I • ,_

111r CALIFORNIA TUMOR TISSUE REGISTRY

"GENITOURINARY PATHOLOGY"

Study Cases, Subscription A

February, 2004

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

Loma Linda University School of Medicine I 1021 Campos Avenue, AR 335 Loma Linda, California 92350

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

E-mail: cur@linkl inc.com Web page: www.cnr.O<g

Web site & Case of the Month: www.cttr.org

i ··, ... 10 ... -,. ~~ ~~.,~ .. - · :.. .... .,::;'(:,1,-.,'l.'--· • .. ·~~

, :~::t.in! P,'\l ~.. r ) sts and palhology residents.

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

malignant neoplasms and tumor-~ke conditions.

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

and malignant neoplasms and tumor-like conditions and relate those processes to pertinent references in the medical liter4ture.

EduCAtional methods and media: Review of representative glass-slides with associated histories. Feedback on consens\15 diagnoses from participating pathologists. Listing of selected references from the medical literature.

Princip•l faculty: Weldon 1<'. Bullock, MD Donald R. Cbase, MD

CME Credit: Lorna Linda University School of Medicine designates this continuing medical

education activity for up to 2 hours of Category 1 of the Physician's Recognition Award of the American Medical Association.

CME credit is offered for the subscription year only.

Accreditation: Loma Linda Universir:y Scbool of Medicine is accredited by the Accreditation

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

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

Tissue from : Left kidney

Clinical Abstract:

Case No. 1 - February :Z004

Accession #29377

Following a two month history of left flank pain, this 48-year-old female had an ultrasound revealing a large cyst.

Gross Pathology: The kidney measured 20.0 x 18.0 x 16.0 em and weighed 2450 grams. It contained a 11.0 x 9.0

x 6.0 em cyst. There were several additional thin-walled secondary cysts measuring up to 4.0 em and appeared to compress the renal pel vis. ·

Cootributor: Sheldon A. MiJier, M.D. Case No. :Z - February 2004 Oxnard,CA

Tissue from: Right kidney Accession #29775

Clinical Abstract: A tumor mass developed in the right kidney of this 78-year-old male.

Gro.u Pathology: The right kidney tumor measured 20.0 em.

Contributor: LLUMC Pathology Group (cz) Loma Linda, CA

Ti5sue from: Right kidney

Clinical Abstract:

Case No.3 - February 2004

Accession #29400

This 5-year-old female developed a tumor in the right kidney.

Gross Pathologv: . The 1,120 gram segment of renal tumor measured 13.0 x 10.5 x 9.5 em. It contained a 11.0 x

8.0 x 7.0 em soft tan tumor mass which was predominantly solid but had cystic areas filled witn hemorrhagic fluid.

Contributor: Faramarz Azizi, M.D. Case No. 4 - Febr uary 2004 Fontana, CA

Tissue from: Right kidney Accession #29412

Clinical Abstract: Following a two month history of right flank pain and a 15 to 20 pound weight loss, this 20-

year-old male underwent a CT scan which showed an irregular right kidney with a hypovascular mass.

Gross Pathology: The kidney contained an ill-defined, yellowish-tan, focally hemorrhagic tumor located in the

lower pole of the kidney and measured 8.0 x 6.0 x 6.0 em.

SPECIAL STUDIES: Pankeratin CK7 CK20 Yimentin Des min MSA Myo-01

positive negative negative positive negative negative negative

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

Tissue from: Right kidney

Clinical Abstract:

Case No. S - February 2004

Accession #29671

Due to discomfort in the right upper quadrant, along with bloating and blood in the urine, this 75-year-old female was found to have an upper abdominal mass on imaging.

Gross Pathology: The 1016 gram segment of kidney was 21.5 x 14.0 x 7.0 em and contained a 14.0 x 12.8 x 7.0

qm irregular, firm, lobulated tumor mass that extended to 0.5 em of one medial and lateral renal border.

Contributor: MPG Little, M.D. Ireland

Tissue from: Right kidney

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

Tissue from: Right kidney

Clinical Abstract:

Case No. 6 - February 2004

Accession #29723

Case No. 6 - February i004

Accession #28853

A total hysterectomy and·bilateral salpyngo-oophorectomy was performed on this 42-year-old female due to severe menorrhagia and an iron deficiency anemia Two years later during gynecologic examination an enlarged right kidney was noted which showed a large right renal tumor and a nephrectomy was performed. (29723)

A mass developed on the right kidney of this 77-year-old male. A right radical nephrectomy was performed. (28853)

Gross Pathology:

80% of the kidney specimen was replaced by alight brown circumscribed tumor 170 x 120 x I I 0 mm. (29723)

The red-tan kidney surrounded by Gerota's fascia and adipose tissue weighed 355 grams and measured 16.0 x 9.0 x 4.5 em. (28853)

Contributor: Pamela D. Boswell, M.D. Case No.7 - February 2004 San Diego, CA

• Tissue from: Bladder Accession #29625

Clinical Abstract: Having had prostate carcinoma ten years ago, this 82-year-old male was experiencing

hematuria. A bladder tumor was found on cystoscopy.

Gross T ~ ~ , ...... ....... • o .,r;.. .• ~ x .:asurements given.

SPECIAL STUDIES: PAP PSA

Contributor: Tai-Po Tscbaog, M.D. Fresoo, CA

Tissue from: Left testicle

Clinical Abstract:

· negative positive in most, but not all of the malignant cells

Case No.8 - February 2004

Accession #29645

This 47-year-old male developed an enlarged left testicle. A radical orchiectomy was performed.

Gross Pathology: The left testicle measured 6.0 x 5.0 x 4.2 em and contained a multilobulated tan tumor mass . - ? measunng ;:,,_ em.

Contributor: LLUMC Pathology Group Lorna Linda, CA

• Tissue from: Left testicle

Clinical Abstract:

Case No. 9 - February 2004

Accession #29426

Some swelling developed on the left side of this 73-year-old male's scrotum. There was a mild increase in the left hydrocele which contained about 50 cc of clear fluid. A left radical orchiectomy was performed.

GrOS5 Pathology: The enlarged testis with attached spermatic cord weighed 76 grams and measured 8.5 x 6.5 x

5.0cm.

SPECIAL STUDIES: LCA CD20 CD3 AEl/3

ConmbutoT: \\tnry S\o11stT, M.D. Pasadena, CA

Tissue from: Right testicle

Clinical Abstract:

positive positive negative negative

Case No. 10 - Vtbruary 'l\)1)4

Accession #29808

For six months this 19-year-old male had a slow progressive swelling, without pain.on the right testicle. A right orchiectomy was performed.

Gross Pathology: The enlarged, hemorrhagic, ovoid testis specimen measured 13.5 x 11.0 x 7.0 em and weighed

746 grams.

CALIFORNIA TUMOR TISSUE REGISTRY

GENITOURINARY PATHOLOGY

Minutes - Subscription A

February, 2004

SUGGESTED READING (General Topics from Recent Literature):

Klmfinan HL. The Role of Poxviruses in Tumor Immunotherapy. Surg 2003; 134(5):731·737. Georginnos SN, Renaut A, Goode A W, et al. The Immunophenotype and Activation Status of the Lymphocytic

Infiltrate in Human Breast Cancers, the Role of the Major Histocompatibility Complex in Cell Mediated Immune Mechan.isms, and their Association with Prognostic Indicators. Surg 2003; J 34(5):827·834.

l'anasuk DB, Bauer TL, Davies AL, et al. Common Malignancies with Uncommon Sites of Presentation. Case I. Anterior Mediastinal Rhabdomyosarcoma J Clin Onco/2003; 21(23):4455-4456.

Russell SJ and Peog KW. Priiner ofMedical Geoomics. PartX. Gene Therapy. Mayo C/in Proc 2003; 78(11): 1370· 1383.

Donadio AC, Motzer RJ, Bajorin DF, et al. Chemotherapy for Teratoma with Malignant Transformation. J Clin Oncol 2003; 21(23):4285-4291.

California Twnor Tissue Registry c/o: Department of Pathology .and Hwnan Anatomy

Lorna Linda University School of Medicine 11021 Campus Avenue, AH335 Lorna Linda, California 92350

(909) 558-4788 FAX: (909) 558-()188

E-mail: cttr@liokline.com Web site & Case of the Montb: w\Vw.cttr.org

Case 1:

Cue2:

Case3:

Case 4:

Case 5:

Cue6:

Case7:

Case 8:

Case9:

FILE DIAGNOSES

C1TR Subscription A

Cystic hamartoma of renal pelvis T-72000, M-75500

Oncocytoma, kidney T-71000, M-82900

Wilms' tumor, favorable histology, kidney T-71000, M-89603

Renal medullary carcinoma, kidney T-71000, M-83123

February 2004

Renal cell carcinoma, conventional clear cell and sarcomatoid, kidney T-71000, M-83123

Chromophobe renal cell carcinoma, kidney T-71000, M-82703

Recurrent high grade prostatic adenocarcinoma, proslate T-77100, M-81403

Classic seminoma, testis T-78000, M-90613

Diffuse large B-celllymphoma, testis T -78000, M-95903

Cue 10: Choriocarcinoma, testis

T-78000, M-91003

Case No. 1, Accession No. 29377 February 2004

Alamc<la <Alameda County Medjc:a! Cen1erl • Cystic nephroma Ar!:adi• !Garfield Medical Center) - Cystic nephroma (multilocular cyst) !lal<erslield • Cystic nephroma Baldwin Park (Kaiser Ponnanen!el - Benign mull!loculated cyst (2); PolycysUc disease(!) Fonll!!!aiK•i:rq Pe!manentel - Angiomyolipoma How!l!dlfremont · Adull polycystic aiscasc Irvine CUC !rvjncl • End stage kidney with simple cyst Laguna &ach <South Coast MedjcaJ Center) - Cystic nephroma Lorna Linda ILoma l.jnda Pa!hology Residents) • Benign cyst with renal atrophy l.ona !!cach l!.a!tcwoo<l Reoional Medical Center\ • Multilocular renal cyst (9) Monterey CCommupjN Hospital ofMontmy Penjp;rulal · Angiomyolipoma Mountain Vjew rEI Camino Pn~tology Group\ • Multilocular cyst Ortnge !Orange Counrv Pa!bolpgy Medical Gmupl - Aogiomyolipoma S!lml!l!!loto CUC Davis Medica! Cepterl • Angiomyolipomo wi!h acquired polycystic disease san Piego CNaval MediC!l] Center\ - Cy>1ic nephroma San francisco CSan Francisco Oencrnl Hospital} • Cystic nephroma S!IDtn Barbara ISnntn B&barn Cnuage Hmpjll!ll • Cystic ncpluoma and angiomyoUpoma Santa ROS!l !Santa Rosa Memoria] HosniWl - Benign cystic ncpluoma (I); Benign cyst { t); Bcnl&n pyclocalie<!al cyst ( 1);

~ • Adull polycystic kidney distaSe A!Jlska IA!aska Native Medical Center} - Simple cys~ acquired Ariw•IMamo1e Mcc!ieaJ Center) - Cystic nephroma (multilocular cyst) and angiomyolipoma Arl<An!!a<! IUnjymity ofArlaylw Medical Center! • Ao&iomyolipoma Colomdo • Simple cyst Co!o!ldo lWhc'81 Rides> - cystic nephroma f lorida (!lantis Hosoj!nll - Renal mullilocu!ar cysr ( I); Benign multilocular cyst (2); Hydronephrosis. chronic obstructive

pyelonephritis (2)

flcrida CMuruoc RegjpnaJ Medjcal Ccnlcrl • Renal cysts E!orjda (Ja!lllhossecl • Hydronephrosis. chronic pyelonephritis Florida IWintq Haven llosoitall • Simple cyst Illinois <Burr Ridge! • Cystic nephroma l!Unojs <EvansJon Hosol!o!) • Chronic obstructive pyelonephritis IndiDnaiBall Memorial Hosoitall - Cystic nephroma !ndjMaiHoward Commyoitv Ho,'l!!jtafJ • Hydronephrosis Louisiana S!a!e llnivcrsity Medical Center - Pel vi renal cyst with effects of hydronephrosis (inlcrslitial cyslitis) Maryland INaljonal Naval Medical Ccn!cr\ • cystic nephroma MJVYIWld IUojyersitv of Maryland Medical Center\ - Cysric nephroma M&sS!Ichusctls !Berkshjre Me!lieal CeD!erl • Hydronephrosis M1.<1!!!!;hUSC!l$ !New Epo!Jnd Medical Ccntq Resklcn\S) · Cystic nephroma vs. hydronephrosis MlchlgM fOakwood Howi(al\ • End·Siage changes, possible ADRKD Michi!t80 CSL Joseph Mcrcv Hgspjtall - Angiomyolipoma Minnesota IFajrview Soylhdale t loSpi!all • End stnge mullicystic kidney, benign New York clong Island Jcwjsh 11ospita!l • Cystic hamartoma of renal pelvis New Yor!r<NAS58u Unjyer.<ity Medical Center\ • Adult polycystic kidney disease New York (New York) - Cystic lesion, favor mixed epitheliaVstmmal neoplasm Nonb CaroUna(Mounllljn Area Pathology) • Simple cortical cys1 (3) Objo !Medical College of Ohio) • Renal multilocular cyst (cystic nephroma) Oklahoma!Tulsal - Multilocular renal cy>1 (cystic nephroma) Pennsylvanja IA!Ieghegy Gencrol Hospi!91\ - llenign cyst l'ennsylvania ICenrre CommunilY HospitaJl - Adult polycystic kidney disease

t ennsylvaniaiConemoygh Memorial Mcdjcal Cen10(l - Adult polycystic kidney l'c!l!)$ylvnnia l!.d!igh Vp]ley Ho•pitall - Benign cyst(!); Multicystic nephroma ( I)

CITR. Febru31)12004 "Minutes'" (Subscription A) 3

PcnnsylvPIIi• 0/PMC Health System) - Polycystic kidney Pennsylyanja CYorJs Hosoilall • Hydronepbrosis (8) Pue!lo Rjco CUnjyasirv of Puerto Ricol • C).'stic nephroma _. Rhode Island lR! Hospital Residents) - Cystic nephroma Texas O.Ybbock) - Benign mesothelial inclusion~ Texas CPnuwh Asmjmes) - Hydrooepluosis with obstructive atrophy (2) T<:XaS !San Aotonjnl • Benign renal~ Texas CScoU & Whjtc Memorial Hospital) - Cystic nephroma West Vjrgjoja !Greenbrier Valley Medical Center) • Cyst and anglomyolipoma Australio !North Oueeosland Pathology) - End stage kidney. simple cyst/hydronephrosis Australia (Royal Prince Alfred Hospital) - End stogc kidney wi~t hyd.ronephromn Connda (FooUtms MediCI!! Center) • Benign simple cyst !iong Konn Ulono Kona Boptist ijqsoitall - Cystic hamartoma ltnlv fNP!!Ics\ • Multilocular renal cyst Jamaica Cfhe Unjvcrsity of the West Indies) • Autosomal dominant polycystic kidney disease Ncthcr!Md• (Amsterdam) • Angiomyolipoma 0Dtar CHompd Medjc:a! Coroorntionl • Simple renal cyst with pyelonephritis SJUdj Ambjn .. Simple renal cyst

Case I • Diagnosis: Cystic hamanoma of renal pelvis

T-72000, M-75500

Consu!!l!tion: Craig Zuppan, M.D., renal pathologist at Loma Linda University Medical Center. "Consistent with cystic bamanoma of renal pelvis.~

Case 1 - References: Mensch t S. TraioerTD and Plante MK. Cystic Hamartoma uftlte Rcnul Pelvis. A be Pathologic Entity. Mod l'arilo/ 1999;

12(4):417-421. Pawnde J, Soosay ON, Del prado W. eta!. CystlcHamartuma of the Renal Pelvis. AmJ Surg Patlro/ 1993; 17(11): 1169-117S. Eblo IN and Bonsib SM. Extensively Cystic Renal Neoplasms. Cyl.1ic Nephroma, Cystic Partially OifJ'crentiated NephroblastolllJl,

Multilocular Cystic Renal Cell Can:inolllJl, and Cystic Hamartoma of Renal Pelvis. Semin Diagn Patho/ 1998; IS( 1):2-20. lfirotn S. Hasc M, Matsumoto S, et al. Cystic Hamartoma of the Renal Pelvis. JmagingFeatures. &dint M•d2000; 18(2): 139-142.

Case No. 2, Accession No. 29775 February 2004

Alarncd!! (Aiamedl C()untv Medical Center) • Onoocytic neoplasm (chromophil renal cell carcinoma vs. onoocytoma) A!tadja CGOJ1ie!d Mes!ica! Center) • Oncocytoma Bakc!l!fitld • Renal oneoc)1oma Bald\\in Parle IK•iser Permanentel • OncocytOma (3) Fontana/Koi!!Cr Pconanentcl • Oncocytoma !iow!l!l!/fremont • Renal oncocytOma lryjne f!JC lryinel • Oncocytoma Laguna Beach CSputb Coast Medical Center) - Oncocytoma Lorna Lindp (Lorna Linda Pathology Resjdegtsl - Oncoc;ytic rcnnl tumor favor oncocytoma long Bensb !La!ccwood Regional Me<fical Center) - Oncocytoma (9) Monterey !Community Hosnital of Montcrey Peninsula) • Oncocywma Moyptain View lEI Camino Pathology Group) - Onoocytoma Oran!!!: !OranAA Coyptv Pa!bology Medical Group) • Oncocytoma Sammsn!O OJC Oavjs Medical Center) • Onoocytoma San Diego (Naval Mes!ical Center) • Onoocytoma San fn!nti!!CO !San fn!ncisco GenCll!l Hospital) • Onoocytomtl Santa B¢311 !Santa Barbara Cottage Hospital) - Renal cell carcinoma, pnular type

4 C1TR, Febnuuy 2004 "Minutes" (Subscription A)

Santa Ro;;a IS;an!A Rosa Memorial Hospill!l\ • Renal oncocytoma (2); Renal cell carcinoma (I)

VentU!!! • OncocytOma Ala<ka (Alaska Natiye M;dical Center\ • Onc:ocytOma AriT,onaiMaryyale M;djs:aJ Csnter\ • Oncocytoma Arkansas CUnjymily ofArkansas M;dis:a! Csntetl - Renal onCOC)1om&

Co!0111do • Oncocytoma Colora4o CWbem Rjdacl • 00cocytoma Florida <Bantist Hospjll!l\ • Renal oncocytoma (5) Florida CMUI\I'OC Resiona) Medical Center) • Oncocytoma florida CTJ!II•h!L''"'ol • Oncocytoma Floridn C\Vinter Hayen HospitaJl .. Oncocytoma Illinois /Burr !tjdge\ • Onoocytoma ll!inols CEyaoston Hosnjtal\ • Oncocytoma Indiana (Ball Memorial HomitaJ\ • Granular cell variant rena! oell carcinoma Indiana Wow!!!ll Cgmmunjtv Hospjta)\ • Onc:oc)1oma Louisillnll Stoto Unjvepiw Medical Center .. Large renal oncocytoma MarviB!Jd fNntjonnl Naval Medica! Center\ • Oncocytoma Maryland OJnjvmjrv of Maryland Mes!ica! Centerl • Oncocytoma MPS'"fhusstts l'Bg1sdtire Medical Center) • 0ncoc)1.oma Massachu.<ens <New £no land Medical Center Residen!Sl • Oncocytoma

Michigan !Oakwood HOS!jtall • Oncocytoma MjehiOM 1St Jogph Mercv Hosnill!l\ • Onc:ocytOma Minnesota <Fojrvjew Sou!hdale Ho•nitall • Renal cell carcinoma, granular cell variant New Yorlj O,ona Island Jewish liospj!all - OnCOCytoma New Yorls <N..,..u t!njversjN Medica! Csnterl • Oncocytoma New Yorls lNew vorl<) • Renal ODcoeytOma North Caro!ino (Mountain Area Pathology) • Oncocytoma Ohio CMcdlCAI Col!eoe ofOhjo\ - Oncocytoma Oklohnma CD!I~!l) • Reno! OOOOCyl\lOUl Pennsy!yanjo CAI!tghcny General Hospital\ · Oncocytoma Penn3ylyanju <Centre Community HospitaJl - ~enal oncocytoma

Pennsylyania CCoMmaush Memorial Medical. Center) • Oncocytoma Psnn:wlyanja CLchigh Valley Hospill!ll • Oocoeytoma (2) Pennsylvania CUPMC Health System) - Renal onCOCytoma Psnnsylvani• fYork Hosoitall • OnCOCytoma (8) rueao Rjco OJoivmjrv of Puerto Rico) • Oncocytoma Rho4e Island IR! Hospital Residents) • Renal oOcocytQrna Icxos <l..ybbock) - Oncocytic carcinoma Tc<as (Pronllh As:eoci•tesl • Renal oncocytoma (2) Texas !San Antonio> • 0ncoc)1oma (less likely chromophobe CA) Texas !Scgn & White Meroorjnl Hospital\ - Oncocytoma We>1 Vjrsjnjp CGrecnbrjer Valley Medical Centet) - Oncocytoma Au>iralla!Nortb Oueons!and Pathology> • Oncocytoma Australia CRowl prince Alfhxl Hospital> - Oncocytoma Canada U'oo!hms M;dical Center\ · Oncocytoma Hong Kong !Hoop Kong Baptist Hosnitall - Renal oncocytoma ltnly {NM!C;S\ • Oncocytoma Ne!llcrlands (Amsterdam) • Oncocytoma of the kidney Ollar CHama4 Medjcal Corporation) • Ooc:ocytOma Saudi Aral!i• • Oncocytoma

Casol • Di-ano.•is: Oncocytoma, kidney

CITR, Fobrua.y 2004 "Minutes" (SIIbscription A) s

T-71 000, M-82900

Case 2 - References: Psihromis K£. Oal Cin P, Dretler SP, ct al. Further Evidence That Renal On<:ocytoma Has Malignant Potaltial. J Uro/1988;

139(3):.S8.5-S87. Alancn KA. Joensuu H, Lipasti JA and Nunni MJ. Renal Oncocytoma. The incidence of 18 Surgical and 17 Autopsy Cases.

HistopoJho/1984; 8(5):731-737. Kovacs 0 , Weller C, Wilkens L, ct aL Renal Oncocytoma. A Phenotypic and Genotypic Entity of Renal Parenchymal Tumors. Am

J Patho/ 1989; 134(5):967-971. Rampino T, Grcgorini M, Soccio G, et al. The Roo Proto-Onoogelle Product is a Phenotypic Marker of Renal Oncoc)10ma. Am J

Surg Patho/2003; 27(6):779-785. Kuroda N, Guo L, Toi M, ct·al. Paxillin. Application of Immunohistochemistry to the Diagnosis of Chromophobe Renal Cell

Carcinoma wtd Oncocytoma. Appl Immrmohistoclwm Mol Morpho/2001; 9(4):315-318.

Case No. 3, Accession No. 29400

Alameda IAiamc!la Countv Medical C#lter) - Nephrobl~oma (Wilms' rumor) Arcldia IGodjeld Me!lical CenJ&rl - Nephroblasloma (Wilms' rumor) Bakrntlc!d • Wilms' rumor Baldwjn M IKajsq Pemtancntel • Wilms' rumor (3) Fontana (J(Nsq PermMqucl ~ Wilms' tumor Howardlfn;mont .. Wilms• tumor Irvine CUC Iryjoe) - Wilms' tumor Laguna Bench !Soyth Coast Medical Center> - Wilms' tumor, favorable histology Loma !.indo (Lorna Linda Pathology Rs;jdemsl - Wilms' tumor (nephroblastOma) Lons !leach f!.akewood Regional Medical Ceoter) - Wllms' tumor (9) Monterey ICommunjty Hospital ofMonwrey Peninsula\ - Wilms' (triphasic) Mountain Yjcw lEI Camino Pathology droupl - Wilms' tumor Ornnse IOrnnse County Pathology Medical Group) - Wilms' tumor SuC!WJJ!,'DJo CUC [)avis Medical Center) - Wilms' tumor, favorable histology San pjcgo CNava! Medjcal Center) - Wilms' rumor San Francim !San f!Wleisco General Hospital) • Nephrobl~ma , lriphanc Santa Barbom (Santa Bar!wa Cotta!!!: Hosnitall • Wilms' tumor, favorable Santa Rosa ISwa Roa Memorial Hosoitall • Wilms' tumor (3) .l!mlllm • Wilms' rumor All§ka (Alt.<!sJ Natjve Mc!lica! Center) - Wilms' lllmol'lnephrobi8Sloma (triphasic pattern) Arizona CMPMJ!e Me<lical Center) • Wilms' tumOI'

Arkansas CUniv•rtity of Arkansas Medica! Center) - Nephroblasloma Colorado • Wilms' tumor Colorado (WheAJ Rid gel • Wilms' tumor F!orjda Olnp!ist Hospjlllll - Nephroblastoma (I); Wilms' tumor (4) Florida (Munroe Regjona! Medical Center) • Wilms' tumor Florida O'ai!Ahn.1Sccl - Nephroblasloma FJodda <Winter Haven Hosnitall - Wilms' tumor !llinojs IBurr Rjdgcl • Wilms' tumor llligo[s CEyanston Hospjtall - Wilms• tumor Indiana CBall Memorial Hosojtall • Wilms' rumor Indiana (Hgwan! r.ommuni!y HospilliD - Wilms' rumor Louisiana SJA)e llojvqsi!y Medical C#IJ&r - Wilms' rumor M!!!YIJ!!!d CN01iona! Naval Medical CenJ&rl · Wilms' lwnor, lriphosic Mw!and IUojymjtv ofMBrv!and Medical Center) - Wilms' rumor Mgs:;acbuscns (Bqtshire Me!lical Centerl - Ncphroblas1oma

February 2004

6 CTTR. Fcbru;uy 2004 "Minutes" (Subscription A)

Massocbuset .. <Ncw Eo2land Medical Center Residcn"l • Wilms' tumor Mjcbjm !Qakwood HospitBJ) • Wilms' tumor Michjaan CSL J9l!e!!b Mercy Hospital\ · Wilms' MjnnC!!O!A Cfairview Sowbda!e Hospital> • Wilms' tumor New Yod< C!.ong Island Jewish Hosoitall • Wilms' tumor New Yort (Nasssu Universitv Medjcal Genteel • Wilms' tumor New York CNew Yorkl · Wilms' tumor North CoroliM IMountain Area Pathology\ • Wilms' tumor (3) Ohjg !Medical College ofOhjo) • Wilms' tumor, serpentine pauem, favorable histology Oklallomn !Tulsa\ • Wilms' tumor PennsyJyanja <Ailcghcnv General Hospitp!) · Wilms' tumor PeMsylyaoja !Centre CommunjiY HgspjJa]l • Wilms' tumor (nephroblastoma) Pennsy!YJ()jD !Conemaugh Memorial Medical <&ntq\ • Wilms' twnor

Pennsy!yagjo (Lehigh Valley HgspjJa]l • Wilms' tumor {I); NephrobiBSIOma ( !) Peon:;y!yoojo CUPMC Health Sl'S!cm\ • Wilms' tumor Pennsylvunla CYort Hospi!l!ll . NephroblllSloma (8) Puerto Rico !University of Puerto Rico) • Wilms' tumor, triphasic, favorable histology Rhode Jsl110d fBI Hospital Residents\ • Wilms' tumor (nephrob!astomu) Texns l!,ybbock\ • Wiims' tumor, favorable histology Texas <Pronotb Ass<>ciatcsl • Wilms' tumor (I); Nephroblastoma (Wilms' tumor), triphlkSie pattern ( I ) Texas /San Antoojo\ • Nephrob!astoma (Wilms' tumor) Texas CSco!! & \Vhite Memorial Hosnita!l • Wilms' tumor, favorable histology West YiRiniaiGn:egbrier Valley Mec!jcpl Center> • Nepbrob!ostoma AUSllllli&INonh OliCCIISiand Pathology\ • Nepbrob!astoma Au!i!!J!Ija !Royal Prince Alfrl:d Hospi!al\ • Triphasic Wilms' tumour Canada Cfw(hjl!s Medica! Center) • Wilms' tumour Hong Kong <Hong Kong Baptist liospjtall .. Wilms• tumor Italy IN!U)!CS) • Wilms' tumor, favorable hlstolosy Jamalcn mte University of the Wcst lndjeS) • Nephroblastoma, (?Focally nnaplostio ?), kidney

Netheflonds <Amsterdam) - Wilms• tumor 0aw !HM!!lJ!d Medica! Cornoratioo\ • Wilms' tumour (oephroblasroma) Saudj Amhja · Wilms' rumor

Coso 3 . Diagnosis: Wilms' tumor, filvorable histology, kidney

T-71000, M-89603

Case 3 • References: llreslow N. Boo!cwith m; Ciol M, ct al. Ago Distribution of Wilms' Tumor. Report From the National Wilms' Tumor Study.

Cancer Res 1988; 48(6):1653-1657. Beckwith J!3 and Palmer NF. Histopathology and Prognosis of Wilms' Tumors. Results From the National Wilms' Tumor Study.

Canctr !978; 41(5):1937·1948. Gessler M. Paustka A. Cavcncc W, ct al. tlomozygous Deletion in Wilms Tumours of a Zinc-Finger G<oe Identified by

Chromosome Jumping. Nature 1990; 343(6260):774-778. Pritchard-Jones K. Kelsey A. Vujanie 0, eta!. Older Age is an Adverse ProaJ!ostie Factor in Stage~ favortlblc Histology Wilms'

Tumor Treated \\ith Vincristine Monocbemothcrapy. A Study by the United Kingdom Children's Cancer Study Group, Wilms' Tumor Working Group. J Clin Onco/2003; 21 (17):3269-3275.

D'Angelo Ml' , Kausik SJ, Scbo TJ, ct al. pS3 lmmunopositivity in Histologically Favorable Wilms Tumor is Nor Relaied to Stage al Prcscnlation or to Bi0!ogiea! Aggression. J Uro/ 2003; 169(5): 1815·1817.

Case No. 4, Accession No. 29412 February 2004

Alameda CA!amc!l• Coumy Medical Cen!crl • Sarcomatoid nma! cell can:i.nomo

CTIR, Fcbnwy 20114 "M'mll!eS" (Subscription A) 7

Alcadi• !Garfield Medjcal Center) • Clear cell carcinoma Bakersfield • Sattonuuoid renal cell carcinoma Baldwin Pads Olejw Pcnnanentel • ? dlabdoid twnor? collecting duct carcinoma (1 ); CoUecting duct carcinoma(!); Clear cell

carcinoma with sareoma10us differentiation (1)

Footana<Kajtcr PermatJ<Otel · MedullaJy carcinoma Howard1FW119!!t • Renal cell carcinoma, high gJ8de (focally san:omatold) !01jne CUC Irvine> · Non-5Cminomatous germ cell tumor Laguna 8eaeh !Sou!h Coast Medical eenterl • Poorly differentiated carcinoma Lorna l.jgda O,oma Linda Pathology Residents) - Renal cell carcinoma (Fuhnrum nuclear, grade 3-4)

Long Beach (!.nkewood Regional Medica] Center) - Sarcomatoid renal cell carcinom~ (9) Momen:y !Communjtv Hru;piml ofMonterev Peninsula) • Medullary carcinoma Mourupin Vjew CEI Camino Pnlhology Grouol • Medullary carcinoma Orumze !Onmae CQI!ntv Pathology Medical Group) • UndHTcrcnlinled carcinoma witb rhabdoid features Sncnuneplo fUC Dayj! Medical Centerl • Medullary carcinoma San Dleoo !NAy!!! Medioal Center) • Medullary carcinoma San Francisco CSnn Fmocjsco GenemJ HospitaJl ~ Rhabdoid tun1or

Santo Bt!!bm CSjlO!ll Bartwa Counoc Hospital) • Rhabdoid tumor Santa RO$i! !SantA RoSA Memorial Hospital) • Renal cell carcinoma with rhabdoid fearu= (I); Renal ceU carcinoma (1): Poorly

dilfcn:ntiated =alec!! carcinoma (1)

Ventura • Transitional cell carcinoma At ask& !Alaska NNjve Medical Ccn!erl - Renal ceU """'inoma, high &J1'(Ie (clear cel!lsaroomatoid) Arizona CMII!YYo!• Medical Center) • Sarcomatoid n:nal cell C~Rinoma Arkarna,• fUnj,·rndty of Arkao.W Medical Center) • Renal medullary eorcinoma Colon!do • Collecting duct carcinoma Colora4o !Wheat Rjdge) - MeduUary carcinoma Florida ffiaotist Hosnita!l • Poorly diffcraJtiated renal cell carcinoma with sareomatO'id features (1); Collecting duct carcinoma vs.

sarcomatOid n:nlll cell carcinoma(!); Sarcomatoid renal cell carcinoma (I); Medullary carcinoma. poorly diffcrcntiuted (I); Rennl cell carcinoma, poorly differentiated,? clear cell (1)

Florida (Munroe Resjonnl Medical Center> • Collecting duct can:! noma f lorida !TnllnhQ.'Scel • Collecting duct careinoma of Bellini Florida !Wimer Hoyeq Hospital) • Sarcomatoid renal cell carcinoma Illinois fByrr Rjdgcl • Renal cell carcinoma, sarcomatoid llljpojs CEyanston tlnsnitall - Sarcomatoid renal cell carcinoma Indiana fBall Mgnoriat Bosnitall - Rhabdoid tumor Indiana !Hownrd Commuoitv Hospita!l - Clear ccU carcinoma Loujsjw St&lc UnivmilV Mes!jcal Center - Rhabdoid tumor vs. ALCL Marylagd fNB!jooaJ Navpl Mes!jca! Center) - Renal cell carcinoma, poorly differentillled with dlabdoid fcarun:s Marylopd CUnivmiiY of Maryland Medical Centetl • Medullary wcinoma Menenhusetts lBerfsShire Medical Center> .. Renal cell carcinoma with rhabdoid features Massachusctu !New !lna!and Medical Center Resjdep!Sl • Medullary carcinoma Michi!!l!!l CO!lkwood Hospital) • Renal mec:lullary carcinoma Michigan 1St. Joseph Mercy Hnsnita1l • Poorly differentiated carcinoma, favor medullary Minnesota Cfnirvjew Southdale Hospital> - Rhabdoid lumor New Yod< !Logo island Jewjsh HospitaJl - Medullary carcinoma New Ynrls !Nas""Y Unjver:;jty Medical Center) • Medullary earcinoma New York !New York\ • Renal medullary C81'Cinoma North Carolina (Mounmin Area Pathology) • Rhabdoid tumor (t); Renal cell carcinoma(!); Renal cell carcinoma, undifferentiated?

rbabdoid ( 1)

Objo !Mes!icpl College ofOhiol • Rhabdoid tumor OI<Jafloma (1\Jial - Renal ceU carcinoma with rhabdoid features Pqmsy!YMja {AlleghenY General Hosnita1l - Ma!igrlllllt undiffen:ntiNed neoplasm with rhabdoid features Pcnnsy!yania ICenue Cornmunitv Hospital) - Renal cell carcinoma, clear cell type, high grode PennrtiYMja !Coocmau!!h Memorial Mes!ica! Center) • Renal cell eorcinoma, sart:OII\B!Oid type

Pennsylyanja (!.chjg!J VO)Iey HospiJaD - Rhabdoid tumor(!); Clear oct! Sattoma(l)

8 CTTR. Fcbru8!)' 2004 "Mini!ICS" (Subscription A)

Pcnnsvlvania IUPMC Health Svmeml - Medullary·carcinoma, kidney Pennsylvania <Yotl\ Hospi!JIIl - Renal cell carcinoma (clear cell type) (8) Puerto Rico <University of Puerto Rico\ - Medullary carcinoma, rcoal cell carcinoma with rnabdoid features Rhode Island IR! Hospjta] ResidemS) : Medullary carcinoma Texas Q,ubbockl - Collecting duct carcinoma Texas <Pro path Associates) - Renal cell carcinoma (I); High grade renal cell carcinoma (I) Texas CSan Antonio) .. Sarcomatoid carcinoma Texas /Scott·& White Memorial ~lospital) - High grade carcinoma with rhabdoid features West Virginia /Greenbrier Valley Medjcal Cen!erl - Sarcomatoid renal cell carcinoma Au;iralia<North Queensland Pathology) - Collecting duct carcinoma Australia fRnyal Prjnce Alfred Hospjtall - Carcinoma with rhabdoid-like cells Cana4a (footbms Medjcql Center> - Medullary carcinoma Hong Kong Qlong Kong Baptjst Hosnitall - Renal medullary carcinoma l!alv !Naples) - Sarcomatoid renal cell carcinoma Jamaica CThc University of the West Indies) • Renal cell carcinoma, clear cell oype Netherlands /Amsterdam) - Rhabdoid tumor Qatar ffiamad Medical Comorationl - Malignant rhabdoid tumour Saudi Arabia • Medullary carcinoma

Case 4- Diagnosis: Renal medull!ifY carcinoma, kidney

T-71000, M·83123

Case 4 - References: Davis CJ, Jr., Mastofi FK and Sesterhenn TA. Reoal Medullary Carcinoma. The Seventh Sickle Cell Nephropathy. Am J S11rg

Pat!to/1995; 19(1):1-11. · Swanz MA, Karth l , Schneider DT, Rodriguez R, eta!. Renal Medullary Carcinoma. Clinical, PaU>olugic, Immunohistochemical,

and Genetic Analysis with Pathogenetic Implications. Uro/2002; 60(6):1083-1089. Chevi!le JC, Lohse CM, Zincke H, eta!. Comparisons of Outcome aod Prognostic Features Among Histologic Suboypes of Renal

Cell Carcinoma. The AmJ ofSurg Pat!to/2003; 27(5):612-624. Dimashkieh H. Choe land Mutcma G. Rcoal Medullary Carcinoma. A RcpoJt of2 Cases and Review of the Literature. Arch

Pa1ho/ Lab Med2003; 127(3):135-138.

Case No. 5, Accession No. 29671 February 2004

Alameda 1Aiam¢da County Me<lica! Center> - Angiosarcoma Arcadia <Garfield Medical Center) - Clear cell carcinoma with fibrosis Bakersfield - Renal cell carcinoma, clear cell type Baldwin Park {Kaiser Permaoeotcl -Renal cell carcinoma with sarcomatoid differentiation (3) Fontana (Kaiser Pennanentel - Conventional renal cell carcinoma Howard/Fremont - Renal cell carcinoma, low grade Irvine fUC Irvine) •· Reoal cell carcinoma, sarcomatoid-type Laguna BeacH (South Coast Medical Center) - Sarcomatoid carcinoma Lorna Linda !Lorna Linda Pathology Resident•) - Renal cell carcinotna,. sarcomatoiotyP.e Long Beach /Lakewood Regional Medical Center) - Renal cell carcinoma (9) Monterey ICommurtity Hosnital of Monterey Peninsula) - R""al cell can:inoma Mountain View CEI Camino Patho!ozy Group) - Sarcomatoid renal ~II carcinoma Ornnse rOraooe County Pathoiogy Medical Group) - Renal cell carcinoma, clear cell type Sacramento IUC Davio Me<lica! CeO)e<l - Renal cell carcinoma San Djego CNaya! Medical Center) - Xaothogranulomatous pyelonephritis (7); Sarcomatoid renal cell caicinoma (6) San francisco /San Francisco General Hospital! • Renal cell carcinoma, clear cell oype Santa Barbara /Santa Barbara Cot!aJ!e Hosoilllll • Renal cell carcinoma, clear cell oype Santa Rosa /Santa Rosa Memorial Hospital! - Renal cell carcinoma, clear cell type (3)

CTTR, February 2004 "Minutes• (Subscription A) 9

Ysm!!!! - Renal cell adonocan:inoma Algska CAIII.llsa Native Medjel Centerl - Renal cell carcinoma, high grade (clear ceiVsarcomaroid) Arizona CMarvyalc MesliC!!l Center\ - Renal cell carcinoma Arkansas CUnlymitv of Arkansas Mesljca! Center) - Renal cell carcinoma, clear cell type: Colorado - Sarcomatoid renal cell C81cinoma Colora4o CWhcat Rjd!!cl - Renal cell carcinoma with sarcomalold featu= Floridaffiaptjst Hospjtall - Fibrosarcoma (I); Clear ceiVsarcomatoid renal cell carcinoma (I); Renal cell carcinoma with

sarcomatoid BrCas ( l); Sarcomatoid renal cell carcinoma (2) Florida (Munroe Regional Mcdjcal Centerl - Renal cell carcinoma Florida CiaJtJb•:sstt) - Clear cell renal carcinoma Flotic!a CWjptq Haven liospj!all - Leiomyosarcoma Illinois fBurr Rjdoel - Epithelioid fibrosarcoma Illinois CEywt!lon Hospit!lll - Renal cell carcinoma, clear cell Indiana fBall Memorial Hospjta!\ - Clear cell renal cell carcinoma Indiana (Howard Commun]tv Hospjta!l - Clear cell carcinoma l,ouisiana Swe UnivqsjiY Me<lica! Center - Sarcoma1oid ren_al cell carcinoma Maryland !National Naval Medical C<:nterl - Renal cell carcinoma. sarcomatoid and clear cell Marvland IUnjyersilv ofMaryiBIJd Medical Center! - Sarcomatoid reaal cell eareinoroa Massachusetl$ CBerkshin: MedjC!!I Center) - Sarcomatoid renal cell carcinoma Massachusetts !New England Medical Centq Residents\ - Renal cell caicinoma with clear cell and sarcomatoid featu= Miehi!11!!! !Oakwood Hospital> - Sarcomatoid carcinoma arising !rom low grade conventional renal cell carcinoma Michil!j!ll CSL Joseph Mcrcv Hospital) - Clear cell carcinoma Minnesota Cfnlrylew Souqtdalc HospjJa!\ - Neuroendocrine neoplasm, ? paraganglfoma New York !Long Island Jewlsb Hosnitall - Sarcomatoid renal cell carcinoma New Yort< INe,_<S!IU Univmjtt Medical Center> - Clear cell carcinoma ,.;th sarc:onwoid changes New York !New York> - SarcomatOid renal carcinoma Nooh Carolina (Mounllljn Arq Pathology) - Renal cell careinoma, clear cell type ( 1 ); Clear cell carcinoma ( 1 ); Clear cell renal

carcinoma ( 1) Ohio (Medical College ofOhjo) - Renal cell eru-cinoma, sarcomatoid variant Oklahoma CTulsal - Sarcoma. NOS · Pennsvlvanja !AIIeghepv Gcnetp! HOS!>i!all - SarcomatOid retial cell carcinoma arising in conventional clear cell type renal cell

carcinoma PennsylvWJi• CCentrc Commynjty Hospjtall - Renal cell carcinoma. clear cell type, with sclerosis and hyalinization Pennsylvania fCqnemaugh Memorial Medjcnl Center} .. Renal cell carcinoma, clc11r cell type Peansylvanio (Lehigh Valley Hospila]l - Renal cell carcinoma (I); Renal coli carcinoma of clenr cell type (I) f'ennsvlvWJi• CVPMC Health Sy;!teml - Conventional clear cell carcinoma of kidney PennsvJvanja (York Hospjta]l - Renal cell carcinoma .,;th sarcomatoid component (8) Puerto Rico (University of l'ueqo Rjeo) - Xanthogranulomalous pyelonephritis Rhode Island CRI Hnspjtlll Residents\ - Sarcomatoid reaal cell carcinoma Texas fLubbockl - Renal cell carcinoma, clear cell type

Texas CPropath Assocjalesl - Sll!(:()matoid renal cell carcinoma (2) Texas <San Amonjol - Adrenal cortical carcinoma, sarcomatoid carcinoma Texas CS00u & White Memorial Hospital! - Hyalinized renal cell carcinoma, clear cell type

West Viroinjo !Greenbrier Valley Me<lical Cenwr\ - Renal cell carcinoma, clear cell Australia !North Ou<AAsland l'lltho!ogy) - Sarcoma10id renal cell carc:inoma Au.stralia !Rpyal Prince Alfu;d Hospital) - Clear cell renal «:II carcinoma with san:omatoid areas Canada <FOO!hill< Medical Center) - Clear cell carcinoma Hono Kon• 01ong Kong Bnptjst Hosnjmll - Renal cell carcinoma, clear cell type lt!lly INaplesl - Clear cell renal cell carcinoma with degenerative changes Jarnajca CThc University of the We.51 Indies} - Sareomaloid renal cell carcinoma arising in clear cell renal cell carcinoma Netherlands <Ams!en!am> - Renal ceO admocarcinoma Oatar Oiam8d Medical Corpoi'Alionl - Lymphangioma Saudi Arnbjn - Renal cell carcinoma, clear cell type

10 CITR, feb<uary 2004 "'Minules" (Sub5aiption A)

Cue 5 - Dlagn00s: Renal cell carcinoma, conventional elear eeU IIJ)d sarcomatoid, kidney

T-71000, M-83123

Ca.~c 5 - References: Moch B. GasserT, Amin MB, ct al. Prognostic Utility of the Rc<:cntly Recommended Histologic Classification WJd Revised TNM

Staging System of Renal Cell Carcinoma. A Swiss Experience with 588 Tumors. C<lncer 2000; 89(3):604-614. Amin MB, Tomboli P, lavidan J. et al. l'rognostic Impact ofHislologic Subcypi~~g of Adult Renal Epithelial Neoplasms. An

Experienceof405 Cases. Am J Slug PaJho/2001.; 26(3):281-291. Krishnan 9 and Truong LD. Renal Epithelial Neoplasms. The Diagnostic Implications of Electron Microscopic Study in 55 Ca.'!CS.

Hum Pat/w/2002; 33(1):63-79. Mion BM. l)hadkamkar N, Slston JW. et al. Prognostic Factors and Survival of Patients with Sareom111old Renal Cell Carcinoma. J

Uro/2002; 167(1):65-70. Kuroiwo K, Konomoto T. Kumazawa J, ct al. Cell Proliferative Activity and Expression of Cell-Cell Adhesion Factors. (E­

Codherin, Alpha-, Beta-, and Oamma-Catenin, and p 120) in Sarcomatoid Renal Cell Carcinoma. J Su'8 Onco/200 I; 77(2): 123-131.

de Peralla-Venrurina M, Mach 11, Amin M, ct al. Sarcomatoid Differentiation in Renal Cell Carcinoma. A Study of I 0 I Cases. Am J Surg PaJho/2001; 25(3):275-284.

Case No. 6, Accession No. 29723 February 2004

Alame4a !Alameda Countv Me4ica! Center) - Oncocytic neoplasm (chromophil n:nal cell carcinoma vs. oncocytoma) AtQdja <Garfield Medical Center! - Chromophobe =a! cell carcinoma

B!Jkmfield • Chromophobe rcoaJ cell carcinoma Baldwin Parle (Kaiser Permancnlcl • OncocytOma (3) fon!J!nu IKulser Pcrmancn(e) - Chromophobe rtnal cell carcinoma How!l!'d/Fremont - Chromophobe renal. celllldenomo, eosinophilic varian~ with lamcllated inclusions !aloe C!IC Irvine) - Chromophobe renal cell carcinoma, eosinophilic variant Luuno Beach (South Coast Medical Center) - Chromophobe renal cell carcinoma Lorna !.inda <Lorna Linda Pathology Residentsl - Oncocytoma I.onc Beach !Lakewood Rcoional Medical Cg)tetl - Chrompbobe carcinoma (9) Monterey CCommunitv Hospjgll of Monterev Peninsula) • Granular cell renal carcinoma Moyotaln View lEI Cimino Palho!ogy Group) - 1\enal cell carcinoma, granular cell type vs. chromophobe carcinoma Orange IO!anoe Cnuntv PAlhologv Medica] Groun) - Renal cell carcinoma, granular cell type

Sncmmento IUC Davis Medical Cen!erl - Renal cell carcinoma, chromophobe !)lpe SM Picco <Naval Medical Ccncer) - Oncocytoma San fnncis:o <San Franciscq Genet11l HoSpiJa!l - Chromophobe renal cell carcinoma SaniJIJWbwa <Santa 8atbom Cottage Hospital! - Renal cell caJcinoma, granular type Santa Rosa <SM!a R<l§!l Memorial Hospitall - Renal cell carcinoma, granular cell type (3) .Ycn.!wJI - Renal cell carcinoma, granular cell type

AIQ.1Jsa CAI!!Ska Native Medlen! Center) - Renal cell carcinoma, papillary Arjr.ono (M!IJ'VValC Medical Ccmerl - Chromophobe rcnol cell carcinoma, eosinophilic variant Arkanso.' !University of Arkansas Me4ica! Center) - Chromophobe Carcinoma, eosinophilic \'ariant (granular cell renal cell

carcinoma) Colgrado - Chromophobe rtnal cell Cllleinoma Coio!ldo <Wheal Ridoel - Chromophobe =a! cell carcinoma flgri!la !Baptist Hospitlll) - Chromophobe renal cell carcinoma (S) Florida <Munroe Regional Medico! Center) - Renal cell carcinoma, chromophobe type Florida !Inll!lbasseel - Ornoular/chromopbobe rennl carcinoma Plorids !Wimer Haven Hosnltall - Oncocytoma Illinois ffiurr Ridge) - Chromophobe reoa! cell carcinoma ll!jnojs <Evanston Hospital) - Chromophobe carcinoma lndiM• @all Memorial HAA>i1ol\ - Chromophobe cell variant renal cell carcinoma

CITR. Fdlnwy 20M "Minute!" (Sub$<Tiption A) II

lndj!l!)a CHownrs! Community Hospital) • Chro100phobe type renal cell corcinoma Louisiana Sque Unjversity Medical Center • Chromophobe renal cell corcinoma M!!O'Iand (NAtional Nml Medical Ceptql • Renal cell carcinoma, chromophobe M!!!Yiand CUpjyeajty ofMarvland Medical Center) • Chromophobe m~al cell carcinoma MI!Sll!!ChW\13 Olqt;sbire Me!lical Cent.erl • Chromophobe renal cell c:arc:inoma M•SSftGhusetJS (New Epgland MC!!ica! Center Residents\ • Cbromophobc renal ecll aucinoma

MjcbjllliQ COA!<woo<l Hospitall • Chromophobe carcinoma Micbjgao <St Joseph Mcrcv Hospital) - Cluomophobc c:areiooma Minnesota CfajMew Southdale Hosnitall • Chromophobe tumor (renal cell carcinoma) New York (Lops Island Jewish Hospital! • Oncocytoma New York CNu*Sau University Medical Center) • Chromophobe carcinoma New York (New vorkl • Renal oncocytoma North Comljna (Mountain Area Pathology) • Chromophobe renal coli cnrcl.noma Ohio (Mcdjcpl Coi!Clle ofOhjol • Renal cell carcinoma, chromophobe type ("S~Mular cell" type) Oklahoma Cl'ulsal - Chromophobe renal cell carcinoma, eosinophilic variant PC!U!svl•Mi• IAIIc&heny General Hospitafl • Renal ce!rcarcinorna, chromophobe type Pennsylvania ICeptre Community Hosnjll!)l · Renal cell carcinoma, chromophobe type

PepnsvlVPDi• <Conemaugh Memorial Medical Center! · Oncocytoma Pennsylvania U.shillh Valley Hospill!)l - Renal cell carcinoma. J111111Uior cell type (2)

PennsyiYMj& 0/PMC Health SVS!el1!l • Chtomopbobc renal cell carcinoma

PennsylvMjt IYO!II Hosojta!l • Renal ocU carcinoma, chn>mophobe (8) Puerto Rico aJpjyscdw of Pu0!!9 Rjeo) - Conventional renal cell carcinoma with eosinophilic cytoplasm Rhode Island CRl Hospital Resjden!S) - Chromophobe renal cell carcinoma Texat; !Lubbockl • Chromophobe carcinoma Texas fPropn!h M$0Cinjesl - Granular cell, renal cell carcinoma Texas ISM Antonjo) .. Oncocytoma Texas IScotl &. White Memorial Hosoitall • Renal cell carcinoma, chromophobe type West Yirajnj• (Qrecnbder Volley Medica] Center) • Renal cell carcinoma, granular cell Austmlia (Noah Queensland Pathology) • Chromophobe carcinomo AyS(rnlja fRova! Prince Alfred Hosoitall • Chromophobe Canada lfoo!hms MC!Iieal Center) • Eosinophilic chromophobe carcinoma Hong Kong CHong Kong Bantist HosnitaD · Chromophobe carcinoma. eosinophilic variant Italy (Nap!!§) • Chromophobe renal cell c:an:inoma Jamaica Obe Vpjyec;ity of the West Indies) • Oncocytoma Ncd>qlaods <Amsten!aml • Oncocytoma of the kidoey Qatar IHamoc! Mcclical Comorationl • Chromophobe renal ecll corelnoma Saudi Arabja • Chromophobe renal cell carcinoma

Case 6- D!agoos!s; Chromophobe renal cell carcinoma, kidney

T-71000,M-82703

Case 6 - References: Thoenes W, Stockel Sand Rumpelt UJ. Human Chromophobe Cell Renal Carcinoma. Vichqw• Arch 8 Cell Patho/198$; 48(3):207-

217. Starkel S. Steart PV, Drcnckhalm 0 and Thocncs W. The Human Chromophobe Cell Renal Carcinoma. Its Probable Relation to

Intercalated Cells of the Collecting Duct. Virohows An:lr C•ll Potlro/!989; 56(4)237-245. Abrahams NA, Ayala AG and Czemlak B. Chromophobe Renal Cell Carcinoma with Sarcomatoid Transformation. Ann Dlogn

PtJJho/2003; 296-299. Chcvillc JC, Lob>e CM. Zincke H. et al. Comparisons or Outcome and Prognostic Feanrres Among Histologic Subtypes of Renal

Cell Carcinoma. Am J Surg Polho/2003; 27(5):612-624. Kuroda N, Toi M. Hiroi M. c:1 al. Review of Chromophobe Renal Cell Carcinoma with Focus on Clinical and PA!hobiologlcal

Aspects. Hlstol Hlsroporho/2003; 18(1):165-171.

t2 CTIR, February 20M "Minutes" (Subscrip4ion A)

•

Case No. 7, Accession No. 29625 February 2004

Alameda CAlame<!• County Medical Center) • Adenocarcinoma Arcadia !Oacfield Medical Ceoterl - Prosuue adcna<:arcinoma Ba}(ersfield - MelaStatic prosuue ean:inoma Bald\\io Park CKaiscr rmnanentel • Consistent \\ilh prostate ean:inoma (heavily fulgurated) (2); PI'QSial£ ean:inoma (I) fontana <Kaiser Pennnncntcl_ ~ Prostatic adcnocnrcinoma Hownrdlfrcmont • Carcinoma of prostatic origin, higb grodc (Gleason's 9) Jrvipe 0/C Irvine) - Collision tumor, proswic adeoocareinoma and urolhc!ial ean:inoma Laguna Beach !Soyth Coast Medical Cemcrl - Melastltic poorly differentiated prosw.ic adcoa<:arcinoma Lorna Ljgdu !Lorna Llndn Pathology Residen!Sl • Poorly differentiated prostate adenocan:inoma (Gleason's. Grade 5) with

urothe!ial features Lon• Bqch Mc"·ood Region1!1 Mcs!ica! CeO)q\ - Proswc ean:inoma (9)

Monterey <Community Hospjtal of Monterey Peninsula) • Prostate carcinoma Mountain view (flJ Camino Patbo!C)gy Group) • Promtic adenoean:inoma Orange <Orange County Pathology Medical Group) • Adenocarcinoma S!l!:!1ll1!C!llo (UC Davl\ Medical Center) • Prostalic carcinoma Sao Oieso !Naval Meslica! Center) • Metastatic prostate carcinoma Sun Frnncisco (San Francisco OeneruJ Ho:mit.a.l\ · Prostatic adenoCW'Cinomo. Santa Barl?B!ll !Santa Barban! Cottase Hospital\ - Metastadc prostate carcinoma to bladder Saom Rosa !Santa Ro:;a Mcroori1!1 Hosnita!l - Prostalic adcnocatcinoma (3) V en turn • Prostatic adcnoean:inoma Alaska !Aioslsa Nntiye Medical Center) - Prostate adenocarcinoma Arizpn•CMarwale Medical Center) • Prostatic adeoa<:arcinoma mewwic to bladder Arlrn•!!!$ filniv=ity ofM:ansat Mcs!ica! Center! • !ofiltnuing pro51atic adeoa<:arcinoma, biphasie "'-combined -..ith urothelia!

carcinoma Colorat!o - Glcason's grode 5+5 adenocarcinoma ofprostutc origin Colorado CWbAA' Ridgcl - Metastatic prostate carcinoma florida <Baptist Hosphatl - Poorly differentiated prostatic adenocarcinoma involving the urinll!)l bladder(!); Higb grade prostate

adenocarcinoma (I); High grade prostate carcinoma (3) Florida (Munroe Regiopal Medica) Center) - l'rostatie adena<:areinoma Florida Q"a!Jaha<See) - Adenocarcinoma, prostatic Florida CWjnter Haven Hosoita!l • Cauterization artifact pi'<IC!udes adequate eva!U81ion Illinojs ffiurr Ridge> - MetaStatic prostatic carcinoma Illinois IEyag<!On Hospital) - Hl&h grade prostutic enrcinomn !ndi!!!lA IBo!! Memorial Hospital> • Prostatic odeoocarcinoma Indiana (Howard Community HMQitall · Suspicious for carcinoma. too much artifact Louisiaoa State Unjyernity Medical Center • Poorly differentiated adenocarcinoma of,prostate in bladder Maryland <National Nayal Medical Center) • Transitional cell ean:inoma, high grndc, with glandular differentiation (8); J'rostatic

adenocarcinoma ( 4)

Maryland fUnivcrnity of Maryland Medical Cegtcrl - Prostatic carcinoma \\itb possible neuroenda<:rine diffen:ntiation M!§sw;bnsetts (Berkshire Medical C.,nter\ - ~ligh grnde urotbeliaJ carcinomn Ma~~erhusctts CNcw Eosland Mcdjca1 Center Residents> · Co11ision tumor oftransitiona1 cell carcinoma and poorly differentiated

proswic adaloc:arcinoma Michioan !Oakwood Hospimll • Carcinoma, consistent \\itb pTOSiale primary Michigan (St Josenh Mercy Hosnitnll - Prostatic adenocarcinoma Minnesota <Fajrvjew SouthdaJe Hoc:pital) • Adenocarcinoma consistent with proste.lc 1°, possible low transitional cell carclnoma New \'ode U.oge l>larx! Je\\ish HosojtaJl - Prostate carcinoma New Y orts <Nassau tlnjversitv Mtdjcal Cenrer) - MetaStatic prostate carcinoma New vor!s !New Yodel • Both urothe!ial carcinoma and high grade proswic carcinoma Nortb Caro!ina(Mounlfjn Area PAthology) - Pros!Alc adenocarcinoma, poorly differentiated (2); Prostate carcinoma ( I) Ohio <Mcs!ical Col!eoe ofQbjol - Invasive hlgb grade urotbelia! carcinoma and poorly differentiated prostatic carcinoma (Gleason

1)

CTTR. Febroaly 2004 "Min'"cs" (Subscription A) 13

Oklahoma (J'ulsnl - Carcinoma Peppsyivanja (AIIc•heny OenemJ Hospital) - Metastatic prostatic adcnocan:inoma Pennsylvania CCcnve Community Hospilllll - High grade proswic adenocarcinoma. b1ad<ler l'eo!uylyania CCon£!1!AUgb Memorial Medical Center) - Melastalic prostatic adenocarcinoma Pcnnsylyaniall,cbjgb Valley HosoitaD - Prostatic adenocarcinoma. ( 1 ): Lymphoma, favor prostate primary ( 1) Peqnsylyanja CUPMC Health Svsteml - Mctastalic prostatic carcinoma and focal high grade urothelial carcinoma PennSlllvanja CYru!c HO$pilall - Prostatic adenocarcinoma (8) Puerto Rjoo CUpjyrnjtv ofPucrto Rico\ - Mctastalic prostate adcnocarcine>ma with neuroendocrine features Rhode Island CRl HospitAl Re.~jdent~l - Adenocarcinoma consistent with prostatic origin Texruj <Lubbock) - Metastatic prostatic carcinoma Texas CProAAth A.lsocigtesl - Recurrent prostatic adenocarcinoma (2) Tcx!l!! CS1w Antgpjol - Poorly differentiated carcinoma, possibly of prostate origin Texas !Scott & White Mgnorinl Hospital) • High grade prostate adenocarcinoma We:.1 Vjrgjnilt !Greenbrier Valley Medical Center) - Prostalic adcnocllrcinoma, rccurn:nt AustmljoCNQtlh Oupensland Plllhology> - Poorly differentio!AOd prostotic odenocarcinoma, ? prostatic duct type: Au.ruulia ffioynl Prince Alfred Hospital) - Prostatic adenocarcinoma wilh high grade area Canado (Foo!hil!s Meslica! Cenwr> - High gr>~dc prostate =cinoma invading bladder Hong Kong Ctlong Kong Baptist Hosoitall .. Prostatic adenocarcinoma illlly !Naples) - Rccumnt meulS181ic prostatic carcinoma Ne!her!ands CAmqmlaml - Poorly differentiated (adcno?) cattinoma Oa!ar fHP!!!Id M;djCI! Comorationl - Metaslalic prostatic carcinoma Sau!li Arabi• • Prostatic adeooearcinoma, high grade

Case 7 - Diagnosio: Recurrent high grade prostatic adenocarcinoma, pros1a1e

T-77100, MC81403

Consu!!lltion: • Jonathan Epstein, M.D., «Recurrent prostatic adenocarcinoma (although we do not goode recurrent proslatic carcinoma, it bas a Gleason grade of 5+4, 9 of 10)"

Case 7 - References: Bok RA and Small EJ. Bloodbcme Biomoiecular Markers in Prostate Cans:cr Development lllld Progr=ion. Narwe Rtvlt:Ws

Cancer2002; 2(12):918-926. Scalzo DA, Ka!lalcury BV, Oaddipati RV, et al. Cell Proliferation Rate by MIB-1 Immunohistochemistry PredlciS Postradiorion

Rccumnce in Prostatic Adeno<:areiooma. Am J Gin PDJho/ 1998: I 09(2): 163-168. Ripple MO. Potter SR. Partin AW, et al. Needle Biopsy ofRccum:nt Adenocarcinoma of the Prostl!te After Rodical Prostatectomy.

Mod Patho/2000; IJ(S}:S21-527. Kobayashi T, Fulculawa S, Oka H, et al. Isolated Rccum:occ of Prostatic Adenocarcinoma to the Anterior Urethra After RadiCI!

Prostatectomy. J Uro/2000; 164(3 Pt I) 780. Wyon SS, Nagabundi S, Koo 1, ct ai. Recurrent Prostate Carcinoma Presenting as Omenll!l Large Cell Carcinoma wilh

Neuroendocrine Differentiation and Resulting in Bowel ObS!TUCiion. Arch PDJhol Lab Med 2000; 124(7): I 074-1076.

Case No. 8, Accession No. 29645

Alamedn CAl ames!• County J14edlcal Center) - Seminoma Arcadia COnrfield Me<ljcal Cemql - Anaplastic seminomo Bnkmfield - Seminoma Baldwin Park IJ{ajs:r Pennanentcl -Seminoma consistent wilh intmlubuinr gcnn cell neoplasia (3) Fontana CKojw PennMentel • Seminoma

Howan!/Fn:moD! - Embryonal carcinoma. Nlc out8118j>lastic semi.noma Irvine fUC lryjnel • Seminoma lo!lU!!B Beach CSouth Coast Medical Center> - Seminoma, classic type: Lorna Lincla fLDma Lincla P!!!bolo!lY Residents) - Seminoma Lons Beach f!.akew90d Reoiona! Medical Center) -Seminoma (9)

February 2004

14 C1TR, Febnwy2004 "Minotcs· (Sul>scriprlon A)

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Monterey CCommunitv Hosnital of Monterey Peninsula) - Seminoma Mountain View ffil Camino PaJhology Group) .. Seminoma Onnoc (Ooogc Countv Pathology Medical Group> - Seminoma. classic $ammcnto fiiC Qavis Medical Center> -Classic seminoma San pjego fNayal Medical Center) - Seminoma San Froocjsco CSrut Francisco General Hospjtnll - Seminoma San!!! Barbara /Santa Barbara Cottage Hosni!!l!l - Seminoma, classic type SanlA Rosa CSnnta Rosa Memorial HosDj\aU - Stmlnoma ~- Seminoma

Alaska (Alaska Native Medical Center) - Seminoma Ari7.QM !Maryyale Medical Center) - Seminoma, tcstitle AdsM!fM Ctlnjversjty ofAdsaruja1 Medical Center> - Seminom~ classic type Colont4o - Seminoma Colom4o !Wheat Ridoe) - Seminoma Florida ffiaptjst Ho.wital) - Seminoma (S) Florida (Munroe Regional Medical Center) • Seminoma Plorjdo ITo!IBhnssecl - Seminoma Floridn CWjnler Haven Hospjtall - Anoplastic seminoma Illinois !Burr Ridge) - Seminoma Jlljnois ffivBllSlon Hospita]> - Seminoma Indian• CBa!l Memorial Hospj!aJl - Seminoma Jndjw Q,loward Community Homjlall .. Seminoma

Loujsjana Sta!t Unjvtrntv Medical Center - Seminoma MIID'Iand <National Naval Medical Center\ - Seminoma MtVYIMd IUnjvmjw of Maryland Medjeol Cen!erJ - Seminoma M!!SS!!Ch\J!;stts !Berkshite Medical Center\ - Mixed germ cell tumor with seminoma and embryonal features Mas:msbugtts CNcw England Medical Center Residents) · Anaplastic seminomo Mjehjqon COnkwood Hospimll - Seminoma Mlchia!IO !Sl Joseph Mercv Hosoitn!l - Sc:mlnomu, classic type Minnesota (Fairview Southda1e HospitAl) · Seminoma New Yor!t CLogg Island Jewish Hosoita!l - Seminoma with pleomorphism New Yort <Nassau Uniymity Medical Center> - Classical seminoma New Yodc INcw York) - Seminoma end iniBilJbular germ cell neoplosia Nonh Comlina CMountain Area Pathology) - Seminoma (3) Ohio !Medjcpl College of Ohio) - Classic seminoma Oklahoma !Tulsa) - Seminoma PennsylVWJja (Allegheny General Hosnitnll .. Seminoma Pennsvlyanja (Centre C,.ommunity Hnsnitan .. Seminoma with increased nuclenr atypia, testes Pennwlyanja CCoaemau&h Memorial Medical CepterJ - Seminoma, classic type Pennsvlvonja C!.ehiob Valley Hospj131\ - Seminoma (2)

Pennsylyanja IUfMC Health Svsteml - Embryonal eareinoma P<nnsylyanja <York Hospita!l - Seminoma (8) Pugto Rico C!Jpjversjtv of Puerto Rico) - Classic seminoma Rbodc !sloru! CR! Hospital Residents) - Seminoma Texas CLubb!x;k) - Seminoma Tew fProoath Associates) - Anaplastic semlnoma (2) Texas <San Antonio) .. Seminoma Texas /Senti & White Memoriol Hospital) - Seminoma West Vlm!nia !Groenbrler Valley Medical Center) - Seminoma Austm)jaiNor!h Oueenslond Pa!bologyl - Scmlnoma AI!Wlllla !Royal frinee Alfred Hospital) - Seminoma Canada <Foothms M;!ieo! Center> - Seminoma Hong Kogg tHong Kong Baptist Hosojtall · Classic seminoma

C1TR_ Fd>rull)' 2004 "Minutes• (Subscriptioft A) IS

Italy <Naples) - Seminoma Jamaica Cfhe University of !he West Indies\ - Seminoma, testis Netherlands !Amsterdam) - Seminoma!Ous and vas<:Uiar invasion and intnuubular genn cell neoplasia Qatar !Hamad Medical Comoration) • Seminoma Saudi Arabia - Seminoma

Case 8 - Diagnosis: Classic seminoma, testis

Tc78000, M-90613

Case 8 References: BabaiWl RJ and Zitgars GK. Testicular Seminoma. The M.D. Anderson Experience. An Analysis of Pathological and Patient

Cbarocteristics, and Treatment Recommendations. J Uro/1988; 139(2):311-314. Florentine BD, Roscher AA. Garrett J, et al. Necrotic Seminoma ofthe Testis. Establishing the Diagnosis with Masson Trichrome

Stain and hnmunostains. Arch Patho/ Lab Med 2002; 126(2):205-206. Cbevllle JC, Rao S, lczkowski KA. et al. Cytoke:rntin Expression in Seminoma of the Human Testls. Am J Clin Patl>o/2000;

113(4):583-588. Leroy X, Augusto D, Leteume E, et at. CD30 and CDII7 (C. Kit) Used in Combination are Useful for Distinguishing Embryonal

Carcinoma from Seminoma. J Histochom Cytochem 20()2; 50(2):283·285. Dubs M; Kwiatkowski MK, Laeng H, Recker F, et at Development of Testicular Seminoma After Previous Negaiive Biopsy for

Testicular lntmepithelia!Ncoplasia. J Uro/1998; 159(6):2095.

Case No. 9, Accession No, 29426

Alameda <Alameda Countv Medical Center\ • B-<>e!Liymphoma Arc8dia COarfield Medical·Centerl • Difl'use largeB-celllymphoma Bakersfield - B-celllymphoma

February 2004

Baldwin Park !Kaiser rennanente) • B-cell lymphoma ? (diffuse small) (I); Malignant lymphoma at least intermediate grade(!); B-celllymphoma, diffuse small with ITGN (I)

Fontana IKniser Pennanente) - Diffuse large B-celllymphoma Howard/Fremont ·Lymphoma (also intratubu(ar germ cell arrest) Irvine (UC lrvjne\ - B-cell lymphoma !&&una Beach (South Coast Medical Center\ - High grade B-cell lymphoma. Lorna Linda floma Linda Pa!hology Resj(!en!Sl - Diffuse B-cell lymphoma l&nolleach fLokewood Regional Medical Center) - Diffuse large cell B-celllymphoma (9) Monwey !Community Hospital of Monterey Penjnsulal - B-celllymphoma, diffuse large cell Mountain View !EI Camino Pathology Group\ - Large cell IY')lllhoma, B-cell type Orange !Orange Coupty Pathology Medical Group) • Diffuse large B-eelllymphoma Sacramento !UC Davis Medical Center) • Diffuse large B-<>elllympboma San Diego !Naval Modica! Center> • Lymphoma, favor diffuse large B-cell San Frnncisco ISan Francisco General Ho<njta!l - Diffuse large B-celllymphoma Santa Barbara ISWlta l!arbnm Cottage Hosoitall - Large B-cclllymphoma · Santa Rosa (Santa )l.osn Memorial Hospital) • Diffuse large cell non-Hodgkin's lymphoma, probable B-ccll type (2); Malignant

lymphoma, diffuse mixed large cell and small cleaved cell type (I) ~ • Malignant lymphoma Alasl<a !NasJsa Native Modica! Center> • B-celllympboma Arir.ona IMarwale Medical Center) • Diffuse large B-cell lymphoma, testicle Arkansas <Univcrsitvof Arkansas Medjcal Cenierl • Diffuse large B-cell lymphoma, testis Colorado • Diffuse larg'e.B-cell malignant. lymphoma Colorado !Wheat Ridce\ - Large cell lymphoma Florida !Bantist Hosoilllll - Lymphoma(2); Lymphoma, large B-cell non-cleaved (I)-; Large B-cell lymphoma (2) Florida {Munroe Re!rlonal Medical Center\ - Lymphoma Florida ITallahac:seel - Large B-celllymphoma ·Ftorjda fWjnter Haven Hospilllll - Rule out lymphoma

16 CTTR, Febru>Jy 2004 "Minutts" (Subscription A)

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Illinois ffiurr Ridge\ - Diffuse large B-cclllymphoma Illinois 1Evaost9n Hosnjtal\ - Lymphoma !ndjaoa ffiall Memorial Hospitall - Non-Hodgkins lymphoma lndiana !Howard Community Hosnital) - Non-Hodgkins lymphoma, mixed type bouisjana State UniversitY Medjcal Ceoter - Malignant lymphoma, B-phcnotype (NOS) M!!!Yiand !National Naval Medical Center\ - Malignaot B-celllymphoma Maryland aJniversitv ofMarvland Medical Center\ - Diffuse large B·celllymphoma Massacbusetts ffierl<shire Medical Center) - Malignant lymphoma, diffuse large B-cell lymphoma Massachusetts /New England Medical Center Residents\ · B-cell lymphoma Mjchjgan {Qakwood Hospjl!JI\ - Diffuse large cell S·celllymphoma MichiQI!n (St. Joseoh Merw Hospital) · Diffuse latge-B-celllympboma Mlnnesota (fairview Southdale Hospital) • B-celllymphoma New York ll..ong Island Jewish Hospitull · Diffuse B-eeU lymphoma New York !Nassau University Medical Ccntu\ - Large B-cell lymphoma, diffuse New York fNew York) - Testicular large B-eell lymphoma "North Carolina <Mountain Area Pathology\ - Laq(e"cell B-celllymphoma (2); Diffuse large B-celllymphoma (I) Ohio <Medical College of Ohio) • Diffuse large cell B-celllympboma, high grade Oklahoma (Tul:;a\ - Malignant large B-ee II lymphoma Pennsylvania (AIIeg!ienv General Hosoital\ - Malignant lymphoma, large cell type

Pennsylvania <Centre Community Hospital) - Malignant lymphoma, large B-cell type, diffuse, testes Pennsylvania <Coneruaullh Memorial Medical Centerl - Large B-celllymphoma Pennsylvania (lehigh Vallev Hospital) - Testicular involvement with B·celllymphoma (I); Large cell lymphoma, B·cell ( I) Pennsylvania (UpMC Health SVsreml - Malignant lymphoma, diffuse B-cell Peoosv!vanja cYor!s Hospitall - Diftuse large B-celllymphoma (8) Puerto Rico (University of Puerto Rion) - Diffuse large B-celllymphoma Rhode Island CRI Hospital Resjdentsl - Diffuse large B-ce!l lymphoma Iex!!S O.ybbockl - Large cell lymphoma Texas <Prona!h As:;ociate<\ - B-celllymphoma. high grade (2) Texa• (San Antonio) - Diffuse large B-celllymphoma Texas (Scott & White Memorial Hospital) - targc cell lymphoma West y jrajnja <Greenbrier yanev Medical Center\ - Large cell lymphoma AuStm!i• (North Queensland Pathology\ - Largo B-ceU lymphoma Australia <Rova] Prince AIITed Ho•pitall - B-cclllymphoma Canada (Foothl!ls Medical Center\ - Diffuse largo B-cell lymphoma Hong Kong <Hong Kong Baoti•i Ho•pital\ • Diffuse-largo B-cclllymphoma ltaly<Naples\ • Malignantlarge .B..:elllymphoma lamaica (The University of the West Indies\ - B·celllymphoma, testis Ne!herlands (Amsterdam) • Diffuse large B-cell Non-Hodgkins lymphoma Qalltr <Hamad Medical Comoration\ - Large "B" cell lymphoma Saudi Arabia • Lymphoma, large B-celltype

Case 9- Diagnosis: Diffuse large B-ceU lymphoma, testis

T-78000, M-95903

Case 9-References: Ferry JA, Harris NL. Young RH, ct al. Malignant Lymphoma of the Testis, Epididymis and Spermatic Cord. A Clinicopathological

StudY. of69 Cases v.;th Jmmuoopheno!ypic Anal)'Sis. Am J SUJ'g.J'atlwl 1994; 18(4):376-390. Mol.ler MB, d' Amore F, Christensen BE. Testicular Lymphoma. A Popuiation-Based Study of lnciUence, Clinicopathological

Correlations and Ptognosis. Thc.Danish Lymphoma Study Group, L YFQ. EurJCancer 1994; 30A(12):1760-1764. Tondini C. Ferreri AJ, Siracusano 1.., et at. Diffuse Large--Cell Lymphoma of !he Testis. JC/in Onco/1999; 17(9):28S4·2858. Shahab Nand Doll DC. Testicular J..ymphoma. Semi" Onco/ 1999; 26(3):259-269. Zucca E, Conconi A, Mugllat Tl, ct al. Patterns of Outcome and Prognostic Factors in Primary Large-Cell Lymphoma of the Testis

io a Survey by the International Extranodal J..ymphoma Study Group. J Clito Onco/2003; 21(1):20-27.

CITR, February 2004 "Minutes" (Subscription A) 17

Case No. 10, Ac«Mion No. 29808

Alameda !A lamed~ CO!!Dtv Medical Cente<l - O!oriocarcinoma Algdia (Qprfie!d Me<fis:al Center) - <l!orioearcinoma Bak=fie!d - Chorioc1111:inoma Baldwjn P!!fk CKajser Pennauentel - Choriocarcinoma (I); Extensively necrotic choriocarcinoma (2) Fontana (Kl!jser PcnnWlente\ - Choriocarcinoma Hownrdlfremont - 01orioearcinoma !rvjne CUC Irvine\ - Chorioearcinoma Laguna Bench (South Coa.<t Me<fjca! Center) • Choriocarcinoma Lomn Undn (Lomn Lindo Palhology Re.~idents) - Choriocurcinoma I .ono Beach (Lakewood Regional Medjcai Center) - Choriocntcinomn (9) Monterey lComrouojty Bosojta] ofMonterev Penjnsulal · Choriocarcinoma Mountajn View tEl Camjno Pathology Group> - ChoriocarCinoma Oranoc IOO!JJge County Patholoey Me!lica! Group) - Choriocarcinoma SarnmanoiUC l>!!vis Medical Cen(erl - Choriocan:inoma San Diego CNava! MC!lical Cen(erl - Mixed germ cell chori001111:inoma. predominant San Francisco !San fnmcisco Genen!! Rosoitall - Chori001111:inoma Saota B!!!ban! !Santa Barbara Cotmge Hospital) • Choriocarcinoma Santa Rl!lil ISapta Rosa Memorial Hospital\ - CboriOCilll:inoma (3) Ymllllll - Choriocarcinoma Alaska !Alo.s!so NoJjvc Medical Cegterl - Choriocarcinoma Ari1pna CMnNvale Medjcol Center} • Choriocarcinoma, testicle Arkanw CUnjycrshy of Arkansas Medical Centerl ~ ChoriocBTCinoma, testis Colot!!do - Choriocarcinonu~

Colora4o !Wbcal Rjdael - Choriocarcinoma Florida !Baph$1 UospiJO!l - Choriocarcinoma (S) Florida CMynroc Regjono1 Medica] Center> · Cboriocan:inoma Florida Cfal!ohassee> - Choriocarcinoma Florida {Wjnter tlaytn Hosoitall - Choriocarcinoma !!ljnojs<Buq Rjdoel - Choriocarcinoma llliooi>lEyw(O!! Hosoital) - Chorioearciooma lpdiMafBall Memorial Hosoitall - Chorioc:an:iooma Iodjapa(HoWICd Communitv Ro:mitall - Choriocarcinoma Louisiana State Upjvmity Me!lica! Center - Choriocarcinoma, testicle Marv!and CNatjooa! Naval Me!lica! Center) - Choriocaroinoma Marvland (Upjyeai!Y ofMuyland Medical Centerl - Choriocarcinoma Massachu.wtt4: Wcdcshjre Medical Center> - Choriocarcinoma MasSACbuxus CNew Ena!and Medical Center RcSidcnl•l - Choriocarcinoma Michjoan IOn!swood tlosnjJO!} - Choriocarcinoma Michisan CSI. Josenh Mcrev Hosnital) · Choriocarcinoma

February 2004

Mjnnesota tpajryiow Southdale Hosnjtnll - Non..seminomatous germ cell tumor? Choriocarciitoma. evaluate with serum I.POX ml!l'kcrs

New York (!.ono Island Jewish 1Jospjl8]l - Choriocarcinoma New Yor!< CNJ!SS!Ju UnjvernjJY Medical Center> - Choriocarcinoma New York !New York) - Chorioc=inoma Nonh Can!! ina (Mountain Area Pathology\ - Choriocarcinoma (3) Ohjo CMeclical College of OhiO) - Choriocarcino018 Oklaboma !Tulsa> - Choriocarcinoma Penn:Mvanja <AJ!eghegy General Hospjtall - Choriocarcinoma Peonsylyania CCenue Communirv HO$Qitall - Cboriocarcinoma. testes

!8 CTT'R. FcbruiU)' 2004 "Minutes" (Subscription A)

Pennsylvania (Conemaugh Memorial Medical Center) - Choriocarcinoma Pennsylvania(Lebigh Valley Hosnita1\ - Non-seminomatous germ cell tumor, favor choriocarcinoma{!); Choriocarcinoma (I) Pennsylyania CUPMC Health System\ - Choriocarcinoma Pennsylvania !Xort Hospjlal\ - Choriocarcinoma (8) Puerto Rico !University of Puerto Rico\ - Choriocarcinoma Rhode Island IR! Hospital Residents\ - Choriocarcinoma Texas !Lubbock\ - Choriocarcinoma Texas <Pro oath Associates\ - Choriocarcinoma (2) Texas £San Antonio) .. Choriocarcinoma To:xas (Scott & White Memorial Hospita!l - Choriocarcinoma West Virginia (Greenbrier Valley MediCal Center) .. Choriocarcinoma Australia CNort1J Oueensland Pathology\ - Choriocarcinoma Australia <Royal f>iince Alfred Hospital) - Choriocarc.inoma Cam!da (foothms Medjcal Center\ - Non-seminomatous germ cell tumor Hong Kong !Hong Kong Baptist Hospi!all - Placental site trophoblastic tumor IL'!Iy (Naples) - Choriocarcinoma Jamaica CThe Uniyersitv of the West In~ies\ - Choriocarcinoma, testis Netherlands !Amsterdam I - Choriocarcinoma, testis O!lt!lr !Hamad Medical Comorntionl - Choriocarcinoma Saudi Anlbia - Choriocan:inoma

Case tO- Diagnosis: Choriocarcinoma, testis

T-78000, M-91003

Case 10 - References: Shimizu S, Nagata Y and Han-yaku It Metastaiic Testicular Choriocarcinoma to the Skin. Report and Review of the Literature. Am

JDermalopathology 1996; 18(6);633-636. Gunnar Teilum M.D. Special Tumors of the Ovary and Testis and Related Extra-Gonadal Lesions Comparative Pathology and

Histologica11dcntificationo JB LippencoJt Company 191\ ; 356'357. Sahraoui S, liassani AT, Quhlatou F. Acbarld A, et ·aJ. Pure Choriocarcinoma of the Testis. Report of a Case and Review of the

Literature. Ann Uro/2001; 35(2):125428.

CJTR, FebruaJY 2004 "Minutes" (Subscription A) 19