CALIFORNIA TUMOR TISSUE REGISTRY

"BRE~T PAmOLOGY"

Study Cas~ Subserlptioo A

January 1999

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

Lorna Linda University School of Medicine 11021 Camp us A\'eoue, AH 335 Lorna Linda, California 92350

(909) 824-4788 FAX: (909) 478-4188

E-mail : cttr@linkline.corn

//JJ

Target audience: Practicing pathologists and pathology residents.

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

malignant neoplasms and twnor-like conditions.

Objectives: ·n,e participant will be able to recognize morphologic features of a variety of benign

and malignant neopln~ms and llm1or-like conditions and relate those processes to pertinent references in tl1e medic:JJ literature.

Educational methods ond media: Review of representative glass slides with associated histories. Feedback on consensus diagnoses fr9m panicipating pathologiSIS. Listing of selected refe.-ences from the medical literature.

Principal faculty: Weldon K. Bullock, MD Donald R. Chase. MD

CME Credit: LomaLinda University School of Medicine designates this continuing medical

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

CME credit is offered for the sub5cription year only.

Accreditation: Loma Linda University School of Medicine is accrcdit~d by the Accreditation

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

CONTRIBUTOR: Nor·u Ostrzcga, M.D. CASE NO. I - J ANUARY 1999 Sylmar, CA

TISSUE FROM: Breast ACCESSION #28048

CLfNICAL ABSTRACT: A 47-year-old female presented with a four month history of a breast mass. Following biopsy,

a left partial mastectomy with axillary lymph node dissection was performed.

GROSS PATHOLOGY: A 4.6 em diameter, well-circumscribed, soft tan tumorwa~ present in the 7.0 em diameter

breast resection.

SPECIAL STIJDJES: ERJPR receptors 2-neu

negative positive

CONTRfBUTOR: Chisa Aoyama, M.D. Sylmar, CA

TISSUE FROM : Breast

CLINICAL ABSTRACT:

CASE NO. 2 - JANUARY 1999

ACCESSION #28140

This 34-year-Qid Hispanic female presented with a long history of a large, left sided breast mass. An excisional biopsy was performed.

GROSS PATHOLOGY: The 13.5 x 10.5 x 6.5 em tumor was covered by a fi brous capsule. The cut surface was

homogeneous, slightly myxomatous. white-tan. without bulging. There was focal hemorrhage but no necrosis or calcification.

SPECIAL STUDIES: Des min Positive for less than I 0% oft he stromal component.

• CONTRIBUTOR: Erucb Karanjawnla, M.D. CASE NO. 3 - JANUARY 1999

Santa Maria, CA

TISSUE FROM : Right breast ACCESSION #24886

CLINICAL ABSTRACT: At the age 17 years, this young woman presented with a right breast mass and was told that it

was probab!y developing breast tissue. A year later she developed pain tbe her right breast and a 2-3 em multilobular mass was excised.

GROSS PATHOLOGY: Multiple fragments of homogenous gray-tan, fleshy, glistening tissue weighed 40.0 grams and

formed a 7.0 x 2.0 em aggregate.

SPECIAL STUDIES: lgG lgA lgM MGP

positive positive positive strongly positive

CONTRIBUTOR: Robert E. Riechmann, Jr., M.D. Covina, CA

TISSUE FROM: Right breast

CLINICAL ABSTRACT:

CASE NO.4 - JANUARY 1999

ACCESSION #28419

This 37-year-old female presented with a mass in the right breast. The mass was surgically removed.

GROSS PATHOLOGY: The 5.5 x 5.0 x 3.7 ern well-circumscribed. firm, ovoid nodule was composed ofhomogenous

glistening white tissue.

CO TRJBUTOR: Amo Roscher, M.D. CASE NO.5 - J ANUARY 1999 Granada Hills, CA

TISSUE FROM: Left breast ACCESSION #28280

CLINICAL ABSTRACT: This 79-year-old Caucasian female repOrted a five month history of an "egg sized" mass in her

left breast. In the few weeks before presentation, it had enlarged and ulcerated. A left mastectomy was performed.

GROSS PATHOLOGY: The 26 x 21 x 16 em breast had a 5.0 em area of skin ulceration. Beneath this was a large

multilobulated fleshy white mass which.bulged on sectioning.

CONTRIBUTOR: Steve Kargas, M.D. CASE NO.6 - JANUARY 1999

TISSUE FROM: Right breast ACCESSION #28411

CLINICAL ABSTRACT: During a work-up for end-stage renal disease. this 60-year-old diabetic female was found to

have a large right breast mass. A modified radical mastectomy was performed.

GROSS PATHOLOGY: The 682 gram mastectomy specimen included a 7.5 x 7.0 x 4.5 em tan-red expansile oval

tumor.

SPECLAL STUDIES: CAM5.2 S-100 Vimentin Kerutin cocktail ' Antitrypsin

patchy positivity negative negative 4+ positive 4+ positive

CONTRIBUTOR: Chisa Aoyama, M.D. CASE NO. 7 - JANUARY 1999 Sylmar, CA

TISSUE FROM: Right breast ACCESSION #28405

CLINICAL ABSTRACT: This 39-year-old female presented with a one year history of a right breast ma.~s. A right

mastectomy was performed.

GROSS PATHOLOGY: Within the resection specimen was a 3.0 x 2.2 x 2.5 em, weU-demarcated, non-capsulated.

yellow-tan nodular tltrnor.

SPECIAL STUDIES: ERIPR HER-2/ncu

negative focally weakly positive

CONTRIBUTOR: William H. Winchell, M.D. S:tnta Cruz, CA

TISSUE FROM: Left breast

CLINICAL ABSTRACT:

CASE NO. 8 - JANUARY 1999

ACCESSION #18213

Abut 3 months after delivery of a normal infant, this 28-year-old Caucasian female presented with a swollen left breast, twice the size of the right. It "'-as fmn. red and tender. Incision into what was thought to be an abscess had yielded only inspissated milk. A mass was excised.

GROSS PATHOLOGY: The specimen consisted of 180 grams of tissue received in multiple fragments which were

pink-tan, soft and rubbery.

CONTRIBUTOR: Don Minckler, M.D. CASE NO. 9 - .JANUAR Y 1999 Los Angeles, CA

TISSUE FROM: Left and righc eyes ACCESSION #22958

CLlNICAL ABSTRACT: This 76-year-old black female presented with decreased vision in both eyes. Ultrasound

showed tumor in the choroid of both eyes. Past medical history was significant for breast carcinoma diagnosed one year previously. Bilateral enucleation was performed ar autopsy.

GROSS PATHO LOGY: The 2.4 em right eye had a 0.5 x 0.7 em raised firm white nodule in the nasal sclera that

was a not separable from the sclera and a 1.8 em firm gray-white mass in the choroid extending from the inferonasal ci liary body back to the area of the optic nerve. The 2.6 em Jell eye had a gray-white choroidal mass extending around the inferior choroid and a 4.0 x 6.0 mass present nasally superiorly.

CONTRIBUTOR: E. M . Butt, M.D. · Pasadena, CA

TISSUE FROM: Right and lefc breast

CLINICAL ABST RACT:

CASE NO. 10 - JANUARY 1999

ACCESSION #8340

A 35-year-old black gravida IV, para Ill , pregnant female presented with bilateral breast masses. The right breast mass had been present for two months. The left breast mass had been noticed one week prior to the time of examination. A bi lateral excisional biopsy was performed.

GROSS PATHOLOGY: There were two well-encapsulated yellow tumors. The one from the right breast measured 3.5

em and lhc one from the left I .5 em in largest diameter. They showed identical microscopic patterns.

CALIFORNIA TUMOR TISSUE REGISTRY

BREAST PATHOLOGY

Minutes- Subscription A

January 1999

SUGGESTED READlNG (Geonal Topics from R~«nt Uterature):

Limiunions of Specific Reverse-Transcriptase Polymerase Chain Reaction Markers in the Detection of Metastases in the Lymph Nodes and Blood of Breast Cancer Patients . .I ofC/in Oncol 1998; !6(8):2632-2640. 805tick PJ, Chatterjee S, Chi DO. Huynh KT, Giuliano AE, et al.

Endovaginal UltraSOUnd to Exclude Endometrial Cancer and O!her Endometrial Abnormalities . JAMA 1998; 280(17):1510-1511. Smith-Bindman R, Kerlikowske K, Feldstein VA, Subak L, Scheidler J, Segal M, et al.

Local Recurrence of Breast Cancer After Cytological Evaluation of Lumpcctomy Margins. Cox CE, Pcndas S, Ku NNK. Reintgen, DS. Greenberg HS, et al. Am Surgeon 1998; 64(6):533-539.

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

Lorna Linda Univer.~ity School cfMedicine 11021 Campus Avenue, AH 335 Lorna Linda, California 92350

(909) 824-4788 FAX: (9U9) 478-4 188

E-mail: cttr@linkline.com

CASE NO. I , ACCESSION NO. 28048 JANUARY 1999

INLAND CRjvcpjde/San Bem;vdjnol - Squamous cell curcinoma ( I); Undiftcrcntiat<d carcinoma (I); Carcinoma high grade with nocrosis (I); Carcinoma. ductal type with <-omedo necrosis ( 1); High grade poorly differentiated du<1 carcinoma (I)

BAKERSFJ£!.0 ICenlllll Valley Swdy Grouo) - Atypical medullary carcinoma ORANGE - Al)pical medullary carcinoma MONTEREy - lnlillnlling dUCUII carcinoma. grade 313 BAY AREA - lnliltrnting ductol carcinoma with medullary features (3) SANTA ROSA - Duct carcinoma. prolmbly irwa.<ive( l); Poorly differentiated du<1al carcinoma ( I); AI)'Pital medullary

carcinoma versus poorly difT..:rcntinted carcinoma (I) LONG QJlACN - l'oorly diLTerenti!lled ductal carcinoma (6) SA.l\1 DIEGO CNaval Medical Cemerl - At>'Pieal medullary carcinoma (14) SACRAM£NTO CUC DavL<l - High grade ductal carcinoma, oomedo necrosis t)pe HAYWARD 1St. Rose Hospilall - Poorly diffcrentillled carcinoma oonsistcnt with grade Ill ductal carcinoma (6) NEVADA !Reno) - High grade invasiV<: duaal enrcinoma (2) TEXAS Cfcxa. Tech Re8ional AC!Id Hlth Cttl - Infiltrating ductal carcinoma NEBRASKA <Creighton Univ.) - Invasive ductal carcinoma. high grade ILLINOIS CH!nsdale Hospital) - lnnltr•ting carcinoma with features of medullary carcinoma (I); Medullary cmcinomo

vs (comed•l-ductal) MIC!iiGAN COakwood HosojJA!l - Medullary carcinoma MIOIIGAN CApo Arbo<l - At}l'iC!II medullary carcinoma (2); Medullary carcinoma (I); Poorly diftCrcntillled d\ICUIJ

carcinoma (I) fLORIDA <Tallahassee! - lnfiht111ing ductal carcinoma. grade 3/3 (4) FLORIDA COr!nndo) - Invasive high grade ductal carcinoma with extcnsiV<: comcdo-t)'PC necrosis OHIO (McCul!ouoh-tlvde Memorial Ho>pital) - lligh grude ductal dlrcinomn with comedo necrosis (comedo

carcinoma) KENTUCKY lllMList Hosoital East) - Invasive duct carcinoma grade Ill (2) LOUISIANA ll..oujsjana State Unjv M<d Qrl - Infiltrating doctal careinoma, high grade. with medullruy features NORTH CARQLINA IWNC PatbQ!ogy Groopl - At)'Piad medullary carcinoma (4) MARYLAND !Woodbine) - Lobularcarcinoma(l); Apocrine c:in:inoma (I) MARYlANQ !National Naval Medjcal Center! - lnflhruting ductal carcinoma. hi gil grade (9): At)'Pical medullary

carcinoma (S) WASHINGTON, D.C. IWaltcr Rood! - lnfiltta.ting ductal carcinoma, grade Ill with DC!S PENNSYLVANIA CConemauflh Mworial Hospital\ - lnfiltraling d\ICUIJ C!lrciooma "itb extensive comedo necrosis. PENNSYI. VANIA IBB Qrouol - Comedo carcinoma in-situ PENNSYLVANIA Clchigh Valley Uos0itall - lofil1t111ing d\ICUIJ carcinoma. gnlde J (I); Medullary carcinoma (I) NEW YORK (Northoonl - Poorly diffcretttiaied dua C!lrciooma NEW JERSEy !Summj!l - Circumscribed, pOOrly di ITcrentialcd invasive ductal carcinoma (3) MASSACHUSf.TIS IBerkshire Medical Ctrl - Medullary carcinoma CONNECTICUT 1\/njv Conn H!tb Ctrl - High grade adcnosquamous carcinoma, fuvor bre~ISt primruy (metastatic, such

as lung primary. cannot be Nled out) AUSTRALIA ISyJ!nev\ - Grad< 3 inva>h-e duct cartinoma (3): Atypical medullary carcinoma (3)

DIAGNOSIS: HTGH GRADE DUCTAL CARCINOMA WITH MEDULLARY FEATURES ("A TYPICAL MEDULLARY CARCINOMA")

T04010, M85103

REFERENCES: Bellamy CO, hul AB. Fkmins S "" al. tloai.O\'l!lsn·e Ductal Cateinoma of1he Rra.st. The Rde\'I.DCO ofH,uotot)c CttePzarion

H•"' Pathal ! 993; 24{1)016-U Hill ACT ae, Oesch CE, Carlson RW. Smith TJ, et al. Tradc..Oift Oetween Survival11nd Breast Prt$ervation for Tltrtc Initial Treatmtnls

of Ductal Canlinoma ln.Situ oftbu Urcast. J Clin Onctl/ 1 996~ 14(l):70·77, Bada\·e S, l-Jtrn RJ'. Ward AM, Mills RJt e1 al. Prediction of Le<;al Rccumnce-()(0ucual C:ucinomaln..Silu of the BreaS-t UsiJ1g Five

Histolo~cal Classifications. A Comparative Study with Long fo'ollow-Up. Hum Patho/1998; 29(9);915·923. Rajan PB. Cran« ML_. Roseo ano Roseni'P. C)"S(Osa.tCOR'II Pbyllodcs in Adole$Ct:nl Giris and Young Women. A S:;.J)• of 4$ Pa11ena.t.

A• J Surf Pallwl 1998: 22( l} <H-69 o·H"' BJ, ttm AD. EI.Sbirbuty A. Y<b SO. Rosen PP, tr al. Sentinel Lymph Nock Biopsy in Bru51 c-. Initial Expericnu at

Memoria! SIOOln·KdtcringCa- C<ntcr. JAm Coi/Su'g 1998: 186(4):423-427.

CASE NO. 2, ACCESSION NO. 28140 JANUARY 1999

rNl.ANP /Rjvec;jde!San lk mardinol - Fibroad<"llOmo whh intraductal carcinoma in·situ (I): Benign cystosarooma phyllodcs (I); Phyllodes tumor, benign (2); l'seudosarcomutosls SltQmal hyperplasia (I)

BAKERSfiELD /Centr;l! Valley Study Oroopl - Pbyl!odes tumor ORANGE - Acti\-e pseudoongiomalous h)llCfJ>I""i" MONTEREY - lnliltroting ductal carcinoma. grade 313 BAY AR!)A - Myofibroblo.stoma ( I ); Benign phyllodes tumor ( I); Benign fibrous tumor (I) SANTA ROSA: Duct carcinoma, inVIISive ( I); Carcinosarcoma (2) LONG BEAC!i - Poorly differentiated ductal carcinoma (6) - (In a seoond set we have case #2 showing only benign

brea.•tlissue suggesti\e of benign phyllodcs tumor without evid of mal is. SAN DIEGO CNaval Medjcul CC11lcrl - Benign Pbyllodcs tumor (I); aordc:rtinc phyflodcs tumor(8); Jwenile

fibroadenoma (2) SACRAMENTO 0/C Dayjs\ · Phyllodes tumor. low grade HA YWABD 1St. Rose Hospilo!\ - Fibroadenoma (cellular Md fibrosin&) (6) 1'-iEVAQA fRcnol - Phyllodcs tumor (2) • TEXAS ITn~~< Tech Regional Aead H!th C!rl - Benign phytlodes tumor NEBRASKA (Creighton Unjy\ • Fibroadenoma wilh fearures orjuvenile giant fibroadenoma ILLINOIS C!iinsdale Boooilllll • Phyllodes tumor (2) MICBIGAN <Oa!;woo<l Ho:;pitnll - Benign phyllodcs tumor MlCBiGAN (Ann Arbor\ • Phyl!odes tumor(2); Phyllodcs tumor. benign (2) FLOR!QA <Tallahassee! • Benign phyllodcs tumO< (4) FLORIDACOrl!!!!dol - Fibromatosis ofbn.'liSI OHIO IMcCyl!ough-Bvde Memorja! tloopj!Qll - C)~tosareoma phyllodcs, benign KENTUCKY <Baotist Hospjllll East\ • Phyl!odes tumor. histologically benign (2) LOUISIANA /Louisiana SlAte lJniv Mcd Ctr) • Phytlodes tumor. low grade NORTH CAROLINA <WNC Pathology Grwal • Giant fibroadenoma (juvenile fibroadenoma) (2): Giant (juvenile)

fibroadenoma (2) MARYl.ANP IWOO<fbinel • Cystosarcoma phyflodes. benign (I); Ju,'eni!c fibroadeooma (I) MARYLAND <Narjonal Noyu! Medical CeO)cr) • Pseudoangiomatous hyperplasia (4); Fibrolldcnoma with KaposJ•s

sarcoma (4); Kaposi's sarcoma (2) WASHINGTON. D C. IWolJcr Reed) - Juvenile fibroadenomo PENNSYkVANlA IGonemauob Memarialllosoi!all · Pseudoangiom:IIOUJ stromal h)llCfJ>Iasia PENNSYl. VANIA <BB Group) • Phytloides tumor ; Cellular Phyl!odes rumor PENNSYLvANIA (Lebjoh Yallcv Hospjta!l • Infiltrating ductlll carcinoma ( I): Poorly ditTcrcntioted carcinoma with

mctnplo.siu (!) NEW yORK lNorlhDO<tl • I' ASH N£W JERSEY <Summit) • Hamartoma (2): Fibroadenoma with pseudo l)mphangiomatous stromo (I) MASSJ\CHUS!)ITS fficrghjre MedicQl Ctr) • Phytlodes rumor (6) vs cellular fibroadenoma (2) CONN£C.1.1CIJT <Univ Conn tilth Ctrl • Cystosarcoma phytlodes w/angjosareoma component AUSTRAI.!A /Sydney) - Giant fibroadenoma

DIAGNOSIS: PHYLLODESTUMOR, BREAST

T04010, M90203

REflki!£NCES: HinlOka N. Mukai M. Hosodn Y and Hilla I. l'hyllodes Tumor of the Breast Containing the lntrac)toplasmic Inclusion

Bodies Jdenriea! \vith lnfuntile Digital Fibromatosis. Am J Surg Potho/ 1994; 18(5):506-5 11. Pielnl$2lco M and Barnes L C)~tosarooma Phytlodcs. A Clini030palbologic Anulysis of 42 Cases. Cancer 1978; 1974-

1983. Bao BR, Meyer IS, and Fry G. Most C)~tosarcoma Phyllod"" and Fibroadenomas Have Progesterone Receptors but

Lack Estrogen Receptor. Stromal Locallmtlon ofProgestcroHe Receptors. Ca11cer 1981; 47:2016-2921. Salvadori 0. Cosumano I', Dol Bo R, et a!. Surgical Treatment ofl'hyllodes TwnoCl< of the Breast. Cancer 1989:

63:2532-2536. Ward RM and Evans HL Cysrosarooma Phyllodes. A Clinioopothologic St\ldy of26 Cases. Conw 1986; 58:2282-

2289.

CASE NO. 3, ACCESSION NO. 24886 JANUARY 1999

INLAND !Rjvmidc/San Bernardino) • l.mmunoblastic san:oma ( I): High-grade l)mphoma (2); B-<elll)mphoma ( I): Plasmablastoma (I)

DAKERSF!ELP {Central Valley Studv Group) • PlasmUC)toma OMNGE · Lymphoma, large cell MONTERI!Y • B.ncin's lymphoma DAY AREA • Plasma oellmastitis and granulomatous rc:aclion (3) SANTA ROSA • L)mphoplasmac)tic neoplasm, lluncitt's·lil<e (I): L~mphoplasmac)101110 versus reactive process (I):

Pseudolymphoma (I) LONG BEACH • High-grade lymphon1a (6) SAN DIEGO CNaval Medical Center\ • Uurldtt's l)mpboma ( 14) SACRAMENTO cue Dayjsl • Diffuse. large cell 8-a:U l)mphoma HAYWARD !St. RMe Hosnitall . Lymphoma, small oon-<:leavcd non-Burkitt's (6) NIWADA !Reno) • Righ Qnlde small non-deaved oell lymphoma (2) TllXA$ CTexas Tech RcgionW Acad H!th Ctr) . Malignant lymphoma. Burkin's type N£BBASKA CCrciM!on !lnivl • Mali8l'Mt l)mphoma, immunoblastic type IL!.INOIS 111insdale Hospjtull . Lymphoma ( I); MWignant lymphoma, large <'<lll immunoblnstic MICHIGAN !Oakwood Hospi!a]l • Burldu's lymphoma MICHIGAN (Ann Arbor\ • Small cell non-cleaved lymphoma, BwltiU's type (4) !'LORIDA CTaJI!!hmrel • L)mphoma (4) FLORIDA !Orlando\ • Larae cell lymphoma ofbrea.11 0 1110 {McCulloush-Hvdc Memorial HospitAl\ · Burkin's lymphoma KEt<TU(K)' (BaptiSI Hosojq!l East I • Molignant l)mphoma, B-<>c!l. high grade (Burldu's) LOUISIANA C!.oujsianaStpl< Unjv Mes! Ctrl · Mali8l'ant l)mphoma, small non-cleaved Durkin's t)JlC NORTI1 CARO!.TNA CWNC PntholoL'VGroup) • High grade lymphomu,likely Burl<in's (4) MARYLAND <Woodbine) • Plasmacytoma (2) MARYl,AND <National Na\-al Mcdjc:aJ Cmtcrl · M>lignantl)mphoma, B""'ll t)pc, extra nodal W 1\SHJNGTON. D.C. CWail•T Reed\ • Durkin's lymphoma PUNNSYLVAN!A (Conemauoh Memorjal Hospital) • High grade l)mphomn PENNSYLVANIA IBB GTO!Jpl . Lymphoma: Burkill's PENNSYLVANIA (Lehif!b Valley Hosnj!8fl · Lymphoma, favor immunoblastic type (m>rkcd aush llrlifact binders

cvalualiOO) (2) NEW YORK CNortbroal · Pscudolymphoma NEW JERSEy (Summit) • Malign:mt lymphoma, large cell t)'JlC (3) MA5SACHUSWS C!lqlssbjre Medical Q rl • Lymphoma COffNECTICUT fiJniv Conn H!th Ctrl • lmmunoblastic l)mphoma AUSTRALIA CSydnevl • Non Hodg)(in's lymphom•? Burkin's? lmmunoblosrlc 7 Mantle

DIAGNOSIS: SMALL NON-CLEAVED FOLLrCULAR CENTER CELL LYMPROMA, DI FFUSE (BURKITT'S LYMPHOMA)

1'04010. M97503

CONSI!L TATION: USC Oinieal Laboratorie$. -Small Noo-Ciea•"Cd Follicul>r Q:nlcr Cell L}mpboma. Diffuse (llurtcin' s Lymphoma).

REfERENCrui: HofTnw.o DG, Tudccr SJ. Ammlnoulides C, Rosen PAa.nd Nocm f. C03 PositiYe Mantle Cdllympboma. "-cpt.Mt ofT"oCastJ.. Am

J Clln PaJ/to/1991; 109(6~639-. Hob CK. Glaspy J, Rosen P, et nl. Wbole IIndy FOO·PET hmging for S10J!ing ofHodglcin's Disea"' and Lymph<lmo J Nucl Med

1991; 38(3):)4).348. DruS'C"ill S. Fillppa DA. Kimmel M. t..iebc::nrwJ PH and Rosen PP. Mali&nantl..ympbon\11. of 1he Brca.S:I. A Study (lr .S3 Patients.. Ann s., 1981; 205(2):1«-150. Cob<1> PL. Broots JJ. lymphomas or the Dreost A Clinicopotholosi< and lllll!llnohisto<llemi<ol Sllld)' of Prinwy ami Secoodal)'

Cases. Ca"''" 1991: 67{5): 1359-1369. ArmitageJO and Wcit~<:nburgct. New Approach to Clll$Sifylng Non-Hod&kin's LympJtomus. Clinicul Features of the Major Histoltlgic

Subtypes. Journal o/Cii•lcol O•col t998; 16{8):2780.2795. DooAR Adkins RB and Gliet AD. Malignant Lymphoma of the Breast. A Re•iewof ll C..SCS. Am"S•rg 1992: 51{12):792-796.

CASE NO. 4, ACCESSION NO. 28419 JANUARY 1999

INLAND CRjven;ide/San Bemnrdinol - Ouctul curcinomn in-situ, clinging type ( I); C)stic hypersccraory lesion(? DC IS) nnd lbr~nomntoid h}perplasia (I); Fibroadenoma (1); Benign fibroadenoma (cyst with epithclinl chonges papilomatosis). Some Dn:4S like g)-necomastia (I); Micropapillaryduct h)~lasia (I)

BAKER$flll!.P <Centrn! valley S!udv f>lll!lnl - lnln!ductal carcinoma ORANGE - Inter and intra-lobulw fibrosis with cystS

MONTfiBRY - lnfiltrnting ductal carcinoma orising in fibrolldenoma E!A Y AREA - Fibroadenoma with fibrocystic changes (3) SANfA ROSA - Fibroadenoma-like reaction with sclerosing udaloois and epithelial hyperplasia ( I); Papillomatosis­

swiss cheese disease (2) lONG BEACH - Ductal carcinoma in-situ (in fibroadenoma?) (6)

SAN DIEGO (Naval Medic;!! Center} - Low grade DCJS (2); Low grade DCIS orising in a fibroadenoma (3); Fibroadenoma with atypical ductal hypcrpltlSia with micropapillary and eribifomt patterns (S)

SACRt\MENTQ <UC Pavjsl - Atypical ductal h)perplasia HAYWARD ISL Rose Hospilall • Swis$ ehccse disiase (fibroc~c without al)pia) (6) NEVAI?A fRenol - Phylloides rumor with atypical hyperplasia (2) TEXAS /Texa1 Tech Re!!ima! Aca4 tilth C!rl - Benign Phyllodcs tumor NEBRASKAfCreiglnon Unlyl - Hamartoma lll!NO!S{Hjnsdale Hospital) - Microglondular adcnosis ( I); Tubular adc,oma (I) MICHIGAN !Oakwood t!osoita!l - Florid hyperplasia and dua dilatioo. oonsistent wilhju,-cnilc papillomatosis MICHIGAN IMn Arhorl - Juvenile popillomatosis (4) FLORIDA ITal!aba<See) - Mkwpapillnry nod mucinous DCIS with fibroadenoma (2); FibrO<tdcnoma with prominc:nl

epithelial h}petplasia ( I) FlORIDA <Orlando) - Fibroc)~tie disease of breast with inlroductal hyperplasia and myomatou.• h)perplasio OHIO (MeCullou!!h·H!'!k Memorial Hospjtall - Benifp> sclerosing lesion(? Fibroodcnclmo with sclerosing adenosis) KENTUCKY CB!!D!iSl HwPital East> - Cystic hypcrsecreiOIY h~lasia (2) LOUISIANA (louisiana State llnjv Med Ctr) - Fibi'OC)'stie disease NOR Til CAROLINA IWNC Pathology Grooo) - Juvenile popilloma(oois (4) MARYl AND <Wooclbinel - Juvenile papillomatosis (2)

MARYLAHD IN!l!iona! Naval Medical Centql - Juvenile popiJIODiliiOSis (9): C).~tic hypcrsecrctory h)perplasia (3) WASH[NGTQN. D.C. !WAlter Rc:cdl • Gastric hyperseactoryc:arcinoma PENNSYLvANIA (CO!Jemnu!!h Memorjq! l!ospital) - Clinajng carcinoma, fibrocystic di,.._...,, sclerosing

fibroadenoma P£NNSYl VANIA @B Group) - Clinging ductal carcinoma PENNSYLVANIA llchi!!h Valley tfospjq!ll - Adenoma vs. adc:oosis (1): Ductal adenoma (I) NEW YORK CNorthDO!l) - Mycid hamartoma NEW JERSEY ($ummj0 - Fib~nomatoid nodule with cystic change (3)

MASSACHUSETTS CBcrksbjre Medical C!r) - Fibroadenoma with fibroc)'Stic chwtgcs and benign duct hyperplasia CONNHCT!CUT IUnjv Conn Hlth Ctrl - Micropapillary inltllcystic carcinoma associated wi(b fibroadenoma AUSTRALIA IS><Inevl - Breast bamanoma with fibroeystie changes

DIAGNOSIS: MYOm ' \ MARTOMA WITH oucr..__ MYPERPLASIA, BREAST ("MUSCULA.R KARMA TOMA ")

T04010, M75500

REFERENCflS: Shcpstono llJ. Wells CA, Deny AR and Ferguson JOP. Mamogmphlc: Appearance ofllislopatbolog,ical Description of ~.: .. ~ ... !ar

Hamanoma of the Broa•L Dr J Radia/1985; 58(689):459-461. Da•·ies JO and Riddell RH. Moseutu Hamaromas of !be Breast. J l'atholl91J; I II(J):l09-211. Easebi V, Cundtl A, Fedeli F, Se•·cri B, c< II. B<uip SIDOOlh Mutck Cell Meupluia ofthe Brast. Tw•ori t980; 66(5~ 60-<>53. Oberman HA. llatnanoo>ound HAmattOO>& Variants of the Brwil. s. .. ,. D{Dg Pathol t989; 6 (2):1)5-145.

CASE NO. 5, ACCESSION NO. 28280 JANUARY 1999

IN! .ANQ CRiverside/San l!ero&diOO) • Stromal sarcoma (I); Mlllip>an~ ~tOSOI\10IIlll pbylkldes (I); San:oma. NOS ( I): Spindle cell neoplasm, hish 8Jnde (rio maligll3lll pb)ilodes tumor, rfo sarroma. neurnl n small muscle n wscular) ( I); High grade malignant fibrous histiocytOOtO (!)

BAKERS FIE! p fCentrnl Volley Study Groypl - Fibrosarcoma ORANGE • Sarcoma, high l)Tode. NOS MONTEREY · Phyllodes tumor BAY AREA - Malignant phyllodes tumor (sarcomatOUS stroma) (3) SANTA ROSA - Phyllodes tumor, m1~ignant or stromal sarcomn. depending on what other areas look like (!);Stromal

s.wwma, low grade (I); SilCOOma LONG BEACH • Malignant phyllodc:s tumor (6) SAN !)!EGO (Naval Medical Cg!!er} • Malignant C)'St05W'alllll'1 ph)ilodes (14) SACRAMENTO rue Davisl • DFSP ""cellular scbwanooma HAYWARD !SL Rose Hmnjtall • Mctupla:stic carcinoma(~ !pox) (6) NEVADA <Renol • Malignant phyllodes (2) TEXAS !Texos Tech Regional Ac:M Ulth Cirl • Malignant C)~tosarc:oma phyllodes NEBRASKA !Creighton Unjy\ • Malignant spindle cell neoplasm, favor flbrosurooma, low grode ILLINOIS !Hi,~<dale Hospital) - SilCooma. suggestive offibrosW'oomo MICHIGAN !Oakwood Hospi!l!ll • Malignant neoplasm rcscmblin& MJ>NS'f. metapla<tic carcinonw cannot be ruled out MICUIGAN !Ann Arbor) • Phyllodcs tumor, malignant (3); Stromal sarcoma, low grade (I) !'!.OR IDA !Tallahassee\ • CysiOW'CX>ma phyllodes, malignant (4) F!.ORIDA (Orlando\ • Low pe fibrosaroomaofbreast OHIO !McCull!!!!!!h·H\ue MemoriAl l !ospital) • Cystosaraxna pb)ilodes. malignant KENTUCKY CBaorist Hosoil!ll f.ASO • Sarooma (I); Malignant phyllodes twnor (I) LOUISIANA fLoojsjMa Slag Unjv Mc<J Orl · Phyllodes twnor, malignant NORTH CAROLINA !WNC Pathology Gn>uol · Malignant phyllodes tumor (3); C)stooarcoma malignant with StrOma

overgrowth (I) MARYLAND !W90dbine) • Lciomyosarooma ( I); Spindle cell sW'oomu (I) MMYLAND !National Naval Mcdjcnl Center\ • High grade pbyllodos tumor ( 14) WASH !NGION D.C. (Walter Roedl • Stromal wooma, lilvor Dr'SP (dermotofibrosarcoma protuber0115) PENNSYL V ANlA CConomaygh Memorial Hospital\ · Malignant phyllodcs tumor. M.FH phenotype PENNSYL VANJA CBB Crroup) • Radial SCW'. 6brosarooma PENNSYLVANIA (Lehigh Valley Hospital\ • Malignant phyllodes tumor (l); MFH (I) NEW YORK INonhOO!!l · Sarooma with ncurogcoie features NEW JERSEY !Summitl • San:oma. possibly netJrOgenic, possibly arising in a pbylkldes tumor (3) MASSACHUSETTS CBcrkshin: Mcdjclll Orl • Malignant peripherlll nerve sheath rumor probably arisiing in a

phyl!odes rumor CONNECTICUT CUniv Conn Hhh Ctrl • Cystosarooma phyllodcs with malignant fibrous histiocytoma and 7

schwannoma differentiation AUSTRAI .IA (Sydney) • Malign1111t phyllodes tumor

DIAGNOSIS: MALIGNANT PHYLLODES T UMOR, BREAST

T04010, M90203

REFERENCE.~:

Pllko MJ. Wang SE, Sbacknc:y SE. Cottin&ton EM. et al. Flow Cytometric: S Fraction u a Pn:dictor of Clinical OuK:ome to Cyst053Ctoma Pbytlod.,. Arch Pochol Lab Med 1990; 114(9); 949-9l2.

Bern~cin L, Oeapc:n 0 and ROS! RK. The O~iptil'c Epide:rmiology ofMalignan1 Cyscosarcom:s PhyUodesT"mors of the BrauL Ca••cer t993; 71( t0): 3020·3024.

Cotm..Cedt:tmflrk 0 , Rutquist l.l: ~..,sondahJ I tu'ld Silfvet:S\\'atd C. Progno:;ti<: 11uCIOfi i.n Cysto~reoma Phyllodc::s A Clinicopathologic Study of77 Palicnts. Canm t99 t: 68(9):2017-2022.

MotTat CJC, Pinder SE, Dixon AR. Elston CW, ct a!. Phyllode.~ Tumours of01e Breast. A Clinioopothologicnl Review ofThirty:l\vo Cases. Histopothol !995; 27(3): 205-218.

CASE NO. 6, ACCESSION NO. 28411

IN!.ANQ I'Rivenidc!San !lqn!!rdjool - Medull>ry catcinoma (I); Melllplastic c:an:inoma (3): High llJ11de melaplastic squamous C:ll'Cinoma (I)

BI\KilRSFIELP (Centro! Valley Study Group) - Mcu.plastic squamous Cllrcinoma OBANGE - Pleomorphic, poorly diOerentiated cureinoma with squamoid lcruures MON'mREY - lnfilltaling ducllll c:an:in=a BAY AREA - Osteoclast-like giant ccU carcinoma (3) SANTA ROSA - l'oorly-diflercntiated malillJlant neoplasm, rule out (2); Anaplastic <»rcinoma, rule out metastasis (I) LONG BEACH - l'oorly-di!Tcrcntiated carcinoma (6) SAN DIEGO<NaVJ!I Medica!Cmtcr) - Mcu.pl8$ticcarcinorua(14) SACBI\MENTO 1\JC Davis> - Poorly differenti:lled carcinoma HAY WARP <St. Rose Hosoitall • Aoapla<!ic Clltcinoma NEVADA <Reno) • Poorly diiTcrcntiuted carcinoma with sarcomatoid features (2) ·mXAS fTgsas Tccb Re•ional Acad Hlth C!rl - Metaplastic squamous carciooma NEBRASKA tcrsiehton Unjvl - Mclaplastic catcinoma, breast ILLINOIS CHinsd!!lc tlosoim]l - Anaplastic ClltCinoma (2) MICHIGAN <Oa!;wsxx! Hospjtall • Poorly dilli:rentia<ed carcinoma MICHIGAN (Ann Arborl - High grade squamous carciooma (2): O ear cell sarcoma (I) Mcwplastic eatcinoma (I) FI,QR!DA Cfai!PhftSS"") • Anaplastic carcinoma ( 4) fLORIDA (Orlando) • High grade ductal carcinoma. breast, with giaot 1umor cells OHIO fMcCullough-llyde Memorjal Hospjta!) - Poorly dilli:tenliated catcinoma with squamous differentiation KI)NJ1JCKY (BanljS! !iospital EqsO - Apocrine catcinoma (2) LO!!!S!ANA 11..oulsillll• State Unjv Med Clrl - Pleomorphic giant cell carcinoma NORTH CAROLINA CWNC Pa<hology Group! - Mctaplaslic c:an:inoma (3): Careinosarooma (I) KENTI!CKY IWooslbjnel - Metaplastic carcinoma (2) MI\RXLAND (Na!lpnal Naval Medical Center> • Anaplastic carcinoma (10): Carcinoma with hepllloid features (3) WASHINGTON p C. lwaJ(er Rq;dl - Metaplastic breast carcinoma PENNSYLVANIA CConcmaogh Memorial Hospilo!l - Metaplastic squamous ocU careinoma PBNHSYL V ANIACBB Crrouo) • Metaplastic du<1al carcinoma PENNSYLVANIA (Lehigh Valley Hospital\ - Curcinoma with osteoclastic giWll cells (I); Metaplastic carcinoma (I) NEW YORK CNonhnoal - Metaplastic carcinoma NEW JERSEY CSumrnitl - LMge cell Wldilferentiaed ducllll carcinoma with tumor giant cells (3) MASSACHUSETTS CBerl<:!hire M!XIical Center) - HistiOC)1oid eatcinoma (2) vs. metaplastic carcinomo (6) CONHllCTJCUT IUojv Conn Hl!b Ctrl - Metaplastic giant cell carcinoma AllSTBAUA <Sydney) - Pleomorphic carcinoma? squamous

DIAGNOSIS: ANAPLASTrC CARCINOMA WITH FOCAL SARCOMATOID MET APLASIA, BREAST

T04010, M81403

REFERENCES: Foschini MP. Dina Rl3&nd Eusebi V, S4rcomatoidNcoplasmsofBrwt. PropOsed Definitions for Biphasi<: and Monophasic

Sarcomatoid Mammuy C.arcin011lAS. Semi" Dlog PatJ,o/ 1993; 10: 128· 1 36. Hcnln&ton CS, Tarin 0. Buely J and Alhanason H. OsteosarcomatOU$ Oifflnnliation in Carcinoma oflhe breast A Case of

Melaplastic Caroiooma with Ostcocl&sts and OSicodaSI-Like Giano Cell~ H/.slOpDI/wl 1994: 24:282-285. - AiJhovcnT, TillUIIaaDS M, Foetens JA and Domcn LC. Difl'crcntial Expression of~ Ptoa.,.croac, ond Epidermal

Orowth Factor Rocepcors in Normal. Benign and Malipnt Human Breast Tissues Using Dual Stainin&lmmunohiscocbemisUy Am J l'allml t994: 144(6): 1238·1246.

Rrnun AC. The cpigenic Modcl ror the Origl.n ofC1nccr. Q Rev Bioi198J ~ 56(1):33-60

CASE NO. 7, ACCESSION NO. 28405 J ANUARY 1999

INLAND CRiv~de/San llqnM!joo) • Hodgkin·s disease (I); Medullorycarciooma {3); Hi gil grade poorly differentiated squamous oc:ll c:an:inoma {I)

!)AKERSf!(;J.Q (Centro! Vol!cv Studv Grouo\ - Medullory c:an:inoma ORANGE - Medullory carcinoma MONTEREY - Medulllll)' carcinoma BAY AREA - Medullory carcinoma (3) SANTA ROSA - Duct carcinC)I11u. invasive, with prominent pl!tSmOC)tosis ( I); Medullary carcinoma (2) J.ONG BEACH - Medulltll)' c:an:inoma (6)

SAN DOW fNaval Medical Cquql - Medullory carcinoma (6); Atypical medullary carcinoma (6)

SACRAMENTO IUC Dovisl - Medulltll)'c:atciooma of breast IIAYW ARD 1St. Rose llospi!f!l - Medullory c:atciooma (some fibrous areas are pema ror solitllly fibrous tumor) NEVAQA CRenol - Poorly differentiated invasive carci.noma with medullary fearures (2}

TEXAS !Texas Tech Regional t\gl4 Hl!h Girl - lnfiltrncing duCUll eurcinoma NEBRASKA !Creighton (Jniyl - Medullary carcinoma ILLINOIS (]:linsdale H!llinjtol) - Medullary carcinoma (2)

MICHIGAN (Oakwood Hosni!llll - Atypical medullary carcinoma MICHIGAN I Ann Arbor) - Medulllll)' carcinoma (2); Atypical medullary carcinoma ( l); Ductal carcinoma ( I) FLORIDA ITallhassoc:l - Medullorycarcinoma(4) FLORIDA IOrlandol - High SJ11deductal c:atciooma of breast v.ith rc:active plasma cell component OHIO IMeCulloosh-Hvde Memorial Hospital) - Medullory c:an:inoma KENJUCKY <Ilaptist HMni!!!l Eas!l - Medullary c:atciooma (2) LOUISIANA !Louisiana State Unjv Mel! C!rl - Medullary c:an:inoma, atypical NORTH CAROLINA IWNC Patbplogy Group) - Medullary earcinoma (4)

MARYLAN)) IW09dbjnel - Medullary carcinoma (2)

MARYLAND <National Naval Mclljcal C\llterl - Medullary carcinoma (4); lnliltr•ring duel a! carcinoma (4); Metaplastic carcinoma (3)

WASI!INGTON D.C. IWul[er Reed) - Olrcinoma with features of medullary carcinoma PENNSYLVANIA IConeroauo!t Memorial Hospital) - Medullary carcinoma PENNSYL V ANJA CBB Gmunl - Medullary c:atcinoma PENNSYLVANIA <Lehi2h Val!evHospitall - Favor medullary carcinoma bt.t need to soc: entire border of tumor

NEW YORK INorthnor!l - Atypical medullaty carcinomJI NEW JERSEY !Summit) • Medullory carcinoma (3)

MASSACHUSEJTS fBerkshin; Medical Qr) - Atypical medullary carcinoma (2) vs high grade ductal cnrcinoma (6)

CONNiiCT!C!JT(!Jniv Conn Hltb Cvl - MeduUarycorcinonta AUSTRALIA ISvdney) - Mellullary cnrcinoma (plasma cells prcdomimue in stroma)

DIAGNOSIS: MEDULLARY CARCINOMA. BREAST

T04010, M851 03

RllJ:ljRENCES: Oo""&J•I.t w. WOZDiak [., LISOCll J and Webe.- K,., aL Vim<orin ;, Pl'ercr..,tl.tlly E.pressed in Hijh Gnd• Oo·<1 -d M«Jullary.!Wt

Not in Lol>ulat Breast Carcino""~ ~m J P•tho/1990; IJ7(S):l0S9-1064. Ri,gaud C. Theobald S. Noel P and Badreddlnc J, et al. Medullary Carcinoma oflho Breast. A MuJticcuter Study orltJ Ofaanostic

Cons;stency. ~rch Pathol l.ab Mtd 1993; 117(10):1005·1003, Rapin V, Cootcsso G. Mouriess t-1 , ~ 111. Medullary Dreast carcinoma. A RcBva1ualton o[95 Qlses orarcalit Cunccr wilh

lnll•mmatoryStroma. Cancer 1988: 61:2503-2510. Wnrsn47. ES and Sih·erberg SO. Medullary Carcinoma of the Bress!. A CliniCO J)IIIholog.ie S1udy with Appraisal of Current Dio&nostic

Cri<cria. Hum Patho/1938; 19:1340·t346.

CASE NO. 8, ACCESSIO N NO. 18213 J ANUARY 1999

INLAN!) (Riverside/San Bemgrdjnol - SecTetory c:urcinoma (2); lipid-rich carcinoma (2); A<.-ute lactational mastitis with mt~kod histiocytic hyperplasia (I)

BAKERSFIELD !Central Valley Study Grounl - Mclll$tU!ic renal cell c.vcinoma ORANGE - l'oorly differemiotod inllltrating carcinoma of no special type MONTEREY - Infiltrating carcinoma. glycogen rich (clcor ceO) BAY ARfiA - Glycogen-rich aon:inoma (3)(rlo trophoblastic tumor) SANTA ROSA - !)uct carcinoma. probably invas.ivc ( I); Anaplastic carcinoma. primary vctliUS see011dary (I);

Cborioeorcinoma versus poorly differentiated c."elnoma ( I) LONG BEACH - Clear cell earcinoma (6)

SAN DIEGO (Naval Medical Ccoterl • Apocrine carcinoma (1 4) SACRAMENTO lUC Davisl - Apocrinelscactory carcinoma HAYWARD ISL Rose Hospital) - Carcinoma, sccrctory(2); Glymgcn -rich carciooma ( I); ln6hnning ductal

c:aroinomo (apocrine vs. sec:rctory) (3) NEVADA !Reno! - Glycogen rich eareinoma; Lipid rich C31Cinorna TEXAS (Texa< Tcoh Regional Acgd tilth Ctrl - lnOit.l'ating du<.1al car<:inoma NEBBASKA !Creighton llnjv.l - Glycogen-rich carcinoma ILLINOIS Oljg:!da!e Hosoi!all - Apocrine carciooma(l); Anaplastic carcinoma with clear cell fCillures ( I) MICHIGAN !Oal;wood HosnjJAII - Invasive carciooma with apocrine feouurcs MICHIGAN CAnnArborl- Cleru-cell corcinoma (4) FlORIDA ITnllaha=l - !)uctal carcinoma, cannot rule out metastasis (renal, clear cell carcioomo. other) (2); Poorly

diffcrcntiuted ductal carcinoma (I) FLORIDA !Orlando) • High grude ductal carcinoma. breast OHIO CMcCullough-liyde Memoria) Hospi!!lll • Apoerino C8JCinorn> K£muCKY ffi8!1CiS! Hosnitnl East> - Apocrine carciooma(l): Sea-etorycarcinoma with apocrine ICatures(l) LOUISIANA !LouisiW>a Swe!Jniv Med Ctrl - Sel.'ftlory carcinoma NORIH CAROLINA CWNC Pgtbology Group) - Olycog.:n-ricb carcinoma (3); Oeatcell (lipid-rich) carcinoma (I) MARYLAND IWsxx!binel - Glycoscn-rich carcinoma (2) MARYLAND <National Naval Mediad Center) -Carcinoma "itb clear-<:ell features. NOS (10); Lipid-rich C31Cinomu

(3) WASHINGTQN. D.C. <Walter Rg;dl - Carcinoma with clear cell feat~RS PENNSYLVANIA <Corernau!!h Memorial Hospital) - Glycogen-rich a<knocarcinoma PENNSYLvANIA IBB GroyQ) - Curcinoma. Glycogen rich carcinoma PENNSYLYANIA(lehigh valley Nospitall - Infiltrating ductal carcinoma with spindle cell features(!); Glycogen rich

carcinoma (I) NEW YORK fNC!!lbportl - Glycogen rich carcinoma NEW JERSEY <Summit) - lipid rich carcinoma (3)

MASSACHllSETIS CBerk.'hire Medical Center\ - Hypersea-e<ory corcinoma CONNECTICUT (\lniv CO!ln Hcghh Qrl - Oear cell carcinoma (favor metU$1atic renal cell carcinoma) AUSTRALIA CSydneyl - Glassy cell carcinoma

DIAGNOSIS: SECRETORY CARCINOMA, BREAST

T' ")10, M85023

CONSULTATION Robert McDivitt, M.D. "Juvenile Secretory Carcinoma."

REfERENC!l.S; Akbllt M. RobinJOO C. Ab MA and Oodwia JT. SecrctOf')' Carc:iooma of lhc BreaJt in AdullS. l..igbt and P.:klctron Micrv>-v.,- ... Sludy

of'Th<oeC.scs with Review of the Lh...nue. o.-r 19U; $t(12):224S-22S<. Krausz T. Jenl<int D. G«lfttotl 0, Pollock OJ and Az:zoponto JG. Secntooy Clr<i,..... of the Ort11$1 ill Mlolu. Emphasis on la<e

Recum;nu and MetaS!asis. llwopothol 1989: 14(1):25-J6. Lamovec J and Bracko M. Sccret.ory Ca.rciooJDil of the Breast. Light MicroscopiCill, I mmwtobi~ochcmic::tltuw! Flow Cytomctnc Study.

Mod Potho/1994; 7(4):475-479. McOiviU RW Grid Stewart FW. Breast C11rcinoma in Children, JAMA 1966; 195{$):388-390.

CASE NO. 9, ACCESSION NO. 22958 JANUARY 1999

INLAND !Riverside/San Beml!Cdino} • Malignant melanoma {I); Mcta~latic breast carcinoma in eye (2): l'a,•c>r meu.,uuic neoplasm. prc>bablc poorly dilferentia!i:d odcnocarcinoct\8. Wculd wnfinn with IPX ( I); ConsiSlent \\1th metnstic breast carcinoma. Would r/o malignant melanoma (I)

BAKERSfiELD /Central V'alley Study Grouol • Diffuse I~ cciii)'ITtphc>ma ORANG£ • Mcta."atic c:urcinoma oonsistcnt with breast prim Ill)' MQNTEREY • MetaSUIIic carcinoma, possible melanoma BAY AREA • Mc1astatic adcnocnrcinoma from breast, poosibly lobulnr type (3) SANTA ROSA • Metastotic carcinoma from breast (3) LONG BEACH • Metastatic carcinoma to C)'e (6) SAN DfllGO INQypl Mcx!ical Cemcrl · Metastatic breast carcinoma ( 14) SACRAMENJO !llC!JAyjs) • Metastatic carcinoma

HAYWARD ISb Rose Hospital) • Meto.,tatic carcinoma (brea" fuvored over mciMomn) (6) NEVADA (Reno\ • Mctaslatic carcinoma "'!"Sistent with breast (2) TEXAS <Icxas J'c'Ch Regional Ac;u! Hhh Ctr} • MetasiJllic odcnoc:orcinoma, primnry brc<ISt NEBRASJ<A !Creighton tlnh•l • MetasU\tic breast carcinoma ILl. !NO IS fHj11<dnlc HosgjtaD • Metaswtic duetal carcinoma'~ melanoma (I); Malignont neq>lasm, ett~SW~ic

adcnocnrcinomu vs malignant melanoma ( I) MICHIGAN (Oakwood HospiU\Il • Malipm neq>lasrn, favor metastatic breast carcinoma MICHIGAN CAnn Arbor) · Ductal adcnocurcinoma with ocuroendocrinc difterentiation (4) FLORIDA !Tallahassee) • Mctaslatic ductal carcinoma ( 4)

FLORIDA !Orlando) · Metastatic adenoc3rcinoma, consistent v.ith breast primruy OHIO IMcCu!lougb-HvAA Memorial Hoopital} • Metastatic brea.1 cancer(? carcinoid vs carcinoma with endocrine

features)

K!lNTUCKY CBn0!1st Bospjta! E11\J) · Metastatic carcinoma, consistent with origin from brea" (2) !.O!IISIANA !Lcujsiana Univ M!d Qr) • Metastatic adenocarcinoma, posterior chamber eye NORTH CAROLINA <WNC Pathology Group\ • Consi!tcnt with mCUC<IIllic brtllSt <:Uttinoma (2); Adenocarcinoma

consistent with; need to r/o melanoma (I) MARYLAND !IV09dbinel • Papillary carcinoma (2) MMYLAND CNatjonal Naval Medical Center) • Meta.<Ulliccarcinoma. consistent with brea" primnry ( 14) WASHINGTON, D.C. (Walter Reedl • Metaslatic lobultlf carcinoma PllNNSYL\IANIA !Conemauoh Memorial Hospjtull - Mttasuuic breast can:inorna PENNSYLvANIA ffiB Gmupl • Metastatic carcinoma (primnry 7) PENNSYLVANIA Cl&hii!h Valley Hospital! - Fa,·or adenocarcinoma - Compnrc to brea" t• and immull<J6tains to rio

melanoma (I): Mc:taslllliccnrcinoma to choroid membrane (I) NEW YORK fNor!hportl • Metauatie breast carcinoma NEW JERSEY !Summit) • Metastulic breast carcinomu to anterior cltambcr of eye (3)

MASSACH!ISEJTS CBerJcshire Medical Center) • Mets breast carcinoma CONNECTICUT !Univ Cgnn H®hh Orl • Mcta."atic breast carcinomu AUSTRALIA !Svdneyl · Mctasta!ic carcinoma (melanoma to be excluded by HMIH5)

DIAGNOSIS: MET ASTATIC L. .RCINOMA TO EYE (CONSISTENT WITH BREAST ORJG IJII)

TXX310, M80106

RJ!J'ERENC!lS: RA Wfnis. 1br Spn:ad ofTumou~ in abc Hum~n Body. Meaast11ic Tumour ofThc fyes. Runcrwonh & Co ,..blishers. LTD Loodon.

Engl•nd. The C. V. Mosl>y Compeny. St Louis MO USA 1952: 296-l91.

CASE NO. 10, ACCESSION NO. 8340

IN!.ANQ CRjverside!San llc:mardinol • Lactllling adenoma (S)

BAKERSFIELD CCC!l[llll Yallev Study Grpup) · Lactaling ad<noma OBANGE · Lacta1ing adenoma MONTERI.W • l.aclalina adenoma BAY AREA • I..actruionul adenoma (3) SANTA ROSA • Lactation adenoma or ··pure" adenoma (3) LONG !lEACH • Laaating ada10111a (6)

SAN DIEGO <Naval Mcdjcal Ccruerl • l=atiog adenoma (14) SACRAMENTO (lJC Doyjsl • l..aeuning adenoma HAYWARD CSb Rose llospilall • l..aclalil>g adenoma (6) NEVA!)A CRcnol • l..acWiing adenoma (2) 'fEXAS ITcxas Tech Roajooa! Acad lil!h Ctrl • Laaalin& adenoma NEBRASKA CCrci!!hlon Univl · l..aaating adenoma J!.UNOIS !Hinsdale Ho.pilall . l..aciOiing adenoma MICHIGAN COal·woos! t!Clt!pilall • l..act•tional nodule MICHIGAN (Ann Arbor\ • Laaaling adenoma (4)

JANUARY 1999

FLORIDA ITal!ahassee) • Thbular adenoma with sca-e1cry change (I); Lactating adenoma (2) FLORIDA COrlandol • Lactating adenoma ofbrcas1 OHIO CMcCul!ough·Hylle Memorial ~lrunjJall . Laclating adenoma KENTUCKY CRaotisl tlo:mj!al Eas!l • I..actatingadcnomu(2) LOIUSlANNA ILO!Jisjanna S\P!e Uojv Mq! Or\ • Lactating adenoma NORDi CAROLINA IWNC Pathology Qroupl • l..aaating udCIIO!lla (4)

MARYLAND !Woodbine\ • l..aaating odenoma (2) MARYLAND <National Naval Medical Ct'PICfl • l.acluting udenoma (14) WASHINGTON D.C. CWu!tcr Reed\ • Laelating adenoma PENNSn.vANlA !Conemaugh Memoria) HospjtaJl · LactO!ing adenoma PENNSYLVANIA IBD Group) • Laaalin& adenoma PENNSYJ. V AN1A ILehjgb Volley Ho.<njJa!l • l.a<1ating adenoma (2) NF.W YORK CNorthoortl • Lactating adenoma NF.W JERSEY CSummill • Laclating adenoma (3) MASSACHUSETTS ffic:rllshire Medjcal Center\ • Lactating adenoma CQNNf£TICUI CUniv C9J1Q Hea!lh Crrl • l..aaating adenoma AUSTRALIA CSvdneyl • Laaaling adenoma

DIAGNOSIS: LACTATING ADENOMA. BREAST

T04000, M81400

REFERENCES; Gill AI. Slirman JA and Gordoa CE. Lllmlio& Adenomas orBr .. ._ Tu M<d J 19SJ; •9:23 1·234. Hertd BF. Zalcudclt C and Ktmi"'O RL. Or_, Ad-~ C••«r 1976; 37:2191·2905.