Libre Pathology - User contributions [en]

Case 117

2015-09-26T14:09:25Z

Vinita: Created page with "===Provided clinical history=== 52 year old woman, hysterectomy done for leiomyoma ===Site=== Uterus- myometrium ===Primary image=== Image: Atypical leiomyoma with bizarre..."

===Provided clinical history===
52 year old woman, hysterectomy done for leiomyoma

===Site===
Uterus- myometrium

===Primary image===
[[Image: Atypical leiomyoma with bizarre nuclei low magnification.jpg |500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>

{{hidden|Intermediate magnification|[[Image: Atypical leiomyoma with bizarre nuclei low magnification 2.jpg|500px|link=|center|]]
<center>Intermediate magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: Atypical leiomyoma with bizarre nuclei high magnification.jpg |500px|link=|center|]]
<center>High magnification. [[H&E stain]].</center>}}

===Differential diagnosis===
{{hidden|Differential diagnosis|<center>Leiomyosarcoma</center>}}

===Additional tests===
====More history====
{{hidden|More history|<center>MORE HISTORY HERE</center>}}

====Ask a colleague====
{{hidden|Ask a colleague|<center>COLLEAGUE'S ADVICE HERE</center>}}

====Stains====
{{Case Stains
| blank=Dr Torres would ask why!
| alcpas=
| alc1=
| alc25=
| aur=
| biel=
| bili=
| iron=
| congored=
| cresylv=
| dieterle=
| diffquik=
| fontana=
| gallyas=
| giemsa=
| gms=
| gomori=
| gram=
| gremelius=
| jms=
| jones=
| kinyoun=
| luxol=
| masson=
| mmas=
| movat=
| mucicar=
| oilredo=
| orecein=
| pas=
| pasd=
| pasf=
| ptah=
| prussian=
| reticulin=
| sudanblackb=
| toluidine=
| verhoeff=
| vonkossa=
| warthinstarry=
| zn=
}}
====IHC====
{{Case IHC
| blank=Dr Torres would ask why!
| a1at=
| acth=
| ae1ae3=
| afp=
| alk1=
| amacr=
| ar=
| atrx=
| b2microglobulin=
| b72_3=
| bcatenin=
| bcl2=
| bcl6=
| bclxl=
| c3=
| ca9=
| calcitonin=
| calponin=
| calretinin=
| cam5p2=
| cathepsink=
| cd10=
| cd117=
| cd138=
| cd15=
| cd1a=
| cd20=
| cd21=
| cd23=
| cd3=
| cd30=
| cd31=
| cd34=
| cd35=
| cd4=
| cd43=
| cd45=
| cd5=
| cd56=
| cd57=
| cd68=
| cd7=
| cd79a=
| cd8=
| cd99=
| cdx2=
| cea=
| chromo=
| ck17=
| ck19=
| ck20=
| ck34be12=
| ck5_6=
| ck7=
| cmv=
| cmyc=
| cyclin_d1=
| d2_40=
| desmin=
| dog1=
| ebv=
| ema=
| erpr=
| f_viii=
| f_xiiia=
| fascin=
| fh=
| fsh=
| gastrin=
| gata3=
| gcdfp=
| gfap=
| gh=
| glucagon=
| glypican3=
| hbme1=
| hbv_core=
| hbv_surf=
| hcaldesmon=
| hcg=
| helicobacter=
| hepatocyte=
| her2=
| hhv8=
| hmb45=
| hnf1beta=
| hpv=
| hsv1=
| hsv2=
| Idh-1=
| inhibin=
| ini1=
| insulin=
| kappa=
| ki67=
| lambda=
| leu7=
| lga=
| lgg=
| lgm=
| lh=
| lysozyme=
| mammogl=
| map2=
| mcv=
| melanin_a=
| mitf=
| mum1=
| myleoperox=
| myo_d1=
| myog=
| napsin=
| nf=
| nkx3_1=
| nse=
| oct3_4=
| p16= patchy positive
| p501s=
| p53=
| p57=
| p63=
| panker=
| pax2=
| pax5=
| pax8=
| pcna=
| pdgfr=
| plap=
| pnl-2c=
| prolactin=
| psa=
| psap=
| rcc=
| s100=
| sma=
| somatsatin=
| synapto=
| tdt=
| tfe3=
| tfeb=
| thyrogl=
| toxopl=
| tsh=
| ttf1=
| ubiquitin=
| uchl1=
| ulex_europe=
| vim=
| vip=
| vzv=
| wt1=
}}

====Molecular testing====
=====Chromosomal translocations=====
{{Case Translocations
| blank=Dr Torres would ask why!
| t1_13=
| t2_13=
| t8_14=
| t9_22bcr_abl=
| t9_22chn_ews=
| t11_14=
| t11_22dsrct=
| t11_22ews=
| t12_15=
| t12_16afh=
| t12_16liposar=
| t12_22=
| t14_18=
| t15_17=
| t16_21=
| t17_22=
| t21_22=
| tx_1=
| tx_17=
| tx_18=
}}
=====Other molecular tests=====
{{Case Molecular
| blank=Dr Torres would ask why!
| alk =
| b_cell_clone =
| bcl2 =
| braf =
| EBV_pcr =
| egrf =
| h3f3a =
| hhv8_pcr =
| identity_test =
| idh1_2 =
| jak2_v617f =
| kit =
| loh_1p19q =
| t_cell_clone =
}}

===Diagnosis===
{{hidden|Diagnosis|<center>ATYPICAL LEIOMYOMA WITH BIZARRE NUCLEI. This smooth muscle tumor shows markedly atypical nuclei, some of which are multinucleate. The nuclei are smudgy and hyperchromatic, raising concern. However, here is no increase in mitotic activity; necrosis is absent. The edge of the tumor is rounded and there is no invasion of surrounding myometrium. These lesions are benign. {{Cite journal | last1 = Ly | first1 = A. | last2 = Mills | first2 = AM. | last3 = McKenney | first3 = JK. | last4 = Balzer | first4 = BL. | last5 = Kempson | first5 = RL. | last6 = Hendrickson | first6 = MR. | last7 = Longacre | first7 = TA. | title = Atypical leiomyomas of the uterus: a clinicopathologic study of 51 cases. | journal = Am J Surg Pathol | volume = 37 | issue = 5 | pages = 643-9 | month = May | year = 2013 | doi = 10.1097/PAS.0b013e3182893f36 | PMID = 23552381 }} {{Cite journal | last1 = Croce | first1 = S. | last2 = Young | first2 = RH. | last3 = Oliva | first3 = E. | title = Uterine leiomyomas with bizarre nuclei: a clinicopathologic study of 59 cases. | journal = Am J Surg Pathol | volume = 38 | issue = 10 | pages = 1330-9 | month = Oct | year = 2014 | doi = 10.1097/PAS.0000000000000249 | PMID = 25140893 }}
</center>}}
 
===Other cases===
{{Cases navigation}}

__NOTOC__

[[Category:Cases]]



[[Category:Cases difficulty 2]]

Case 115

2015-09-26T14:01:38Z

Vinita:

===Provided clinical history===
54 year old woman, incidental lesion discovered at time of risk reducing salpingooophorectomy

===Site===
Fallopian tube

===Primary image===
[[Image: Nodular histiocytic hyperplasia in fallopian tube 1.jpg |500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>

{{hidden|Intermediate magnification|[[Image: Nodular histiocytic hyperplasia in fallopian tube 2.jpg |500px|link=|center|]]
<center>Intermediate magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: Nodular histocytic hyperplasia high mag.jpg |500px|link=|center|]]
<center>High magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: Nodular histiocytic hyperplasia in fallopian tube 4.jpg |500px|link=|center|]]
<center>High magnification. [[H&E stain]].</center>}}

===Differential diagnosis===
{{hidden|Differential diagnosis|<center>THE DDx GOES HERE</center>}}

===Additional tests===
====More history====
{{hidden|More history|<center>MORE HISTORY HERE</center>}}

====Ask a colleague====
{{hidden|Ask a colleague|<center>COLLEAGUE'S ADVICE HERE</center>}}

====Stains====
{{Case Stains
| blank=Dr Torres would ask why!
| alcpas=
| alc1=
| alc25=
| aur=
| biel=
| bili=
| iron=
| congored=
| cresylv=
| dieterle=
| diffquik=
| fontana=
| gallyas=
| giemsa=
| gms=
| gomori=
| gram=
| gremelius=
| jms=
| jones=
| kinyoun=
| luxol=
| masson=
| mmas=
| movat=
| mucicar=
| oilredo=
| orecein=
| pas=
| pasd=
| pasf=
| ptah=
| prussian=
| reticulin=
| sudanblackb=
| toluidine=
| verhoeff=
| vonkossa=
| warthinstarry=
| zn=
}}
====IHC====
{{Case IHC
| blank=Dr Torres would ask why!
| a1at=
| acth=
| ae1ae3=
| afp=
| alk1=
| amacr=
| ar=
| atrx=
| b2microglobulin=
| b72_3=
| bcatenin=
| bcl2=
| bcl6=
| bclxl=
| c3=
| ca9=
| calcitonin=
| calponin=
| calretinin= Negative
| cam5p2=
| cathepsink=
| cd10=
| cd117=
| cd138=
| cd15=
| cd1a=
| cd20=
| cd21=
| cd23=
| cd3=
| cd30=
| cd31=
| cd34=
| cd35=
| cd4=
| cd43=
| cd45=
| cd5=
| cd56=
| cd57=
| cd68= Positive see image
| cd7=
| cd79a=
| cd8=
| cd99=
| cdx2=
| cea=
| chromo=
| ck17=
| ck19=
| ck20=
| ck34be12=
| ck5_6=
| ck7=
| cmv=
| cmyc=
| cyclin_d1=
| d2_40=
| desmin=
| dog1=
| ebv=
| ema=
| erpr=
| f_viii=
| f_xiiia=
| fascin=
| fh=
| fsh=
| gastrin=
| gata3=
| gcdfp=
| gfap=
| gh=
| glucagon=
| glypican3=
| hbme1=
| hbv_core=
| hbv_surf=
| hcaldesmon=
| hcg=
| helicobacter=
| hepatocyte=
| her2=
| hhv8=
| hmb45=
| hnf1beta=
| hpv=
| hsv1=
| hsv2=
| Idh-1=
| inhibin= Negative
| ini1=
| insulin=
| kappa=
| ki67=
| lambda=
| leu7=
| lga=
| lgg=
| lgm=
| lh=
| lysozyme=
| mammogl=
| map2=
| mcv=
| melanin_a=
| mitf=
| mum1=
| myleoperox=
| myo_d1=
| myog=
| napsin=
| nf=
| nkx3_1=
| nse=
| oct3_4=
| p16=
| p501s=
| p53=
| p57=
| p63=
| panker=
| pax2=
| pax5=
| pax8=
| pcna=
| pdgfr=
| plap=
| pnl-2c=
| prolactin=
| psa=
| psap=
| rcc=
| s100=
| sma=
| somatsatin=
| synapto=
| tdt=
| tfe3=
| tfeb=
| thyrogl=
| toxopl=
| tsh=
| ttf1=
| ubiquitin=
| uchl1=
| ulex_europe=
| vim=
| vip=
| vzv=
| wt1=
}}

====Molecular testing====
=====Chromosomal translocations=====
{{Case Translocations
| blank=Dr Torres would ask why!
| t1_13=
| t2_13=
| t8_14=
| t9_22bcr_abl=
| t9_22chn_ews=
| t11_14=
| t11_22dsrct=
| t11_22ews=
| t12_15=
| t12_16afh=
| t12_16liposar=
| t12_22=
| t14_18=
| t15_17=
| t16_21=
| t17_22=
| t21_22=
| tx_1=
| tx_17=
| tx_18=
}}
=====Other molecular tests=====
{{Case Molecular
| blank=Dr Torres would ask why!
| alk =
| b_cell_clone =
| bcl2 =
| braf =
| EBV_pcr =
| egrf =
| h3f3a =
| hhv8_pcr =
| identity_test =
| idh1_2 =
| jak2_v617f =
| kit =
| loh_1p19q =
| t_cell_clone =
}}

===Diagnosis===
{{hidden|Diagnosis|<center>NODULAR HISTIOCYTIC HYPERPLASIA IN THE FALLOPIAN TUBE. Originally called nodular histiocytic and mesothelial hyperplasia, it was reported in hernia sacs and was believed to be of predominant mesothelial cells. The advent of immunohistochemistry indicated that the vast majority of the cells are histiocytes. In the gynecologic tract it is reported in the endometrium also, where it can simulate neoplasia. {{Cite journal | last1 = Parkash | first1 = V. | last2 = Domfeh | first2 = AB. | last3 = Fadare | first3 = O. | title = Nodular histiocytic aggregates in the endometrium: a report of 7 cases. | journal = Int J Gynecol Pathol | volume = 33 | issue = 1 | pages = 52-7 | month = Jan | year = 2014 | doi = 10.1097/PGP.0b013e3182894365 | PMID = 24300536 }}</center>}}
 
===Other cases===
{{Cases navigation}}

__NOTOC__

[[Category:Cases]]



[[Category:Cases difficulty 4]]

Case 116

2015-09-26T14:00:55Z

Vinita: Created page with "===Provided clinical history=== 45 year old woman, with intractable uterine bleeding unresponsive to hormone therapy. Mass lesion in the myometrium ===Site=== Uterus- myomet..."

===Provided clinical history===
45 year old woman, with intractable uterine bleeding unresponsive to hormone therapy. Mass lesion in the myometrium

===Site===
Uterus- myometrium

===Primary image===
[[Image: Leiomyoma with changes secondary to tranexamic acid treatment low magnification.jpg |500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>

{{hidden|Intermediate magnification|[[Image: NAME OF IMAGE GOES HERE |500px|link=|center|]]
<center>Intermediate magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: Leiomyoma with changes secondary to tranexamic acid treatment high magnification.jpg |500px|link=|center|]]
<center>High magnification. [[H&E stain]].</center>}}

===Differential diagnosis===
{{hidden|Differential diagnosis|<center>Smooth muscle tumor of undetermined malignant potential(STUMP), leiomyosarcoma </center>}}

===Additional tests===
====More history====
{{hidden|More history|<center>Patient had received lysteda for control of bleeding </center>}}

====Ask a colleague====
{{hidden|Ask a colleague|<center>COLLEAGUE'S ADVICE HERE</center>}}

====Stains====
{{Case Stains
| blank=Dr Torres would ask why!
| alcpas=
| alc1=
| alc25=
| aur=
| biel=
| bili=
| iron=
| congored=
| cresylv=
| dieterle=
| diffquik=
| fontana=
| gallyas=
| giemsa=
| gms=
| gomori=
| gram=
| gremelius=
| jms=
| jones=
| kinyoun=
| luxol=
| masson=
| mmas=
| movat=
| mucicar=
| oilredo=
| orecein=
| pas=
| pasd=
| pasf=
| ptah=
| prussian=
| reticulin=
| sudanblackb=
| toluidine=
| verhoeff=
| vonkossa=
| warthinstarry=
| zn=
}}
====IHC====
{{Case IHC
| blank=Dr Torres would ask why!
| a1at=
| acth=
| ae1ae3=
| afp=
| alk1=
| amacr=
| ar=
| atrx=
| b2microglobulin=
| b72_3=
| bcatenin=
| bcl2=
| bcl6=
| bclxl=
| c3=
| ca9=
| calcitonin=
| calponin=
| calretinin=
| cam5p2=
| cathepsink=
| cd10=
| cd117=
| cd138=
| cd15=
| cd1a=
| cd20=
| cd21=
| cd23=
| cd3=
| cd30=
| cd31=
| cd34=
| cd35=
| cd4=
| cd43=
| cd45=
| cd5=
| cd56=
| cd57=
| cd68=
| cd7=
| cd79a=
| cd8=
| cd99=
| cdx2=
| cea=
| chromo=
| ck17=
| ck19=
| ck20=
| ck34be12=
| ck5_6=
| ck7=
| cmv=
| cmyc=
| cyclin_d1=
| d2_40=
| desmin=
| dog1=
| ebv=
| ema=
| erpr=
| f_viii=
| f_xiiia=
| fascin=
| fh=
| fsh=
| gastrin=
| gata3=
| gcdfp=
| gfap=
| gh=
| glucagon=
| glypican3=
| hbme1=
| hbv_core=
| hbv_surf=
| hcaldesmon=
| hcg=
| helicobacter=
| hepatocyte=
| her2=
| hhv8=
| hmb45=
| hnf1beta=
| hpv=
| hsv1=
| hsv2=
| Idh-1=
| inhibin=
| ini1=
| insulin=
| kappa=
| ki67=
| lambda=
| leu7=
| lga=
| lgg=
| lgm=
| lh=
| lysozyme=
| mammogl=
| map2=
| mcv=
| melanin_a=
| mitf=
| mum1=
| myleoperox=
| myo_d1=
| myog=
| napsin=
| nf=
| nkx3_1=
| nse=
| oct3_4=
| p16=
| p501s=
| p53=
| p57=
| p63=
| panker=
| pax2=
| pax5=
| pax8=
| pcna=
| pdgfr=
| plap=
| pnl-2c=
| prolactin=
| psa=
| psap=
| rcc=
| s100=
| sma=
| somatsatin=
| synapto=
| tdt=
| tfe3=
| tfeb=
| thyrogl=
| toxopl=
| tsh=
| ttf1=
| ubiquitin=
| uchl1=
| ulex_europe=
| vim=
| vip=
| vzv=
| wt1=
}}

====Molecular testing====
=====Chromosomal translocations=====
{{Case Translocations
| blank=Dr Torres would ask why!
| t1_13=
| t2_13=
| t8_14=
| t9_22bcr_abl=
| t9_22chn_ews=
| t11_14=
| t11_22dsrct=
| t11_22ews=
| t12_15=
| t12_16afh=
| t12_16liposar=
| t12_22=
| t14_18=
| t15_17=
| t16_21=
| t17_22=
| t21_22=
| tx_1=
| tx_17=
| tx_18=
}}
=====Other molecular tests=====
{{Case Molecular
| blank=Dr Torres would ask why!
| alk =
| b_cell_clone =
| bcl2 =
| braf =
| EBV_pcr =
| egrf =
| h3f3a =
| hhv8_pcr =
| identity_test =
| idh1_2 =
| jak2_v617f =
| kit =
| loh_1p19q =
| t_cell_clone =
}}

===Diagnosis===
{{hidden|Diagnosis|<center>LEIOMYOMA WITH TRANEXAMIC ACID ASSOCIATED MICROINFARCTION. This smooth muscle tumor depicts no atypia. When in this situation it is prudent to request detailed clinical history. Clinicians often do not inform of all agents given to patients to control uterine bleeding. {{Cite journal | last1 = Ip | first1 = PP. | last2 = Lam | first2 = KW. | last3 = Cheung | first3 = CL. | last4 = Yeung | first4 = MC. | last5 = Pun | first5 = TC. | last6 = Chan | first6 = QK. | last7 = Cheung | first7 = AN. | title = Tranexamic acid-associated necrosis and intralesional thrombosis of uterine leiomyomas: a clinicopathologic study of 147 cases emphasizing the importance of drug-induced necrosis and early infarcts in leiomyomas. | journal = Am J Surg Pathol | volume = 31 | issue = 8 | pages = 1215-24 | month = Aug | year = 2007 | doi = 10.1097/PAS.0b013e318032125e | PMID = 17667546 }}</center>}}
 
===Other cases===
{{Cases navigation}}

__NOTOC__

[[Category:Cases]]



[[Category:Cases difficulty 7]]

Case 115

2015-09-26T13:53:28Z

Vinita: Created page with "===Provided clinical history=== 54 year old woman, incidental lesion discovered at time of risk reducing salpingooophorectomy ===Site=== Fallopian tube ===Primary image=== [..."

===Provided clinical history===
54 year old woman, incidental lesion discovered at time of risk reducing salpingooophorectomy

===Site===
Fallopian tube

===Primary image===
[[Image: Nodular histiocytic hyperplasia in fallopian tube 1.jpg |500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>

{{hidden|Intermediate magnification|[[Image: Nodular histiocytic hyperplasia in fallopian tube 2.jpg |500px|link=|center|]]
<center>Intermediate magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: Nodular histocytic hyperplasia high mag.jpg |500px|link=|center|]]
<center>High magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: Nodular histiocytic hyperplasia in fallopian tube 4.jpg |500px|link=|center|]]
<center>High magnification. [[H&E stain]].</center>}}

===Differential diagnosis===
{{hidden|Differential diagnosis|<center>THE DDx GOES HERE</center>}}

===Additional tests===
====More history====
{{hidden|More history|<center>MORE HISTORY HERE</center>}}

====Ask a colleague====
{{hidden|Ask a colleague|<center>COLLEAGUE'S ADVICE HERE</center>}}

====Stains====
{{Case Stains
| blank=Dr Torres would ask why!
| alcpas=
| alc1=
| alc25=
| aur=
| biel=
| bili=
| iron=
| congored=
| cresylv=
| dieterle=
| diffquik=
| fontana=
| gallyas=
| giemsa=
| gms=
| gomori=
| gram=
| gremelius=
| jms=
| jones=
| kinyoun=
| luxol=
| masson=
| mmas=
| movat=
| mucicar=
| oilredo=
| orecein=
| pas=
| pasd=
| pasf=
| ptah=
| prussian=
| reticulin=
| sudanblackb=
| toluidine=
| verhoeff=
| vonkossa=
| warthinstarry=
| zn=
}}
====IHC====
{{Case IHC
| blank=Dr Torres would ask why!
| a1at=
| acth=
| ae1ae3=
| afp=
| alk1=
| amacr=
| ar=
| atrx=
| b2microglobulin=
| b72_3=
| bcatenin=
| bcl2=
| bcl6=
| bclxl=
| c3=
| ca9=
| calcitonin=
| calponin=
| calretinin= Negative
| cam5p2=
| cathepsink=
| cd10=
| cd117=
| cd138=
| cd15=
| cd1a=
| cd20=
| cd21=
| cd23=
| cd3=
| cd30=
| cd31=
| cd34=
| cd35=
| cd4=
| cd43=
| cd45=
| cd5=
| cd56=
| cd57=
| cd68= Positive see image
| cd7=
| cd79a=
| cd8=
| cd99=
| cdx2=
| cea=
| chromo=
| ck17=
| ck19=
| ck20=
| ck34be12=
| ck5_6=
| ck7=
| cmv=
| cmyc=
| cyclin_d1=
| d2_40=
| desmin=
| dog1=
| ebv=
| ema=
| erpr=
| f_viii=
| f_xiiia=
| fascin=
| fh=
| fsh=
| gastrin=
| gata3=
| gcdfp=
| gfap=
| gh=
| glucagon=
| glypican3=
| hbme1=
| hbv_core=
| hbv_surf=
| hcaldesmon=
| hcg=
| helicobacter=
| hepatocyte=
| her2=
| hhv8=
| hmb45=
| hnf1beta=
| hpv=
| hsv1=
| hsv2=
| Idh-1=
| inhibin= Negative
| ini1=
| insulin=
| kappa=
| ki67=
| lambda=
| leu7=
| lga=
| lgg=
| lgm=
| lh=
| lysozyme=
| mammogl=
| map2=
| mcv=
| melanin_a=
| mitf=
| mum1=
| myleoperox=
| myo_d1=
| myog=
| napsin=
| nf=
| nkx3_1=
| nse=
| oct3_4=
| p16=
| p501s=
| p53=
| p57=
| p63=
| panker=
| pax2=
| pax5=
| pax8=
| pcna=
| pdgfr=
| plap=
| pnl-2c=
| prolactin=
| psa=
| psap=
| rcc=
| s100=
| sma=
| somatsatin=
| synapto=
| tdt=
| tfe3=
| tfeb=
| thyrogl=
| toxopl=
| tsh=
| ttf1=
| ubiquitin=
| uchl1=
| ulex_europe=
| vim=
| vip=
| vzv=
| wt1=
}}

====Molecular testing====
=====Chromosomal translocations=====
{{Case Translocations
| blank=Dr Torres would ask why!
| t1_13=
| t2_13=
| t8_14=
| t9_22bcr_abl=
| t9_22chn_ews=
| t11_14=
| t11_22dsrct=
| t11_22ews=
| t12_15=
| t12_16afh=
| t12_16liposar=
| t12_22=
| t14_18=
| t15_17=
| t16_21=
| t17_22=
| t21_22=
| tx_1=
| tx_17=
| tx_18=
}}
=====Other molecular tests=====
{{Case Molecular
| blank=Dr Torres would ask why!
| alk =
| b_cell_clone =
| bcl2 =
| braf =
| EBV_pcr =
| egrf =
| h3f3a =
| hhv8_pcr =
| identity_test =
| idh1_2 =
| jak2_v617f =
| kit =
| loh_1p19q =
| t_cell_clone =
}}

===Diagnosis===
{{hidden|Diagnosis|<center>Nodular histiocytic hyperplasia in the fallopian tube. Originally called nodular histiocytic and mesothelial hyperplasia, it was reported in hernia sacs and was believed to be of predominant mesothelial cells. The advent of immunohistochemistry indicated that the vast majority of the cells are histiocytes. In the gynecologic tract it is reported in the endometrium also, where it can simulate neoplasia. {{Cite journal | last1 = Parkash | first1 = V. | last2 = Domfeh | first2 = AB. | last3 = Fadare | first3 = O. | title = Nodular histiocytic aggregates in the endometrium: a report of 7 cases. | journal = Int J Gynecol Pathol | volume = 33 | issue = 1 | pages = 52-7 | month = Jan | year = 2014 | doi = 10.1097/PGP.0b013e3182894365 | PMID = 24300536 }}</center>}}
 
===Other cases===
{{Cases navigation}}

__NOTOC__

[[Category:Cases]]



[[Category:Cases difficulty 4]]

Case 112

2015-09-24T18:30:49Z

Vinita:

===Provided clinical history===
42 year old woman with a 9 cm ovarian mass

===Site===
ZZZ

===Primary image===
[[Image: Gross of borderline serous tumor of the ovary 01.jpg|500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>

{{hidden|Intermediate magnification|[[Image: Low maginification of borderline serous tumor of the ovary.jpg |500px|link=|center|]]
<center>Intermediate magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: Intermediate magnification of a borderline serous tumor showing eosiniophilic cells.jpg |500px|link=|center|]]
<center>High magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: Microinvasion in a borderline serous tumor of the ovary.jpg |500px|link=|center|]]
<center>High magnification. [[H&E stain]].</center>}}

===Differential diagnosis===
{{hidden|Differential diagnosis|<center>SEROUS CYSTADENOFIBROMA OR ENDOCERVICAL TYPE BORDERLINE MUCINOUS TUMOR OR PAPILLARY CLEAR CELL CARCINOMA SIMULATING BORDERLINE TUMOR </center>}}

===Additional tests===
====More history====
{{hidden|More history|<center>MORE HISTORY HERE</center>}}

====Ask a colleague====
{{hidden|Ask a colleague|<center>CONSIDER DOING IMMUNO STAINS ?</center>}}

====Stains====
{{Case Stains
| blank=Dr Torres would ask why!
| alcpas=
| alc1=
| alc25=
| aur=
| biel=
| bili=
| iron=
| congored=
| cresylv=
| dieterle=
| diffquik=
| fontana=
| gallyas=
| giemsa=
| gms=
| gomori=
| gram=
| gremelius=
| jms=
| jones=
| kinyoun=
| luxol=
| masson=
| mmas=
| movat=
| mucicar=
| oilredo=
| orecein=
| pas=
| pasd=
| pasf=
| ptah=
| prussian=
| reticulin=
| sudanblackb=
| toluidine=
| verhoeff=
| vonkossa=
| warthinstarry=
| zn=
}}
====IHC====
{{Case IHC
| blank=Dr Torres would ask why!
| a1at=
| acth=
| ae1ae3=
| afp=
| alk1=
| amacr=
| ar=
| atrx=
| b2microglobulin=
| b72_3=
| bcatenin=
| bcl2=
| bcl6=
| bclxl=
| c3=
| ca9=
| calcitonin=
| calponin=
| calretinin=
| cam5p2=
| cathepsink=
| cd10=
| cd117=
| cd138=
| cd15=
| cd1a=
| cd20=
| cd21=
| cd23=
| cd3=
| cd30=
| cd31=
| cd34=
| cd35=
| cd4=
| cd43=
| cd45=
| cd5=
| cd56=
| cd57=
| cd68=
| cd7=
| cd79a=
| cd8=
| cd99=
| cdx2=
| cea=
| chromo=
| ck17=
| ck19=
| ck20=
| ck34be12=
| ck5_6=
| ck7=
| cmv=
| cmyc=
| cyclin_d1=
| d2_40=
| desmin=
| dog1=
| ebv=
| ema=
| erpr= POSITIVE
| f_viii=
| f_xiiia=
| fascin=
| fh=
| fsh=
| gastrin=
| gata3=
| gcdfp=
| gfap=
| gh=
| glucagon=
| glypican3=
| hbme1=
| hbv_core=
| hbv_surf=
| hcaldesmon=
| hcg=
| helicobacter=
| hepatocyte=
| her2=
| hhv8=
| hmb45=
| hnf1beta=
| hpv=
| hsv1=
| hsv2=
| Idh-1=
| inhibin=
| ini1=
| insulin=
| kappa=
| ki67=
| lambda=
| leu7=
| lga=
| lgg=
| lgm=
| lh=
| lysozyme=
| mammogl=
| map2=
| mcv=
| melanin_a=
| mitf=
| mum1=
| myleoperox=
| myo_d1=
| myog=
| nf=
| nkx3_1=
| nse=
| oct3_4=
| p16=
| p501s=
| p53=
| p57=
| p63=
| panker=
| pax2=
| pax5=
| pax8=
| pcna=
| pdgfr=
| plap=
| pnl-2c=
| prolactin=
| psa=
| psap=
| rcc=
| s100=
| sma=
| somatsatin=
| synapto=
| tdt=
| tfe3=
| tfeb=
| thyrogl=
| toxopl=
| tsh=
| ttf1=
| ubiquitin=
| uchl1=
| ulex_europe=
| vim=
| vip=
| vzv=
| wt1= POSITIVE
}}

====Molecular testing====
=====Chromosomal translocations=====
{{Case Translocations
| blank=Dr Torres would ask why!
| t1_13=
| t2_13=
| t8_14=
| t9_22bcr_abl=
| t9_22chn_ews=
| t11_14=
| t11_22dsrct=
| t11_22ews=
| t12_15=
| t12_16afh=
| t12_16liposar=
| t12_22=
| t14_18=
| t15_17=
| t16_21=
| t17_22=
| t21_22=
| tx_1=
| tx_17=
| tx_18=
}}
=====Other molecular tests=====
{{Case Molecular
| blank=Dr Torres would ask why!
| alk =
| b_cell_clone =
| bcl2 =
| braf =
| EBV_pcr =
| egrf =
| h3f3a =
| hhv8_pcr =
| identity_test =
| idh1_2 =
| jak2_v617f =
| kit =
| loh_1p19q =
| t_cell_clone =
}}

===Diagnosis===
{{hidden|Diagnosis|<center>BORDERLINE SEROUS TUMOR OF THE OVARY WITH MICROINVASION.</center>
 The characteristic feature of borderline serous tumor is the hierarchical branching of the papillae, where the papillae progressively branch from larger ones to smaller one and finally into tufts of epithelial cells. The cells show only mild to moderate atypia. A cytadenofibroma may have similar proliferation, but by convention should be less than 5% of the tumor. Focal mucinous change may also occur. Papillary clear cell carcinoma simulating borderline tumor will show a WT1-ve, ER-ve, PR-ve immunoprofile in contrast to the positive profile of the serous tumor. Often clusters of cells with abundant eosinophilic cytoplasm are seen at the surface of papillae (star, image 2; oval image 3) or in lymphatic like spaces either as single cells or small papillary clusters. This theoretically represents microinvasion which is variably defined by different authors (<3 or 5 mm or 10mm2). However, recent evidence suggests that the two patterns of invasion have vastly different prognosis. The AEC (abundant eosinophilic cells) are p16 positive and reflect a terminally differentiated senescent phenotype. If invasion is exclusively composed of this cell type, then these do not portend a poor prognosis.<ref name=pmid24441661>{{Cite journal | last1 = Maniar | first1 = KP. | last2 = Wang | first2 = Y. | last3 = Visvanathan | first3 = K. | last4 = Shih | first4 = IeM. | last5 = Kurman | first5 = RJ. | title = Evaluation of microinvasion and lymph node involvement in ovarian serous borderline/atypical proliferative serous tumors: a morphologic and immunohistochemical analysis of 37 cases. | journal = Am J Surg Pathol | volume = 38 | issue = 6 | pages = 743-55 | month = Jun | year = 2014 | doi = 10.1097/PAS.0000000000000155 | PMID = 24441661 }}</ref> These cells are significantly more often seen in BRAF mutated tumors, and are perhaps associated with a better prognosis. <ref name=PMID 25188864> {{Cite journal | last1 = Zeppernick | first1 = F. | last2 = Ardighieri | first2 = L. | last3 = Hannibal | first3 = CG. | last4 = Vang | first4 = R. | last5 = Junge | first5 = J. | last6 = Kjaer | first6 = SK. | last7 = Zhang | first7 = R. | last8 = Kurman | first8 = RJ. | last9 = Shih | first9 = IeM. | title = BRAF mutation is associated with a specific cell type with features suggestive of senescence in ovarian serous borderline (atypical proliferative) tumors. | journal = Am J Surg Pathol | volume = 38 | issue = 12 | pages = 1603-11 | month = Dec | year = 2014 | doi = 10.1097/PAS.0000000000000313 | PMID = 25188864 }}<ref>

====References====
{{Reflist|1}}

}}
 

===Other cases===
{{Cases navigation}}

__NOTOC__

[[Category:Cases]]



[[Category:Cases difficulty 2]]

Case 112

2015-09-24T18:28:26Z

Vinita:

===Provided clinical history===
42 year old woman with a 9 cm ovarian mass

===Site===
ZZZ

===Primary image===
[[Image: Gross of borderline serous tumor of the ovary 01.jpg|500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>

{{hidden|Intermediate magnification|[[Image: Low maginification of borderline serous tumor of the ovary.jpg |500px|link=|center|]]
<center>Intermediate magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: Intermediate magnification of a borderline serous tumor showing eosiniophilic cells.jpg |500px|link=|center|]]
<center>High magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: Microinvasion in a borderline serous tumor of the ovary.jpg |500px|link=|center|]]
<center>High magnification. [[H&E stain]].</center>}}

===Differential diagnosis===
{{hidden|Differential diagnosis|<center>SEROUS CYSTADENOFIBROMA OR ENDOCERVICAL TYPE BORDERLINE MUCINOUS TUMOR OR PAPILLARY CLEAR CELL CARCINOMA SIMULATING BORDERLINE TUMOR </center>}}

===Additional tests===
====More history====
{{hidden|More history|<center>MORE HISTORY HERE</center>}}

====Ask a colleague====
{{hidden|Ask a colleague|<center>CONSIDER DOING IMMUNO STAINS ?</center>}}

====Stains====
{{Case Stains
| blank=Dr Torres would ask why!
| alcpas=
| alc1=
| alc25=
| aur=
| biel=
| bili=
| iron=
| congored=
| cresylv=
| dieterle=
| diffquik=
| fontana=
| gallyas=
| giemsa=
| gms=
| gomori=
| gram=
| gremelius=
| jms=
| jones=
| kinyoun=
| luxol=
| masson=
| mmas=
| movat=
| mucicar=
| oilredo=
| orecein=
| pas=
| pasd=
| pasf=
| ptah=
| prussian=
| reticulin=
| sudanblackb=
| toluidine=
| verhoeff=
| vonkossa=
| warthinstarry=
| zn=
}}
====IHC====
{{Case IHC
| blank=Dr Torres would ask why!
| a1at=
| acth=
| ae1ae3=
| afp=
| alk1=
| amacr=
| ar=
| atrx=
| b2microglobulin=
| b72_3=
| bcatenin=
| bcl2=
| bcl6=
| bclxl=
| c3=
| ca9=
| calcitonin=
| calponin=
| calretinin=
| cam5p2=
| cathepsink=
| cd10=
| cd117=
| cd138=
| cd15=
| cd1a=
| cd20=
| cd21=
| cd23=
| cd3=
| cd30=
| cd31=
| cd34=
| cd35=
| cd4=
| cd43=
| cd45=
| cd5=
| cd56=
| cd57=
| cd68=
| cd7=
| cd79a=
| cd8=
| cd99=
| cdx2=
| cea=
| chromo=
| ck17=
| ck19=
| ck20=
| ck34be12=
| ck5_6=
| ck7=
| cmv=
| cmyc=
| cyclin_d1=
| d2_40=
| desmin=
| dog1=
| ebv=
| ema=
| erpr= POSITIVE
| f_viii=
| f_xiiia=
| fascin=
| fh=
| fsh=
| gastrin=
| gata3=
| gcdfp=
| gfap=
| gh=
| glucagon=
| glypican3=
| hbme1=
| hbv_core=
| hbv_surf=
| hcaldesmon=
| hcg=
| helicobacter=
| hepatocyte=
| her2=
| hhv8=
| hmb45=
| hnf1beta=
| hpv=
| hsv1=
| hsv2=
| Idh-1=
| inhibin=
| ini1=
| insulin=
| kappa=
| ki67=
| lambda=
| leu7=
| lga=
| lgg=
| lgm=
| lh=
| lysozyme=
| mammogl=
| map2=
| mcv=
| melanin_a=
| mitf=
| mum1=
| myleoperox=
| myo_d1=
| myog=
| nf=
| nkx3_1=
| nse=
| oct3_4=
| p16=
| p501s=
| p53=
| p57=
| p63=
| panker=
| pax2=
| pax5=
| pax8=
| pcna=
| pdgfr=
| plap=
| pnl-2c=
| prolactin=
| psa=
| psap=
| rcc=
| s100=
| sma=
| somatsatin=
| synapto=
| tdt=
| tfe3=
| tfeb=
| thyrogl=
| toxopl=
| tsh=
| ttf1=
| ubiquitin=
| uchl1=
| ulex_europe=
| vim=
| vip=
| vzv=
| wt1= POSITIVE
}}

====Molecular testing====
=====Chromosomal translocations=====
{{Case Translocations
| blank=Dr Torres would ask why!
| t1_13=
| t2_13=
| t8_14=
| t9_22bcr_abl=
| t9_22chn_ews=
| t11_14=
| t11_22dsrct=
| t11_22ews=
| t12_15=
| t12_16afh=
| t12_16liposar=
| t12_22=
| t14_18=
| t15_17=
| t16_21=
| t17_22=
| t21_22=
| tx_1=
| tx_17=
| tx_18=
}}
=====Other molecular tests=====
{{Case Molecular
| blank=Dr Torres would ask why!
| alk =
| b_cell_clone =
| bcl2 =
| braf =
| EBV_pcr =
| egrf =
| h3f3a =
| hhv8_pcr =
| identity_test =
| idh1_2 =
| jak2_v617f =
| kit =
| loh_1p19q =
| t_cell_clone =
}}

===Diagnosis===
{{hidden|Diagnosis|<center>BORDERLINE SEROUS TUMOR OF THE OVARY WITH MICROINVASION.</center>
 The characteristic feature of borderline serous tumor is the hierarchical branching of the papillae, where the papillae progressively branch from larger ones to smaller one and finally into tufts of epithelial cells. The cells show only mild to moderate atypia. A cytadenofibroma may have similar proliferation, but by convention should be less than 5% of the tumor. Focal mucinous change may also occur. Papillary clear cell carcinoma simulating borderline tumor will show a WT1-ve, ER-ve, PR-ve immunoprofile in contrast to the positive profile of the serous tumor. Often clusters of cells with abundant eosinophilic cytoplasm are seen at the surface of papillae (star, image 2; oval image 3) or in lymphatic like spaces either as single cells or small papillary clusters. This theoretically represents microinvasion which is variably defined by different authors (<3 or 5 mm or 10mm2). However, recent evidence suggests that the two patterns of invasion have vastly different prognosis. The AEC (abundant eosinophilic cells) are p16 positive and reflect a terminally differentiated senescent phenotype. If invasion is exclusively composed of this cell type, then these do not portend a poor prognosis.<ref name=pmid24441661>{{Cite journal | last1 = Maniar | first1 = KP. | last2 = Wang | first2 = Y. | last3 = Visvanathan | first3 = K. | last4 = Shih | first4 = IeM. | last5 = Kurman | first5 = RJ. | title = Evaluation of microinvasion and lymph node involvement in ovarian serous borderline/atypical proliferative serous tumors: a morphologic and immunohistochemical analysis of 37 cases. | journal = Am J Surg Pathol | volume = 38 | issue = 6 | pages = 743-55 | month = Jun | year = 2014 | doi = 10.1097/PAS.0000000000000155 | PMID = 24441661 }}</ref> These cells are significantly more often seen in BRAF mutated tumors, and are perhaps associated with a better prognosis. {{Cite journal | last1 = Zeppernick | first1 = F. | last2 = Ardighieri | first2 = L. | last3 = Hannibal | first3 = CG. | last4 = Vang | first4 = R. | last5 = Junge | first5 = J. | last6 = Kjaer | first6 = SK. | last7 = Zhang | first7 = R. | last8 = Kurman | first8 = RJ. | last9 = Shih | first9 = IeM. | title = BRAF mutation is associated with a specific cell type with features suggestive of senescence in ovarian serous borderline (atypical proliferative) tumors. | journal = Am J Surg Pathol | volume = 38 | issue = 12 | pages = 1603-11 | month = Dec | year = 2014 | doi = 10.1097/PAS.0000000000000313 | PMID = 25188864 }}

====References====
{{Reflist|1}}

}}
 

===Other cases===
{{Cases navigation}}

__NOTOC__

[[Category:Cases]]



[[Category:Cases difficulty 2]]

Case 112

2015-09-24T18:00:36Z

Vinita: Created page with "===Provided clinical history=== 42 year old woman with a 9 cm ovarian mass ===Site=== ZZZ ===Primary image=== Image: Gross of borderline serous tumor of the ovary 01.jpg|5..."

===Provided clinical history===
42 year old woman with a 9 cm ovarian mass

===Site===
ZZZ

===Primary image===
[[Image: Gross of borderline serous tumor of the ovary 01.jpg|500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>

{{hidden|Intermediate magnification|[[Image: Low maginification of borderline serous tumor of the ovary.jpg |500px|link=|center|]]
<center>Intermediate magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: Intermediate magnification of a borderline serous tumor showing eosiniophilic cells.jpg |500px|link=|center|]]
<center>High magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: Microinvasion in a borderline serous tumor of the ovary.jpg |500px|link=|center|]]
<center>High magnification. [[H&E stain]].</center>}}

===Differential diagnosis===
{{hidden|Differential diagnosis|<center>SEROUS CYSTADENOFIBROMA OR ENDOCERVICAL TYPE BORDERLINE MUCINOUS TUMOR OR PAPILLARY CLEAR CELL CARCINOMA SIMULATING BORDERLINE TUMOR </center>}}

===Additional tests===
====More history====
{{hidden|More history|<center>MORE HISTORY HERE</center>}}

====Ask a colleague====
{{hidden|Ask a colleague|<center>CONSIDER DOING IMMUNO STAINS ?</center>}}

====Stains====
{{Case Stains
| blank=Dr Torres would ask why!
| alcpas=
| alc1=
| alc25=
| aur=
| biel=
| bili=
| iron=
| congored=
| cresylv=
| dieterle=
| diffquik=
| fontana=
| gallyas=
| giemsa=
| gms=
| gomori=
| gram=
| gremelius=
| jms=
| jones=
| kinyoun=
| luxol=
| masson=
| mmas=
| movat=
| mucicar=
| oilredo=
| orecein=
| pas=
| pasd=
| pasf=
| ptah=
| prussian=
| reticulin=
| sudanblackb=
| toluidine=
| verhoeff=
| vonkossa=
| warthinstarry=
| zn=
}}
====IHC====
{{Case IHC
| blank=Dr Torres would ask why!
| a1at=
| acth=
| ae1ae3=
| afp=
| alk1=
| amacr=
| ar=
| atrx=
| b2microglobulin=
| b72_3=
| bcatenin=
| bcl2=
| bcl6=
| bclxl=
| c3=
| ca9=
| calcitonin=
| calponin=
| calretinin=
| cam5p2=
| cathepsink=
| cd10=
| cd117=
| cd138=
| cd15=
| cd1a=
| cd20=
| cd21=
| cd23=
| cd3=
| cd30=
| cd31=
| cd34=
| cd35=
| cd4=
| cd43=
| cd45=
| cd5=
| cd56=
| cd57=
| cd68=
| cd7=
| cd79a=
| cd8=
| cd99=
| cdx2=
| cea=
| chromo=
| ck17=
| ck19=
| ck20=
| ck34be12=
| ck5_6=
| ck7=
| cmv=
| cmyc=
| cyclin_d1=
| d2_40=
| desmin=
| dog1=
| ebv=
| ema=
| erpr= POSITIVE
| f_viii=
| f_xiiia=
| fascin=
| fh=
| fsh=
| gastrin=
| gata3=
| gcdfp=
| gfap=
| gh=
| glucagon=
| glypican3=
| hbme1=
| hbv_core=
| hbv_surf=
| hcaldesmon=
| hcg=
| helicobacter=
| hepatocyte=
| her2=
| hhv8=
| hmb45=
| hnf1beta=
| hpv=
| hsv1=
| hsv2=
| Idh-1=
| inhibin=
| ini1=
| insulin=
| kappa=
| ki67=
| lambda=
| leu7=
| lga=
| lgg=
| lgm=
| lh=
| lysozyme=
| mammogl=
| map2=
| mcv=
| melanin_a=
| mitf=
| mum1=
| myleoperox=
| myo_d1=
| myog=
| nf=
| nkx3_1=
| nse=
| oct3_4=
| p16=
| p501s=
| p53=
| p57=
| p63=
| panker=
| pax2=
| pax5=
| pax8=
| pcna=
| pdgfr=
| plap=
| pnl-2c=
| prolactin=
| psa=
| psap=
| rcc=
| s100=
| sma=
| somatsatin=
| synapto=
| tdt=
| tfe3=
| tfeb=
| thyrogl=
| toxopl=
| tsh=
| ttf1=
| ubiquitin=
| uchl1=
| ulex_europe=
| vim=
| vip=
| vzv=
| wt1= POSITIVE
}}

====Molecular testing====
=====Chromosomal translocations=====
{{Case Translocations
| blank=Dr Torres would ask why!
| t1_13=
| t2_13=
| t8_14=
| t9_22bcr_abl=
| t9_22chn_ews=
| t11_14=
| t11_22dsrct=
| t11_22ews=
| t12_15=
| t12_16afh=
| t12_16liposar=
| t12_22=
| t14_18=
| t15_17=
| t16_21=
| t17_22=
| t21_22=
| tx_1=
| tx_17=
| tx_18=
}}
=====Other molecular tests=====
{{Case Molecular
| blank=Dr Torres would ask why!
| alk =
| b_cell_clone =
| bcl2 =
| braf =
| EBV_pcr =
| egrf =
| h3f3a =
| hhv8_pcr =
| identity_test =
| idh1_2 =
| jak2_v617f =
| kit =
| loh_1p19q =
| t_cell_clone =
}}

===Diagnosis===
{{hidden|Diagnosis|<center>BORDERLINE SEROUS TUMOR OF THE OVARY WITH MICROINVASION. The characteristic feature of borderline serous tumor is the hierarchical branching of the papillae, where the papillae progressively branch from larger ones to smaller one and finally into tufts of epithelial cells. The cells show only mild to moderate atypia. A cytadenofibroma may have similar proliferation, but by convention should be less than 5% of the tumor. Focal mucinous change may also occur. Papillary clear cell carcinoma simulating borderline tumor will show a WT1-ve, ER-ve, PR-ve immunoprofile in contrast to the positive profile of the serous tumor. Often clusters of cells with abundant eosinophilic cytoplasm are seen at the surface of papillae (star, image 2; oval image 3) or in lymphatic like spaces either as single cells or small papillary clusters. This theoretically represents microinvasion which is variably defined by different authors (<3 or 5 mm or 10mm2). However, recent evidence suggests that the two patterns of invasion have vastly different prognosis. The AEC (abundant eosinophilic cells) are p16 positive and reflect a terminally differentiated senescent phenotype. If invasion is exclusively composed of this cell type, then these do not portend a poor prognosis.(Am J Surg Pathol 2014;38:743–755). These cells are significantly more often seen in BRAF mutated tumors, and are perhaps associated with a better prognosis. (Am J Surg Pathol 2014;38:1603–1611) ( </center>}}
 
===Other cases===
{{Cases navigation}}

__NOTOC__

[[Category:Cases]]



[[Category:Cases difficulty 2]]

Case 111

2015-09-24T16:41:00Z

Vinita: Created page with "===Provided clinical history=== 28 year old woman with a positive pregnancy test. Cornual mass on ultrasound. No fetal heart identified. ===Site=== Pregnancy ===Primary im..."

===Provided clinical history===
28 year old woman with a positive pregnancy test. Cornual mass on ultrasound. No fetal heart identified.

===Site===
Pregnancy

===Primary image===
[[Image: Ariasstella changes in endometrium 4x.jpg |500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>

{{hidden|Intermediate magnification|[[Image: Ariasstella changes in endometrium 20x.jpg |500px|link=|center|]]
<center>Intermediate magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: NAME OF IMAGE GOES HERE |500px|link=|center|]]
<center>High magnification. [[H&E stain]].</center>}}

===Differential diagnosis===
{{hidden|Differential diagnosis|<center>CLEAR CELL CARCINOMA</center>}}

===Additional tests===
====More history====
{{hidden|More history|<center>MORE HISTORY HERE</center>}}

====Ask a colleague====
{{hidden|Ask a colleague|<center>COLLEAGUE'S ADVICE HERE</center>}}

====Stains====
{{Case Stains
| blank=Dr Torres would ask why!
| alcpas=
| alc1=
| alc25=
| aur=
| biel=
| bili=
| iron=
| congored=
| cresylv=
| dieterle=
| diffquik=
| fontana=
| gallyas=
| giemsa=
| gms=
| gomori=
| gram=
| gremelius=
| jms=
| jones=
| kinyoun=
| luxol=
| masson=
| mmas=
| movat=
| mucicar=
| oilredo=
| orecein=
| pas=
| pasd=
| pasf=
| ptah=
| prussian=
| reticulin=
| sudanblackb=
| toluidine=
| verhoeff=
| vonkossa=
| warthinstarry=
| zn=
}}
====IHC====
{{Case IHC
| blank=Dr Torres would ask why!
| a1at=
| acth=
| ae1ae3=
| afp=
| alk1=
| amacr=
| ar=
| atrx=
| b2microglobulin=
| b72_3=
| bcatenin=
| bcl2=
| bcl6=
| bclxl=
| c3=
| ca9=
| calcitonin=
| calponin=
| calretinin=
| cam5p2=
| cathepsink=
| cd10=
| cd117=
| cd138=
| cd15=
| cd1a=
| cd20=
| cd21=
| cd23=
| cd3=
| cd30=
| cd31=
| cd34=
| cd35=
| cd4=
| cd43=
| cd45=
| cd5=
| cd56=
| cd57=
| cd68=
| cd7=
| cd79a=
| cd8=
| cd99=
| cdx2=
| cea=
| chromo=
| ck17=
| ck19=
| ck20=
| ck34be12=
| ck5_6=
| ck7=
| cmv=
| cmyc=
| cyclin_d1=
| d2_40=
| desmin=
| dog1=
| ebv=
| ema=
| erpr=
| f_viii=
| f_xiiia=
| fascin=
| fh=
| fsh=
| gastrin=
| gata3=
| gcdfp=
| gfap=
| gh=
| glucagon=
| glypican3=
| hbme1=
| hbv_core=
| hbv_surf=
| hcaldesmon=
| hcg=
| helicobacter=
| hepatocyte=
| her2=
| hhv8=
| hmb45=
| hnf1beta= POSITIVE
| hpv=
| hsv1=
| hsv2=
| Idh-1=
| inhibin=
| ini1=
| insulin=
| kappa=
| ki67=
| lambda=
| leu7=
| lga=
| lgg=
| lgm=
| lh=
| lysozyme=
| mammogl=
| map2=
| mcv=
| melanin_a=
| mitf=
| mum1=
| myleoperox=
| myo_d1=
| myog=
| nf=
| nkx3_1=
| nse=
| oct3_4=
| p16=
| p501s=
| p53=
| p57=
| p63=
| panker=
| pax2=
| pax5=
| pax8=
| pcna=
| pdgfr=
| plap=
| pnl-2c=
| prolactin=
| psa=
| psap=
| rcc=
| s100=
| sma=
| somatsatin=
| synapto=
| tdt=
| tfe3=
| tfeb=
| thyrogl=
| toxopl=
| tsh=
| ttf1=
| ubiquitin=
| uchl1=
| ulex_europe=
| vim=
| vip=
| vzv=
| wt1=
}}

====Molecular testing====
=====Chromosomal translocations=====
{{Case Translocations
| blank=Dr Torres would ask why!
| t1_13=
| t2_13=
| t8_14=
| t9_22bcr_abl=
| t9_22chn_ews=
| t11_14=
| t11_22dsrct=
| t11_22ews=
| t12_15=
| t12_16afh=
| t12_16liposar=
| t12_22=
| t14_18=
| t15_17=
| t16_21=
| t17_22=
| t21_22=
| tx_1=
| tx_17=
| tx_18=
}}
=====Other molecular tests=====
{{Case Molecular
| blank=Dr Torres would ask why!
| alk =
| b_cell_clone =
| bcl2 =
| braf =
| EBV_pcr =
| egrf =
| h3f3a =
| hhv8_pcr =
| identity_test =
| idh1_2 =
| jak2_v617f =
| kit =
| loh_1p19q =
| t_cell_clone =
}}

===Diagnosis===
{{hidden|Diagnosis|<center>ARIAS STELLA CHANGES/REACTION. The diagnosis in this case is straightforward and relatively easy in this very young patient with a positive pregnancy test. However, it can be challenging in an older patient who comes in with bleeding. Arias Stella reaction shows endometrial glands lined by clear cells with atypia. Intranuclear inclusions (arrow) are often present. There can be occasional mitotic activity, which can further heighten its mimicry to clear cell carcinoma. Furthermore, the clear cells of Arias Stella are positive for Napsin and HNF1Beta, markers that are positive in clear cell carcinoma. AMACR is reportedly negative in Arias Stella while being positive in clear cell carcinoma although too few cases are tested to be confident of this claim. </center>}}
 
===Other cases===
{{Cases navigation}}

__NOTOC__

[[Category:Cases]]



[[Category:Cases difficulty 2]]

Case 108

2015-09-23T17:38:45Z

Vinita: Created page with "===Provided clinical history=== 36 year old pregnant woman with multiple polypoid lesions on the vulva ===Site=== Vulva ===Primary image=== Image: Fibroepithelial polyp of..."

===Provided clinical history===
36 year old pregnant woman with multiple polypoid lesions on the vulva

===Site===
Vulva

===Primary image===
[[Image: Fibroepithelial polyp of the vulva with atypical cells on low magnification.jpg |500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>

{{hidden|Intermediate magnification|[[Image: Fibroepithelial polyp of the vulva.jpg|500px|link=|center|]]
<center>Intermediate magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: NAME OF IMAGE GOES HERE |500px|link=|center|]]
<center>High magnification. [[H&E stain]].</center>}}

===Differential diagnosis===
{{hidden|Differential diagnosis|<center>THE DDx GOES HERE</center>}}

===Additional tests===
====More history====
{{hidden|More history|<center>MORE HISTORY HERE</center>}}

====Ask a colleague====
{{hidden|Ask a colleague|<center>COLLEAGUE'S ADVICE HERE</center>}}

====Stains====
{{Case Stains
| blank=Dr Torres would ask why!
| alcpas=
| alc1=
| alc25=
| aur=
| biel=
| bili=
| iron=
| congored=
| cresylv=
| dieterle=
| diffquik=
| fontana=
| gallyas=
| giemsa=
| gms=
| gomori=
| gram=
| gremelius=
| jms=
| jones=
| kinyoun=
| luxol=
| masson=
| mmas=
| movat=
| mucicar=
| oilredo=
| orecein=
| pas=
| pasd=
| pasf=
| ptah=
| prussian=
| reticulin=
| sudanblackb=
| toluidine=
| verhoeff=
| vonkossa=
| warthinstarry=
| zn=
}}
====IHC====
{{Case IHC
| blank=Dr Torres would ask why!
| a1at=
| acth=
| ae1ae3=
| afp=
| alk1=
| amacr=
| ar=
| atrx=
| b2microglobulin=
| b72_3=
| bcatenin=
| bcl2=
| bcl6=
| bclxl=
| c3=
| ca9=
| calcitonin=
| calponin=
| calretinin=
| cam5p2=
| cathepsink=
| cd10=
| cd117=
| cd138=
| cd15=
| cd1a=
| cd20=
| cd21=
| cd23=
| cd3=
| cd30=
| cd31=
| cd34=
| cd35=
| cd4=
| cd43=
| cd45=
| cd5=
| cd56=
| cd57=
| cd68=
| cd7=
| cd79a=
| cd8=
| cd99=
| cdx2=
| cea=
| chromo=
| ck17=
| ck19=
| ck20=
| ck34be12=
| ck5_6=
| ck7=
| cmv=
| cmyc=
| cyclin_d1=
| d2_40=
| desmin= POSITIVE
| dog1=
| ebv=
| ema=
| erpr=
| f_viii=
| f_xiiia=
| fascin=
| fh=
| fsh=
| gastrin=
| gata3=
| gcdfp=
| gfap=
| gh=
| glucagon=
| glypican3=
| hbme1=
| hbv_core=
| hbv_surf=
| hcaldesmon=
| hcg=
| helicobacter=
| hepatocyte=
| her2=
| hhv8=
| hmb45=
| hnf1beta=
| hpv=
| hsv1=
| hsv2=
| Idh-1=
| inhibin=
| ini1=
| insulin=
| kappa=
| ki67=
| lambda=
| leu7=
| lga=
| lgg=
| lgm=
| lh=
| lysozyme=
| mammogl=
| map2=
| mcv=
| melanin_a=
| mitf=
| mum1=
| myleoperox=
| myo_d1=
| myog=
| nf=
| nkx3_1=
| nse=
| oct3_4=
| p16=
| p501s=
| p53=
| p57=
| p63=
| panker=
| pax2=
| pax5=
| pax8=
| pcna=
| pdgfr=
| plap=
| pnl-2c=
| prolactin=
| psa=
| psap=
| rcc=
| s100=
| sma= NEGATIVE
| somatsatin=
| synapto=
| tdt=
| tfe3=
| tfeb=
| thyrogl=
| toxopl=
| tsh=
| ttf1=
| ubiquitin=
| uchl1=
| ulex_europe=
| vim=
| vip=
| vzv=
| wt1=
}}

====Molecular testing====
=====Chromosomal translocations=====
{{Case Translocations
| blank=Dr Torres would ask why!
| t1_13=
| t2_13=
| t8_14=
| t9_22bcr_abl=
| t9_22chn_ews=
| t11_14=
| t11_22dsrct=
| t11_22ews=
| t12_15=
| t12_16afh=
| t12_16liposar=
| t12_22=
| t14_18=
| t15_17=
| t16_21=
| t17_22=
| t21_22=
| tx_1=
| tx_17=
| tx_18=
}}
=====Other molecular tests=====
{{Case Molecular
| blank=Dr Torres would ask why!
| alk =
| b_cell_clone =
| bcl2 =
| braf =
| EBV_pcr =
| egrf =
| h3f3a =
| hhv8_pcr =
| identity_test =
| idh1_2 =
| jak2_v617f =
| kit =
| loh_1p19q =
| t_cell_clone =
}}

===Diagnosis===
{{hidden|Diagnosis|<center>FIBROEPITHELIAL POLYP WITH ATYPICAL CELLS OF THE VULVA (PSEUDOSARCOMATOUS FIBROEPITHELIAL STROMAL POLYP) These are unusual polyps that occur in patients on hormone therapy (Tamoxifen or progesterone) or in pregnant patients. They can be highly celluar with mitotic activity and atypia. The multinucleate cells are characteristic as is the absence of a grenz zone. The young age is also typical. The can recur but do not metastasize. </center>}}
 
===Other cases===
{{Cases navigation}}

__NOTOC__

[[Category:Cases]]



[[Category:Cases difficulty 4]]

Case 107

2015-09-23T17:32:05Z

Vinita:

===Provided clinical history===
53 year old woman with a 11 cm cystic mass with focal small solid area on ultrasound, thought to be a cystadenoma or cystadenofibroma preoperatively

===Site===
Ovary- epithelial

===Primary image===
[[Image: Tubulocystic clear cell carcinoma of the ovary.jpg |500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>

{{hidden|Intermediate magnification|[[Image: High magnification of tubulocystic clear cell carcinoma of ovary.jpg|500px|link=|center|]]
<center>Intermediate magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: High magnification of tubulocystic clear cell carcinoma of the ovary.jpg|500px|link=|center|]]
<center>High magnification. [[H&E stain]].</center>}}

===Differential diagnosis===
{{hidden|Differential diagnosis|<center>THE DDx GOES HERE</center>}}

===Additional tests===
====More history====
{{hidden|More history|<center>MORE HISTORY HERE</center>}}

====Ask a colleague====
{{hidden|Ask a colleague|<center>COLLEAGUE'S ADVICE HERE</center>}}

====Stains====
{{Case Stains
| blank=Dr Torres would ask why!
| alcpas=
| alc1=
| alc25=
| aur=
| biel=
| bili=
| iron=
| congored=
| cresylv=
| dieterle=
| diffquik=
| fontana=
| gallyas=
| giemsa=
| gms=
| gomori=
| gram=
| gremelius=
| jms=
| jones=
| kinyoun=
| luxol=
| masson=
| mmas=
| movat=
| mucicar=
| oilredo=
| orecein=
| pas=
| pasd=
| pasf=
| ptah=
| prussian=
| reticulin=
| sudanblackb=
| toluidine=
| verhoeff=
| vonkossa=
| warthinstarry=
| zn=
}}
====IHC====
{{Case IHC
| blank=Dr Torres would ask why!
| a1at=
| acth=
| ae1ae3=
| afp=
| alk1=
| amacr=
| ar=
| atrx=
| b2microglobulin=
| b72_3=
| bcatenin=
| bcl2=
| bcl6=
| bclxl=
| c3=
| ca9=
| calcitonin=
| calponin=
| calretinin=
| cam5p2=
| cathepsink=
| cd10=
| cd117=
| cd138=
| cd15=
| cd1a=
| cd20=
| cd21=
| cd23=
| cd3=
| cd30=
| cd31=
| cd34=
| cd35=
| cd4=
| cd43=
| cd45=
| cd5=
| cd56=
| cd57=
| cd68=
| cd7=
| cd79a=
| cd8=
| cd99=
| cdx2=
| cea=
| chromo=
| ck17=
| ck19=
| ck20=
| ck34be12=
| ck5_6=
| ck7=
| cmv=
| cmyc=
| cyclin_d1=
| d2_40=
| desmin=
| dog1=
| ebv=
| ema=
| erpr= NEGATIVE
| f_viii=
| f_xiiia=
| fascin=
| fh=
| fsh=
| gastrin=
| gata3=
| gcdfp=
| gfap=
| gh=
| glucagon=
| glypican3=
| hbme1=
| hbv_core=
| hbv_surf=
| hcaldesmon=
| hcg=
| helicobacter=
| hepatocyte=
| her2=
| hhv8=
| hmb45=
| hnf1beta= POSITIVE
| hpv=
| hsv1=
| hsv2=
| Idh-1=
| inhibin=
| ini1=
| insulin=
| kappa=
| ki67=
| lambda=
| leu7=
| lga=
| lgg=
| lgm=
| lh=
| lysozyme=
| mammogl=
| map2=
| mcv=
| melanin_a=
| mitf=
| mum1=
| myleoperox=
| myo_d1=
| myog=
| nf=
| nkx3_1=
| nse=
| oct3_4=
| p16=
| p501s=
| p53=
| p57=
| p63=
| panker=
| pax2=
| pax5=
| pax8=
| pcna=
| pdgfr=
| plap=
| pnl-2c=
| prolactin=
| psa=
| psap=
| rcc=
| s100=
| sma=
| somatsatin=
| synapto=
| tdt=
| tfe3=
| tfeb=
| thyrogl=
| toxopl=
| tsh=
| ttf1=
| ubiquitin=
| uchl1=
| ulex_europe=
| vim=
| vip=
| vzv=
| wt1= NEGATIVE
}}

====Molecular testing====
=====Chromosomal translocations=====
{{Case Translocations
| blank=Dr Torres would ask why!
| t1_13=
| t2_13=
| t8_14=
| t9_22bcr_abl=
| t9_22chn_ews=
| t11_14=
| t11_22dsrct=
| t11_22ews=
| t12_15=
| t12_16afh=
| t12_16liposar=
| t12_22=
| t14_18=
| t15_17=
| t16_21=
| t17_22=
| t21_22=
| tx_1=
| tx_17=
| tx_18=
}}
=====Other molecular tests=====
{{Case Molecular
| blank=Dr Torres would ask why!
| alk =
| b_cell_clone =
| bcl2 =
| braf =
| EBV_pcr =
| egrf =
| h3f3a =
| hhv8_pcr =
| identity_test =
| idh1_2 =
| jak2_v617f =
| kit =
| loh_1p19q =
| t_cell_clone =
}}

===Diagnosis===
{{hidden|Diagnosis|<center>CLEAR CELL CARCINOMA OF THE OVARY. This is the most commonly missed pattern of clear cells carcinoma in the ovary. Another pattern that is commonly missed is the papillary pattern which resembles a borderline serous tumor. Most often the luminal contents are watery, but can be thick and tenacious. The tumor is difficult to recognize because the atypia is not pronounced. Closer examination will reveal hobnailed cells (image 2). Smaller cysts often reveal the diagnostic clear cells. Tumor cells are characteristically WT1, ER, PR negative which distinguishes it from a serous tumor. However, this immunoprofile is also true of mucinous tumors of the ovary, although that is uncommonly in the differential. Tumor cells are positive for Napsin, HNF1beta and Arid IA, which distinguishes it from its mimics. </center>}}
 

===Other cases===
{{Cases navigation}}

__NOTOC__

[[Category:Cases]]



[[Category:Cases difficulty 4]]

Case 107

2015-09-23T17:28:54Z

Vinita: /* Diagnosis */

===Provided clinical history===
53 year old woman with a 11 cm cystic mass with focal small solid area on ultrasound, thought to be a cystadenoma or cystadenofibroma preoperatively

===Site===
Ovary- epithelial

===Primary image===
[[Image: Tubulocystic clear cell carcinoma of the ovary.jpg |500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>

{{hidden|Intermediate magnification|[[Image: High magnification of tubulocystic clear cell carcinoma of ovary.jpg|500px|link=|center|]]
<center>Intermediate magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: High magnification of tubulocystic clear cell carcinoma of the ovary.jpg|500px|link=|center|]]
<center>High magnification. [[H&E stain]].</center>}}

===Differential diagnosis===
{{hidden|Differential diagnosis|<center>THE DDx GOES HERE</center>}}

===Additional tests===
====More history====
{{hidden|More history|<center>MORE HISTORY HERE</center>}}

====Ask a colleague====
{{hidden|Ask a colleague|<center>COLLEAGUE'S ADVICE HERE</center>}}

====Stains====
{{Case Stains
| blank=Dr Torres would ask why!
| alcpas=
| alc1=
| alc25=
| aur=
| biel=
| bili=
| iron=
| congored=
| cresylv=
| dieterle=
| diffquik=
| fontana=
| gallyas=
| giemsa=
| gms=
| gomori=
| gram=
| gremelius=
| jms=
| jones=
| kinyoun=
| luxol=
| masson=
| mmas=
| movat=
| mucicar=
| oilredo=
| orecein=
| pas=
| pasd=
| pasf=
| ptah=
| prussian=
| reticulin=
| sudanblackb=
| toluidine=
| verhoeff=
| vonkossa=
| warthinstarry=
| zn=
}}
====IHC====
{{Case IHC
| blank=Dr Torres would ask why!
| a1at=
| acth=
| ae1ae3=
| afp=
| alk1=
| amacr=
| ar=
| atrx=
| b2microglobulin=
| b72_3=
| bcatenin=
| bcl2=
| bcl6=
| bclxl=
| c3=
| ca9=
| calcitonin=
| calponin=
| calretinin=
| cam5p2=
| cathepsink=
| cd10=
| cd117=
| cd138=
| cd15=
| cd1a=
| cd20=
| cd21=
| cd23=
| cd3=
| cd30=
| cd31=
| cd34=
| cd35=
| cd4=
| cd43=
| cd45=
| cd5=
| cd56=
| cd57=
| cd68=
| cd7=
| cd79a=
| cd8=
| cd99=
| cdx2=
| cea=
| chromo=
| ck17=
| ck19=
| ck20=
| ck34be12=
| ck5_6=
| ck7=
| cmv=
| cmyc=
| cyclin_d1=
| d2_40=
| desmin=
| dog1=
| ebv=
| ema=
| erpr= NEGATIVE
| f_viii=
| f_xiiia=
| fascin=
| fh=
| fsh=
| gastrin=
| gata3=
| gcdfp=
| gfap=
| gh=
| glucagon=
| glypican3=
| hbme1=
| hbv_core=
| hbv_surf=
| hcaldesmon=
| hcg=
| helicobacter=
| hepatocyte=
| her2=
| hhv8=
| hmb45=
| hnf1beta= POSITIVE
| hpv=
| hsv1=
| hsv2=
| Idh-1=
| inhibin=
| ini1=
| insulin=
| kappa=
| ki67=
| lambda=
| leu7=
| lga=
| lgg=
| lgm=
| lh=
| lysozyme=
| mammogl=
| map2=
| mcv=
| melanin_a=
| mitf=
| mum1=
| myleoperox=
| myo_d1=
| myog=
| nf=
| nkx3_1=
| nse=
| oct3_4=
| p16=
| p501s=
| p53=
| p57=
| p63=
| panker=
| pax2=
| pax5=
| pax8=
| pcna=
| pdgfr=
| plap=
| pnl-2c=
| prolactin=
| psa=
| psap=
| rcc=
| s100=
| sma=
| somatsatin=
| synapto=
| tdt=
| tfe3=
| tfeb=
| thyrogl=
| toxopl=
| tsh=
| ttf1=
| ubiquitin=
| uchl1=
| ulex_europe=
| vim=
| vip=
| vzv=
| wt1= NEGATIVE
}}

====Molecular testing====
=====Chromosomal translocations=====
{{Case Translocations
| blank=Dr Torres would ask why!
| t1_13=
| t2_13=
| t8_14=
| t9_22bcr_abl=
| t9_22chn_ews=
| t11_14=
| t11_22dsrct=
| t11_22ews=
| t12_15=
| t12_16afh=
| t12_16liposar=
| t12_22=
| t14_18=
| t15_17=
| t16_21=
| t17_22=
| t21_22=
| tx_1=
| tx_17=
| tx_18=
}}
=====Other molecular tests=====
{{Case Molecular
| blank=Dr Torres would ask why!
| alk =
| b_cell_clone =
| bcl2 =
| braf =
| EBV_pcr =
| egrf =
| h3f3a =
| hhv8_pcr =
| identity_test =
| idh1_2 =
| jak2_v617f =
| kit =
| loh_1p19q =
| t_cell_clone =
}}

===Diagnosis===
{{hidden|Diagnosis|<center>CLEAR CELL CARCINOMA OF THE OVARY. This is the most commonly missed pattern of clear cells carcinoma in the ovary. Another pattern that is commonly missed is the papillary pattern which resembles a borderline serous tumor. Most often the luminal contents are watery, but can be thick and tenacious. The tumor is difficult to recognize because the atypia is not pronounced. Closer examination will reveal hobnailed cells (image 2). Smaller cysts often reveal the diagnostic clear cells. Tumor cells are characteristically WT1, ER, PR negative which distinguishes it from a serous tumor. However, this immunoprofile is also true of mucinous tumors of the ovary, although that is uncommonly in the differential. Tumor cells are positive for Napsin, HNF1beta and Arid IA, which distinguishes it from its mimics. </center>}}
 

===Other cases===
{{Cases navigation}}

__NOTOC__

[[Category:Cases]]



[[Category:Cases difficulty 4]]

Case 107

2015-09-23T17:25:50Z

Vinita: Created page with "===Provided clinical history=== 53 year old woman with a 11 cm cystic mass with focal small solid area on ultrasound, thought to be a cystadenoma or cystadenofibroma preoperat..."

===Provided clinical history===
53 year old woman with a 11 cm cystic mass with focal small solid area on ultrasound, thought to be a cystadenoma or cystadenofibroma preoperatively

===Site===
Ovary- epithelial

===Primary image===
[[Image: Tubulocystic clear cell carcinoma of the ovary.jpg |500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>

{{hidden|Intermediate magnification|[[Image: High magnification of tubulocystic clear cell carcinoma of ovary.jpg|500px|link=|center|]]
<center>Intermediate magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: High magnification of tubulocystic clear cell carcinoma of the ovary.jpg|500px|link=|center|]]
<center>High magnification. [[H&E stain]].</center>}}

===Differential diagnosis===
{{hidden|Differential diagnosis|<center>THE DDx GOES HERE</center>}}

===Additional tests===
====More history====
{{hidden|More history|<center>MORE HISTORY HERE</center>}}

====Ask a colleague====
{{hidden|Ask a colleague|<center>COLLEAGUE'S ADVICE HERE</center>}}

====Stains====
{{Case Stains
| blank=Dr Torres would ask why!
| alcpas=
| alc1=
| alc25=
| aur=
| biel=
| bili=
| iron=
| congored=
| cresylv=
| dieterle=
| diffquik=
| fontana=
| gallyas=
| giemsa=
| gms=
| gomori=
| gram=
| gremelius=
| jms=
| jones=
| kinyoun=
| luxol=
| masson=
| mmas=
| movat=
| mucicar=
| oilredo=
| orecein=
| pas=
| pasd=
| pasf=
| ptah=
| prussian=
| reticulin=
| sudanblackb=
| toluidine=
| verhoeff=
| vonkossa=
| warthinstarry=
| zn=
}}
====IHC====
{{Case IHC
| blank=Dr Torres would ask why!
| a1at=
| acth=
| ae1ae3=
| afp=
| alk1=
| amacr=
| ar=
| atrx=
| b2microglobulin=
| b72_3=
| bcatenin=
| bcl2=
| bcl6=
| bclxl=
| c3=
| ca9=
| calcitonin=
| calponin=
| calretinin=
| cam5p2=
| cathepsink=
| cd10=
| cd117=
| cd138=
| cd15=
| cd1a=
| cd20=
| cd21=
| cd23=
| cd3=
| cd30=
| cd31=
| cd34=
| cd35=
| cd4=
| cd43=
| cd45=
| cd5=
| cd56=
| cd57=
| cd68=
| cd7=
| cd79a=
| cd8=
| cd99=
| cdx2=
| cea=
| chromo=
| ck17=
| ck19=
| ck20=
| ck34be12=
| ck5_6=
| ck7=
| cmv=
| cmyc=
| cyclin_d1=
| d2_40=
| desmin=
| dog1=
| ebv=
| ema=
| erpr= NEGATIVE
| f_viii=
| f_xiiia=
| fascin=
| fh=
| fsh=
| gastrin=
| gata3=
| gcdfp=
| gfap=
| gh=
| glucagon=
| glypican3=
| hbme1=
| hbv_core=
| hbv_surf=
| hcaldesmon=
| hcg=
| helicobacter=
| hepatocyte=
| her2=
| hhv8=
| hmb45=
| hnf1beta= POSITIVE
| hpv=
| hsv1=
| hsv2=
| Idh-1=
| inhibin=
| ini1=
| insulin=
| kappa=
| ki67=
| lambda=
| leu7=
| lga=
| lgg=
| lgm=
| lh=
| lysozyme=
| mammogl=
| map2=
| mcv=
| melanin_a=
| mitf=
| mum1=
| myleoperox=
| myo_d1=
| myog=
| nf=
| nkx3_1=
| nse=
| oct3_4=
| p16=
| p501s=
| p53=
| p57=
| p63=
| panker=
| pax2=
| pax5=
| pax8=
| pcna=
| pdgfr=
| plap=
| pnl-2c=
| prolactin=
| psa=
| psap=
| rcc=
| s100=
| sma=
| somatsatin=
| synapto=
| tdt=
| tfe3=
| tfeb=
| thyrogl=
| toxopl=
| tsh=
| ttf1=
| ubiquitin=
| uchl1=
| ulex_europe=
| vim=
| vip=
| vzv=
| wt1= NEGATIVE
}}

====Molecular testing====
=====Chromosomal translocations=====
{{Case Translocations
| blank=Dr Torres would ask why!
| t1_13=
| t2_13=
| t8_14=
| t9_22bcr_abl=
| t9_22chn_ews=
| t11_14=
| t11_22dsrct=
| t11_22ews=
| t12_15=
| t12_16afh=
| t12_16liposar=
| t12_22=
| t14_18=
| t15_17=
| t16_21=
| t17_22=
| t21_22=
| tx_1=
| tx_17=
| tx_18=
}}
=====Other molecular tests=====
{{Case Molecular
| blank=Dr Torres would ask why!
| alk =
| b_cell_clone =
| bcl2 =
| braf =
| EBV_pcr =
| egrf =
| h3f3a =
| hhv8_pcr =
| identity_test =
| idh1_2 =
| jak2_v617f =
| kit =
| loh_1p19q =
| t_cell_clone =
}}

===Diagnosis===
{{hidden|Diagnosis|<center>CLEAR CELL CARCINOMA OF THE OVARY. This is the most commonly missed pattern of clear cells carcinoma in the ovary (as is the papillary pattern which resembles a borderline serous tumor). Most often the luminal contents are watery, but can have a thicker quality to it. The tumor may be difficult to recognize because the atypia is not pronounced. However, hobnailed cells are a clue and clear cells are often more commonly identified in the smaller cysts. Tumor cells are characteristically WT1, ER, PR negative which distinguishes it from a serous tumor. However, this immunoprofile is also true of mucinous tumors of the ovary, although that is uncommonly in the differential. Tumor cells are positive for Napsin, HNF1beta and Arid IA, which distinguishes it from its mimics. </center>}}
 
===Other cases===
{{Cases navigation}}

__NOTOC__

[[Category:Cases]]



[[Category:Cases difficulty 4]]

Case 105

2015-09-22T18:25:07Z

Vinita:

===Provided clinical history===
56 year old woman, with history of increased menstrual bleeding. 4.5 cm mass on ultrasound of the uterus

===Site===
Uterus- stromal

===Primary image===
[[Image: Highly cellular leiomyoma junction of tumor to myometrium at 20x.jpg |500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>

{{hidden|Intermediate magnification|[[Image: Highly cellular leiomyoma at edge to myometrium at 20x.jpg |500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: Highly cellular leiomyoma on showing thick walled vessels at 20x.jpg |500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: Highly cellular leiomyoma at 200x.jpg |500px|link=|center|]]
<center>High magnification. [[H&E stain]].</center>}}

===Differential diagnosis===
{{hidden|Differential diagnosis|<center>Endometrial stromal neoplasm - nodule vs sarcoma </center>}}

===Additional tests===
====More history====
{{hidden|More history|<center>MORE HISTORY HERE</center>}}

====Ask a colleague====
{{hidden|Ask a colleague|<center> Would immunostains help? </center>}}

====Stains====
{{Case Stains
| blank=Dr Torres would ask why!
| alcpas=
| alc1=
| alc25=
| aur=
| biel=
| bili=
| iron=
| congored=
| cresylv=
| dieterle=
| diffquik=
| fontana=
| gallyas=
| giemsa=
| gms=
| gomori=
| gram=
| gremelius=
| jms=
| jones=
| kinyoun=
| luxol=
| masson=
| mmas=
| movat=
| mucicar=
| oilredo=
| orecein=
| pas=
| pasd=
| pasf=
| ptah=
| prussian=
| reticulin=
| sudanblackb=
| toluidine=
| verhoeff=
| vonkossa=
| warthinstarry=
| zn=
}}
====IHC====
{{Case IHC
| blank=Dr Torres would ask why!
| a1at=
| acth=
| ae1ae3=
| afp=
| alk1=
| amacr=
| ar=
| atrx=
| b2microglobulin=
| b72_3=
| bcatenin=
| bcl2=
| bcl6=
| bclxl=
| c3=
| ca9=
| calcitonin=
| calponin=
| calretinin=
| cam5p2=
| cathepsink=
| cd10= FOCAL POSITIVE
| cd117=
| cd138=
| cd15=
| cd1a=
| cd20=
| cd21=
| cd23=
| cd3=
| cd30=
| cd31=
| cd34=
| cd35=
| cd4=
| cd43=
| cd45=
| cd5=
| cd56=
| cd57=
| cd68=
| cd7=
| cd79a=
| cd8=
| cd99=
| cdx2=
| cea=
| chromo=
| ck17=
| ck19=
| ck20=
| ck34be12=
| ck5_6=
| ck7=
| cmv=
| cmyc=
| cyclin_d1=
| d2_40=
| desmin= FOCAL POSITIVE
| dog1=
| ebv=
| ema=
| erpr=
| f_viii=
| f_xiiia=
| fascin=
| fh=
| fsh=
| gastrin=
| gata3=
| gcdfp=
| gfap=
| gh=
| glucagon=
| glypican3=
| hbme1=
| hbv_core=
| hbv_surf=
| hcaldesmon= POSITIVE
| hcg=
| helicobacter=
| hepatocyte=
| her2=
| hhv8=
| hmb45=
| hnf1beta=
| hpv=
| hsv1=
| hsv2=
| Idh-1=
| inhibin=
| ini1=
| insulin=
| kappa=
| ki67=
| lambda=
| leu7=
| lga=
| lgg=
| lgm=
| lh=
| lysozyme=
| mammogl=
| map2=
| mcv=
| melanin_a=
| mitf=
| mum1=
| myleoperox=
| myo_d1=
| myog=
| nf=
| nkx3_1=
| nse=
| oct3_4=
| p16=
| p501s=
| p53=
| p57=
| p63=
| panker=
| pax2=
| pax5=
| pax8=
| pcna=
| pdgfr=
| plap=
| pnl-2c=
| prolactin=
| psa=
| psap=
| rcc=
| s100=
| sma= FOCAL POSITIVE
| somatsatin=
| synapto=
| tdt=
| tfe3=
| tfeb=
| thyrogl=
| toxopl=
| tsh=
| ttf1=
| ubiquitin=
| uchl1=
| ulex_europe=
| vim=
| vip=
| vzv=
| wt1=
}}

====Molecular testing====
=====Chromosomal translocations=====
{{Case Translocations
| blank=Dr Torres would ask why!
| t1_13=
| t2_13=
| t8_14=
| t9_22bcr_abl=
| t9_22chn_ews=
| t11_14=
| t11_22dsrct=
| t11_22ews=
| t12_15=
| t12_16afh=
| t12_16liposar=
| t12_22=
| t14_18=
| t15_17=
| t16_21=
| t17_22=
| t21_22=
| tx_1=
| tx_17=
| tx_18=
}}
=====Other molecular tests=====
{{Case Molecular
| blank=Dr Torres would ask why!
| alk =
| b_cell_clone =
| bcl2 =
| braf =
| EBV_pcr =
| egrf =
| h3f3a =
| hhv8_pcr =
| identity_test =
| idh1_2 =
| jak2_v617f =
| kit =
| loh_1p19q =
| t_cell_clone =
}}

===Diagnosis===
{{hidden|Diagnosis|<center>HIGHLY CELLULAR LEIOMYOMA. The differential diagnosis is between an endometrial stromal tumor (nodule or sarcoma) and a highly cellular leiomyoma. Although the immunohistochemical stains can be helpful if CD10 negative, a high percentage of cellular leiomyoma mark with CD10, a stain traditionally assumed to mark stromal tumors. Conversely,endometrial stromal neoplasms with smooth muscle differentiation will mark with muscle markers. The characteristic features of highly cellular leiomyoma are the cleft like spaces at the edge of the tumor, the thick-walled vessels within the tumor, and the "spindled" spindle cells as opposed to rounded spindled cells. They also lack the spiral arterioles characteristic of endometrial stromal neoplasms. The edge of a cellular leiomyoma is often irregular, sometimes raising concern not for an endometrial stromal nodule (which if misdiagnosed as, has no clinical implications) but for an endometrial stromal sarcoma (which does have prognostic and surgical implications). The irregular tongues of tumor in cellular leiomyoma are generally small, do not extend for more than a few millimeters beyond the tumor and "fade" into the surrounding myometrium; whereas these tongues are sharply circumscribed in endometrial stromal sarcoma. </center>}}
 
===Other cases===
{{Cases navigation}}

__NOTOC__

[[Category:Cases]]



[[Category:Cases difficulty 4]]

Case 105

2015-09-22T18:20:16Z

Vinita:

===Provided clinical history===
56 year old woman, with history of increased menstrual bleeding. 4.5 cm mass on ultrasound of the uterus

===Site===
Uterus- stromal

===Primary image===
[[Image: Highly cellular leiomyoma junction of tumor to myometrium at 20x.jpg |500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>

{{hidden|Intermediate magnification|[[Image: Highly cellular leiomyoma at edge to myometrium at 20x.jpg |500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: Highly cellular leiomyoma on showing thick walled vessels at 20x.jpg |500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: Highly cellular leiomyoma at 200x.jpg |500px|link=|center|]]
<center>High magnification. [[H&E stain]].</center>}}

===Differential diagnosis===
{{hidden|Differential diagnosis|<center>Endometrial stromal neoplasm - nodule vs sarcoma </center>}}

===Additional tests===
====More history====
{{hidden|More history|<center>MORE HISTORY HERE</center>}}

====Ask a colleague====
{{hidden|Ask a colleague|<center> Would immunostains help? </center>}}

====Stains====
{{Case Stains
| blank=Dr Torres would ask why!
| alcpas=
| alc1=
| alc25=
| aur=
| biel=
| bili=
| iron=
| congored=
| cresylv=
| dieterle=
| diffquik=
| fontana=
| gallyas=
| giemsa=
| gms=
| gomori=
| gram=
| gremelius=
| jms=
| jones=
| kinyoun=
| luxol=
| masson=
| mmas=
| movat=
| mucicar=
| oilredo=
| orecein=
| pas=
| pasd=
| pasf=
| ptah=
| prussian=
| reticulin=
| sudanblackb=
| toluidine=
| verhoeff=
| vonkossa=
| warthinstarry=
| zn=
}}
====IHC====
{{Case IHC
| blank=Dr Torres would ask why!
| a1at=
| acth=
| ae1ae3=
| afp=
| alk1=
| amacr=
| ar=
| atrx=
| b2microglobulin=
| b72_3=
| bcatenin=
| bcl2=
| bcl6=
| bclxl=
| c3=
| ca9=
| calcitonin=
| calponin=
| calretinin=
| cam5p2=
| cathepsink=
| cd10= FOCAL POSITIVE
| cd117=
| cd138=
| cd15=
| cd1a=
| cd20=
| cd21=
| cd23=
| cd3=
| cd30=
| cd31=
| cd34=
| cd35=
| cd4=
| cd43=
| cd45=
| cd5=
| cd56=
| cd57=
| cd68=
| cd7=
| cd79a=
| cd8=
| cd99=
| cdx2=
| cea=
| chromo=
| ck17=
| ck19=
| ck20=
| ck34be12=
| ck5_6=
| ck7=
| cmv=
| cmyc=
| cyclin_d1=
| d2_40=
| desmin= FOCAL POSITIVE
| dog1=
| ebv=
| ema=
| erpr=
| f_viii=
| f_xiiia=
| fascin=
| fh=
| fsh=
| gastrin=
| gata3=
| gcdfp=
| gfap=
| gh=
| glucagon=
| glypican3=
| hbme1=
| hbv_core=
| hbv_surf=
| hcaldesmon= POSITIVE
| hcg=
| helicobacter=
| hepatocyte=
| her2=
| hhv8=
| hmb45=
| hnf1beta=
| hpv=
| hsv1=
| hsv2=
| Idh-1=
| inhibin=
| ini1=
| insulin=
| kappa=
| ki67=
| lambda=
| leu7=
| lga=
| lgg=
| lgm=
| lh=
| lysozyme=
| mammogl=
| map2=
| mcv=
| melanin_a=
| mitf=
| mum1=
| myleoperox=
| myo_d1=
| myog=
| nf=
| nkx3_1=
| nse=
| oct3_4=
| p16=
| p501s=
| p53=
| p57=
| p63=
| panker=
| pax2=
| pax5=
| pax8=
| pcna=
| pdgfr=
| plap=
| pnl-2c=
| prolactin=
| psa=
| psap=
| rcc=
| s100=
| sma= FOCAL POSITIVE
| somatsatin=
| synapto=
| tdt=
| tfe3=
| tfeb=
| thyrogl=
| toxopl=
| tsh=
| ttf1=
| ubiquitin=
| uchl1=
| ulex_europe=
| vim=
| vip=
| vzv=
| wt1=
}}

====Molecular testing====
=====Chromosomal translocations=====
{{Case Translocations
| blank=Dr Torres would ask why!
| t1_13=
| t2_13=
| t8_14=
| t9_22bcr_abl=
| t9_22chn_ews=
| t11_14=
| t11_22dsrct=
| t11_22ews=
| t12_15=
| t12_16afh=
| t12_16liposar=
| t12_22=
| t14_18=
| t15_17=
| t16_21=
| t17_22=
| t21_22=
| tx_1=
| tx_17=
| tx_18=
}}
=====Other molecular tests=====
{{Case Molecular
| blank=Dr Torres would ask why!
| alk =
| b_cell_clone =
| bcl2 =
| braf =
| EBV_pcr =
| egrf =
| h3f3a =
| hhv8_pcr =
| identity_test =
| idh1_2 =
| jak2_v617f =
| kit =
| loh_1p19q =
| t_cell_clone =
}}

===Diagnosis===
{{hidden|Diagnosis|<center>HIGHLY CELLULAR LEIOMYOMA. The differential diagnosis is between an endometrial stromal tumor (nodule or sarcoma) and a highly cellular leiomyoma. Although the immunohistochemical stains can be helpful if CD10 negative, a high percentage of cellular leiomyoma mark with CD10, a stain traditionally assumed to marker stromal tumor. Likewise, if the endometrial stromal neoplasm has smooth muscle differentiation, those areas will mark with muscle markers. The characteristic feature is the cleft like spaces at the edge of the tumor, the thickwalled vessels within the tumor, and the spindled spindle cells as opposed to rounded spindled cells. Endometrial stromal neoplasms will have the characteristic spiral arterioles also. The edge of a cellular leiomyoma is often irregular sometimes raising the concern not for a nodule but for an endometrial stromal sarcoma. However, the tongues of tumor are generally small, do not extend for more than a few millimeters and "fade" into the surrounding myometrium. These tongues are sharply circumscribed in stromal neoplasms. </center>}}
 
===Other cases===
{{Cases navigation}}

__NOTOC__

[[Category:Cases]]



[[Category:Cases difficulty 4]]

Case 105

2015-09-22T18:09:13Z

Vinita:

===Provided clinical history===
56 year old woman, with history of increased menstrual bleeding. 4.5 cm mass on ultrasound of the uterus

===Site===
Uterus- stromal

===Primary image===
[[Image: Highly cellular leiomyoma junction of tumor to myometrium at 20x.jpg |500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>

{{hidden|Intermediate magnification|[[Image: Highly cellular leiomyoma at edge to myometrium at 20x.jpg |500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: Highly cellular leiomyoma on showing thick walled vessels at 20x.jpg |500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: Highly cellular leiomyoma at 200x.jpg |500px|link=|center|]]
<center>High magnification. [[H&E stain]].</center>}}

===Differential diagnosis===
{{hidden|Differential diagnosis|<center>THE DDx GOES HERE</center>}}

===Additional tests===
====More history====
{{hidden|More history|<center>MORE HISTORY HERE</center>}}

====Ask a colleague====
{{hidden|Ask a colleague|<center>endometrial stromal tumor versus a cellular leiomyoma. Would immunostains help? </center>}}

====Stains====
{{Case Stains
| blank=Dr Torres would ask why!
| alcpas=
| alc1=
| alc25=
| aur=
| biel=
| bili=
| iron=
| congored=
| cresylv=
| dieterle=
| diffquik=
| fontana=
| gallyas=
| giemsa=
| gms=
| gomori=
| gram=
| gremelius=
| jms=
| jones=
| kinyoun=
| luxol=
| masson=
| mmas=
| movat=
| mucicar=
| oilredo=
| orecein=
| pas=
| pasd=
| pasf=
| ptah=
| prussian=
| reticulin=
| sudanblackb=
| toluidine=
| verhoeff=
| vonkossa=
| warthinstarry=
| zn=
}}
====IHC====
{{Case IHC
| blank=Dr Torres would ask why!
| a1at=
| acth=
| ae1ae3=
| afp=
| alk1=
| amacr=
| ar=
| atrx=
| b2microglobulin=
| b72_3=
| bcatenin=
| bcl2=
| bcl6=
| bclxl=
| c3=
| ca9=
| calcitonin=
| calponin=
| calretinin=
| cam5p2=
| cathepsink=
| cd10= FOCAL POSITIVE
| cd117=
| cd138=
| cd15=
| cd1a=
| cd20=
| cd21=
| cd23=
| cd3=
| cd30=
| cd31=
| cd34=
| cd35=
| cd4=
| cd43=
| cd45=
| cd5=
| cd56=
| cd57=
| cd68=
| cd7=
| cd79a=
| cd8=
| cd99=
| cdx2=
| cea=
| chromo=
| ck17=
| ck19=
| ck20=
| ck34be12=
| ck5_6=
| ck7=
| cmv=
| cmyc=
| cyclin_d1=
| d2_40=
| desmin= FOCAL POSITIVE
| dog1=
| ebv=
| ema=
| erpr=
| f_viii=
| f_xiiia=
| fascin=
| fh=
| fsh=
| gastrin=
| gata3=
| gcdfp=
| gfap=
| gh=
| glucagon=
| glypican3=
| hbme1=
| hbv_core=
| hbv_surf=
| hcaldesmon= POSITIVE
| hcg=
| helicobacter=
| hepatocyte=
| her2=
| hhv8=
| hmb45=
| hnf1beta=
| hpv=
| hsv1=
| hsv2=
| Idh-1=
| inhibin=
| ini1=
| insulin=
| kappa=
| ki67=
| lambda=
| leu7=
| lga=
| lgg=
| lgm=
| lh=
| lysozyme=
| mammogl=
| map2=
| mcv=
| melanin_a=
| mitf=
| mum1=
| myleoperox=
| myo_d1=
| myog=
| nf=
| nkx3_1=
| nse=
| oct3_4=
| p16=
| p501s=
| p53=
| p57=
| p63=
| panker=
| pax2=
| pax5=
| pax8=
| pcna=
| pdgfr=
| plap=
| pnl-2c=
| prolactin=
| psa=
| psap=
| rcc=
| s100=
| sma= FOCAL POSITIVE
| somatsatin=
| synapto=
| tdt=
| tfe3=
| tfeb=
| thyrogl=
| toxopl=
| tsh=
| ttf1=
| ubiquitin=
| uchl1=
| ulex_europe=
| vim=
| vip=
| vzv=
| wt1=
}}

====Molecular testing====
=====Chromosomal translocations=====
{{Case Translocations
| blank=Dr Torres would ask why!
| t1_13=
| t2_13=
| t8_14=
| t9_22bcr_abl=
| t9_22chn_ews=
| t11_14=
| t11_22dsrct=
| t11_22ews=
| t12_15=
| t12_16afh=
| t12_16liposar=
| t12_22=
| t14_18=
| t15_17=
| t16_21=
| t17_22=
| t21_22=
| tx_1=
| tx_17=
| tx_18=
}}
=====Other molecular tests=====
{{Case Molecular
| blank=Dr Torres would ask why!
| alk =
| b_cell_clone =
| bcl2 =
| braf =
| EBV_pcr =
| egrf =
| h3f3a =
| hhv8_pcr =
| identity_test =
| idh1_2 =
| jak2_v617f =
| kit =
| loh_1p19q =
| t_cell_clone =
}}

===Diagnosis===
{{hidden|Diagnosis|<center>HIGHLY CELLULAR LEIOMYOMA</center>}}
 
===Other cases===
{{Cases navigation}}

__NOTOC__

[[Category:Cases]]



[[Category:Cases difficulty 4]]

Case 105

2015-09-22T18:06:28Z

Vinita:

===Provided clinical history===
56 year old woman, with history of increased menstrual bleeding. 4.5 cm mass on ultrasound of the uterus

===Site===
Uterus- stromal

===Primary image===
[[Image: Highly cellular leiomyoma junction of tumor to myometrium at 20x.jpg |500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>

{{hidden|Intermediate magnification|[[Image: Highly cellular leiomyoma at edge to myometrium at 20x.jpg |500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: Highly cellular leiomyoma on showing thick walled vessels at 20x.jpg |500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: Highly cellular leiomyoma at 200x.jpg |500px|link=|center|]]
<center>High magnification. [[H&E stain]].</center>}}

===Differential diagnosis===
{{hidden|Differential diagnosis|<center>THE DDx GOES HERE</center>}}

===Additional tests===
====More history====
{{hidden|More history|<center>MORE HISTORY HERE</center>}}

====Ask a colleague====
{{hidden|Ask a colleague|<center>COLLEAGUE'S ADVICE HERE</center>}}

====Stains====
{{Case Stains
| blank=Dr Torres would ask why!
| alcpas=
| alc1=
| alc25=
| aur=
| biel=
| bili=
| iron=
| congored=
| cresylv=
| dieterle=
| diffquik=
| fontana=
| gallyas=
| giemsa=
| gms=
| gomori=
| gram=
| gremelius=
| jms=
| jones=
| kinyoun=
| luxol=
| masson=
| mmas=
| movat=
| mucicar=
| oilredo=
| orecein=
| pas=
| pasd=
| pasf=
| ptah=
| prussian=
| reticulin=
| sudanblackb=
| toluidine=
| verhoeff=
| vonkossa=
| warthinstarry=
| zn=
}}
====IHC====
{{Case IHC
| blank=Dr Torres would ask why!
| a1at=
| acth=
| ae1ae3=
| afp=
| alk1=
| amacr=
| ar=
| atrx=
| b2microglobulin=
| b72_3=
| bcatenin=
| bcl2=
| bcl6=
| bclxl=
| c3=
| ca9=
| calcitonin=
| calponin=
| calretinin=
| cam5p2=
| cathepsink=
| cd10= FOCAL POSITIVE
| cd117=
| cd138=
| cd15=
| cd1a=
| cd20=
| cd21=
| cd23=
| cd3=
| cd30=
| cd31=
| cd34=
| cd35=
| cd4=
| cd43=
| cd45=
| cd5=
| cd56=
| cd57=
| cd68=
| cd7=
| cd79a=
| cd8=
| cd99=
| cdx2=
| cea=
| chromo=
| ck17=
| ck19=
| ck20=
| ck34be12=
| ck5_6=
| ck7=
| cmv=
| cmyc=
| cyclin_d1=
| d2_40=
| desmin= FOCAL POSITIVE
| dog1=
| ebv=
| ema=
| erpr=
| f_viii=
| f_xiiia=
| fascin=
| fh=
| fsh=
| gastrin=
| gata3=
| gcdfp=
| gfap=
| gh=
| glucagon=
| glypican3=
| hbme1=
| hbv_core=
| hbv_surf=
| hcaldesmon= POSITIVE
| hcg=
| helicobacter=
| hepatocyte=
| her2=
| hhv8=
| hmb45=
| hnf1beta=
| hpv=
| hsv1=
| hsv2=
| Idh-1=
| inhibin=
| ini1=
| insulin=
| kappa=
| ki67=
| lambda=
| leu7=
| lga=
| lgg=
| lgm=
| lh=
| lysozyme=
| mammogl=
| map2=
| mcv=
| melanin_a=
| mitf=
| mum1=
| myleoperox=
| myo_d1=
| myog=
| nf=
| nkx3_1=
| nse=
| oct3_4=
| p16=
| p501s=
| p53=
| p57=
| p63=
| panker=
| pax2=
| pax5=
| pax8=
| pcna=
| pdgfr=
| plap=
| pnl-2c=
| prolactin=
| psa=
| psap=
| rcc=
| s100=
| sma= FOCAL POSITIVE
| somatsatin=
| synapto=
| tdt=
| tfe3=
| tfeb=
| thyrogl=
| toxopl=
| tsh=
| ttf1=
| ubiquitin=
| uchl1=
| ulex_europe=
| vim=
| vip=
| vzv=
| wt1=
}}

====Molecular testing====
=====Chromosomal translocations=====
{{Case Translocations
| blank=Dr Torres would ask why!
| t1_13=
| t2_13=
| t8_14=
| t9_22bcr_abl=
| t9_22chn_ews=
| t11_14=
| t11_22dsrct=
| t11_22ews=
| t12_15=
| t12_16afh=
| t12_16liposar=
| t12_22=
| t14_18=
| t15_17=
| t16_21=
| t17_22=
| t21_22=
| tx_1=
| tx_17=
| tx_18=
}}
=====Other molecular tests=====
{{Case Molecular
| blank=Dr Torres would ask why!
| alk =
| b_cell_clone =
| bcl2 =
| braf =
| EBV_pcr =
| egrf =
| h3f3a =
| hhv8_pcr =
| identity_test =
| idh1_2 =
| jak2_v617f =
| kit =
| loh_1p19q =
| t_cell_clone =
}}

===Diagnosis===
{{hidden|Diagnosis|<center>HIGHLY CELLULAR LEIOMYOMA</center>}}
 
===Other cases===
{{Cases navigation}}

__NOTOC__

[[Category:Cases]]



[[Category:Cases difficulty 4]]

Case 105

2015-09-22T18:04:12Z

Vinita: Created page with "===Provided clinical history=== 56 year old woman, with history of increased menstrual bleeding. 4.5 cm mass on ultrasound of the uterus ===Site=== Uterus- stromal ===Prima..."

===Provided clinical history===
56 year old woman, with history of increased menstrual bleeding. 4.5 cm mass on ultrasound of the uterus

===Site===
Uterus- stromal

===Primary image===
[[Image: Highly cellular leiomyoma junction of tumor to myometrium at 20x.jpg |500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>

{{hidden|Intermediate magnification|[[Image: Highly cellular leiomyoma at edge to myometrium at 20x.jpg |500px|link=|center|]]
<center>Intermediate magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: Highly cellular leiomyoma on showing thick walled vessels at 20x.jpg |500px|link=|center|]]
<center>High magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: Highly cellular leiomyoma at 200x.jpg |500px|link=|center|]]
<center>High magnification. [[H&E stain]].</center>}}

===Differential diagnosis===
{{hidden|Differential diagnosis|<center>THE DDx GOES HERE</center>}}

===Additional tests===
====More history====
{{hidden|More history|<center>MORE HISTORY HERE</center>}}

====Ask a colleague====
{{hidden|Ask a colleague|<center>COLLEAGUE'S ADVICE HERE</center>}}

====Stains====
{{Case Stains
| blank=Dr Torres would ask why!
| alcpas=
| alc1=
| alc25=
| aur=
| biel=
| bili=
| iron=
| congored=
| cresylv=
| dieterle=
| diffquik=
| fontana=
| gallyas=
| giemsa=
| gms=
| gomori=
| gram=
| gremelius=
| jms=
| jones=
| kinyoun=
| luxol=
| masson=
| mmas=
| movat=
| mucicar=
| oilredo=
| orecein=
| pas=
| pasd=
| pasf=
| ptah=
| prussian=
| reticulin=
| sudanblackb=
| toluidine=
| verhoeff=
| vonkossa=
| warthinstarry=
| zn=
}}
====IHC====
{{Case IHC
| blank=Dr Torres would ask why!
| a1at=
| acth=
| ae1ae3=
| afp=
| alk1=
| amacr=
| ar=
| atrx=
| b2microglobulin=
| b72_3=
| bcatenin=
| bcl2=
| bcl6=
| bclxl=
| c3=
| ca9=
| calcitonin=
| calponin=
| calretinin=
| cam5p2=
| cathepsink=
| cd10= FOCAL POSITIVE
| cd117=
| cd138=
| cd15=
| cd1a=
| cd20=
| cd21=
| cd23=
| cd3=
| cd30=
| cd31=
| cd34=
| cd35=
| cd4=
| cd43=
| cd45=
| cd5=
| cd56=
| cd57=
| cd68=
| cd7=
| cd79a=
| cd8=
| cd99=
| cdx2=
| cea=
| chromo=
| ck17=
| ck19=
| ck20=
| ck34be12=
| ck5_6=
| ck7=
| cmv=
| cmyc=
| cyclin_d1=
| d2_40=
| desmin= FOCAL POSITIVE
| dog1=
| ebv=
| ema=
| erpr=
| f_viii=
| f_xiiia=
| fascin=
| fh=
| fsh=
| gastrin=
| gata3=
| gcdfp=
| gfap=
| gh=
| glucagon=
| glypican3=
| hbme1=
| hbv_core=
| hbv_surf=
| hcaldesmon= POSITIVE
| hcg=
| helicobacter=
| hepatocyte=
| her2=
| hhv8=
| hmb45=
| hnf1beta=
| hpv=
| hsv1=
| hsv2=
| Idh-1=
| inhibin=
| ini1=
| insulin=
| kappa=
| ki67=
| lambda=
| leu7=
| lga=
| lgg=
| lgm=
| lh=
| lysozyme=
| mammogl=
| map2=
| mcv=
| melanin_a=
| mitf=
| mum1=
| myleoperox=
| myo_d1=
| myog=
| nf=
| nkx3_1=
| nse=
| oct3_4=
| p16=
| p501s=
| p53=
| p57=
| p63=
| panker=
| pax2=
| pax5=
| pax8=
| pcna=
| pdgfr=
| plap=
| pnl-2c=
| prolactin=
| psa=
| psap=
| rcc=
| s100=
| sma= FOCAL POSITIVE
| somatsatin=
| synapto=
| tdt=
| tfe3=
| tfeb=
| thyrogl=
| toxopl=
| tsh=
| ttf1=
| ubiquitin=
| uchl1=
| ulex_europe=
| vim=
| vip=
| vzv=
| wt1=
}}

====Molecular testing====
=====Chromosomal translocations=====
{{Case Translocations
| blank=Dr Torres would ask why!
| t1_13=
| t2_13=
| t8_14=
| t9_22bcr_abl=
| t9_22chn_ews=
| t11_14=
| t11_22dsrct=
| t11_22ews=
| t12_15=
| t12_16afh=
| t12_16liposar=
| t12_22=
| t14_18=
| t15_17=
| t16_21=
| t17_22=
| t21_22=
| tx_1=
| tx_17=
| tx_18=
}}
=====Other molecular tests=====
{{Case Molecular
| blank=Dr Torres would ask why!
| alk =
| b_cell_clone =
| bcl2 =
| braf =
| EBV_pcr =
| egrf =
| h3f3a =
| hhv8_pcr =
| identity_test =
| idh1_2 =
| jak2_v617f =
| kit =
| loh_1p19q =
| t_cell_clone =
}}

===Diagnosis===
{{hidden|Diagnosis|<center>HIGHLY CELLULAR LEIOMYOMA</center>}}
 
===Other cases===
{{Cases navigation}}

__NOTOC__

[[Category:Cases]]



[[Category:Cases difficulty 4]]

Case 103

2015-09-21T18:39:51Z

Vinita:

===Provided clinical history===
55 year old woman, uterine bleeding, polypoid mass

===Site===
Uterus

===Primary image===
[[Image:Uterine adenosarcoma - low mag.jpg |500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>

{{hidden|Intermediate magnification|[[Image: Uterine adenosarcoma - intermed mag.jpg |500px|link=|center|]]
<center>Intermediate magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: Uterine adenosarcoma - high mag.jpg |500px|link=|center|]]
<center>High magnification. [[H&E stain]].</center>}}

===Differential diagnosis===
{{hidden|Differential diagnosis|<center>THE DDx GOES HERE</center>}}

===Additional tests===
====More history====
{{hidden|More history|<center>MORE HISTORY HERE</center>}}

====Ask a colleague====
{{hidden|Ask a colleague|<center>COLLEAGUE'S ADVICE HERE</center>}}

====Stains====
{{Case Stains
| blank=Dr Torres would ask why!
| alcpas=
| alc1=
| alc25=
| aur=
| biel=
| bili=
| iron=
| congored=
| cresylv=
| dieterle=
| diffquik=
| fontana=
| gallyas=
| giemsa=
| gms=
| gomori=
| gram=
| gremelius=
| jms=
| jones=
| kinyoun=
| luxol=
| masson=
| mmas=
| movat=
| mucicar=
| oilredo=
| orecein=
| pas=
| pasd=
| pasf=
| ptah=
| prussian=
| reticulin=
| sudanblackb=
| toluidine=
| verhoeff=
| vonkossa=
| warthinstarry=
| zn=
}}
====IHC====
{{Case IHC
| blank=Dr Torres would ask why!
| a1at=
| acth=
| ae1ae3=
| afp=
| alk1=
| amacr=
| ar=
| atrx=
| b2microglobulin=
| b72_3=
| bcatenin=
| bcl2=
| bcl6=
| bclxl=
| c3=
| ca9=
| calcitonin=
| calponin=
| calretinin=
| cam5p2=
| cathepsink=
| cd10= POSITIVE
| cd117=
| cd138=
| cd15=
| cd1a=
| cd20=
| cd21=
| cd23=
| cd3=
| cd30=
| cd31=
| cd34=
| cd35=
| cd4=
| cd43=
| cd45=
| cd5=
| cd56=
| cd57=
| cd68=
| cd7=
| cd79a=
| cd8=
| cd99=
| cdx2=
| cea=
| chromo=
| ck17=
| ck19=
| ck20=
| ck34be12=
| ck5_6=
| ck7=
| cmv=
| cmyc=
| cyclin_d1=
| d2_40=
| desmin=
| dog1=
| ebv=
| ema=
| erpr=
| f_viii=
| f_xiiia=
| fascin=
| fh=
| fsh=
| gastrin=
| gata3=
| gcdfp=
| gfap=
| gh=
| glucagon=
| glypican3=
| hbme1=
| hbv_core=
| hbv_surf=
| hcaldesmon=
| hcg=
| helicobacter=
| hepatocyte=
| her2=
| hhv8=
| hmb45=
| hnf1beta=
| hpv=
| hsv1=
| hsv2=
| Idh-1=
| inhibin=
| ini1=
| insulin=
| kappa=
| ki67=
| lambda=
| leu7=
| lga=
| lgg=
| lgm=
| lh=
| lysozyme=
| mammogl=
| map2=
| mcv=
| melanin_a=
| mitf=
| mum1=
| myleoperox=
| myo_d1=
| myog=
| nf=
| nkx3_1=
| nse=
| oct3_4=
| p16=
| p501s=
| p53=
| p57=
| p63=
| panker=
| pax2=
| pax5=
| pax8=
| pcna=
| pdgfr=
| plap=
| pnl-2c=
| prolactin=
| psa=
| psap=
| rcc=
| s100=
| sma=
| somatsatin=
| synapto=
| tdt=
| tfe3=
| tfeb=
| thyrogl=
| toxopl=
| tsh=
| ttf1=
| ubiquitin=
| uchl1=
| ulex_europe=
| vim=
| vip=
| vzv=
| wt1=
}}

====Molecular testing====
=====Chromosomal translocations=====
{{Case Translocations
| blank=Dr Torres would ask why!
| t1_13=
| t2_13=
| t8_14=
| t9_22bcr_abl=
| t9_22chn_ews=
| t11_14=
| t11_22dsrct=
| t11_22ews=
| t12_15=
| t12_16afh=
| t12_16liposar=
| t12_22=
| t14_18=
| t15_17=
| t16_21=
| t17_22=
| t21_22=
| tx_1=
| tx_17=
| tx_18=
}}
=====Other molecular tests=====
{{Case Molecular
| blank=Dr Torres would ask why!
| alk =
| b_cell_clone =
| bcl2 =
| braf =
| EBV_pcr =
| egrf =
| h3f3a =
| hhv8_pcr =
| identity_test =
| idh1_2 =
| jak2_v617f =
| kit =
| loh_1p19q =
| t_cell_clone =
}}

===Diagnosis===
{{hidden|Diagnosis|<center>DIAGNOSIS GOES HERE</center>}}
 
===Other cases===
{{Cases navigation}}

__NOTOC__

[[Category:Cases]]



[[Category:Cases difficulty 4]]

Case 103

2015-09-21T18:33:00Z

Vinita:

===Provided clinical history===
XXX year old man/woman, YYY

===Site===
ZZZ

===Primary image===
[[Image:Uterine adenosarcoma - low mag.jpg |500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>

{{hidden|Intermediate magnification|[[Image: NAME OF IMAGE GOES HERE |500px|link=|center|]]
<center>Intermediate magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: NAME OF IMAGE GOES HERE |500px|link=|center|]]
<center>High magnification. [[H&E stain]].</center>}}

===Differential diagnosis===
{{hidden|Differential diagnosis|<center>THE DDx GOES HERE</center>}}

===Additional tests===
====More history====
{{hidden|More history|<center>MORE HISTORY HERE</center>}}

====Ask a colleague====
{{hidden|Ask a colleague|<center>COLLEAGUE'S ADVICE HERE</center>}}

====Stains====
{{Case Stains
| blank=Dr Torres would ask why!
| alcpas=
| alc1=
| alc25=
| aur=
| biel=
| bili=
| iron=
| congored=
| cresylv=
| dieterle=
| diffquik=
| fontana=
| gallyas=
| giemsa=
| gms=
| gomori=
| gram=
| gremelius=
| jms=
| jones=
| kinyoun=
| luxol=
| masson=
| mmas=
| movat=
| mucicar=
| oilredo=
| orecein=
| pas=
| pasd=
| pasf=
| ptah=
| prussian=
| reticulin=
| sudanblackb=
| toluidine=
| verhoeff=
| vonkossa=
| warthinstarry=
| zn=
}}
====IHC====
{{Case IHC
| blank=Dr Torres would ask why!
| a1at=
| acth=
| ae1ae3=
| afp=
| alk1=
| amacr=
| ar=
| atrx=
| b2microglobulin=
| b72_3=
| bcatenin=
| bcl2=
| bcl6=
| bclxl=
| c3=
| ca9=
| calcitonin=
| calponin=
| calretinin=
| cam5p2=
| cathepsink=
| cd10=
| cd117=
| cd138=
| cd15=
| cd1a=
| cd20=
| cd21=
| cd23=
| cd3=
| cd30=
| cd31=
| cd34=
| cd35=
| cd4=
| cd43=
| cd45=
| cd5=
| cd56=
| cd57=
| cd68=
| cd7=
| cd79a=
| cd8=
| cd99=
| cdx2=
| cea=
| chromo=
| ck17=
| ck19=
| ck20=
| ck34be12=
| ck5_6=
| ck7=
| cmv=
| cmyc=
| cyclin_d1=
| d2_40=
| desmin=
| dog1=
| ebv=
| ema=
| erpr=
| f_viii=
| f_xiiia=
| fascin=
| fh=
| fsh=
| gastrin=
| gata3=
| gcdfp=
| gfap=
| gh=
| glucagon=
| glypican3=
| hbme1=
| hbv_core=
| hbv_surf=
| hcaldesmon=
| hcg=
| helicobacter=
| hepatocyte=
| her2=
| hhv8=
| hmb45=
| hnf1beta=
| hpv=
| hsv1=
| hsv2=
| Idh-1=
| inhibin=
| ini1=
| insulin=
| kappa=
| ki67=
| lambda=
| leu7=
| lga=
| lgg=
| lgm=
| lh=
| lysozyme=
| mammogl=
| map2=
| mcv=
| melanin_a=
| mitf=
| mum1=
| myleoperox=
| myo_d1=
| myog=
| nf=
| nkx3_1=
| nse=
| oct3_4=
| p16=
| p501s=
| p53=
| p57=
| p63=
| panker=
| pax2=
| pax5=
| pax8=
| pcna=
| pdgfr=
| plap=
| pnl-2c=
| prolactin=
| psa=
| psap=
| rcc=
| s100=
| sma=
| somatsatin=
| synapto=
| tdt=
| tfe3=
| tfeb=
| thyrogl=
| toxopl=
| tsh=
| ttf1=
| ubiquitin=
| uchl1=
| ulex_europe=
| vim=
| vip=
| vzv=
| wt1=
}}

====Molecular testing====
=====Chromosomal translocations=====
{{Case Translocations
| blank=Dr Torres would ask why!
| t1_13=
| t2_13=
| t8_14=
| t9_22bcr_abl=
| t9_22chn_ews=
| t11_14=
| t11_22dsrct=
| t11_22ews=
| t12_15=
| t12_16afh=
| t12_16liposar=
| t12_22=
| t14_18=
| t15_17=
| t16_21=
| t17_22=
| t21_22=
| tx_1=
| tx_17=
| tx_18=
}}
=====Other molecular tests=====
{{Case Molecular
| blank=Dr Torres would ask why!
| alk =
| b_cell_clone =
| bcl2 =
| braf =
| EBV_pcr =
| egrf =
| h3f3a =
| hhv8_pcr =
| identity_test =
| idh1_2 =
| jak2_v617f =
| kit =
| loh_1p19q =
| t_cell_clone =
}}

===Diagnosis===
{{hidden|Diagnosis|<center>DIAGNOSIS GOES HERE</center>}}
 
===Other cases===
{{Cases navigation}}

__NOTOC__

[[Category:Cases]]



[[Category:Cases difficulty 4]]

Case 103

2015-09-21T18:32:20Z

Vinita: Created page with "===Provided clinical history=== XXX year old man/woman, YYY ===Site=== ZZZ ===Primary image=== center| <cente..."

===Provided clinical history===
XXX year old man/woman, YYY

===Site===
ZZZ

===Primary image===
[[Image: File:Uterine adenosarcoma - low mag.jpg |500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>

{{hidden|Intermediate magnification|[[Image: NAME OF IMAGE GOES HERE |500px|link=|center|]]
<center>Intermediate magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: NAME OF IMAGE GOES HERE |500px|link=|center|]]
<center>High magnification. [[H&E stain]].</center>}}

===Differential diagnosis===
{{hidden|Differential diagnosis|<center>THE DDx GOES HERE</center>}}

===Additional tests===
====More history====
{{hidden|More history|<center>MORE HISTORY HERE</center>}}

====Ask a colleague====
{{hidden|Ask a colleague|<center>COLLEAGUE'S ADVICE HERE</center>}}

====Stains====
{{Case Stains
| blank=Dr Torres would ask why!
| alcpas=
| alc1=
| alc25=
| aur=
| biel=
| bili=
| iron=
| congored=
| cresylv=
| dieterle=
| diffquik=
| fontana=
| gallyas=
| giemsa=
| gms=
| gomori=
| gram=
| gremelius=
| jms=
| jones=
| kinyoun=
| luxol=
| masson=
| mmas=
| movat=
| mucicar=
| oilredo=
| orecein=
| pas=
| pasd=
| pasf=
| ptah=
| prussian=
| reticulin=
| sudanblackb=
| toluidine=
| verhoeff=
| vonkossa=
| warthinstarry=
| zn=
}}
====IHC====
{{Case IHC
| blank=Dr Torres would ask why!
| a1at=
| acth=
| ae1ae3=
| afp=
| alk1=
| amacr=
| ar=
| atrx=
| b2microglobulin=
| b72_3=
| bcatenin=
| bcl2=
| bcl6=
| bclxl=
| c3=
| ca9=
| calcitonin=
| calponin=
| calretinin=
| cam5p2=
| cathepsink=
| cd10=
| cd117=
| cd138=
| cd15=
| cd1a=
| cd20=
| cd21=
| cd23=
| cd3=
| cd30=
| cd31=
| cd34=
| cd35=
| cd4=
| cd43=
| cd45=
| cd5=
| cd56=
| cd57=
| cd68=
| cd7=
| cd79a=
| cd8=
| cd99=
| cdx2=
| cea=
| chromo=
| ck17=
| ck19=
| ck20=
| ck34be12=
| ck5_6=
| ck7=
| cmv=
| cmyc=
| cyclin_d1=
| d2_40=
| desmin=
| dog1=
| ebv=
| ema=
| erpr=
| f_viii=
| f_xiiia=
| fascin=
| fh=
| fsh=
| gastrin=
| gata3=
| gcdfp=
| gfap=
| gh=
| glucagon=
| glypican3=
| hbme1=
| hbv_core=
| hbv_surf=
| hcaldesmon=
| hcg=
| helicobacter=
| hepatocyte=
| her2=
| hhv8=
| hmb45=
| hnf1beta=
| hpv=
| hsv1=
| hsv2=
| Idh-1=
| inhibin=
| ini1=
| insulin=
| kappa=
| ki67=
| lambda=
| leu7=
| lga=
| lgg=
| lgm=
| lh=
| lysozyme=
| mammogl=
| map2=
| mcv=
| melanin_a=
| mitf=
| mum1=
| myleoperox=
| myo_d1=
| myog=
| nf=
| nkx3_1=
| nse=
| oct3_4=
| p16=
| p501s=
| p53=
| p57=
| p63=
| panker=
| pax2=
| pax5=
| pax8=
| pcna=
| pdgfr=
| plap=
| pnl-2c=
| prolactin=
| psa=
| psap=
| rcc=
| s100=
| sma=
| somatsatin=
| synapto=
| tdt=
| tfe3=
| tfeb=
| thyrogl=
| toxopl=
| tsh=
| ttf1=
| ubiquitin=
| uchl1=
| ulex_europe=
| vim=
| vip=
| vzv=
| wt1=
}}

====Molecular testing====
=====Chromosomal translocations=====
{{Case Translocations
| blank=Dr Torres would ask why!
| t1_13=
| t2_13=
| t8_14=
| t9_22bcr_abl=
| t9_22chn_ews=
| t11_14=
| t11_22dsrct=
| t11_22ews=
| t12_15=
| t12_16afh=
| t12_16liposar=
| t12_22=
| t14_18=
| t15_17=
| t16_21=
| t17_22=
| t21_22=
| tx_1=
| tx_17=
| tx_18=
}}
=====Other molecular tests=====
{{Case Molecular
| blank=Dr Torres would ask why!
| alk =
| b_cell_clone =
| bcl2 =
| braf =
| EBV_pcr =
| egrf =
| h3f3a =
| hhv8_pcr =
| identity_test =
| idh1_2 =
| jak2_v617f =
| kit =
| loh_1p19q =
| t_cell_clone =
}}

===Diagnosis===
{{hidden|Diagnosis|<center>DIAGNOSIS GOES HERE</center>}}
 
===Other cases===
{{Cases navigation}}

__NOTOC__

[[Category:Cases]]



[[Category:Cases difficulty 4]]

LP:Sandbox

2015-05-03T14:44:23Z

Vinita:

[[File:Granulocytic Dysplasia.jpg|thumb | Atypical granulocytic lineage cells in a patient with myelodysplasia.]][[Image:Atypical_ductal_hyperplasia_-_very_low_mag.jpg|thumb|[[Atypical ductal hyperplasia]]. Very low magnification. [[H&E stain]]. (WC/Nephron)]]

The '''sandbox''' is a test page.

This is a place where things can be tried.

A reference follows this sentence.<ref>This is a reference.</ref>

Another references follows this sentence.<ref>{{Cite journal | last1 = Bonert | first1 = M. | last2 = Saville | first2 = BA. | title = A non-dimensional analysis of hemodialysis. | journal = Open Biomed Eng J | volume = 4 | issue = | pages = 138-55 | month = | year = 2010 | doi = 10.2174/1874120701004010138 | PMID = 21673980 |URL = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3111706/ }}</ref>
==Section==
This is another section.

[[tubular adenoma of the gastrointestinal tract|Tubular adenoma]]s are a precursor [[CRC]]<ref name=pmid25930481>{{Cite journal | last1 = Roloff | first1 = KA. | last2 = Brown | first2 = E. | last3 = Stepanyan | first3 = G. | last4 = Valenzuela | first4 = GR. | title = Timing of Indicated Repeat Cesarean Delivery Before 39 Weeks of Gestation [151]. | journal = Obstet Gynecol | volume = 125 Suppl 1 | issue = | pages = 52S | month = May | year = 2015 | doi = 10.1097/01.AOG.0000463691.56327.ae | PMID = 25930481 }}</ref>
[[File:Example.jpg]]

[[A brokennn link is here]].

[[File:link_to_nonexistant_file.jpg]]

==DOI==
doi:10.1038/ng.2868

[[doi:10.1038/ng.2868]]

==See also==
*[[Sandbox]].

==References==
{{Reflist|1}}

[[Category:Stuff]]

LP:Sandbox

2015-05-03T14:27:10Z

Vinita:

<gallery>
File:Granulocytic Dysplasia.jpg|thumb | Atypical granulocytic lineage cells in a patient with myelodysplasia.
Image:Atypical_ductal_hyperplasia_-_very_low_mag.jpg|thumb|[[Atypical ductal hyperplasia]]. Very low magnification. [[H&E stain]]. (WC/Nephron)
</gallery>
The '''sandbox''' is a test page.

This is a place where things can be tried.

A reference follows this sentence.<ref>This is a reference.</ref>

Another references follows this sentence.<ref>{{Cite journal | last1 = Bonert | first1 = M. | last2 = Saville | first2 = BA. | title = A non-dimensional analysis of hemodialysis. | journal = Open Biomed Eng J | volume = 4 | issue = | pages = 138-55 | month = | year = 2010 | doi = 10.2174/1874120701004010138 | PMID = 21673980 |URL = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3111706/ }}</ref>
==Section==
This is another section.

[[tubular adenoma of the gastrointestinal tract|Tubular adenoma]]s are a precursor [[CRC]]<ref name=pmid25930481>{{Cite journal | last1 = Roloff | first1 = KA. | last2 = Brown | first2 = E. | last3 = Stepanyan | first3 = G. | last4 = Valenzuela | first4 = GR. | title = Timing of Indicated Repeat Cesarean Delivery Before 39 Weeks of Gestation [151]. | journal = Obstet Gynecol | volume = 125 Suppl 1 | issue = | pages = 52S | month = May | year = 2015 | doi = 10.1097/01.AOG.0000463691.56327.ae | PMID = 25930481 }}</ref>
[[File:Example.jpg]]

[[A brokennn link is here]].

[[File:link_to_nonexistant_file.jpg]]

==DOI==
doi:10.1038/ng.2868

[[doi:10.1038/ng.2868]]

==See also==
*[[Sandbox]].

==References==
{{Reflist|1}}

[[Category:Stuff]]

LP:Sandbox

2015-05-03T14:26:16Z

Vinita:

<gallery>
[[File:Granulocytic Dysplasia.jpg|thumb | Atypical granulocytic lineage cells in a patient with myelodysplasia.]][[Image:Atypical_ductal_hyperplasia_-_very_low_mag.jpg|thumb|[[Atypical ductal hyperplasia]]. Very low magnification. [[H&E stain]]. (WC/Nephron)]]
</gallery>
The '''sandbox''' is a test page.

This is a place where things can be tried.

A reference follows this sentence.<ref>This is a reference.</ref>

Another references follows this sentence.<ref>{{Cite journal | last1 = Bonert | first1 = M. | last2 = Saville | first2 = BA. | title = A non-dimensional analysis of hemodialysis. | journal = Open Biomed Eng J | volume = 4 | issue = | pages = 138-55 | month = | year = 2010 | doi = 10.2174/1874120701004010138 | PMID = 21673980 |URL = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3111706/ }}</ref>
==Section==
This is another section.

[[tubular adenoma of the gastrointestinal tract|Tubular adenoma]]s are a precursor [[CRC]]<ref name=pmid25930481>{{Cite journal | last1 = Roloff | first1 = KA. | last2 = Brown | first2 = E. | last3 = Stepanyan | first3 = G. | last4 = Valenzuela | first4 = GR. | title = Timing of Indicated Repeat Cesarean Delivery Before 39 Weeks of Gestation [151]. | journal = Obstet Gynecol | volume = 125 Suppl 1 | issue = | pages = 52S | month = May | year = 2015 | doi = 10.1097/01.AOG.0000463691.56327.ae | PMID = 25930481 }}</ref>
[[File:Example.jpg]]

[[A brokennn link is here]].

[[File:link_to_nonexistant_file.jpg]]

==DOI==
doi:10.1038/ng.2868

[[doi:10.1038/ng.2868]]

==See also==
*[[Sandbox]].

==References==
{{Reflist|1}}

[[Category:Stuff]]

LP:Sandbox

2015-05-03T14:22:08Z

Vinita:

[[File:Granulocytic Dysplasia.jpg|thumb | Atypical granulocytic lineage cells in a patient with myelodysplasia.]][[Image:Atypical_ductal_hyperplasia_-_very_low_mag.jpg|thumb|[[Atypical ductal hyperplasia]]. Very low magnification. [[H&E stain]]. (WC/Nephron)]]
The '''sandbox''' is a test page.

This is a place where things can be tried.

A reference follows this sentence.<ref>This is a reference.</ref>

Another references follows this sentence.<ref>{{Cite journal | last1 = Bonert | first1 = M. | last2 = Saville | first2 = BA. | title = A non-dimensional analysis of hemodialysis. | journal = Open Biomed Eng J | volume = 4 | issue = | pages = 138-55 | month = | year = 2010 | doi = 10.2174/1874120701004010138 | PMID = 21673980 |URL = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3111706/ }}</ref>
==Section==
This is another section.

[[tubular adenoma of the gastrointestinal tract|Tubular adenoma]]s are a precursor [[CRC]]<ref name=pmid25930481>{{Cite journal | last1 = Roloff | first1 = KA. | last2 = Brown | first2 = E. | last3 = Stepanyan | first3 = G. | last4 = Valenzuela | first4 = GR. | title = Timing of Indicated Repeat Cesarean Delivery Before 39 Weeks of Gestation [151]. | journal = Obstet Gynecol | volume = 125 Suppl 1 | issue = | pages = 52S | month = May | year = 2015 | doi = 10.1097/01.AOG.0000463691.56327.ae | PMID = 25930481 }}</ref>
[[File:Example.jpg]]

[[A brokennn link is here]].

[[File:link_to_nonexistant_file.jpg]]

==DOI==
doi:10.1038/ng.2868

[[doi:10.1038/ng.2868]]

==See also==
*[[Sandbox]].

==References==
{{Reflist|1}}

[[Category:Stuff]]

LP:Sandbox

2015-05-03T14:11:14Z

Vinita:

[[File:Example.jpg]][[Image:Atypical_ductal_hyperplasia_-_very_low_mag.jpg|thumb|[[Atypical ductal hyperplasia]]. Very low magnification. [[H&E stain]]. (WC/Nephron)]]
The '''sandbox''' is a test page.

This is a place where things can be tried.

A reference follows this sentence.<ref>This is a reference.</ref>

Another references follows this sentence.<ref>{{Cite journal | last1 = Bonert | first1 = M. | last2 = Saville | first2 = BA. | title = A non-dimensional analysis of hemodialysis. | journal = Open Biomed Eng J | volume = 4 | issue = | pages = 138-55 | month = | year = 2010 | doi = 10.2174/1874120701004010138 | PMID = 21673980 |URL = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3111706/ }}</ref>
==Section==
This is another section.

[[tubular adenoma of the gastrointestinal tract|Tubular adenoma]]s are a precursor [[CRC]]<ref name=pmid25930481>{{Cite journal | last1 = Roloff | first1 = KA. | last2 = Brown | first2 = E. | last3 = Stepanyan | first3 = G. | last4 = Valenzuela | first4 = GR. | title = Timing of Indicated Repeat Cesarean Delivery Before 39 Weeks of Gestation [151]. | journal = Obstet Gynecol | volume = 125 Suppl 1 | issue = | pages = 52S | month = May | year = 2015 | doi = 10.1097/01.AOG.0000463691.56327.ae | PMID = 25930481 }}</ref>
[[File:Example.jpg]]

[[A brokennn link is here]].

[[File:link_to_nonexistant_file.jpg]]

==DOI==
doi:10.1038/ng.2868

[[doi:10.1038/ng.2868]]

==See also==
*[[Sandbox]].

==References==
{{Reflist|1}}

[[Category:Stuff]]

LP:Sandbox

2015-05-03T13:57:43Z

Vinita:

[[Image:Atypical_ductal_hyperplasia_-_very_low_mag.jpg|thumb|[[Atypical ductal hyperplasia]]. Very low magnification. [[H&E stain]]. (WC/Nephron)]]
The '''sandbox''' is a test page.

This is a place where things can be tried.

A reference follows this sentence.<ref>This is a reference.</ref>

Another references follows this sentence.<ref>{{Cite journal | last1 = Bonert | first1 = M. | last2 = Saville | first2 = BA. | title = A non-dimensional analysis of hemodialysis. | journal = Open Biomed Eng J | volume = 4 | issue = | pages = 138-55 | month = | year = 2010 | doi = 10.2174/1874120701004010138 | PMID = 21673980 |URL = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3111706/ }}</ref>
==Section==
This is another section.

[[tubular adenoma of the gastrointestinal tract|Tubular adenoma]]s are a precursor [[CRC]]<ref name=pmid25930481>{{Cite journal | last1 = Roloff | first1 = KA. | last2 = Brown | first2 = E. | last3 = Stepanyan | first3 = G. | last4 = Valenzuela | first4 = GR. | title = Timing of Indicated Repeat Cesarean Delivery Before 39 Weeks of Gestation [151]. | journal = Obstet Gynecol | volume = 125 Suppl 1 | issue = | pages = 52S | month = May | year = 2015 | doi = 10.1097/01.AOG.0000463691.56327.ae | PMID = 25930481 }}</ref>

[[A brokennn link is here]].

[[File:link_to_nonexistant_file.jpg]]

==DOI==
doi:10.1038/ng.2868

[[doi:10.1038/ng.2868]]

==See also==
*[[Sandbox]].

==References==
{{Reflist|1}}

[[Category:Stuff]]

Placenta creta

2015-05-01T14:13:04Z

Vinita:

'''Placenta creta''' is an uncommon pathology of [[placenta|placental]] attachment.

==General==
*What?
**Trophoblastic tissue deeper than it should be, so the placenta fails to separate at time of delivery
*Clinical?
**Failure of placenta to deliver spontaneously
**Postpartum hemorrhage leading to a hysterectomy.<ref name=pmid18514815>{{Cite journal | last1 = Tantbirojn | first1 = P. | last2 = Crum | first2 = CP. | last3 = Parast | first3 = MM. | title = Pathophysiology of placenta creta: the role of decidua and extravillous trophoblast. | journal = Placenta | volume = 29 | issue = 7 | pages = 639-45 | month = Jul | year = 2008 | doi = 10.1016/j.placenta.2008.04.008 | PMID = 18514815 }}</ref>
**May be associated with antepartum hemorrhage
**Discovered on ultrasound during pregnancy, especially when associated with placenta previa
*Pathogenesis?
**It is suspected that it arises as there is defect in the endometrium/myometrium -- ''not'' deep trophoblastic invasion.<ref name=pmid18514815/>
**Risk factors:<ref name=pmid23466142>{{Cite journal | last1 = Wortman | first1 = AC. | last2 = Alexander | first2 = JM. | title = Placenta accreta, increta, and percreta. | journal = Obstet Gynecol Clin North Am | volume = 40 | issue = 1 | pages = 137-54 | month = Mar | year = 2013 | doi = 10.1016/j.ogc.2012.12.002 | PMID = 23466142 }}</ref>
***Placenta previa.
***Previous caesarian section.

Note:
*Normal: trophoblastic tissue attaches to the decidua.<ref name=Ref_Pathde_974>{{Ref Pathde|974}}</ref>
*Retained placentas have less multinucleated trophoblastic giant cells.<ref name=pmid19734475>{{Cite journal | last1 = van Beekhuizen | first1 = HJ. | last2 = Joosten | first2 = I. | last3 = de Groot | first3 = AN. | last4 = Lotgering | first4 = FK. | last5 = van der Laak | first5 = J. | last6 = Bulten | first6 = J. | title = The number of multinucleated trophoblastic giant cells in the basal decidua is decreased in retained placenta. | journal = J Clin Pathol | volume = 62 | issue = 9 | pages = 794-7 | month = Sep | year = 2009 | doi = 10.1136/jcp.2009.065953 | PMID = 19734475 }}</ref>
===Placenta accreta===
*Trophoblastic tissue (directly) adherent to the myometrium.<ref name=Ref_Pathde_974>{{Ref Pathde|974}}</ref>

Image:
*[http://library.med.utah.edu/WebPath/jpeg2/PLAC040.jpg Placenta accreta (med.utah.edu)].<ref>URL: [http://library.med.utah.edu/WebPath/EXAM/IMGQUIZ/plfrm.html http://library.med.utah.edu/WebPath/EXAM/IMGQUIZ/plfrm.html]. Accessed on: 3 December 2011.</ref>
*[http://www.flickr.com/photos/lunarcaustic/4114362341/ Placenta accreta (flickr.com/lunar caustic)].

===Placenta increta===
*Trophoblastic tissue extends into the myometrium.

===Placenta percreta===
*Trophoblastic tissue penetrates through the myometrium.

==Sign out==
<pre>
PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, BIRTH:
- PLACENTAL DISC WITH THIRD TRIMESTER VILLI WITHIN NORMAL LIMITS, AND A
DISRUPTED MATERNAL SURFACE COMPATIBLE WITH A HISTORY OF PLACENTA ACCRETA.
- THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS.
- FETAL MEMBRANES WITHIN NORMAL LIMITS.
</pre>

==See also==
*[[Placenta]].

==References==
{{Reflist|2}}

[[Category:Placenta]]