CALIFORNIA TUMOR TISSUE REGISTRY

"DIGESTIVE SYSTEM PATHOLOGY"

Study Cases, Subscription A

September 2006

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

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

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

E-mail: cttr@liokline.com

2

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 tumor-like conditions.

Objectives: The participant will be able to recognize morphologic features of a variety of benign

and malignant neoplasms and tumor-like conditions and relate those proeesses to pertinent references in the medicalliterantre.

Educational methods and media: Review of representative glass slides with associated histories. Feedback on consensus diagnoses .from participating patbplogists. Ustiog of selected references from the medical literature.

Principal facultv: Donald R. Chase, MD

CME Credit: Lorna Linda University School of Medicine designates thls 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 subscription year only.

Accreditation: Lorna Linda University School of Medicine .is accredited by the Accreditation

Counci.l for Continuing Medical Education (ACCM'E) to sponsor continuing medical educatipn for physicians.

Study Cases, September 2006, Subscription A

Contributor: Philip Robinson, M.D. Case No. 1 - September 2006 Boynton Beach, FL

Tissue from: Small Intestine Accession #29217

Clinical Abstract: Tllis 76 year old woman pre$ented with abdominal pain and was found to have cholelithiasis

and a small bowel intussusception.

Gross Pathology: An 18 em long segment of small bowel inctuded a I 0 em long intussusception. At the leading

edge of the intussusception was a 4 em diameter submucosal mass with overlying erosion of the mucosa. The cut surfac-e of the mass was homogeneous tan-brown and extended to the underlying mUSGularis propria.

SPECIAL STUDIES: Spindle cells were negative for pankeratin, S I 00, desrnin and CD34.

Contributor: James McCusker, M.D. Case No. 2 - September 2006 Woodland, CA

Tissue from: Sigmoid colon Accession #30166

Clinical Abstract: A 74 year old woman had a portion of her sigmoid colon resected at the time of a ventral hernia

repair.

Gross Pathology: A 12 em long portion of colon contained two polyps and multiple diverticula. The polyps were

I .2 x 0. 7 em and l x 0.8 em in diameter. The cut surfaces were cystic, filled with gelatinous material, as were several foci in the undei'l ying subperito.neal tissues.

Study Cases, September 2006, Subscription A 3

Contributor: LLU Pathology Group Gdc) Lorna Linda,. CA

Tissue from: Cecum

Clinical Abstract:

Case No. 3 - September 2006

Accession #29734

An 80 year old man with cirrhosis underwent a right hemicolectomy.

Gross Pathology: Adjacent to the ilececal valve in this 16 em long segment of Colon and terminal ileum was a 6.(

x 5.0 x 2.5 cni red-broWn mass with heaped up edges. '

Contributor: James Anhalt, M.D. Case No. 4 - September 2006 Bakersfield, CA

Tissue from: Small bowel Accession #29445

Clinical Abstract: A 57 year old man presented with symptoms of bowel obstruction and underwent segmental

.resection of his small intestine.

Gross Pathology: , A 10 em long segment of small intestine showed a 2 em long region of narrowing by a

submucosal nodular thickening. The cut surface was golden-yellow and fibrotic.

4 Study Cases, September 2006, Subscription A

Contributor: LLU Pathology Group (mrd) Loma Linda, CA

Tissue from: Gastric omentum

Clinical Abstract:

Case No. S - September2006

Accession #29093

An 81 year old man complained of increasing abdominal girth. CT scan showed a large abdominal mass in the left upper quadra.nt, abutting and displacing the stomach, left lateral segment of liver, inferior vena cava and spleen. The mass was resected along with a partial gastrectomy and partial resection of the liver.

Gross Pathology: The 3450 gram specimen included a 30 x 26 x 12 em, multinodular, partially

cystic soft tissue mass attached to a 7 em long portion of gastric wall. The cut surface was yellow-white with multiple areas of cystic degeneration and hemorrhage.

Special Studies: Positive: CD34, smooth muscle actin Negative: Desmin, SlOO

Contributor. Garib, Albert, M.D. Case IHi September 2006

Tissue from: Stomach ~ccessioo #30125 (originally #30109)

Note: Corrected History: Original mailing inadvertently included the wrong clinical data for case 6. Please replace this page with the one that was originally sent to you.

Clinical Abstract: A 75-year-old male resident of a care facility was brought in the ER for

abdominal discomfort ,weakness and hypoglycemia. Workup revealed that the patient had pancreatitis. He had had some upper abdominal gastric surgery previously. A re­excisional biopsy was performed.

Gross Pathology: The 25 gram oval, velvet, pink specimen measured 5.5 x 4.0 x 4.0 em. Much of

the structure was covered with a pink, smooth membrane. There were two sutures present that marked the margins of a resection on the pink membrane.

Special studies: Positive: Negative:

CD34, CDll7 SIOO

Contributor: LLU Pathology Group (kt) Loma Linda, CA

Tissue from: Gallbladder & L iver

Clin:ical Abstract:

Case No. 7 - September 2006

Accession #29340 & TR54-6038

A 57 year old woman underwent a liver transplant for advanced cirrhosis associated with alcoholic liver disease.

A 61 year old man had a known lung mass. He had a rapid downhill course and died.

Gross Pathology: The I ,350 gram, 24.0 x 14.5 x 8.5 em multinodular l iver had an attached 9.0 x 5.5 x 2.5 em

gallbladder with a single 2.5 em smooth black stone. Within the wall ofthe gallbladder was a 2.2 x 1.5 x 1.1 em firm mass. Grossly, llie overlying mucosa· was intact.

Autopsy snowed a 4 em diameter mass occluding th.e rigbt mainstem bronchus and numerous nodules involving the liver.

Special Stains : Variably positive: Cytokeratin cocktail, CAM 5.2, chromogranin Strongly positive: Synaptophysin, NSE

Contributor: Peter Morris, M.D. Case No. 8 - September 2006 Santa Barbara, CA

Tissue from: Gallbladder Accession #29440

Clinical Abstract: During work-up for gallstone pancreatitis, this 72 year old woman was tound on CT to have a

polypoid mass within he.r gallbladder.

Gross Pathology: The 64 gram, 8.5 x 4.5 x 4.5 em gallbladder was filled by a 7.5 x 3.5 x 3.0 em red-tan, focally

hemorrhagic exophytic mass attached to the wall by a 5.5 em wide base. Cut sections show the mass to penetrate into the gallbladder wall to within 0.1 em of the serosal surface and liver bed margins.

6 Study Cases, September 2006, Subscription A

Contributor: John McGill, M.D. Case No. 9 - September 2006 Pasadena, CA

Tissue from: Pancreas Accession #30146

Clinical Abstract: After compl~ning of persistent abdominal pain, this 62 year old woman was found to have a

large mass involving the body and tail of her pancreas.

Gross Pathology: The distal pancreas and attached spleen weighed 422 grams. A 12 .5 x 7.2 x 6.5 em mass

replaced most of the resected pancreas. The cut surface showed multiple small cysts, devoid of papillations .and filled with clear fluid. There were occasional foci of hemorrhage and greater than half of the mass was calcified .

Contributor: Faramarz Azizi, M.D. Case No. 10 - September 2006 Fontana, CA

Tissue from: Pancreas Accession #29954

Clinical Abstract: After experiencing two episodes of peri-uipbilical pain radiating to the right upper quadrant,

this 33 year woman presented for work-up. An ultrasound of the abdomen showed a 5.1 x 4.8 em solid mass in the pancreas. CT scan showed a 7 x 5 em heterogeneous mass, predominantly solid, in the body and tail of the pancreas. She underwent a distal pancreatectomy.

Gross Pathology: The21 0 gram, !52 x 7.3 x 6.5 em distal pancreas contained a 6.5 x 6.0 x 5.2 em hemorrhagic,

variegated gray-white mass.

Special Studies: Negative: pancytokeratiil, chromogranin, synaptophysin, glucagon, insulin

Study Cases, September 2006, Subscription A

CALIFORNIA TUMOR TISSUE REGISTRY

"DIGESTIVE SYSTEM PATHOLOGY"

Minutes - Subscription A

September, 2006

SUGGESTED READING (General TopiC$ from Recent Literature):

MJ. Immunohistochemical Algorithm To Facilitate Diagnosis And Sub typing Of Rhabdomyosarcoma: The Children's Oncology {)roup Experience. Morotti RA, Nicol KK, et al. Am J Surg Pathol, 2006 Aug; 30:962-8.

Gastric Large Celt Neuro-endocrine Carcinomas: A Distinct Clinicopathologic Entity. Jiang S-X, Mikam.i T, et at. Am J Surg Pathol, 2006 Aug; 30:945-53.

"Lobular Neoplasia Ill Breast Core Needle Biopsy Specimens Is Associated With A Low Risk Of Ductal Carcinoma In­Situ Or Invasive Carcinoma On Subsequent Excision. Renshaw AA, Derhagopian RP, et at. Am J Clin Pathol, 2006 Aug; 126:310-13.

Guidelines For Colonoscopy Surveillance After Cancer Resection: A Consensus Update By The American Cancer Society And U.S. Multi-Society Task Force On Colorectal Cancer. Rex OK, Kahi CJ, Levin B, et al: CA Cancer J Clin, 2006; 56:160-7.

A Monotonous Population Of Elongated Celts (MPECs) In Colorectal Adenoma Indicates A High Risk Of Metacbronous Cancer. Soreide K, Buter TCE, Janssen EAM, et al: Am J Surg Pathol, 2006 Sep; 30(9): 1120· 29

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, Californi.a 92350

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

E-mail: cttr@linkline.com Web site & Case of the Month: \VWIV.cttr.org

Case 1:

Case 2:

Case3:

Case 4:

Case 5:

Case 6:

Case 7:

Case 8:

Case 9:

FILE DIAGNOSES

(Preferably submitted·on website at www.ctJr.org. Click "subs.criptions", !hen submit an.~wers".)

CTTR Subscription A

Inflammatory fibroid polyp, small intestine T-64000, M-76830

Endometriosis of colon (transmural), sigmoid colon T-67700, M-76500

September, 2006

Villous adenoma with foci of high-grade dysplasia ("intramucosal carcinoma") T-67100, M-826111, M-74000

Signet-ring adenocarcinoma, small intestine T-64000, M-84903

Gastrointestinal stromal tumor, gastric omentum T-63850, M-88903

Gastrointestinal stromal tumor (GIST), stomach T-63000, M-88903

Small cell carcinoma/neuroendocrine carcinoma, gaUbladder T-57000, M-8041/3

Adenoca.rcinoma with papillary features, gaUbladder T -57000, M-8260/3

Serous microcystic adenoma, pancreas T-59000, M-8140/0

Case 10:

2

Solid pseudopapillary neoplasm, pancreas T-59000, M-80001

CITR., September, 2006 "'Minutes" (Subseriprion A)

Case No. 1 - Accession No. 29217 September, 2006

Baldwjn Parle CKaj;;g Pgm3JJC!]tel - Inflammatory myofibroblastic rumor {4)

fgnrana (J(ajaq Permanentel · Inflammatory llbroid tumor ~ - Inflammatory fibroid polyp Gtanada Hms - lnflamma~ory pseudotumor Hayward tHgywnrrl-frqjmontl - lntlammo.t·ary fibroid polyp La Jolla !Scrlnru Health! - Inflammatory fibroid polyp La Jolla CScrjnns Clinic Hematooatbology fc:Uowsbjp) - Inflammatory fibroid polyp Lorna Ljndft (l .~ma Linda Universirv Residents) - M&1ocytosis (systemic) l.Dn• Beach «Y A !.ong Beach Hcal!heare Svsu:ml - Inflammatory psC\Idotumor (myofibroblastic tumor); Inflammatory fibroid

polyp (I) Mooten::y !Communjty Hospital of !he Mooten::y Peninsula! - lnflammMory myofibroblastic rumor vs inflammatory fibroid polyp Monten::y Parle CGarfield Medical Canq) - Low-grade GIST Oaklagd !Alnmeda Coun'Y Medical Center! - Inflammatory fibroid polyp Orunge !Omgsc Coumy Medical Group) - Inflammatory myofibroblastic rumor Orange CUniypcsjty of California lnrinc) - lnfla.mmotory fibroid polyp Orange Coynty CKnjssr Pennanentel - lntlommatory fibroid polyp Oxnard 1St Johg's Rcaionol Medical Comer) - Inflammatory fibroid polyp (4) Sru:nuncn1o CU. C. l)ayjs Rcsjdeutsl - lnflnmmotory myofibroblasric rumor Sag pjeoo !Alvarado Pathology Associates\ - lnOammatory fibroid polyp San Diego !Naval Medical Center! - Inflammatory fibroid polyp San Diego CUCSP Medical Cenrerl - Inflammatory fibroid polyp San franci!CO !San Francjw General HO!iJliu!ll - Inflammatory fibroid polyp Sallie Barba!n - Inflammatory pSC\Idotumor Santa Rosa <Santa Rosa Msmqrial Hospjtall . Inflammatory pseudorumor (3) Wopdlnod Hills CKaiser Permanents Mesfjcol Center> • Lnflammatory fibroid polyp Woodlngd Jijlls !Suda's Soldiers) - Inflammatory myofibroblastic tumor Arkftn!JI.< 0 /AMSl - lnflalDmatoryfibroid polyp, small inresu'ne Florida !Amedpqtbl - Oasrrointestinal stromal tumor Florida (Bnptisr Hospjyl Peo.aoola) - Inflammatory fibroid polyp (3), (eosinophilic granulomatous polyp)(!) Florida Uepksqn Memorial Ho:soitall · Inflammatory fibroid polyp Floris!a ITallahOSS« Parhology Associates) - Inflammatory fibroid polyp Floris!a <Wimer Haven Hospi;aD - Grnnularion riS$ue (2) Uljogj, llgypln Universitv Medical Cenrerl .. Inflammatory fibroid polyp Illinois fMncNeu! Memorial Homira!\ - OIST, benign (I); Fibromatosis vs. GIST, do CDI17 srain (I) !ndiann fHownal Resional Medical Center) - Inflammatory librous polyp Kansas lPhy.sjcinns Refqence t.aborruooo . Inflammatory fibroid polyp Kentucky CUnjycQjty ofLoujsyjUe.) - lnOammnl'Ory fibroid polyp Loui~iana ll.oujsiano State lJnjyeJ'$itv Health Scjence Center) · Inflammatory fibroid polyp lnyjfijML Slidcl! a Inflammatory fibroid tumor Maryland <Npnhwest Hosoita! Center! - Inflammatory fibroid polyp Maryland CUnjvmi'Y of Maryland! - Inflammatory fibroid polyp ~arv!Md <SiJm Springs) - Gasuointestit~a1 strOma] tumor Massachu1em <Bgkzhire Medical Center) · I. Inflammatory pseudotumor. 2. Inflammatory myofibroblascie tumor Ma.1sachU!eUs (Tufts-New England Medical Ceo!Crl • [nf!ammatory pscudotumor Ma.c;5>ochu!ent. Pc;abody · Gastrointestinal strOmal tumor, small intestine MichigAn fOokwood Howitllll - lnfl•mmatory fibroid polyp (2). inflammatory pstudotumor(l) Mjchjgan 1St Jmeph's Mercy HosoitaD • Inflammatory fibroid polyp MjnnS{iota (fajrview Ridges HospjtaD .. Inflammatory fibroid polyp Montana Missoula - Inflammatory fibroid polyp Nc!n.<ka CCrcjghton UnjversiM - ln601Dmatory fibroid polyp New York f!.ons I< land Jewish Medical Center> - Inflammatory polyp

CITR, Seprembcr, 2006 ''Minures" (Subscription A) 3

New Ymt <Nasglu Univmjtv McdjccpJ Cm!q l - Vascular leiomyoma Ns;w York CStg Uitiyersi'Y of New Voris at Stony Brpokl - InOammtto:y fibrous tumor New Xor!fCSUNX Do-..1JS!!~ RqjdcntiJ • lnJiammatof)' fibroid polyp Nonb Carolina fMoon!l!in An;n PDtbologyl - lnflrunmatOf)' fibroid polyp (3) Nonh Carolina (pathologim M!!djcal !.ab9r•toryl - lnflammatof)' myofibroblasric tumor (!); lnflnmmntory fibroid polyp(!) Psnn$ylyp,njo CI?rexel Uniymjrv Collcye gfMsdjcjoe) - (nflammatory myofibroblasric rumor Pcnn'>'lvngjg (Lehigh Valley Hrn;nita!) - GIST Pennsylvania CMt _ Njwmy Mcdjenl Ccpter) - Inflammatory myofibroblnstic 1umo:r. small bowel Pq msylvanjo CPennsylyaojo Hg:mj!ol Residents) - Inflammatory polyp IcxQS l!.ackland AFB\ - Inflammatory fibroid polyp TsxM CMcthodjst Hospital\ - Inflammatory fibroid polyp Th'OC <Sgnt & White Memnrial HOFpitaJl ~ Inflammatory fibroid polyp Tens. Lubbgck - Gastrointe:Slin.al scromaJ tumor

WCS! yjrgjnia ((jmrobrig Valley M!!dical Center) • Inflammatory fibroid polyp Weg Virginia C\Vetzel Coupry Ho:mjtall - Inflammatory fibroid polyp Wjsconsjn {Meriter Pathology\ - In flammatory fibroid poi1P Austrplip <Oueemland Pathology Gmypl - Eosinophilic pseudouamour Australia fRoya.t Hobart HospilQ!) - Inflammatory fibroid polyp Ay!i\rnlj• fRoval Prince Alfred Ho<pholl - [nflammatory fibroid polyp Auwlia !Suml'lln Njoolajdq Po!hologyl - Inflammatory fibroid polyp Bmzi! C!.aboratorio AnBtomja PatolotjCQ E Citologia} • Inflammatory fibroid polyp, small intestine CanD4a !Pasoua Hosnitall • lnflammatOf)' fibroid polyp C.!Qada Olnjymity Hospital ofSbcr!xpokel - Thmour, bemangiopcriC)"oma-likc Gqmanv lln<tirut fur Pathok>gie UKEl - lnflammatOf)' fibroid polyp Hong Kcmg (pamela Youde Ne£bmglg EMJqp Homitall - Inflammatory fibroid polyp lr<:lqpd CKcrry Qmeral Hnspitall - Inflammatory fibroid polyp Jnnon lKvo to Univmjty Hnspitall .. Jnflammatory fibroid polyp Orono !Khoula Hospilnll - lnflnmmntory fibroid polyp • Pumo Rico <Universitv ofPuqtn Ricpl - Inflammatory fibrous polyp Oa!Ar !Hamad Medical Corooradon) - [nflammatory fibroid polyp Saudi Arpbjo CKjog Fohad National Guard Homitall - lnflammalory fibroid polyp Saudi Arabia IMCID - Inflammatory fibroid polyp Sjnoopore CKK W9mm's & Cbildrm's Hospital\ • Inflammatory fibroid polyp The NO(herlands Am§!elyscn • GastrOintestirtaJ strontal tumor (GISi) !lnjt!!d Kingdom COxfon! Study Gmyol • Small intestine- Inflammatory fibroid polyp

Ca~e 1 -Diagnosis: Inflammatory fibroid polyp, small intestine

T-64000, M-76830

Ca!\e I - References: Santos Gda C, Alves VA, Wakamatsu A, Zucoloto S: Inflammatory Fibroid Polyp: An Immunohistochemical Study. Arq

Gastroenterol, 2004 Apr-Jun: 41(2):104-7. Ozolek JA, Sasatonri E, Swa!slcy PA, et ol: Inflammatory Fibroid Polyps Ofibe<lastrointestinal Tract: Clinical, Pathologic, And

Molecular Cbaracterisrles. Appl lmmunohi.otcx;hem Mol Morpho/, 2004 Mar; 12(1);59-66. Makhlouf HR, Sobin LH: Innammotof)' Myofibroblastic Tumors (Inflammatory Pseudotumors) Of the Gastrointestinal T<acc How

Closely Are They Related To lnfl•mm~tQty Fibroid Polyps? H11m Pathol, 2002 Mar; 33 (3):307-1 S. Do ln Plaza R, Picardo Al, Cubcrcs R, ct a!: Innammatof)' Fibroid Polyps Of the Large Intestine. Dig Dis Sci, 1999 Sep;

44(9):1810-6.

4

Case No. 2 - Accession No. 30166 September, 2006

Ba!dwjn P&k <Koj:ser Pennanente> - Adenocarcinoma, mucinous type (1); Mucinous adenocarcinoma (l)~ Invasive well­differentiated mucinous adenocarcinoma of colon (adenoma malignum) (I); Woll-differemiatcd adenocarcinoma, mucin producing (I)

Footona <Kajsq Pqmanentel - Endometriosis (jlendale • Endosalpingiosislendomeoiosis GrAnac!a Hills • Well-differentiated adenocarcinoma Hamrd fHayward-ErpgnwQ - Carcinoma in a polyp La Jolla <Scriom Hea)thl • Endometriosis !.a JolLa IScripos Cljnjc Hemampad!o!ogy feflpWl\hjpl • Endometriosis (6); Mullerian ncoplasm, l\vS {I)

Loma Linda ilpma I inda Universjry Bs;sjdmts) - Colitis cystica profunda Lpog Beach NA Long Beach Heahharo Sy:..1eml • Papillary serous odenocarcinomp arising in endometriosis; Mucin-producing

papillary adenocarcinoma ( I) Momqey <Communjry Hospital of the Monterev Peninsula> - Endometriosis Monuasy Pads ({jarfie!d Medical Ccmcrl . Mucinous cystic borderline tumo< implants Oakland CA!amglq Counrv Medical C<;Ofsrl - Colitis cystica profunda Oronge COrange County Medjcal Group) . Colitis cySticn profunda Onwge CUnjycrsjw pfCalifomia Irvine> - Meta.stat'ic adenocarcinoma, probably from endometrium Orange County CKaj:;er Pennanente> · Metastatic ovarian carcinoma OxgM! CSL John"s Regional Mediea) Center) • Mucinous adenocarcinoma (I); Inverted villoglandular polyp (2), displaced

epitbelium (I); Inverted villous polyp (I) Sacrumcnto ru.c. Qayjs Residents) .. Endosalpingiosis San Qjcgo CAJvaradq Pathology Assgcinrcs> - Colitis cystica profunda San Dleoo CNawl Medical Center) • I. Polypoid endometriosis; 2. Florid cystic endosalpingiosis Son Diego IUCSD Ms:<fisal Center\ • Old endometriosis San Emncisco !Sqn f!I!Qcjsoo Geneml t!ospitall • Atypical endosalpingiosis (borderline PST) Santa BnrbAra - Adenocarcinoma arising in polyp

Santo Rosa fSM!.A Rosa Memorial Ho>'Pital> - Jnflammatory J'olyp, NOS ( 1 ); Reactive adeaom.atous polyp with possible associated ovarian cyst or endomelriosis (I); Colitis cystica profunda (I )

Woodland Hills (Knjw Pqmanerue Medical Cmtsrl .. Endomeoiosis Woo4Jand Hills !Suda'< So!dj!lr1!) - E.ndomeoiosislendosalpingiosis Arkansas OJAMSl ~ Endometrioma, sigmoid colon florida CAmcQpathl .. Mucinous adenocarcinoma Florida £Baptist Hpsnjtal Pensacola) .. Endometriosis (3)

F!Qrida IJ"""wo Memorial Hospital\ • Endosalpingiosis Florida ITallaba.sse Pathology Associ•Jal - Col iris cystica profunda; Inflammatory myoglandular polyp floddo <Winter Hoven Hosnitall Papillary mucinous adenocan:inoma, metnstntic (I); Mota.stntic papillary mucinous

adenoc:arcinomo (I) rmpojs <Loyola Uojyec;ity Medical CentW - Papillary adenocarcinoma in endometriosis lllinoi& (MecNea! Memorial HmjJJ!l • Adenocarcinoid (I); Adenocarcinoma, rio et~dometria! origin (I) IndjMa <Hmyyd Regjonal Medical Centql - Mucinous adenocarcinoma K@UBM CPhvsiciMs Refqence Laborotoryl - Endometriosis Ken lucky <Universjty of Ip ujsvil1e) ~ Mullcrianosis vs. colitis cysdca profunda loyjsjMa <louisiana Srarc Univensitv Health Science Cpptql - Colitis cystica profunda LoujsjMa Slidell · Juvenile (retention) polyp

M)l!)!land CNgrthwt;~r Hospital Center\ • Cystitis cystica profunda Mmland (lfujyernjry ofMarylandl • Wcll-differi!l1tiared adenocarcinoma arising from endometriosis MorviMd <Silver Springs) - Colonic adenocarcinoma Mogac.husen:s ffietk!!hire Medical Cemm .. Endometriosis M!l'S<huserts ITuftt..New England Ms;djcal Ccmql • Colitis cyslica pro!Unda Ma.<wchusetts. PeabQdy • Hyperplastic polyps, diverticulosis Mjchi•an (Oakwood HospjJ!lll · Mucinous carcinoma(!); Juvenile polyps (1) Mjebjgan (St Joseph's Mercy Hosnjtal) .. Adenocarcinoma arising in polyp

CITR. Scprcmhcl-, 2006 "'MiJ>JIC$" (Subocripljoo A) s

MjoOf!3oJa lfairview Ridges HosnjtaD .. Endometriosis wilh mucinous differcntiation!M.ullcrianosis Montana. Mi<SOula • Colitis cystica profunda Neb!\<ka !Creiohton UniYSl!liM • Endomelriosis with focal Uypia New York fLQng Island Jewi-sh MosJjqll Ccnsql - Mcsastatic endometrial carcinoma

New 'fork !Nassau Univemty Mslical Ccntql • Endomariosis with focal hyperplasia, colon New York CState UniversirvofNew ygrt at Stony Bmokl - Polypoid endometriosis

New York !SUNY Downstate Retiden~<l • Flat serrated adenoma and colitis eysrica profunda "'' Scmotcd adenoma and hyperplastic polyp with invasion

North Comljna <Mountain Arua Potbglogyl · Adc"lloearcinomo (2); Coli lis cystica profunda/prolapse (I) Ngrth Carolina (palhologisis Medico) Lnbgratorvl • Endometriosis (J); 'Veil-differentiated adenocarcinoma ( I) Objo IMcCullough-Hvde Mernpriel Ho<pju!ll . Endosalpingiosis Pennsvlyania Wrsxel t lnjyersjtv Col legs of MStdjcinel - Adenocarcinoma (moderately differenriated) Psontylyania Cl.sbigh Valley Homira!) - Juvenile polyp Psnnsvlyania fMt Njt!IJw Medjgl Centcrl - Endomcttiosis. sigmoid colon Pcnnrtlyania fPennsvlvaniq Homjtpl RgjdCJ!tsl - Neoplasia arising from endometriosis Texas llacklaod AFBl • Colitis eysliea profunda Tsxa1 fMethodist Hosnjml) - Modenucly·differentiated adenocarcinoma Tcxqs <Scott & White Mem<lrial Hosnjcan .. Colitis cysrica profunda Texos. !.uhbock . Adenocarcinoma arising from a polyp We.5] Vicgjoja <Ga;enbriq Valley Medical Cquerl -- Adenocarcinoma - mucous production We:g Virgjnja (Wctzcl Counry Hospjtall - Adenocarcinoma invading through the muscularis propria into the serosa (T3) Wjgnsjn (Meriler Pathology) - Endometriosis AumaUa (Queensland Pathology Group) • Colitis cysrica profunda Aw•uplia CRonJ Hoban HMpjJIIl .. Endometriosis AusrraHa <Roval Prince Alfred H(')§nitall .. Endometriosis Au~ttaliA (Sullivan Njcnla jde.~ Patbolggyl - Endometriosis (atrOphlc)IEndooervicosis

Bmzjl CLpbgmcorio Anatomja Pnrologjeg E Cjtglggjal - Prolapse polyp associated with colitis cystica profunda and divenicular diseWie ( l ); Endomeoiosis ( l)

Canada Q>asqua HosoitaJ) - Endometriosis with hyperplaSia Canndn (Unjvep;itv HQWital of SherbmQkel .. Endometriosis Oennnny liMritut fUr Patbologjo UKEl .. Adenocarcinoma (endomctrioid adenocarcinoma, arising from endometriosis) Hong Kong <Pamela Youdc Neth91Qie EMtqn Hospjtall · Cystitis cystica profundus. likely relaied tO hernia repair !p;lMd IKeny General Hospital\ . Enc!omettiosis 1!1!!11! IKmo Uni...-sitv HO<pitall • Muoosal prolapse Oman IKhpu!a Ho:mital\ · I. Ulunated adenoma with adenomucinosis. 2. Adenocalcinoma. Puerto Rjco <University of Pueap Rjco) .. Serous-mucinous rumor implants/Endometriosis Oarar (Hamad Medjcal Corpomrionl • Colitis cystic profunda Saudj Anlbja <King Fabad Natjonol Qyprd Hospitall - Colitis cystico profunda and serrated adenomn Saydj Arabia IMCHl • Adenoeercinomo Stngooore!KK Women's & Children's HpspjtaQ .. Tubular adenoma wilh possible involvement of diverticula and pseudo-invasion The NetherJands. Amstelveen .. Well .. diffcrentiated mucinous adet~ocarcinoma Units! Kjnsdom (Oxford Study Qmypl • Colon- Favor endomettio&is

c.,, 2 • Diagnosis: Endometriosis or colon (transmural), sigmoid colon

T-67700, ~-76500

Case 2 - References: Sciumc C, Gtn~ci G, Piscllo F, ct al: Intestinal Endometriosis: An Obscure Couse of Cyclic Rectal Bleeding. Ann Ita/ Chir, 2004

May-Jun; 75(3):379-84. Kovalllll'is A, Kohler C, Kuhnc-Heid R, Schneider A; Histopathological Extent Of Rectal Invesion By Roctovnginal Endomeoiosis.

H11m Reprod, 2003 Jun; 18(6):1323-7. Dcval 8 , Rafii A, Felce Dachez M, e1 a!: Sigmoid Endomariosis In A Post-Menopausal Woman. Am J Obsttt Gyffl!aJI, 2002 Dec;

187(6):liD-5.

6 CTTR, S<ptemb<r, 2006 "Minutes" (Subscription A)

Hoong CD, Boettcher AK, Jessurun J,., al: An Unusual Rectosigmoid Moss: Endomcmoid Adenocarcinoma Arising In Colonic Endomeoiosis: Case Rc:pon And Literarun: Review. American Surgeon, 2005; 71(8):694-7.

DimO<Jiis P, Koutroubalds IE, Tzardi M, et al: A Case Of Sigmoid Endomeoiosis Difficuh To Differentiate From Colon Conca. BMC Gastroenrerolog;y, 2003; 3:18.

Parker RL, Dadmanesh F, Young RH, Clement PB: Polypoid Endometriosis: A Clinicopathologic Analysis Of24 Cases And A Review Of The Literature. Am J Surg Pot hoi. 2004; 28(3):285-97.

Case No. 3 - Accession No. 29734 September, 2006

Baldwin Pari< CKaiscx PqmMentel - Tubulovillous adenoma ( I); Villous adenoma (2); Villous adenoma with focal hig)l-aradc dysplasia (I)

Fon110a (Kaiser Permano:nrel - Tubular adenoma with big)l-grade dysplasia ~ - Villous adenoma \m1pqda Hj!ls - Pcutz-Jehger polyp Hsywnrd <Hayward-freemontl ~ Vlllous adenoma l.a Jnl!aiScripps Heahbl - Tubulovillous adenoma La JollaiSctiops Clinic Hcmatooatho!ogy fcllow$iol - Villous adenoma Lomo Linda Cloma Lindo Unlymiry Resi®nttl - Villous adenoma Lons Bcacb CV A Lono Beach Healthcare Syscem) • Villous adenoma with focal high·l:'1'dt dysplasia Maorerey CCommunjty Hn:mital of the Monterey Peninsula) • Villous adenoma with possibl-e focal high-Jl'ode dysplasia Mopten;y Park (Garfield Medical Center) - Villous adenoma with moderate dysplasia Oa!slaod (Alameda Counrv Medical Centorl • Villous adenoma O!lnae IQumge Cougrv MC!!ical Group) - Villous adenoma Oranae CUniversirv ofC,Jjfomia Irvine) .. Villous adenoma Orange Counrv CKaiser Pmn!lJlentel . Adenocarcinoma in villotubular adenoma Oxnqrd CSI John'< Regiggal Medjcal Comer) • Villous adenQil\3 (4) Sacmmcnto flJ C. Davis R((§jdsptsl - l'ubulovillous adenoma with severe dysplasia (in·silu carcinoma) San Qh;gg CAJyara_do Prubology AW>!jjotesl . lntramuoosa) adenocarcinoma in an adenomatous pOlyp San Piego CNaval Me4ieal Centerl - Tubulovillous adenoma with high-grade dysplasia Sag Pievo CUCSD M¢jg!l Center) - TubuloV11IO<Js adenoma San Frppcjsco <San Francj3co General Hospi(Ril · TubuloviliOU$ adenoma with severe utypia Sanm Barharn · Adenoco.rcinoma in-situ arisins in dyspl&-tic villous adenoma SantA Rosa CSanra. Rosa Memorial Ho~niw.D - Villous adenoma (3) Woodl3ad HW~ fKaise:r Pqmanence Medical Center) - Villous adenoma with carcinoma in-situ Woodland Hms ISuda's Soldier$) - Villous adenoma with focal hi8)>-grode dysplasia ArlsMsa< CUAMSl - Tubulovillous ad..,oma, cecum Floridn (Ameripatbl - Tubulovillous adenoma with CIS Florida <Baptist Hosnitul pensncolal • Serrntcd adenoma (3) f lorida CJnckson Memorial Ho~pitai> • Villous adenoma florida <Tallahassee PaJbolgoy A..OOatesl - Villous adenoma with severe dysplasia F!orid.a !Wjgrer Haven HomiJall - Adenocarcinoma in-situ within villous adCDDma (I); Adenocarcinoma in-siru in adenomatous

villous pol}'P (I) Uljopjs Cloyola Uniymity Medical Centerl • Villous adenoma with high-grade dy$plasia l!ljnoj• (MacNeal Memorial H~ita!) - Villous adenoma with bigh·grade dysplasia (I); Scmtted adenomn (I) Indiana (Howard Regjopol Medical Center) - Villous adenoma Kansas IPhvsicians Refqonce !.aboratorvl - Villous adenoma with no hig)l-grade dysplasia present Kenrucky Olnjvep!iJY of Loujsyj!lel - Tubulovillous adenoma with hig)l-grode dysplasialintramucosal carcinoma Louisjana<Loujsiana Swe Ugiymjty Health Scimce Centql - Villous adenoma Lnuisinoa Sljdell - Villous admoma with CIS M!l!yland INonhwest Ho.<nital Cegtql - Tubulovi!lous adenomn with high-grade dysplasia Maryland CUnivmiiY ofMarvlaudl - T-V odenomawith focalli·O dySJ)Iasia

C1TR. Septcmbcs. 2006 "MiiiUic$" (Subscription A) 7

MNYIMd !SHyer Springs) • Tubulovillous adenoma ML<ucby<eccs CBeticsrure Modica! Ccntql • I. Adenocarcinoma in-sit\1; 2. Villous adenoma widt high-grede dysplasia Ma.•ucby<e~L• <Tufts-New Enclaru! Modica! Csmql - Villog!andular adenoma widt h igh-grade dysplasia MosasbuWtt Pgtbodv - Villous adenoma. c:ecum Mlchjgan !Oaltwgod H!!Sj)jm!l - Villous adenoma (2)

Mjcbjw CSt Joseph's Mercy Ho:mjtp!l - Adenoma

Mjnnmoto {fai.-view Ridges Hospital\ - Villous adenoma, with area of high-grade dysplasia Mnotnno Mjswula • Villous adenoma

Ncbmska <Cn;jgbtoo [Jnivezsi[\1) - ln-siru carcinoma of villous adenoma New Mgxico CL.a llniyqsjdad De Nueyg Mexicol - Tubulovillous adcnomo with focal carcinoma in-situ New Yods CLong Island Jcwitb Medical Center) - Villous adenoma New 'lode INa.<Sau UnivlniN Modjgl Cquql - Villous adenoma New yorts CSlftte Universitv ofNc;w York" Stpnv Brt)()t;l - Villous adenoma

New Yotk !SUNY Downsmte ResidcnW - Villous adenoma widt severe dysplasia, cannot rule out invasion Nonb Coroljnn {Mountain Area Pptholgavl - Tubulovillous adenoma (3)

North Cnmljga IPatbo!oxjst< Mesljca! Laboratory) • Villous adenoma(2), with high-grade dysplasia ( I) Objn lMc;CuiJough-Hydc Memorial HospitaD • Villous adenoma with ttdcnocnrcinoma in-situ PeonsylyMia (Drexel UniycrsjN C.ollcgeof Medldnel - ViHous adenoma with high~gradedysplasia (carcinoma in-situ) Pennsylyania (Lehigh Valley Hospital\ • Adenoma Pennsy!yanja (Mt Nittanv Medical Centerl - Sessi1e serrated adenoma. cecum PqmsyJnni• {Pennsv1vania Hospital Rslidcnp\ - Villous adenoma Texu CJ,.oskiMd AFB) - Villous adenoma

Texu lMg,hodj;;t Rospjta)l - Villous adenoma

Texas <Scott & White Mcmorjol Hospjtoll • Villous adenoma Tex!).l, Lubbock - Severe dysplasio in villous polyp West yjrsjnia <Greenbrier Valley Medical Center> - Vi11ous adenoma West Yirginja fWet7.el Countv Hospitp!) • Villous adenoma WjsooMjn !Msritt;t Pathology) - Villous adenoma with high-grade dyspiBsia Au~rralj;, COuomslend pafhology Omupl - Villous adenoma. low-grade dysplasia AutrmHp (Roval-Hoban Ho~nltaJl - Tubulo-villous adenoma. No invasion in the submitted section. Aus(Tjllia !Royal Prinoc A}tied HM!liiAJ\ • Villous adenoma widt high-padc dysplasia Au<tmlia ISumvan Nicolaides Pathology) - Villous ada!oma

B!!ll!jl !!.abomtorio Anaromia Pato!ogjca E CjtoJo!!ja) - Villous edenoma widt high-grade dysplasia Canada CPawua HO$QiWl • Villous adctlOma Canada CUniycriiitv Hosniml ofShqbrogksl - Villous adenoma with Jow-arade dysplasia Gmnany C!O!!ilu• fur Pathologje UJ<El • Villous adenoma (focally high-grade) Hong Kong (pamela Youde Nethersole !;a3rcm Hosoitall - Villous adenoma, low-gt.ade dysplasia Ireland (Kerry General Hpsojtall • Villous adenoma

Japan <Kyoto Universitv HospjtaD • Vi11ous adenoma Omag !Khoula Homitall • Tubulovil!ous adenoma with modemte dysplasia Pucno Rjco CtJnjversity ofPueno Ricg) - Villous adenoma

Oow CHamad Modical Gomorarionl • Villous adenoma widt high-grede dysplasia amounting to intntmucosal carcinoma Saudi Arabja CKjng Fahad National Qyard Hospjtpll - Villous adenoma.. high-grade

Saydj Arnbja (M CH) - High-grade dysplasia in adenoma!O\!S polyp Sinaapore CKK Women's & Children's Hgspjtall • Tubulovillous ndtfloma with low-grade dysplasia The Netherlands Arostclyeen - Villous adenoma

tJnhed Kjngdom !Oxford Study Gmunl • Caecum - Villous adenoma, modenttc dysplasia

c ... 3 • Diagnosis:

8

Villous adenoma with foci or high-grade dysplasia ("intramucosal c.a:rcinoma"), cecum T-67100, M-826111, M-74000

CITR. Sql!emb<r, 2006 "Minuta' ' (Sub«:ripticn A)

Case 3 -- References: Takara M, Yao T, Nishiyama KJ: Phenotypic Alteration In ·Malignant Transfonnacion Of Colonic Villous Tumours: With Special

Refefeoce To A Comparison With Tubular Tumours. Histopathology, 2003 Oc~ 43(4):332-9. Yao T, Kajiwara M, Kouzuki T, et al: Villous Tumor Of The Colon And Rectum With Special Reference To Roles Of p53 And bcl-

2ln Adenoma-Carcinoma Sequence. Pathollnt, 1999 May; 49(5):374-82. No•.oe t, M'atsumata t , Sugimachi K: Carcinoma In Villous Adenoma Of Ascending Colon Assgciated With Saronid Reaction In

The. Regional Lymph Nodes. J Clin Gastroentcrol, 1999 Jun; 28(4):377-9. Dippc B, Petrowsky H., Kruger S, et al: The Malignancy Pot¢tltial OfColorectal Polyps-HistOmorphometric, Histochemical And

l.mmunohistocliemical Study Of The Dysplasia-Carcinoma Sequence. Zemra7bl Cltir, 1995; 120(7):556-63.

Case No. 4 - Accession No. 29445 September, 2006

BaJdwjp parJs CKaiser Permanentel • Poorly<>()ifferentiated '(signet-riilg" car.cinoma (1)~ Sjgnet-ring adenocarcinoma ( I): Invasive poorly-differentiated (signet-ring) adenocarcinoma (I); Signet-ring cell carcinoma (I)

Fomana £Kaiser Pennanente) - Signl!t-ring cell carcinoma, metastatic vs. primary Glendale - Signet-ring cell carcinoma Granada Hills • Signet-ring cell tumor Hayward <Hayward-Freemontl • Diffuse (signet-ring) carcinoma La Jolla <Scdnns Heal !I!\ • Poorly-differentiated signet-ring cell adenocarcinoma La Jolla <Scripps CJjnic Hcmaropathology Fellowship) - Signct~ring carcinoma lama Linda <Lorna Linda Univs;rsjtv Resjdent<.i) - Diffuse (signet·ring) type adenocarcino:ma l(}ng Beach <YA Long Bcacfi HeaJthcare System> - Signet·ring cell carcinoma; Neuroendocrine carcinoma (Goblet cell

~denocarcinoid) ( 1)

MontLm (Commpnity Hospita1 of the Montercv P¢njnsuJa) - Signet-ring carcinom~ rule out metastasis Monterey Park (Garfield Medical Center) • Signet-ring cell a?enocari:inoma Oakland (Alameda County Medical Center). - Signet-ring carcinoma Orange (Orange CountvMMjAAJ Gmunl - Adenocarcinoma, signet-ring Qrange (University of California Irvine) - Signet-ring cell carcinoma Orange Countv <Kaiser Pennanentel - Signet,-ring ceil carci_nom~ metastatic? Oxnard fSL John •s Regional Medical Center) - Signet-ring adenocarcinoma (4)

SacmmeDto (UC. Dayis Residents) - Adenocarcinoma with prominent signet-ring cells San Diego (Alvarndo PAthology Associates) .. Signet•ring cc.ll adenocat:cinoma San Diego (NawJ Medical Center) .. Signet .. ring cciJ carcinoma San Diego <UCSD Medjca! Cepterl • Signet-ring carcinoma san Francisco CSan FranciSCO Gtme;ral Hosnitah - Aggressive Goblet cell carcinoid Sagra Barbara - Signet·ring cardnoma Santa Ro~a <Santa Rosa Memorial Hosoitan - Signet-ring adenocarcinoma (3 ). primary vs. metastatic ( 1) Woodland Hills <Kaiser Permanente Medical Ccntcrl - Signet-ring cell carcinoma. ? metastatic Woodland Hjlls CSuda·~ SoldjerSl ~ Signet-ring adenocarcinoma Arkansas CUAMSl - Signet-ring cell ad~ocarcinoma, small bowel Florida (Amgjpsth) - Signet-ring C;8fCinoma Florida <Baptistllospitnl Pensacola\ - Goblet cell carcinoid (2); Signet-ring cell adcnocan:inoma (I)

Florida (Jackson Memorial Ho:;pi!!l!l , Signet•ring carcinoma FJorida CTa!1ahassee Pathology Associates) - Si.g1let-ring cell adenocarcinoma Florida <Winter Haven Hosoita!l - Signet cell adenocarcinoma (2) Oljnoj$ <Loyola UniversiN Medical Center) · Signet-ring cell cateil')oma. rule O"'lt neuroendocrine Illinois (MacNeal Memorial Hospita!l - Signet-cell carcinoma (I); Signet-ring cell adenocarcinoma (I) Indiana (Howard RcgjMal MedjcaJ Center) - Signet·ring carcinoma Kansas CPhysicjans Rsfqenee Laboraton1 - Metastatic signet-ring oc11 can.inoma Kentucky CUnivcrsity oflpujsYi!Jel - Signet-ring carcinoma vs. Goblet cell carcinoid

CITR. September. 2006 "M.ioutcs" (Subscription A) 9

lpuisian• CLouisiana State Unjymjtv Hcahb Science Cenrerl • Signcc~rina cell adenocarcinoma Loui!i•n• Slidell • Signet•ring adenocarcinoma Moryland !Northwest Homiml Cenrcrl - Signe<-ring cell adenoc:an:inoma Morvland Olnjyqsitv ofMarviMdl • Signc:t·ring adenocarcinoma Mnryland !Sjhy Springs> - Goblet cell can:inoid MMqebusetts <Berkshire Medjcal Center) • Adenocarcinoma, slgnet·rina cell type Ma~s.acbysetq <Tufts. New England Medjco! Ce01erl - Mucin-producing adenocarcinoma, pooriY·diffcrcntiated, signet-ring cell type Mossnchysett* Peabody • Signet-ring cell carcinoma, small bowel Mjcbjoao /Oakwood Homita!l - Mucinous carcinoma, signet-ring type (I); Signct-ri11g adenocarcinoma (I) MicbisM <Sl. Joseph's Mercy Homital> • SigncHing cell adenocarcinoma Minne;sota (fairview Ridges HosnjtaD • Signet·ring cell carcinoma{? Gastric primary)

Mpn!M• Mi!!!OO!a - Signet-ring cell adenocarcinoma Nc!zm:oka ICreiabtno University) • Signt<·ring cell carcinoma New Yor!c l!.ong Island Jewish MediC!!! Center> - Signet-ring cell carcinoma. primary New )'ode, CNM:;,au Universirv Medjgl Center) • Mucinous adenocorcinoma, diffusely infiltrating Now York (State UnjymjwofNew york gt Stony BrooJsl -·Goblet cell carcinoid New York CSUNY Qownsiace Resjdcms\ .. Goblet adcnocarcinoid Noah Carolina !Mountain AfSI PmbQiosyl - Signet-ring cell carcinoma (I): Signer-ring adenocarcinoma ( I); Diffuse (signc:l-ring)

adenocarcinoma {l) Noah Carolina (Pathologists Medicall.gborntorv} - Signet-ring cell can:inoma (2) Objo <McCuUpugh-Hvde Memorial Hosnjmll - Signet-ring cell adenocarcinoma Pennsvtvania (Drexel \Jojymjty College of Medjcigcl - Sigrtet-ring cell carcinoma

Pennsylvania !Lehigh Valley Homjran • Signet·ring carcinoma

Penn'Yiyania CMt Ninany Medical Cqucrl .. Oobla ceU carcinoid tumor, small bowel PenDRy!yania (pennsvlyanja HomjruJ Re;,jdents> • Signet·ring cell C8J'cinoma Texas !Lpckland AFBl - Signet-rio& adenocarcinoma Toxns CMs;thodjst tfmmital\ • Slgnet-ring cell carcinoma Texas CScqu & White Memorial HpsnhoD • Signet-ring e<;JI carcinoma TexM. Lubbock - Signc:l-ring cell carcinoma Wey1 Virginia CGreenbriq VaUey Mcdjc;pl Center) .. Signer.ring carcinoma Weg YiD!inia !Wetzel Countv HosniiAil - Poorly-diffen::ntialed mueinc>us adenocarcinoma \\ith signer-ring fcarurcs invading the

serosa (f3) Wjsconsjn (Mcritq Pathology) - Signct"'(;Cll c:arcin~ metaStatic Ay~llJHa (Queensland ParhoJogy Gmun> • Goblet cell carcinoid Aus(TIIin !Royal Hoban Hosoi<all - Signet-ring ceU carcinoma, small bowel AustrnHn CRoyll1 Prince Alfred Hospjto!) .. Signet-ring cell carcinoma(? MetaStatic) Aystru!in (Sullivan Nicolaides Pathology) .. Adenocarcinoma, signet-rl"& type Btoril (Laboratodo Anatomia Patologjcn E Cjto!ogial • Adenocarcinoma, invasive. poorly-<liffcrcntiat·ed with signet-ring cells,

small intestine Con ad• cpasqua Hospital) - SigneHing cancer Conoda (University Hospital ofShezhrookel .. Signet·ring ccU carcinoma GmniDY llnstitut furPa!hololrielJKEl - Signet-ring adcnocan:inoma Hooa KooaiPamela Youc!e NctbC!l!!l!e F.M!em HospitaD - Poorly-difl'c:rentiated (signer-ring cell) carcinoma h!:land CKmy Genera! Homita!l - Signet-ring carcinoma, exclude Goblet cell carcinoid JapM CKyp!o Unlversitv Homitall • SiiJlct·ring cell carcinoma. possibly metascntic Oman O<boy!a Hosnit!lll " Signet-ring cartinom3 Pucno Rjco (Uojyqsjty nfPuenn Rjepl • SigncHing cell adenocarcinoma OQ!nr CHnmad Medical CQmQrntjonl .. Signet·ring cell carcinoma Snudj Ambia (King Fahad Notional Guard Homital> • SigneHing cell carcinoma Saudi Arnbja CMCH) - Signet-ring adenocarcinoma Sjnganpre lKK Women's &: Chi! dreg's HomjtA)\ - Signer-ring cell c:an:inom' to ~elude metaStases The Nsthmands Atrutelveen - Undiffc.-cntiated mucinous adenocarcinoma (diffcn:ntial diagnosis: Gobla cell carcinoid) Uniled Kingdom <Oxford Study Groypl - Small intestine- Goblet cell carcinoid (pending immunohistod1anistry)

10 CTTR, Sept<mbc. 2006 ••Minutes'. (Subscription A)

Cass: 4 · Diagnosis; Signet-ring adenocarcl.noma, small Intestine

T-64000,~-84903

Director's Note: The twnor was clinically thought to be intestinal in origin. The stomae!Lwas "normal". (dtc)

Case 4 - References: Nguy<ll MD, Plasil B. Wen P, Fronkel WL: Mucin Profiles In Signc1-Ring C<ll Carcinoma. Arch Pathol Lab Med, 2006 Jun;

130(6}:799-804. King-Yin Lam A, Ong K.. Ho YH: Coloreelal Mucinous Adenocarcinoma: The Clinicopalhologic Fearurcs And Significance Of p 16

And p53 Expression. Dis Colon R<ehmt. 200:, Sep; 49(9):1275-83. Srewan SL, Wike JM, Karo I, et al: A Papulati0.1· 9as<Cl Study Of Colorcctal Cancer Histology In The United States, 1998-2001;

Cancer, 2006 Sep I; 107(5 Suppl): 1128-41. Fu Kl, SanoY, Knto S, er al: Primary Signer-Ring Cell Carcinoma Of The Colon Ar Early Stage: A Case Report And A Review Of

The tirerature. World J Ga.tti'()I!Jo~rol, 2006 Jun 7; 12(21 ):3446-9. Pontes J, Fernandes C, Panao £,"'a!: Synchronic Signee-Ring C=inoma And Adenocarcinoma Complicating Extensive And Long­

Standing Ulcerative Colitis. Hepoto-Gastroentuology, 1999; 4{)£25):236-9. Ogino S, Brahmandam M, Cantor M, et al: Distinct Molecular Features OfColorectal Cotci noma With Signet-Ring Cell Component

And Colorectal Carcinoma With Mucinous Component. Mod !'athol, 2006; 19(1):59-68. Bloomston M, Walker M, Frankel WL: Radical Resection In Signer-Ring Carcinoma Of The Ampullo Of Vater. Report Of An 11-

Year Survivor. Am Su~, 2006; 72.(2): 193-5.

Case No. S - Accession No. 29093

Bnldwjn Parle fKajsq Peonanentc) - OIST (uncertllin m.alignant potential) (4) Eon twa £Kaiser Pqmanmtel - GastrOintestinal stromal tumor G!eqdalc - GIST

Gmnada Hills - Gastric:: leiomyoma Hayward IHayward-fn:gnont) - Lciomyosarc:oma vs. SFT I ,a Jg!la CScriPP$ Hpaltbl .. Gastrointestinal stromal tumor, favor malianant LA Jolin (ScriPPs Clinjc Hemarooatbology Fellowshjpl - OasO'ointcsrinal stromal tumor (GIST), malignant Lorna Linda !Loma Linda Universjrv Rcsidentq) - Solitary fibrous tumor Loos Beach CVA kgng Bs;ach HeaJthCArc Syggnl - Malignant gastrointestinal stromallumor Montqcy £Commuojry Hgspjtplgf"x Mogtqey Pminwla) - GIST

Monrsrcy Parle fGAdjcld Medic::al Ccmtql - GIST. intermediate grade Onklnnd (AlamedA Counrv Medjcal Center> - Gastrointestinal stromal tumor, malignont Omoge COrnnge Coymy Medjcal Gmyn\ .. Leiomyosarcoma OmogefiJniversitv of California Inrincl - Gastrointestina1 stromal tumor Omnpe Counry CKojw Pmnanentel - OIST Oxnard fSL John's R<aional M«lical CeOJerl - GIST (4) Sncmmcnto CU.C Oayis Residems) • Solitary fibrous rumor San Djcgo CAivnmdo Pathology Assocjotcsl - ·Gastrointestinal strOmal tumor, malignant Sao Diego CNMJ Medical Center> · Malignant gastrointesrlnal stroma.l tumor Sao Pieso lUCSP Me<lig! C<mg) • Malignant gastTOintestinal stromal tumor Son Fmocisco !Son froncisco Genml HomitaD · Lelomyosarcoma Snntn Barbara • OastrointestinaJ stromot tumor

September, 2006

Sapta Rosa <Santo Rosn Memorial Hosoita!l - Gastrointest1nal srromal tumor (2); GIST vs. smooth muscle tumor vs. solitary fibrous tumor (I)

Wocx!land Hills fKajw Pennanenu: Mos!ical Center) • GIST Wogdland Hm, fSy<la'• So!djersl - Malignant GIST (high risk) Artnnsas aJAMS) · GasrrointeStinal stromal tumor, stomach/omentum Flpdda <Amcrinath> - Malignant fibrohistiocytomn

CTT1t September. 'l006 "Minutes" (Subscripcjon A) II

Florida CBapti!l Hospital PenS!!Mia\ - Leiomyosarcoma (I); GIST vs. leiomyosarcoma, need C-kit (I): GIST (I) flnrid.a IIK!tton Memorial HomjtA!l - Gastroinu:stioal stromal rumor (GISl) florid• Cfal!aheswr Pathology Angdotgl - GIST, high risk malign1J\l poumtial

Florid.a !Winter Haven Hosoim!l - leiomyosarcoma (2) lllinojs Cloyola Uni,'ei'Si'Y Medjcal Cquer) - Spindle cell rumor, favor GIST lmnojs 1Ma£Neal Memorial Hospjrol\ - Leiomyosorcoma (I); GIST(!) !ndjana (Hgward Regional Mtdjcal Cqou;rl - GIST

Kansps !Physjcians Reference l.i!borotorv> - (GIS1) Gastrointcstinul stromul tumor, low-grade morphology, but greater than 5.0 em, therefore high-grade

Keptyckv IUniversitv g:" Louisvme> - Malignant OJST J,pui:tjano Cl,ouiffiana S:.. ' te lfnjyqsjtv Health Scjense Ceotsrl - Favour leiomyosarcoma over GIST Louisjmp Slidell - Leiomyosarcoma

Maryland !Nonhwes< Hospital Cenrgl - Gasaoinu:stinal SO'Ornal rumor Maryland !Uniyersi'Y ofMarylandl - GIST Marvlaod CSitver Springs) .. leiomyosarcoma

Ma-.saclJusett~ lBerkshire Medical Center) .. Malignant spindle cell cumor, consistent wilh GIST Mossncbusett$ <Tufts-New Enalood Modjcnl Center) - GastrOintestinal Str0n1al tumor/Solitary fi'brous tumor Ma:sgchuscus. Peabody • Leiomyosarcoma, gastric omentum Mjcbjgan COnkwgod HospjtnD • Gnstrointcstinal stromal tumor (2), of low malignant potential ( l) Mjcbjqon CSt Jpscpb•sMc..rcy HolfPitJO • Oastroint~1inal stromal tumor MinDCj$91jP (fairview Ridges HospjtoU • Gastrointcstina1 stromal rumor Montana, Missoula • Gasrroinresrinal stromal rumor Nebmd;a CCreigbtQQ tJnjvmjM .. GIST

New York Oppg Island Jewjsb Mpdjql Csntgl - Gastrointestinal stromal tumor New York fN&~sau Unjyqsjtv Medjca! Ccnrql • GIST

New XorJs <Stnts UpjyersjtyofNew York llt Stony Brookl - Leiomyosarcoma Now Yodc CSUNY Downstate Rcsjdent§) - Gastrointestinal stromal rumor, malignant Nonh Cqro!ina (Mountain Area P•tho!ogyl - GIST (3)

Noah Carolina (pathologists Medkn! LahorntoN) - Malignant gastrointestinal strornaJtumor (2)

Ohjn CMcC\J!lough-Hyde Memorial Hpmjtall .. Spindle ce.Jl pa.ncr~tic endocrine rumor Pcnn;syiYAnja CDrexe1l1nivec;1ty Co!lrrgeo(Medieinel - GIST. high risk of aggressive behavior Pcnnsylyanja !lehigh Valley Ho:mi!lll - GIST, malignant PennMyanja{Mt Ninany Medical CcnJq) - GIST, favor malignan~ StOIIllc:h

PennsvJvanja <Pennsylvania Hospital Be:;jdents) ... Gastroinrestinal Stnm'lal tumor

Iexa.• C!.ackland AFBl - GIST J)xos (Methodist Hospital) - Otl$trointestinal stromal rumor

TexM (Scott & White Memorial Hosnjto!) .. OJST

Texas Lubb9sk - Leiomyosarcoma Wszt yjrginiaCGrcenbricr Valley ModiCA! Center> - Leiomyosarcoma West Virginia (Wetzel Counrv Ho:.pitall - Malignant GIST Wi5SOO<in !Meriter Pathology\ - GIST AIW!Jija (Queensland Pathology Gmvp\ - leiomyosarcoma/GIST Au!!!JiioiRoval Hobart Rospi!!!l\ - GIST Au•!rJiiaiRoval f>rince Alfred Hospj!lll - Gastrointestinal stromal tumour (high risk} AysrraHa CSulliyan Nicolaides Patboloav) - GIST

BmU <Labgmtodo Anatomia Patologjca, E Cjm!ogja'l - GIST, omenrum Cunadp !Pgsqua HqwitaD • GIST

Canada !Unjycrsity Hosoital ofSherbmokcl - GIST, high risk Germany C!n<titut fur Patbolooie UKEl - GIST (malignant) Hpog Kong (Pamela Youde Nethepsole EMtem Ho);niro.l) - OIST Ireland IKqrv Gs;nml Homjmll • GIST Joptp <KYotO Unjymjrv Homitall • Gastrointestinal suomal t\lmor Om&n CK hQYia Ho;spj1all - Gastrointestinal suomal tumour

12 CITR. Sep<embet, 2006 "Minutes" (Subscription A)

Puerto Rico fUnjyeplj'Y of J>ueno Rico) • Smooth muscle tumor vs. Gastrointestioal Stt"Omal t\lmor (GIST) vs. Solitary fibrous tumor

Oa!ar CHalnad Medical Comorarionl · Gastrointestinal stromal t\lmor, probably malignant Saudj Arabia (King Fahad National Guard Hosoi!all · GIST Saudi Arabja CMCHl . Gastrointestinal stromal tumour, hlgh-gnide. Singapore CKKWompn's & Children·~ Hosnital) - Gastrointcstina1 stromal tumour, high risk The Netherlands AmstelvCC!J • Gastrointestinal stromal tumor (GISD United Kingdom toxford Stydy Groypl - Gastric omentum - Leiomyosarcoma

Case 5 - Diagnosis: Gastrointestinal stromal tumor, gastric omentum

T-63850, M-88903

Director 's note: A CDI17, done later, was positive. (dre)

Case 5 -References: Oba T, Hamatsu T, Kuroda Y, et al: Gastrointestinal Stromal Tun!or Of The Omentum: Report Of A Case. Fukuolw lgaku Zasshi,

2003 Dec; 94(12):347-50. Maki RG: Gastrointestinal Stromal Tumors R&'Pond To Tyrosine Kinas"" Targeted Therapy" Curr Treat Options Gastroenterol,

2004 Feb; 7(1):13-17. Miettinen.M, MakhloufH, Sobin LH, Lasom J: Gascrointestinal StJ:omal Tumors OfTheJejuoum And Ileum: A Clinicopathologic,

Immunohistochemical, And Molecular Generic Study Of906 Cases Before lmatinib With Long-Term Follow-Up. Am/ Surg Patlwl, 2006; 30(4):477-89.

Vander Zwan SM, DeMatteo RP: Gastrointestinal Stromal Tumor: 5 Years Later. Cancer, 2005: 104(9):1781-8. Kuhlgatz J, Sander B, Golas MM, et al: Differential Diagnosis Of Gastrointestinal Leiomyoma Versus Gastrointestinal Stromal

Tumor. International Journal ofColon!cJal Disease, 2006; 21 (I ):84-8.

Case No. 6 - Accession No. 30125 (originally 30109)

Baldwin Park (J(ajsqferrnanentel • GIST (4)

Fomana fKaiscr Pcrmanente) - Gastrointestinal stroma1 rumor Glenc!ale • GIST Granada -Hm~ - G4$rric stromal rumor

Hayward <Hayward-FreemonO • GIST 1,& Jo)Ja <Scrion~ Health} - Gastrointestinal str9J118) tumor, favor benign La Jolla /Scrinns qjnjc Hematooathology Fe!Jowshju> - Oastrointe~tinal sll'Omal rumor (GIS1) Lorna Linda (Lorna Linda Universirv Resiaents) - GIST

September , 2006

Long Beach (VA Long Beach Healthcare Svsteml • Gastrointestinal stromal tumor ofunkn.own malignant potential Mpnt.erev fCommunity Hospital of the Monterey Peninsula) • GIST Monwev Park (Garfield Medical Center) · GIST, lnrermedillte to high grade Oakland <Alameda Countv Medical Center) - GasltOintestinaJ stromalJumor Orange COranse Countv Medical Group) • Gl stromal tumor Orange (Unjyt."[§jty of Caljfomia lrvine) - Gastrointestin~l strOmal tumor Orange County CKajscr Pe:nnanente) - GJST Oxnru>dCSt John's Reqjonal Me4jcal Center) • 7 sarcomatoid carcinoma (I); GIST (3) Sru;ramento fU.C Dayjs Re§ident<l - GIST San D-iego CA!vMado Pathology As._~QCiates.) - Gastrointestinal stromal tumor. malignant San Diego (Naval Medjcal Ccntvl · Gastroi.ntestinal stromal tumor (GISD San Francisco <San Francisco Gr-nc.ral Homitall - Gastrointesrina1 stromal rumor Santa Barba!ll · Consistent with GIST Santa Rosa <Santa Rosa Memorial Rospita]) - Gastrolntestina! SO'Omal tumor (2)~ Spindle cell neoplasm of gasoic wall consistent

widt gastrointestinal stromal tumor (I)

CITR, Septemlxr, 2006 "Minutes" (Subscription A) 13

Wooc!land Hms CK.ojsq Pcnnanente Mcdjc;al Croter) - GIST Woodland HmsCSuda's Soldiers) - GIST (high risk) Adcansa.<j fuAMSl · GaslfOintestinal stromal tumor, scomnch f lpdda CAmerinmhl .. Gastrointestinal stromal tumor Flodda CBaOO!\t Hospj!AI Pen<!l&nlal - GIST (3) Florida Clacl<son Msmorjal Hosojtal\ - GIST F10Jida CTaJiahesse Pathology Asws;jord) - GIST, low risk maJignant po«:n(ial florida (Winter Hoven Hospital\ - GIST (2) !!linojs Cl.&wolo Unjyen;ity Medical Cauer) - Gastric mucosa with underlying probable GIST !!!jnois <MacNeAl Memorial Ho.pjtQil - Stomach GIST ( I); GIST vs. smooth muse!"' tumor(!) Indiana CHoWJrd Regional Medical Cemerl - GIST Kansas (Phvsiciw Reference Labo!lunyl - Gaslrointestinal stromal rumor, high-grade Kenruc!cy Qlnjymjrv of Louisville) - GIST of uncauin malignant potential Lgujsjana ll..ouiljonn State University tlc3!tb Science Ct;nterl - Favour GIST Lgujsjana, Slidell .. GIST rumor

Mruyland fNorthWi}st Ho:..12ital Center> .. Gastrointesrinal stromal tumor Maryland CUnjymjiY ofMarvlapsO - Stomach GIST Maryiand £Silvq Swings> .. Gasm>inlcs:tinal StrOmal rumor M!!Ssachurem IB<r1qhjre Modica! Cemerl - GIST Ma.,sachusen.~ <Tufts-New England Mqljc;aJ Center) - Leiomyoblastom.alle1omyosa:rcoma Mjchjgan COakwpod Hospitall - Gastrointestinal stromal turnor(2) Mjshjgan <st. Jpficph 's Mercy Hosohall - Gustrointcstinitl stromal tumor Minnesota (f ojrvicvt Rjdgq Ho$pital) · Gaslrointestinal stromal tumor Montana, Missoula - Gastrointestinal suomal rumor Nebraska !Creightop tmjymjNl · GIST Nev.· Yotk CNa.uau Uniyersirv Medical Centql - GlST Nsw York CStAte lJnjyersirv of New VPrk p! Stony Broolsl • OlST New York <SUNY Down~tate Residents> - Gastrointestinal Slromal tumor Nonh Carolina CMoupJ!!jn Area Patbqlogy} - GIST (3) Nonh Carolina (patho!ggjss Modjca! l,aboratorv\ - Guaointcstinal stromal IUIOO< (2), benign (I) Ol!io CMcCullouoh-Hydc Mgporial Ho:mjtall - Gl saomaJ twnor Pennsvlvania CDrexcl Uniycrsity College oCMesJjcjne) - OIST Pennwlvania ILebjah Valley Hosojmll - GIST PennsylvAnia CMt. Njttnny Medical CGJJ!Crl - GIST, favor be11igt1, stomach PCMsvlvanja (fsmn:NIYAAia Hospital Bcsjdentsl .. GastT'Ointcstinal strOmal tumor Tq:M Cl.ackland AfBl - GIST, stOmaCh Texas (Methodist Hmpjr.aD - Gascrointe:Min.al stromal rumor Te>!as CScort & Whjtc Mqnorial Hpspjta!l - GIST Texas l .uhhock - Gastrointestinal strOmal tumor West Virgjoja COres;nbrier Vallev Modica! Center} · Gastroinlestinal strOmal tumor West Viminja <Wetzel \..ountv Hospjl@ll - Malignant GIST \Yjmnsin CMnitq Patbologv) - GIST

Australia COuttnaland Pothotpgy Grounl - GIST Australia ffioval Hobart Hospjta!l - GIST Aysm!lia £Rnval Prince Alftod Hosnjrall - Gastrointestinal siromal tumour (intcrmodiate risk) Austntlj!) <Sumvno Njcolaides Patholopy) - GIST Bwil C[&bpratorio Anatomia Patoloe!ca E CitoJogia) - GIST, gastric Canada CPosguo HOSQjtall · GIST Canada fUnjvmirv Ho:~pjO!I of Sherbrpof<el - GIST, spindle cell Germany (fnstitut fur patbolooie liKE\ • GIST Hong Kong (prune! A, )'pyde Nstbm plg Enstcm Hosnirall · GIST Ireland £Kenv Gepeml Hgspjra!l - GIST Japan <Kyoto Uniyersitv HowitaD .. 011StrOinte$tinal Stn)mal tumor

!4 CITR, S<ptemb«, 2006 "Minutes" (Subo<:ription A)

Oman fKhoula Homitan - I . Wrong slide of gastrointe.'tinal stromal tumour by mistake kept. 2. Spindle HCC infih:rating stomach Puerto Rico Nniversitv of Puerto Rico) - Gastrointestinal stromal tumor (GISD, borderline Oatar <H.a'inad Medical Comoratlon) · Gastrointestinal stromal tumor, borderline Saudi Arabja I King fahad National Guard Hospital\ - GIST Saudj Arnbja (MCH) - GastrOintestinal stromal tumour, low-grade Singaporc.<KK Women's & Cbjldwn·s Hospjtan - Gastrointestinal stromal tumour, i.ntenncdiate risk The Netherlands Amstelveen • Gastric wall with a GIST United Kingdom !Oxford Study Group> - Stomach - Gastrointestinal stromal tumour~ recurrent1 intermediate malignant risk

Ca~ 6- Diagnosis: Gastrointestinal stromal tumor (GIS'I), stomach

T-63000, M-88903

Case 6 - References: Kawanowa K. Sakuma Y, Sakurai S, c:t al: High Incidence Of Microscopic Gastrointestinal Stromal Tumors In The Stomach. Hi1m

Pathol, 2006 Scp 21; (Epub ahead of print) Hata Y, lahigami S, Natsugoe S, et al: P53 And MlB-1 Expression In Gastrointestinal Stromal Tumor (GIST) Of The Stomach.

Hepatagasrraemerawgy, i006 Jul-Aug, 53(70):613-5. Cladera P, Orellana Fernandez R, Darnell Martin A, et al: Gastrointestinal Stromal Tumors: Experience In 49 Patients. Clin Trail$/

Oncol, 2006 Aug; 8(8):594-8. Bardell T, 1alink DW, Hurlbut DJ, Mercer CD: Gastrointestinal Stromal Tumour: Vaned Pres..,tation Of A Rare Disease. Can J

Surg, 2006 Aug; 49(4):286-9. Santambrogio R, Montorsi M, Schubert L, el'al: Laparoscopic Ultrasound-Guided Resection OfGa<tric Submucosal Tumors. Surg

Endosc, 2006 Aug; 20(8): 1305-7.

Case No. 7 - Accession No. 29340 & TRS4-6038 September, 2006

Baldwin Park (Kaiser Permanentel - Undifferentiated "small cell" carcinoma (I); Neuroq~doctinc carcinoma ('3), small cell (I'); Fsmblna (Knjsq Pennanente) - Neuroendocrine carcinoma Glendale - Adenoctl{einoma and signet-ring cell carcinoma_ Granada Hjlls - Poorly-differentiated large cell rumor with neuroendocrine carcinoma Hayward CHayward .. frcerpont) - Adcnomatous hyperplasia + small cell carcinoma La Jolla <Scnpps Health) - Poorly-differentiated adenocarcinoma with neuroendocrine features I& Jolin CScdnns Clinic Hematooathology fellowship) .. Poorly-differentiated neuroendocrine carcinoma lpma Linda CLQma linda Universirv Residents) .. SmaH cell carcinC?ma Long Beach <VA !.Oil a Beach Healthcare System) - Neuroendocrine carcinoma (2), poody-differeiltiated ( 1), high-grade (1) Monrcrey·ccommunitv Hosoiral of the Monterey Peninsula) · -Poorly·differentiared neuroendocrine carcinoma, metastatic Monterey Park (Garfield Medjca! Center) - Neuroendocrine small cell anaplastic carcinoma Oakland (Alameda County Medical Centcrl - Undifferentiated carcinoma, small cell type

Orange COrangeCounry Medical Groun> 4 Na~roeodocrine carcinoma Oi'angeCUniversitv OfCalifomja Irvincl · Neuroendo<.:rinecarcinoma.& intta4 epitbelial carei110ma Orange County <Kaiser Pennane-:ttel · Ncurocn4ocrinc carcinoma Oxotlfd CSt John's Reg·ional Medical Center) · Carcinoma of neuroendocrine· (l); Small cey neuroendocrine carcinoma (1);

Neuroendocrine carcinoma (2), fulnkly malignant carcinoid (! ). Saeramea(o_(U.C . .Da\lisJl.@den!§) - Ncurocndocri~e carcinoma, .Orade Ill San Diego (Alvarado Parhology A.ssocjatesl - Large cell neuroendocrine carci~oma San Diego <Naval Medica! Center) • Primary small cell carcinoma of !he. gallbladder (TRO l-29340) San pjego (UCSD·MedicaJ Center> 4 Poorly--differentiated neuroendocrine carcinoma San Francjsco <San Frnnej~co General Hospital\ - Neuroendocrine carcinoma Santa Barbara - Small cell neuroendocrine carcinoma Santa Rosa (Santa Rw M¢rnorial Hospitall - Neuroendocrine carcinoma (3) Woodland Hi11s lKajsq Peqnoocptc Modisal Centerl - Small' cell neuroer~docrine carcinoma. favor metastatic

CITR,Septcmbor, 2006 "M(outes" (Subscription A) 15

W9odland Hms CSuda's So!dim> • MetaStatic small cell carcinoma Artwun• CUAMSl · MCISStatic pulmonll)' small cell carcinoma, gallbladder florida {Amerjpatb) · Atypical carcinoid

Florida {Baptist Hospjta], Pmsaco!Al • Neuroendocrine carcinoma (2), high·grode ( !); Mixed undifTcn:nriated smaU cell carcinoma and poorly..<fifTerentiated adenocarcinoma (I)

Floddollackson Memorial Ho:;pjtall • Ncuroc:ndoetinecarcinoma, lnraeeell, Grode II floddo (Tol!ahru;M~e Pathology Associatql ~ Small cell carcinoma

F!odda <Wjgtcr Haven Hospjlall • Small cell carcinoma (2) Jlljnojs <J ,pyola Universitv Medical Center) • AtypicaJ carcinoid

J!!jnoi• (MacNeal Memorial HospjtaJl • Neuroendocrine carcinoma (I), small cell neuroendocrine tumor(!) Indian• fRoward Recional Me<lical C.enrq> • Carcinoid Kanw <Phy:;jciaps Reference ybO!lltoryl • Small cell carcinoma, rnew~atic lo gallb ladder (whaJ does TTF-1 show'!) Kenrudsy Ngjvmitv of Louisville> • Mixed odenocateinomn- small cell carcinoma LoujJiMo Cl oujsjana State Univmiry Hc:glth Science Center) • Merasrarie smaJI cell carcinoma Loui,jMa. Slidell • MaJignant carcinoid Mgrv!and CNorthwest Hospital Cenrecl • Small cell carcinoma Maryland CUnjvernitv ofMarvlagdl • l.IJns - Small cell carcinoma (wrona slidc) MnNiond £Sj!vq Springs> - Metastatic smull cell carcinoma Ma.,snshuseu~ CRedq;bjrs,Mcdjca! Centcit ~ I. Adenocarcinoma with malignant neuroendocrine fetttures• 2. Small ocJI cancer MMsnchu!tett:; Ciufts-Ncw EogJnnd MWiql Cmtgl - Poor)y~iffercntiatod neuroendocrine carcinoma Massachusect~ Peabody - Malignant can:inoid nnnor

Mjcbi•an COalswpod Hosoi111ll • Neuroendocrine carcinoma, mixed small and huge cdl (I); Small cell carcinoma (I} Mjehi•an !St. Joseph's Mercy Hn<t1im!l • large cdl neuroendocrine carcinoma MjnnqotA CfaiMew Ridg<os Hosnjtall .. Neu.rocndocrine c:an;inoma, hiah-aradc MnntMa Missoula - Sma11 u.ll cnrcinomo Nebraska CCrejgbtoo Unjvertjtvl .. Small cell carcinoma New York <LQng lsiMd Jcwjsb McsJjcg! Csntsr) - Mixed tumor, adenocarcinoma with small cell carcinoma New York <Nwau Unjycrsity M odical Censer) .. Neuroendocrine carcinoma. predominantly s.mall cell type. gallbladder New Ygrk <State Universitv of New york Jlt Stony Brook> - Neuroendocrine carcinoma New york CSUNY Downsrare Resjden!sl • Small ceiJ carcinoma Noah CWjna (Mountain Area PatbQJngy) • MetaStatic small cell carcinorM (3)

NMh Carolina {Patbo!ogjm Me<lical l.fbMnoryl · SmaU cell neuroendocrine carcinoma (I}; Small cell carcinoma (I) Objo CMcCullougb-Hydc Mcmgriol Homjtall • Undifferentiated neuroendocrine carcinoma

Pmosylyania <Drexel Ur-Jversiry Collets pf Medjcine) - Neuroendocrine carcinoma Pennsvlvnnia !Lehigh Valley Ho<nj!all • Neuroendocrine carcinoma, Grade Ill Pconsylyqpjp CMt Nittany Medjcal Csntql • Small cell carcinoma. gallbladder PenMylypnia CPennsvlvania Hosnital Resjdeots) - Small cell c:arclnoma Toxas <Lockland AFBl • Neuroendoedne carcinoma Texas CMechodj:u HQspjtft!} - Metastatic small cell carcinoma Texas fSopu & White Memorial Homjtall - Ncuroa1docrine carcinoma Iexo' Lubbock - Metastatic neuroendocrine carcinoma Wesc Vjrtinjo CGrpcnbrier Valley Medjql Center) • Neuroendocrine c.an:inoma

Wqt Virxigja (Wetzel Counrv HospjW\ .. Neuroendocrine carcinoma

WiKQMin CMeriter Pathology) - Carcinoid Au.urnlia COueensland Pat!mlogy Grpunl .. Neuroendocrine carcinoma

Au<trnlja /Roval Hobart Hospital\ • High-grade neuroendocrine carcinoma In gallbladder wall in a background of high-grade mucosal dysplasia

Au•JTiliiA <Royal Prince Alfred HospiJo!l • Mems1n1ic high-grade neuroendocrine car.cinoma (? Lung primary) AystmHp (Su!liyan Nicolaides Pathology) .. ln-s1tu carcinoma and metaStatic small ceH undifferentiated carcinoma Brazil <Laboratorio Anatomia P•toiP!liCft t; Cjtp!pgjt!) - Hi,gh-grade neuroendocrine tumor {NE carcinoma.. poorly...cfifferentiatod} Canoda £Pugua Ho:mjtaJ> - Neuroendocrine carcinoma

Cwd,a OJgjymjry Hospjll!! ofShgbmokcl · SmaU cell neuroendocrine carcinoma+ high-grade dysplasia (epithelium) Gqmaoy Ongjrut fur Patbologjs UK El • Neuroendocrine rumoc (arypical carcinoid)

16 CTIR. September, 2006 "Minute:<" (Subscription A)

Hong Kons IPamela Youde Neohersolc Ea,stqn Hornirall - Carcinoma with neuroendocrine features lrel11nd !Kmy GS!!S!J!I Hp<pi!!ll - Carcinoid 1Um011C

hmln (Kypr,o Unjymjrv Hospjtall - Neuroendocrine c:arcinoma Oman CKbgula HomjtaD - Neuroendocrine carcinoma Puerto Rjco C!Jnivmitv of Puerto RiCQl - Neuroendoaine carcinoma (mC!liS!atic ?)I Adenocarcinoma of gallbladder Oatar IHnmnd Me!lical Corporation) - N;urocndocrine carcinoma with focal scvcrc muoosal dysplasia Saudj Amhja (King fab!\d National Guard Hospjt1J;l) - Poorly-differentiated neuroendocrine carcinoma Sft!J<H Arobja CMCHl · Small cell carcinoma Sjngap(}re CKK Women's & Cbildreo•s HO$nj[A!l .. Small cell carcinomu 11 " Netherland• Alnstelveen - Metastatic small cell lung cancer and adenocarcinoma of the gallbladder J:L ited Kjnsdem !Oxford Srudv Grounl - Lung - small cell car<:inoma

Case 7 - D!amosjs: SmaU cell carcinoma/neuroendocrine carcinoma, gaUbladder

T-57000, M -804113

Director's note: Most study sets bad tumor of gallbladder origin. A few had simila:r neoplasm involving lung. (drc}

Case ? - References: Bahadur S, Shaukat A, Gibbs J, eta!: Cisplatin And Gemcitabine For Small Cell Carcinoma Of The Gallbladder. Am J Cl!n Oncol,

2005 Aug; 28(4):425-6. Okamoto H, Miura K. Ogawan~ T, c:t a!: Small-Cell Carcinoma Manifesting Systemic Lymphadenopathy Combined With

Adenocarcinoma In The Gallbladder: AggrcssiVCliCSS And Sensitivity To <l>c:mo<hc:rnpy. J GastroeJlt«nol, 2003; 38(8):801-5. Fujii H, Aocake T, Horiudti T. ct al: Small Cell Carcinoma Of The Gallbladder: A Case Report And Review Of 53 Cases In The

Litcrntun:. Hep<Uogostroenrerology, 2001 Nov-Dec; 48(42):1588-93. Pavithnln K, Doval DC, Vaid AK, Venna RN: Small Cell Carcinoma Of The Gallbladder Case Report And Review Of The

Litc:rnture. Tnop Gastroenlenol, 2001 Ju!.Sep; 22(3):170-1. Moskal TL, Zhong PJ, Nova HR: Smoll Cell Carcinoma OfThe Gallbladder. J Surg O~ol, 1999 Jan; 70(1):54-9.

Case No. 8 - Accession No. 29440 September, 2006

Baldwin Park (Kaiser Pcnnanm!cl - Adenocarcinoma with neuroendocrine features ( I); Moderatdy-dilfen:ntiated ada~oc:an:inoma of the gallbladder (3), invasive ( I}

Fontana <Kfissr PguutntjQtel - Adef'oca.rcinoma, gallbladder Gtenda1c . Adcnoca~inoma Gmnado Hj!ls - Well-differentiated adenocarcinoma HaywArd CHoywnrd-Frcemontl - Adenocarcinoma, gallbladder La Jpllo !Scdnps Hcal!hl - Adenocarcinoma La Jolla CSctinps C!jnjc Hematopatbo)ggy Fellowship) - Primary adenocarcinoma of the gallbladder Lorna Linda (Lorna Linda Univcrsitv Resjdc;nt•> • Adenocarcinoma Long Beach NA Long Beach Healtbcan; System\ - Adenocarcinoma, modcnte!y wdl-diffi:rcllriated Monterey !Cmnmunitv Hosoital ofrhe Montsn;v Peninsula> • Adenocarcinoma. moderately dilfm:nriated Monterey Pads !Garfield Medical Cemerl - Modcnue!y differentiated adenocarcinoma of gallbladder Oakland {Aiame!l• Countv Medical Ccntql - Adenocarcinoma, invasive Omngt COronae County MedjC!!I GrouQl • Adenocarcinoma Orange CUojy@t:!jty of CaHfomjalryjnel . Adenocarcinoma Orange Couow (Kaiser Pennanento) .. Adenocarcinoma Oxnard (St. John's Regional Medical Ccmcr) - Adenocarcinoma of gallbladde-r (4), moderately differentiated (I) Sacramento CU C Davis Residents) .. Adenocarcinoma San Dieco (Aiww!o Pathology Associates) - Adenocarcinoma of gallbladder S11n Diego fNaYAI Me!lical Center> - Invasive papi!l3Jy ad<nocarcinoma of !he gallbladder San Diego N CSQ Medical Ccn<erl - Enteric-type adcnoearQnoma

CITR, September. 2006 "Minutes" (Subscription A) 17

San Fmncism (Sag fnmcisco Genem! Hotojtall • Adenosquamous carcinoma SM[! Barbara .. Adenocarcinoma Santa Bog /SAAra Bog Memorja! Hll'!J!itall - Adcno=cinoma of eallbladdcr (3) Woodland Hm~ CKaigr fmnpnents MgdicoJ Csntcr) · Invasive adenoeateinoma with focal squamous differentiation Wogd!aod Hi' I£ CSuda's So!djm) .. Adenoean:inoma ArkansM fUAMSl - Adenocarcinom11, gallbladder Florida IAmedpatb) - Adenocarcinoma

Flpd<la <Bontjst HospjfAI pepsacolal .. Adenocarcinoma with papillary features ( I); Invasive adenocarclnomo (l)i Adenocarcinoma. C.B. I" •

Florida (Jpckson Memorial Hospim)) • Adenocarcinoma of the gallbladder Florida CTallabassee Pa!hology Associates\ - Adenocarcinc>ma of gallbladder florjda CWinter Hayen Hrupitall - Adenocarcinc>ma (2)

llljnojt Clgyola Univmirv Medical Cguql • Papillary adenocarcinoma

Illinois IMKNsa! Memorial Homitall - Infiltrating adenocarciflOIIla, intestinal type ( 1 ); Gallbladder odcnoc:ardnoma (I) Indian• Wow!!!d Regional Medic;ll CcnJql - Adenocarcinom~~, gallbladder Kaoy!( CPbysjcjaos Refm nce Labtmtorvl • Invasive moderately-di~erentiated adenocarcinoma, invades lamina propria (pT! a) Kcmucky CUniversi'Y of l.ouisyille) • Ad<mocarcinoma of the gallbladder Loujsjnna (Louisiana State Unjyea;!rv Heqhh Sclet1ce Center) - InvASive adenocarcinoma 1-&uisjana. Slidell - Polypoid adenoearclnoma Marvlnod CNorthw¢:Sl Ho!tpital Center> .. In-situ and invasive adenocarcinoma Maryland OJnjversjrv Qf MAryland) .. Papillary adenocarcinoma

Mary)Md CSilyq Springs) - Well-<liff=ntiated gallbladder adenocarcinc>ma M!WAdJuSC!!s !Berkshire Medical Centro - Adenocarcinoma of gallbladder Mawwhusetll' CTuft.<-New En•land Me!lical Center\ - Adenocarcinoma, pllbladdcr Ma.<.scbusetts Peabodv - Adenocarcinoma, gallbladder Miebi••n 10al<wood HO!;pital\ - Adenocarcinoma, inteStinal type (I); Cllolangiocarcinoma (! ) Mjcbjgnn CSt. Jru;enh,s Mercy Hosp jtn!) .. Adenocarcinoma Mjoncspta Cf l)irvis;w Ridges Ho:mj~a!l .. Adcno<:arcinoma Moptpnq Mjssoula • invasive adcnoCili'Cinoma Nebrnska !Creighton University) - Adenocarcinoma of gallbladder New York fl.ong Island Jewjsh Me!lical Cen!erl - Adeoocarcinoma, moderately tc> poorly-differentiated New Yprls !Nassau Universirt M<dical Caner) - Infiltrating adenc>carcinoma, gallbladder New ym cswe Univmjrv pf New ymt 11 Stpgy Brookl • Adenocarcinoma arising in a villous adenoma New York CStJNY Qownsmte R<;ti<kntJl .. Adenocarcinoma

Noah Carolina (Mountain Area PatboiAAy) - Adenocarcinoma (2); Mc>derately differc:otiated adenocarcinoma (I) Nonb Carglina (pathologists Medical Lqbomtoryl • Adenocarcinoma (2) Ohjo (McCullough· Hyde Memorial Hosnital) .. Adenocarcinoma

pennty!yanin £Drexel Unjyersity College of Medicjne) - Adenocarcinomn of gallbladder (cholangiocarcinoma) Pcnnsvlyonia Cl.ehjgh Val lev Ho~nl1aJ> .. Adenocarcinoma PennsylyMja fML Njtp1ny Medjcal CAntql • Invasive papillary adenocarcinoma, gallbladder Penn:wlyanja fPmnMvania Hospital Rqjdmts) .. Gallbladder carcinoma TcxM l!.oclllagd AEBI - Adenocarcinoma, gallbladder Tew IMstbodi<J HospitaD - Mc>dcrately-differenliated adcnocarcinc>ma Tnu <Scost & White Memorial Hcspir.aJl • Invasive adenocarcinoma Tsxa Lubbock • AdenOClll'Cinoma West Yirgjoja !Grttnhrier Volley Mcdjca! CcnJerl - Adenocarcinoma. NOS West Yirginjn <Wetzel Counw Hospital\ .. Invasive modenu.ely-differentiatcd adenocarcinoma Wjl)pnns jn CMeriter PathnloM • Adenocarcinoma Austrnlin COyeeoslapd pathnlpgy Gmun\ .. Adenocarcinoma of gallbleddcr

AymnHn CRowl Hobart Hospjta!l - Papillary and invasive adenocarcinoma of gallbladder Ay!!trJ!Iia fRgyal Prince Alfred Hospital\ - Adenocarcinc>ma. moderately-differentiated, arising in villc>us adenoma with higb-g<Mc

dysplasia Msm!ia /Sullivan Nicolaides PAJbp!oM - ~dcnocarcinoma of gallbladder

18 CiTR, September, 2006 "'Minuu:s· (Subscription A)

Brazil C!.abo!lltorio Ana<omia Patologjca E Cjto!ogjal - Adenocarcinoma, invasive, -11-diff"crcotiated (papilla.y ?, intestinal type?) eanw <Pwua HosgjtpD - Adenocarcinoma. gallbladder Canad!l IOnjymirv Hospital ofSbetbrtx>kel - Wcll-dilferenliated infiltrativo adenocarcinoma, biliary type

GqmMy Clos:tjrut fur Pathologje UK.El - lnwsive adenocardnoma

Hong Kong rPamela YoudcNethmgle t;qstern Hpmjtall ~ Adenocarcinoma Ireland IKcny General Hospital} - CholangiocQ(Cinoma JapM <Kyoto Ynjyprsjtv Hosnitall - Adenocarcinoma Oman <Khoula Hosrijtall - Adenocarcinoma Pueao Rjcp CUnjymjty of Puerto Rjco) - Oallbladder adenocarcinoma Oatw (Hamad Medical Corporation) - Adctloean:inoma arising in villous adenoma Saydj Arabia fKjng Fahad Nation;aJ Guard Hosnita.ll .. Invasive adenocarcinoma on top of adenom'!!tous polyp Saudi Alllbja CMCH) - Adenocarcinoma Sincanom CKK. Wornen'• & Children'• Homjr.al\ - Adcnocarcin(lma of gallbladder The Netherland!. Affi!tclycsn - Adenocarcinoma of the gallbladder United Kjngdom <Oxford Swdv Gmupl - Gallbladder- Moderately-differentiated adenocarcinoma

Case 8 - Diagnosis: Adenocarcinoma with papillary features, gallbladder

T-57000, M-8260/3

Case 8- References: l.angnet C, l..cmmcn:r M, Komprat P: Analysis of KIT (CO 117) Exp.-ession In Oallbladdez Carcinomas By Tissue M icroarray. Eur

J Surg Onct>l, 20<» Oa; 30(8):847-50. Vlad L, Osian G, lan<:ll C, et al: Oallbladder Calcinoma. A Oinical Study Of A St:ric:s Of38 Cases. Rom J GastJ'O«ntuol, 2003

Ssp; 12(3):199-202 Ono T, Komal$u M, Hosbino T, •• al: Alpha·fctoprotcin, Carcinoembryonic Antigen, And Carbohydrate Antigen 19-9 Producing

Gallbladder Cancer. J Gastroenterol, 19% Oct; 31 (5):742-6. Nuzzo G, Clemente G, Cadcddu F, ct al: Papillary Carcinoma OfThc Gallbladdet And Anomalous Pancrearic:o-Biliary Junction.

Report Of Three C~ And Review Of The Literature. Hepoto·Gostroelllcrology, 2005; 52(64):1034-8. Mukhopadhyay S, Landas SK: Putative Precursors Of Gallbladder Dysplasia: A Review Of400 Routinely Resected Specimens.

Arch Pathol Lab Med, 2005; 129(3):386-90.

Case No. 9 • Accession No. 30146 September, 2006

Baldwin Park CKa!sq Pqmaneotel - Microcystic S<rous adenoma (2); Microeystic serous cystadenoma (I); Serous cystadenoma (I) Eonwa <Knisgr Pt:rmMcptc;l - Microcystic ~erous cystadenoma Glevdale - Serous cystadenoma Gnapada Hilla - Mucinous non-neoplastic C)'SIS Haywml CHoyward-Freemont) - Microcystic adenoma La Jolla ISerinM Hcalthl - Serous llllcrocystic adenoma la Jolla CSqjPP' Clinic Hematopatbo\ogy Ee!!gwsbjpl • Serous microcystic adenoma Lorna Uoda (l.gma Linda Uniyeajrv Rsrjdgufl · Serous cysmdcnoma long Bcacb CVA Long Beach Health care SY"teml - Serous llllcrocyslie adenoma: Serous cyst adenoma (I) Monrcrey CCommynjty Hosnital of the Momcrey Penjnsulal · Serous microcystic adenoma Monmy Park CGnrficld Mec!ical Center\ - Solid pscudopapilla.y rumor Oakland (Alameda Counw Medjcnl Cetuer\ - Serous microcystic adenoma Orange <Orange Cpynty Medical Gmunl . Microcystic adenoma Onmge ClJnjycrsjty of California Jryjnel · Microcystic serous cyStadenoma. Orange County CKaiser Pennancntcl - Serous cystadenoma Oxnard CSJ John's Regional Medical CenJql - Microcystic cystadc:noma (3): Serous cystadenoma (microcyslic adenoma) (I} Sagamauo 0! C Davis Residents) • Serous miaocyslic cys<adcnoma Sa.'\ Diego (Ainmdo Parhologv Associarc;V • Microcyslic serous cystadenoma

CTTR, September, 2006 "Minut<S" (Subserlption A) 19

San Diesto <Nnva! Medical Centg! • Serous miaocystic carcinoma San Diego CUCSp Me4ical Center> • Serous microcystic ad.,oma San Fmnejscg (San Emncisco Genemt Hosnitall - Serous microcystic adenoma Soma Barbara .. Microcystic cystadenoma

Santa Rosa (Saara Rosa Memoripl Hospjmll - Serous cystttdenoma (1}; Microcystic: cystadenoma (J); Serous microcyslic adenoma (I) .

Woodland Hi!!siJ<ajsr Pqmanente Me4ical Cen!er) - Microcystic cystadenoma Wros!land Hills CSyda's Soldier:;\ • MiCTOC)'Stio admoma (serous adenoma} Arkansas CUAMS> .. Serous microcywt:ic adenoma, pancreas florida IAmeripnth\ • Serous cystadenoma Florida <BapriM Ho~nital. pegsacqlnl .. Serous microcystic adenoma {1 ); MiCJ '-"Ystic serous adenoma (1 ); Microcystic adenoma (1) florida CJashoo Memorial Hospitall • Microcystic cystad.,oma of the pancre.a florida Cia!laha~se Pathologv Asmj11esl - Microcystic cystadenoma florida <Wimer Hayen Hosoital) - Cystadenoma (2)

JUjnois fLovola Uojyersity MeQjcn! Center) - Microcystic serous adenoma

IUjnois <MncNca! Memorial Hospitnll - Micrucystic serOt.!,S cystadenoma (1): Mic~ystic cystadenoma (I) Indiana (Howp,rd Regional Medical Center) - Microcyst'ie adenoma Knns:a<~ fPh>1jdans Refqs;nce Labora!Qrvl • Serous microcystic adenoma

Kt:ni!!C!sv CUnivmitv of louisville) • Serous microcysrie adenoma of pancreas lllujttjana CLouisjMa State Uniyeajtv Hmlth Science Csnu:r> - Microcystic serous cystadenoma Loujs:jana. Slidell .. Serous cystadenoma

Mnryland <Nortbwc:u Hospiml Cep!gl - Microcystic serous cystadenoma MIDland Ct!ojymicv ofMarylgndl - Microcystic serous cystadenoma Marvland lSjlyq Spring() - Serous cystadenoma Mmtthur.qt$ CB@hire Mcdjcal Cquql • Serous cystadenoma

Mass.achussns (Thf\.~-New England Medical Centerl - Serous microcystic adenoma, pancreas Ma.-twbysctU. Peabody - Serous cystic rumor. pan~

Mjcbjgan COakwppd Hospita!l • Serou$ microcystic adenoma(!}; Serous neoplasm (1} Mjchigan <St Joseph's Mercy HosPjmO - Microcystic adenoma Minnesota (fojrdew Ridges Hp:mitall - Serous cystadenoma

Montana Mi$l9tlla - Serous microcystic: rumor

Nebra<~ka CCrcighion UniymjM - Serous microcystic adenoma New York Cl..ong 1$1Dnd JC\\tish Modjcpl Center) - SerouJ; microcystic cystadenoma New York <Nnssou Uojversitv Msdjcal Center> - Serous cystadenoma. pancrc~ New York CSrare Universitv of New Vork 01 Stony Brook) - Serous cyst adenoma New York: CSlJNY Downstate Rgjdents} - Miaocystic serous adenocarcinoma Nonh Cam!ina <Mountain An;a PaJbologyl • Microcystic ocrous cystadenoma (2); Serous microcysric adenoma (I) Nonh Cam!iu• (paJbo!osim Ms:dic;al yboratory\ • Serous microcystic adenoma (I); Mic:rocystic adenoma (1} Ohio !Moeul!oyoh-Hyde Memorial Homjta!l • Lymplulogioma pennsylyanja (Drexel Universirv CoUogc of Medjcioq> - Serous microcystic cystadenoma Pennsv)vania <Lehigh Valley Hospjpl> - Microcystic adenoma Pennsylvania fMt. Ninany Medical Center> - Microcystic serous cystadenoma. pancreas Pcnnsvlvania CPsQn1Yivania Hp;mitAI Residents> - Microcystic cysa:ader.oma Texas fi.acklaod AfB\ - Serous miorocystic cystadenoma Texas !Metbodj!t Hospirall - Serous microcystic adenoma

Iexos I Soon & Whjce Memorial tlosnjtall - Serous microcystie adet!Oma Texa:-, Lubbock • Serous microcystic ndcnoma We!t Virginia CGtoenbdcr Valley Mgdjgl Center> - Serous microcystic adenoma West Virginia fWs:p;l Counrv Homjtall - Serous cysradenocna Wisconsin CMqirq PatholoM - Microcystic serous adenoma Australia {OyOCO$h\nd Pathplogy Groun) - Serous cyst ndenoma Australia CRgypl Hoban Hospital> .. Serous microcystic adt.-noma AusunJia CRpyal Prince Alfred Hosnjtpl\ .. Serous microcy,tic adenoma

20 CTIR, Scpecrnbe., 2006 •MinuJes• (Subscription A)

Aumlio !Sullivan Nico!ajdcs Pa!bok!gy) - Microcystie serous cystadeoom.a Brpjl CLaboratorio Anawmja Patologjca E Cjtologial · MiCI'OC)'$tic serous cysmdenoma. pancree.s Omadq fP11Squa HospjtaD - Microcystic adenoma CMudq <Universirv Ho:mjtal of Sherbrookc) - Mieroeystic .serous cystadenoma Gqmaoy fJn-stirut fur Pptbo!ogie UJ<E> - Serous mierocystic udcnomo Hong Kong CPamela You de Nethersole E!L"u;m Hosnjta]l - Serous cystic adenoma (microcystic) Ireland IKazy Genml Hosoi!31l - Miaocystie serous cyswlenoma Jwn !Kvoto Univrnjrv Hospital) - Serous cystic neoplasm (SCI'OU$ cystadenoma} of the pan<JQS Oman CKhoula Hosnitoll .. Microcystic serous cystadenoma Pueno Rico ftJnivenjtyofPueno Rico) - Microcystlc cystadenoma Oarw !Hamad Medical Cornomtjonl - Serous mieroeystic adenoma Saudj ArAbia !Kjng fabo4 Naliona) Guyd HospjJa!l - M icrocystadcnoma (serous cystadenoma} Saudj Arabia (MCHl - S<rous cyswlcnorna, microcysric Siogpore <KK Women) & Children's Hotpitoll - Serous microcystic adenoma The Netherlands Amstc!ycco - Microcysric serous cystadenoma of We pancreas Unilod Kingdom !Oxfur4 Srudy ('rmupl - PMcrcas- Mierocysric (s~us} cystadenoma

Case 9 • Diagnosis: Serous mlcrocystic adenoma, pancreas

T-59000, M-8140/0

C85e 9 References: Moruna G, Guarise A: Cystic Tumors Of The Pancreas. Cllnc~r Imaging, 2006 Jul 13; 6:60.71. Reese SA, Traverso LW. Jacobs TW, Longnooker DS: Solid Serous Adenoma OfThe PancteaS: A Rare Variant Within Tilo Family

Of Panc:eatie Serous Cysrie Neoplasms. Pancreas, 2006 Jul; 33(1):96-9. Yasuhara Y, Sakaida N, Uemura Y, a a!: Serous Microcystie Adenoma (Glycogen· Rich Cystadenoma) OfThc Pancreas: Study Of

II Cases Showina Clinieopathological And lmmunohistochemiea! Correlalions. Patlwlcgy International, 2002; 52(4}:307-12. Omcroglu A, Paner GP, Ciesla MC, Hartn1lln G: Serous Microcystic Adenoma Of Tho Pancreas. Arch Pathol LAb Med, 2001 ;

125(12): 1613-4. Loii'OnO R, Vyas SH, Molina CP, Waxman 1: Microcyslic Adenoma OfThe Pancreas: Cytologic Appca{Qnce On Percutaneous And

Endoscopic Ultra.sound-Guided Fine-Needle Aspiration: Report Of A Case. Dlagn Cytopathol, 1999; 20(5):298-301 .

Case No. 10 - Accession No. 29954 September , 2006

Ba!dwjn Park !Kaiser Pennanentel • Solid-cystic pseudopapill81)' rumor (3); Solid cystic (pscudopapill81)'} epithelial neoplasm of pancreas ( 1}

FontMo (J(ajsq f>mnMmtsl - Solid and PscudopapiUary wmor Glendd!le • Solid-pseudopapiU81)' rumor of pancross Gnmoda Hills • Sol!id·pseudopapillary rumor Hayward CHaywnn!-fr..,montl • Islet cell tumor (NE Grade I) La Jolla !Scrioos Hcalthl • Solid-pseudopapillary rumor !.a J())la ISaipps Cljnje Hematopatho!ogy felloWllhipl • Solicl-pseudopapilla!y NlllOf (of pancreas) Lorna Linda lloma Linda Universirv Rajdqn(! - Solid-pscudopapiUary rumor Lona Beach CVA Lons Beach Healthcan; Svvem> - Neuroendocrine carcinoma; Isler cell tumor (I) Monterey CCommunirv Hospital of the Monterey Pcnjnsulal - Solid psc:udOpapillary tumor Monterey Park (Garfield Modica! CC!Jter) • Solid pscudopapil!ary tumor O!lk!Md CA!amoda C'.qunty Medical Center> • Solid pscudopapi!lary neoplasm Or!oae !Orange Couorv Medical Qroyol - Solid-pseudopapil!ary rumor Omoac IUoiver.rirv o[Ca!jforoia Irvine) • Solid pseudopapillary NlllOf

Omnsg Cquntv fK.aisgr Pqmanentel - Solid-cystic pseudopapillary tumor Oxnord 1St John's Rcajonal Medical Cemerl • SPPT (Solid pscudopapillary rumor), pancreas (4) Snsmmcnto CU.C Oayjf Rssident.c;l - Solid p~dopapillary rumor

21

San Diego !Alvarado Pathology Associate.<;) - Pancreatic endocrine neoplasm, malignant? San Diego (Naval MesJical Centerl - Solid pseudopapillarytumor San Pic¥Cj IUCSD Me<lical Cent..-) - Solid pseudopapiUary tumor San Francisco (San Francisco General Hosnicall - SoJid pseudopapillary rumor SanJa Barbara • Solid pseudopapil!ary tumor Santa Rosa !Santa Rosa Memorial Hospjta!l - Solid pscudopapi!!ary tumor of pancreas (1); Solid pseudopapil!ary neoplasm (2), of

pancreas (1)

Woodland Hills !Kaiser f>ennaoente Medical Centerl - Solid-pscudopapillary tumor Woodland Hills ISuda's Soldiers) - Solid & papillary tumor (pscudopapillary) Arkansas IUAMS\ - Solid cystic-papillary epithelial neoplasm, pancreaS Florida IAmerina!hl - Solid-pspi!!ary tumor Florida (Baptist Ho'oi!!ll. Pcgsacolal - Acinar cell carcinoma (1 ); Papillary/solid epithelial neoplasm, PSEN (2)

Florjda (Jackson Memorial Hosnitall - Solid-pseudopapillary tumor of the pancreas Florida CTallahassee Pathology A.~sociatesl - Pancreatic endoc.'Tinc tumor florida !Wimer Haven Hospital\ - Solid pseudopspillary tumor (2) IJlinois £Loyola Universitv Medical Center> - So!id-pscu~opapiiJaty rumor Illinois !MacNeal Memorial HnS!Ji!!l!\ - Solid pscudopapillary tumor (I); Solid and pseudopapillary tumor (I) Jndjana <Howard RegjMal Medical Center) .. Paraganglioma Kansas CPhySjciMs Reference Laboratory) - Solid pseudopapillary tumor Kentucky IUniversitv of Louisville) - Solid pseudopspillary tumor loujsjana <Louisiana State Universirv Health Scieru;;e Center) - Solid~pscudopapillary rumor Louisiana Slidell - Undifferentiated· adenocarcinoma (clear cell) Marvland /Nor!hwe<t Hospital Center> - Solid pscudopapill;iry tumor Marv!and (Ugjyeryjtv ofMarvlandl - Solid pseudopapillary tumor Maryland <SHyer Swings) · Solid .. pseudopapillary tumor

MM§!!cbusetts IBcrlssbire Me<lica! Center) • Solid pseudopapillary tumor MMsacbusctts. <Tufts-New England Medica.! Center) - Solid pseudopapillruy rumor, pancreas Massachusetts. Peabody .. Pseudopapillary tumor, pancreas Michigan I Oakwood Hospital) - s·olid cystic-papillary epithelial neoplasm (2) Michigan 1St Joseph's Mercy Hosnitall - Solid and pseudocystic papillary neopla>ll!l Minnesota <Fajrvipw RidgljS Hosoita)) • Solid-pseudopapil1ary tumor MomaruL Mj&~oula - Solid-cystic-papillary epithelial tumor Nebraska ICrcjghton University) - Solid pseudopapillary tumor New X oils flong Island Jewish Medical Center> - Solid pse<~dopspillary tumor New Y orlc INa.<sau lJnjveryjty Modjcal Center) • Solitary cystic papillary epithelial neoplasm, pancreas New York I State University of New YorJs at Stony Brookl - Solid pseudopapillary epithelial neoplasm New York (SUNY Dowg$llljc Resjdentsl • Solid pse)ldopapillary tumor of ~ancrcas Nor!h Carolina IMougtajn Area Pathology) - Solid pseudopapillary tumor (3)

North Carolina (pathologists Medical Laboratory\ - Solid pseudopspillary tumor (solid and papillary epithelial neoplasm (2)) Ohjo IMcCullough-Hvde Memorial Hospjta!) - Synovial sarcoma Pennsylvania <Drexel Unjver~itv CoUcge of Medicine) • Solid pseudopapillary tumor Pennsylvania CLehjgh Va!Jey Hospjtall .. Papillary and solid epithelial neoplaSm Pennsylvania <Mt Nittanv MecJjcal Center) · Solid·pseudopa:pHJary tumOr, panCTea.s Pennsylvania Cfennsvlyanja Hospital Residents) · Solid-p~eudopap.ilhuy neoPlasm TexM l!.acJslapd AFBl - Solid pseodi>-papillary tumor Tgas (Methodist Hospital) - Solid pseudopapillary tumor Texas !Scott & White Memorial Hn<ni!!lll - Solid-pscudopapillary neoplasm Texas Lubbock - ~Solid pseudopapillary tumor West Virginia <Cl7Unhrier Valley Medical Center) · Solid pseudopapillaty tumor West Virginia (Wetzel Coonty Hospjtal\ - Solid and cystic papillary epithelial neopl""m Wiscon~in £Merjter Pathology) - Solid pseudopapillary fum,or Australia !OuocnsJand Pathology Group) · .Solid cystic pseudopapillary rumor Au~ttrnlia <Royal Robart Hos-nitall . Solid p$Wdopapillary tumour of pancreas

22 CITR, September, 2006 "Minutes" (Subscription A}

Australia fRoyall:'rincc Alfred Hospjtal\ - Solid pS<:Udopapillazy neoplasm Aus!l'lllia {Sullivan Nicolaides Pathology) - Solid-pseudopapillazy tumour of pancreas Bmzjl fl.§bomtorio A:natgmia PatQiqgiea E CitQlngia) - Solid-pseudop.apilliU)• tumor, pancTtCaS Canada {Pasqua Hospjtan - Solid pseudopapillary tumor Canada fUniycrsity HosnjtaJ of ShcrbrooJscl - Solid pseudo-papillary tumour Germany (Jnstirut fur Pathologic UJ<El - Pseudo-papillary tumor Hong Kong (pamela Youde Nethersole Eastern Hospital\ - Solid-pseudopapillarytumor Ireland !Kerry Genqalliosnita1> - Clear cell tumour.? metasmtic renal cell carcinoma Jaoan !Kyoto UnjyCJ1ijtv Hospjtal\ - Solid-pseudopapillary neoplasm (solid cystic neoplasm) of the pan<-reas Oman (Xhoula Hosgjtall - Solid cystic pscudopapilhuy tumour Puerto Rico <UnivcrsiiY of Pueno Rico> - Solid cystic-pseudopapillllry neoplasm Oatar (Hamad Medical Comorarion\ - Solid cystic ncopla>m of pancreas Saudi Arabja {Kins Fahad National Guard Hosoital\ - Solid pseudopapillary neoplasm Saydj Arabja CMCFD - Solid-cystic-papillary epithelial neoplasm Sjngaoore CKK·Wom¢D 's & Cbi1drep•!-i Ho~pira)) - Solid pseudopapillary neoplasm The> Nctberlands. AroSfelveen - Solid pseudopapillacy tumor <if the pancreas United Kingdom £Oxford Study Qrouo> - Pancreas- Solid pselldopapil1ary tumour

Case 10 -Diagnosis: Solid pseudopapillary neoplasm, pancreas

T-59000, M-80001

Case I 0 - References: Siquini W, Marmorate C, Guercioni G, et al: Solid Pseudopapillary Tumor Of the Pancreas. A Repon Of3 Cases And A Review Of

The Literature. 'Chir /tal, 2006 Mar-Apr; 58(2):235-45. Tipton SG, Smyrk·TC, Sarr M.G, Thompson GB: Malignant Potenti,al Of Solid Pseudopapillacy Neoplasm Of The Pancreas. Br J

Surg, 2006 Jun; 93(6):733-7. Peng CH, Chen DF, Zhou GW, et al: The Solid-Pseudopapillary Tumor Of Pancreas: The Clinical Characteristics And Surgical

Treatment. JSurg Res, 2006 Apr; 131(2):276-82. _ Bhanot P, Nealon \VH, Walser EM1 Clinical,. Imaging, And Cytopathological Fearures Of Solid Pseudopapillary Tumor Of The

Pancreas: A Clinicopathologic Study Of Three eases And Review Of The Literature. Diagn Cytopa~hol, 2005; 33(6):421-8. Pettinato G, Di Vizio D, Manivel JC, et al: Solid-Pseudopapillary Tumor Of The Pancreas: A Neoplasm With Distinct And Highly

Charncteristic Cytological features. Diagn Cytopathol, 2002; 27(6):32.5-34. Klimstra DS, Wenig BM, Heffcss CS: Solid-Pscudopapillary Tumor Of The Pancreas: A Typically Cystic Carcinoma Of Low

Malignant Potential. Sem Diagn Pathol, 2000; 17(1 ):66-80.

CITR, Seplember, .006 "Minutes" (Subscription A) 23