma Woodland Hills <Woo<lland Hills Medical Center) • Spindle cell (sarcomatoid) carcinoma Alabama CCuonjoeham Patholoev. LLC\ · Carcinosarcoma t\rl<ansas, Searv - lnnammatory pseudorumor Georgia. Deearur - Sarcomatoid urothelial carcinoma Illinois (Heanland Regional Medical Center • Sarcomatoid (spindle cell) urothelial carcinoma Illinois (Loyola University Medical Center) · Sarcomatoid urothelial cell carcinoma Kansas (CoiTeyyille Regjonal Medical Center) • Sarcomatoid carcinoma Tennessee (Wake fprest Universitvl - Carcinosarcoma Kansas (Peterson Laboratory Services) • Sarcomatoid carcinoma Maryland <Silver Sprjn!ill - Sarcomatoid carcinoma Massachusetts <Beverly Hospital\ . Sarcomatoid urotheliul carc inoma Michigan, Monroe • Carcinosarcoma (sarcomatoid carcinoma) Nevada CSunrjse HospjJal) - Sarcomatoid carcinoma New York Horseheads - Carcinosarcoma New York CStony Brook Universitv Hospital) - Sarcomatoid urothelial carcinoma Ohio CC!eycland Clinic Foundation) - Sarcomatoid urothclial carcinoma Oklahoma (Amerioath Oklahoma) · Sarcomatoid urothelial carcinoma Orinda <Kaiser Pcnnanente) • Sarcomatoid carcinocna Pcnnsy!vanja (Conemaugh Valley Memorial Hosoitall . Sarcomatoid carcinoma Pennsylyania IPrexel University) • Sarcomatoid carcinoma

May, 2008

CTTR, May, 2008; "Monutes" (Su~scrlpuon 6)

Texas. Crystal Beach • Adenocarcinoma poorly differentiated with mucinous features Texas. Lubbock • Sarcomatoid renal cell carcinoma Texas fSc<>tt & White Hospital) - Sarcomatoid carcinoma Wisconsin fSt .Mary Hospital) · Sarcomatoid carcinoma Canada {University ofSherbrooke) - Sarcomatoid carcinoma Ireland CUCH Galwav) • Myxoid sarcomawid carcinoma of bladder Japan (Asashi General Hospital) · Spindle cell carcinoma Japan (Saiseikai Maebashi Hospital) - Sarcomatoid carcinoma Saudi Arabia CKing Abdulaziz Medical City) • Metaplastic carcinoma Spain (Hospital Povisa) .. Urothelial carcinoma. sarcomatoid varianl The Netherlands. Amstelveen - Pseudosarcoma, mothelial carcinoma United Kingdom (John Radcliffe Hospital\ · Sarcomatoid carcinoma

Case 6. Diagnosis: Sarcomatoid carcinoma, bladder

T· 74000, M-801 03

Case 6 · References: \Vrlght JL, Blade PC, ct al. Differences in Survival Among: Paticnls vJith Sarcomatoid Carcinoma. Carcinosarcoma and UrotheliaJ

Carcinoma of !he Bladder. J Urol 2007: 178(6):2302-2306.

Spiess PB and Tuziak T, Cl al. Pscudosarcumatous and Sarcomatous Prolifcra1ions of the Bladder. Hum l'atl:o/2007,; 38(5):753-761. Sung r-..fr. Wang M, et at Histogenesis. ofSartomatofd Urothcl.ial Caricnoma of the Urinary Bladder. Evidence for a Common

Clonal Origin wilh Divergent Differemiation. J /'{l{ho/2001; 2 11(4):420-430.

Kourda N, Zeddini A, et al. Sarcomatoid Renal Cci i'Carcinoma in a Young Aduh. I'Oihologica 2006: 98(3):181-183.

Case No. 7 - Accession No. 30145

Chatswonh - Seminoma Costa Mesa (College Hospital) - Seminoma, c lassic type Escondido - Sem!noma Glendale - Seminoma Lama Linda. LLUMC • Sem in om a Los Angeles {LAC/USC Medical Center) • Seminoma Palo Alto - Seminoma San Diego (Naval Medical Center) - Seminoma San Diego fUCSD) - Seminoma, classic type Santa Rosa !Chrisms Santa Rosa Hospital\ • Spennatocytic seminoma Woodland Hills {Woodland Hills Medical Center) • Seminoma Alabama {Cunningham Pathologv, LLC) • Seminoma Arkansas. Seary - Seminoma Georgja. Decatur • Seminoma Illinois CHeanland Regional Medical Center • Seminoma (classic) Illinois (Loyola Universitv Medical Center) - Seminoma Kansas (Coffeyville Regional Medical Center) • Seminoma, typical Tennessee {Wake Forest University) • Seminoma Kansas (Peterson Laboratorv Services) • Seminoma Marvland (Silver Springs) · Classic seminoma Massachuseus (Beverlv Hospital) - Seminoma Michigan, Monroe - Seminoma Nevada fSunr·ise Hospital) - Seminoma, classical type r'lew York, Horseheads · -Seminoma New York (Stonv Brook Universitv Hospital) - Seminoma Ohio (Cleveland Cl inic Foundation) - Seminoma Ok lahoma (Ameripath Oklahoma) - Seminoma Orinda {Kaiser Pennanente) - Seminoma (classic)

(.1'TR, tvl:\y, 2008, "Minu!cs" (S\Ibscriplioo B)

May,2008

9

pennsylvania CConemautth Valley Memorial Hospjtall - Seminoma Pennsylvania CDrexel University) - Seminoma Texas. Crystal Beach - Seminoma Texas. Lubbock - Classic seminoma Texas IScon & White Hospital) - Seminoma Wisconsin CSt .Mary Hospitall • Seminoma Canada (Universitv ofSherbrooke) • Seminoma Ireland IUCH Galwav) - Classic seminoma Japan IAsashi General Hospital) • Seminoma Japan CSaiscjkai Maebasbj Hospital) • Seminoma Saudi Arabja !King Abdulaziz Med jcn! Citv) • Aggressive anglomyxoma Spain !Hospital Povisa) - Seminoma The Nethcrlpnds. Arnstelveen - Seminoma testis United Kingdom (John Radcliffe Hospital) - Seminoma

Case 7- Diagnosis: Classic seminoma, testis

T-78000, M-90613

Case 7 - References: Flynn MJ. Childcrhousc A, MMd GM. ct al. Unusual Cystic Change In Classic Seminoma of the Testis. Am J Su'g Ptuho/2006:

30{1 ):137-139. Berney DM, lee A. Shamash J, et aJ. The Association Bct"een lntratubular S.emioom!l and lnv&si\'C Genn Cell Tumors. Hum

Patho/2006; 37(4):458·461. Vatdevenilo JP, Gallegos I, ct al. Correlation Between Primary Tumor Pathologic Fc~Hures and Pres(nce of Clinical Metastasis 1U

Diagnosis orTesticulor Sominoma. u,o/2007; 70(4):777·780. Emerson R.E and Ulbright TM. Morphological Approach 10 Tumours of the Testis and Parate>tis. J C/ln P01hol 2001; 60(8): 866·

880.

Case No. 8 - Accession No. 30548

Chatsworth · Embryonal carcinoma Costa Meso !College Hospltall • Seminoma, spercnarocytic Escondido • Granulosa cell tumor Glendale - Malignant Senoli cell tumor Lorna Linda. LLUMC - Spermatocytic seminoma Los Angeles CLACIUSC Medical Ccnrerl - Lymphoma Palo Alto • Adu lt granulosa cell tumor, rule our lymphoma San Diego CNaval Mcdjcal Center) • Spermatocytic seminoma, anaplastic variant San Diego NCSDl - Senoli cell rumor Santa Rosa {Chrisms San!.ll Rosa Hospital) - Alveolar rhabdomyosarcoma vs. l)•mphoma Woodland !iiJ!s !Woodland Hills Medical Center) • Lymphoma (diffuse large B-cell) Alabama (Cunnineham Pathology, LI.C) - Embryonal carcinoma Arkansas, Searv - Large cell lymphoma Georgia, Decatur - Senoli cell tumor

May, 2008

Illinois (Heonland Regional Medical Center • Sex cord stromal tumor, favor Scnoli tumor Illinois (LQyo!a Univcrsjtv Medical Cenler) - Senoli cell tumor Kansas !Coffeyville Regional Medical Center) - Embryonal carcinoma Tennesses (Wake Forest Universi!Vl • Scnoli cell tumor Kansas (Peterson Labonorv Seryicesl • Lymphoma, large cell Maryland !Silver SpringS) • Carcinoid rumor Massachuseus (Beverly Hospital) - Granulosa cell tumor Michiean, Monroe - Seminoma Nevada (Sunrise Hospital) - Diffuse large 8-celllymphoma New York. Horseheads • Senoli-Leydig cell tumor New York !Stony Brook University Hospital) - Scrtoli cell 1umor

!0 CTTR, May, 2008. "Minutes" !Subscnp:100 0)

Ohio (Cleveland Clinic Foundation) • Adult granulosa cell tumor Oklahoma CAmeripath Oklahoma) • Sex cord, stroma l tumor, unclassifi ed Orinda (Kaiser Pormanentel . Spermatocytic seminoma l'cnnsvlvania (Conemaugh Valley Memorial Hospital) • Diffuse large 13-cell lymphoma Pennsvlvania {Drexel University) • Granulosa cell tumor Texas . Crvstal 8£llcb · Granulosa cell tumor, adult type, testicular adnexa Texas. Lubbos;k • Large cell lymphoma Texas {Scou & White Hospital) • Large cell lymphoma Wisconsin CSt .Mary Hospital) · Spcrmatocytic seminoma Cunuda {University ofSherbrooke) • Non-Hodgkin's malignant lymphomu Ireland CUCH Galway) . Adult rypc granulosa cell tumor Japan {Asashi General Hospital) · Carcinoma of rete testis Jpoan CSaiseikai Maebashi Hospital) · Granuloma cell rumor Saudi Arabia ()(jng Abdulaziz Medical Ci'Yl • Granulosa cell tumor Spain <Hospital Povjsp) • Small cell malignant tumor The Netherlands, Amstelveen · Spermatocytic seminon111 United Kingdom IJphn Radcliffe Hospjtall • Gr,anuloso cell tumor vs. carcinoid

Case !! • Diagnosis: Senoli cell tumor. sclerosing type, testis

T-78000, M-86400

Outside Consultation: Richard Kempson, M.D. (Stanford University Medical Center): "Sertoli cell lUmor, sclerosing type."

Case 8 • Referencss: Sa to K. Tacnibana H. et al. Seno!i Cell Tumor of the Testis, Not Otherwise Specif.,d, Presenting Extensive Hemorrhage end

Ovcrcxprcssion of'' lpha-MethYk•cyi-CoA Rncemase {AMACRIP504S). V~rchows Arch 2001; 450(3):361-363. Oarghol'll A, Alioth riR, et •'- Giant Sertoli Cell Nodule of lhe Testis. Distinction From Other Sc1toli Cclll.esions. J Clln Patho/

2006; 59( II): t223. Sato K. Ucda Y. ct al. Large Cell Cale•fYing Scrtoli Cell Tumor ofthe Testis. Comparative Immunohistochemical Study with

Leydig Cell Tumor. Comparative Immunohistochemical Study with Leydig Cell Twnor. Patho /nt 2005; 55(6):366-371. Oliva E. Alvan:z T and Young RH. Senoli Cell Tumors of the OvOJY. A Clinicopathologic and Immunohistochemical Study of 54

Cases. Am J Su•g Pathoi 200); 29(2):143-156. Drown B. Ram A, et al. Conservative Manligcmcm ofbilmernl Senoli Cell Tumors or the Testicle in Association with the Carney

Complex. II Cnsc Rcpon. Pediat• Surg 2007: 42{9):p!; 13-1 S.

Cnse ~o. 9 - Accession No. 30337

Chatsworth . Teratocarcinoma CQ!(a Mesa (College Hospital} • Teratocarcinoma Escondido . Teratoma and yolk sac tllmor Glendale . Yolk sac tumor and immature teratoma Lorna Linda, LLUMC • Teratocarcinoma Los Angeles (LACNSC Medical Center) • Yolk sac tumor Palo Aho · Immature teratoma San Diego (Naval Medical Centet·) • Mixed green cell tumor with teratoma and yolk sac

May, 2008

San Diego (UCSPl • Malignant1nixed germ cell tumor with endodemnal sinus lUmOr and immature teratoma Santa Rosa (Chris!us Santa Rosa Hospital) • Yolk sac carcitloma Woodland Hills (Wpodland Hills Medical Cemer) · Teratoma, immature Alabama (Cllnningham Patholoe.v, l.LC\ · Yolk sac tumor Arkansas. Seary • Mixed germ cell tumor (yolk sac and immature teratoma) Georgia. Decatur • Immature teratoma Ill inois !Heartland Regional Medical Center • Immature teratoma plus yolk sac tumor Illinois (Loyola Unjyersjrv Medical Center) • Mixed germ cell rumor, mature and immatme teratoma and )'Oik sac

tumor

CfiR. May, 2008, '"Mmutcs .. (Subscripllon 9 ) II

Kansas CCoffevvme Regional Medical Center) - Teratoma, malignant Tennessee {Wake Forest Unive>sitv} • Immature teratoma and yolk sac tumor Kansas (Peterson Luboratorv Services> • Mixed germ cell tumor, immature teratoma and yolk sac Mnry la11d !Silver Spl'ings) - Immature teratoma Massachusetts (Beverly Hospital\ • Immature teratoma Michigan, Monroe • Mixed germ cell tumor (immature teratoma and yolk sac tumor) Nevada (Sunrise HospjtaD • Mixed germ cell rumor with yolk sac tumor and immature teratoma New York. Horseheads • Immature teratoma New York <Stony Brook Univers itv Hospital) - lmmarure teratoma with yolk sac tumor Ohjo (Cleveland Clinic Foundation) • Immature teratoma and yolk st1c tumor Oklahoma CAmerjpath Oklahoma) • Immature teratoma Orinda <Kaiser Pennanente} • Teratoma with immature elements Pennsvlvania (Conemaueh Valley Memorial Hospital) • ~ixed germ cell tumor/immature teratoma Pennsvlvania IDrexel University) - Immature teratoma Texas, Crvsral Beach - Mixed germ cell tumor including teratomatous olcmcnts Texas. Lubbock • Mixed non-sem inomatous genn cell tumor Texas CScorr & White Hospitall • Mixed genn ccll tumo,· with immatt1rc teratoma and yo lk sac Wisconsin CSt ,Mary Hospital) - Malignant m'ixed germ cell tumor (malignant teratoma and yolk sac rumor) Canada <University of Sherbrookel • Immature teratoma with yolk sac tumor lreiO!ld CUCH Galway) • Immature teratoma Jaoan (Asashi General Hospital) • York sac rumor arising in teratoma Japan ISaiscikai Macbnshi HospitA\l • Immature teratoma and yolk sac tumor Saudi Arabia <K ing Abdu laziz Medical Citv) - Mixed gcnn cell tumor (immature teratoma and yolk sac tumor) Spain !Hospital Povisa) • Teratoma and yolk sac turno1· The Netherlands, Amstelveen - Immature teratoma United Kin~dom Uoho Radcliffe Hospital) - Malignant teratoma

Ca.e 9 - Diagnosis : Mixed gem1 cell tumor with immature teratoma and yolk sac tumor, testis

T-78000, M-907 13

Case 9 • References: Moshatafa AA. FOSler RS, « al. Histology in Mixed Germ Cell Tumors. Is Then: A Favorite Pairin&? J Uro/ ~; 171(4) 1471·

1473. Agnarsson BA, Gudbjnrtsson T. ct al. Testicular Ge1m Cell Tumours in Iceland. A Nationwide Clinicopathological Stu~y. tl i'MIS

2006; I t4(1t}:779·783. llamazaki Sand Okada S. Expression ofCD34 Antigen in Testicular Mixed Gcnn Cell Tulllor. Pathollw 2003; 53( 12):853-857. Arrigo T, Messina Mf', ct al. Testicular Mierolhhiasis hcral<ling Mixed Germ Cell Tumor of the Testis in a Boy. J £ndocrmollnvest

2006: 29(1):82-85. Lau SK, Weiss LM and Chu PG. Association oflntratubular Semmama and lntratubular F.mbryonol Carcinoma with ln'a>"e

Testicular Germ Cell Tumors. Am J Surg Patho/2007: 31(7):104)-1049.

Case No. 10 - Accession No. 30545 May,2008

Chatswonh • Coccobacillary cellulitis with lymphoplasmacytic reaction, need polarization 01 rule out foreign body, rule out extramedullaJ)• myeloma

Costa Mesa !College Hospital) • Benign fibroma Escondido • Myxoid liposarcoma Glendale - Low grade inflammatory sarcoma Lorna Linda. LLUMC - Low-grade myxosarcoma Los Anaeles {LAC/USC Medical Center) - Myxoid liposarcoma Palo Alto · Cystic lymphomagioma Son Diego (Naval Medical Center) • Aggressive angiomyxoma Sno Diego CUCSDl • Angiomyofibroblastoma with inflammatory pscudotumor-like features Santa Rosa (Christus Santa Rosa Hosnillill - Myxoid sarcoma, liposarcoma Woodland Hills (Woodland Hills Medical Center} - Liposarcoma, well-differentiated

12 CITR, May, 2003, "Mu•nes" (Subscnptioft 8 )

Alabama ICunnmgham Pathology. LLCI - Myxoid inflammatory pseudotumor Arkansas. Scmy - Myxoid malignant fibrous histiocytoma Georgia. Deca!l!r • Aggressive angiomyxomn Illinois (Heartland Re2ional Medical Center - Myxoid srromal neoplasm, NOS Illinois ILovola Universitv Medical Center) - Angiomyxoma Kansas ICoffevvi!le Regional Medical Cemerl - Angiomyxoma with chron ic inflammation Tennessee (Woke Forest Universjtvl · Angiomyofibroblnstoma Kansas IPetersqn Labonory Servjces\ - Aggressive angiomyxoma Marvland ISilyer Springs) - Myxoid liposarcoma Massachugns IBeverlv Hospital\ - Atypical lipomatous tumor/we li-d itTerentiated liposarcoma M1chigan, Monroe - Myxoid malignanl fibrous histiocytoma Nevada (Sunrise Hospital\ - Myxofibrosarcoma New York, !Jorseheads • Liposarcoma New York IStpny Brook Unjyersitv Hospital) - Aggressive angiomyx om a Ohio I Cleveland Clinic Foundation) - Chronic orchtis Oklahoma (Ameripath Oklahoma) - Solitary fibrous tumor Pennsylvania {Conemaugh Valley Memorial Hospital) - Calcifying fibrous pseudorumor Pennsylvania £Drexel University) - Aggrcssiv~ angiomyxoma Texas, CryS(fll Beach • Inflam matory pesudol\lmor Texas. Lubbock - Liposarcoma Texas CScou & White Hosojta!l - Liposarcoma Wisconsin 1St ,Mary Hospj!a!l - Well-differentiated sclerosing liposarcoma Canada (Unjyersitv ofSherbrooke} - Myxoid liposarcoma Ireland (UCH Cal way) - Ca vcmous lymphangioma Japan {Asashj General Hospl!a)) - Culllneous my~oma Japan ISaisejkai Maebashi I Jo:miud) - Low grade myxoid malignant fibrous histiocytoma Saudi Arabia IKjng Abdulaziz Medical Cirv\ - Seminoma, classical Spajo Cl-losphal Povisa) - Liposarcoma The Nethel'londs, Amstelvccn - Superficial angiomyxomallymphangiomn Unhed Kingdom (John RadcliiTe Hospital) - Aggressive angiomyxoma

Case I 0 • Oingnosis: Well-differentiated liposarcoma with sclerosis, scrotum

T -79400, M-90 7 13

Case 10 - References: Montgomery E ond Fischer C. Pamtesticular Liposarcoma. A Clinicopathologic S1udy. Am J S"''l Pat/101 2003; 27(1 ):40-4 7. Klijanienko J. Cuillaud JM and Lag~e R. Fmc-Noodle Aspirauon m Liposarcom._ CytOhistolot~ic C<ln'elative S1udy Including

Weii-D•ffcn:ntiatcd, Myxoid. and Pleomorphic Variants. D1n[111 Cytopatho/2004; 30(5):307-312. Kooby DA. 1\ntohcscu CR. l~rcnnan MF, ct a!. Atypical LipolnntousTumor/Wcii·Oirferenliated Liposiorcoma of 1hc Ex1rcmity and

Trunk Wall lmponancc or l li>lologicat Subtype with Trcnuncnt Recommendations. AnnSurg Ollco/2004; 11(1):78-84. Kim liS. Park SJ!, ct at. Aggressive Ang,iomyxoma or Childhood. Two Unusual Co<cs Developed in 1he Scrorum. P<diatr Dev

Patho/2003: 6(2):187-191 .

13