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2023 Case StudiesTake a closer look at the cases that will be discussed at this year's conference. Here you'll find the Case History of each with links to their biopsies. Quick JumpCase History / 01Kristine Konopka / Thoracic Pathology A 56-year-old male with the pathology requisition listing preoperative diagnosis as “ILD.”
Case History / 02Vipul Dadhania, MBBS / GU Pathology A 56-year-old woman with history of incidental 3.5 cm right kidney mass detected on MRI scan, who underwent partial nephrectomy. Case History / 03Kyle Conway / Neuropathology A 48-year-old man presents with rapid onset of right-sided facial weakness following 3 weeks of severe headaches. MRI shows multifocal lesions consistent with subacute infarcts, involving the left frontal cortex, right insular cortex, and right cerebellum. An angiogram shows no diagnostic findings. A biopsy of dura and cortex is performed in the right frontal cortex near an area of suspected infarct changes. Case History / 04Sula Schechter / Gastrointestinal Pathology A 69-year-old man with a 1 cm gastric wall mass incidentally found during laparoscopy. Case History / 07Douglas Rottmann / GYN Pathology A 46-year-old patient presented with heavy vaginal bleeding and was found to have a beta-hCG of over 200,000 mIU/mL. On hysterectomy, a large (8.7cm) mass was seen involving the lower uterine segment and cervix. Cut sections showed a tan-red, hemorrhagic, and necrotic mass confined to the uterus. Case History / 08Angela Wu / GU Pathology 77-year-old with PSA of 7.6 and a prior biopsy (3 years prior) with atypical small glands adjacent to high grade prostatic intraepithelial neoplasia undergoing a repeat 12 core biopsy. Case History / 09David Chapel / GYN Pathology A 29-year-old pregnant woman presented to the emergency department with vaginal bleeding and was diagnosed with a missed abortion at 9 weeks of gestation. Beta-hCGwas 625,000. Ultrasound revealed an 11.3 cm uterus with a thickened, heterogeneous endometrial cavity with cystic spaces measuring at least 5.6 cm. No fetus was identified. Case History / 10Paul Harms / Dermatopathology A 56yoF presented with a mildly erythematous papule on her scalp. Shave biopsy was performed and demonstrated a dermal proliferation of atypical epithelioid cells, with a zone of separation from the overlying epidermis. There was no evidence of regression or scar. SOX10 immunohistochemistry was positive, and cytokeratin immunohistochemistry was negative. The findings were concerning for metastatic melanoma or primary dermal melanoma.
Case History / 11Eman Abdulfatah / Genitourinary Pathology A 64-year-old man with no significant history presented to the emergency department with back and flank pain.CT scan showed a markedly enlarged prostate gland with amass demonstrating extraprostatic extension into the left seminal vesicle as well as adjacent rectosigmoid colon, rectosigmoid colonic mesentery, and adjacent soft tissue.Serum PSA level was 16.1ng/mL. He subsequently underwent a prostate biopsy. Case History / 14Tao Huang / Thoracic Pathology Case 01 / A 25-year-old man presented with spontaneous pneumothorax. Case 02 / A 32-year-old man presented with left flank pain and small ureteral stone with incidentally noted right pneumothorax. Case History / 15Sean Ferris / Neuropathology A now 81-year-old man began having balance issues in May of 2021. Six months later he developed nausea and occasional vomiting, and subsequent CT Head and MRI Brain demonstrated a cystic peripherally enhancing lesion in the cerebellar vermis. He underwent extension subtotal resection of the lesion in January of 2022. Case History / 16Karen Choi / GI Pathology A 60-year-old patient was admitted for severe diarrhea. Flexible sigmoidoscopy was performed and found severe inflammation and ulcers in the rectum and sigmoid colon, which was biopsied. Case History / 19Ellen Chapel / Breast Pathology A 30-year-old female presents for an excisional biopsy of a left breast mass.
Break Out Cases
Break Out Case History / 01David Chapel & Ellen Chapel / Frozen Sections Case 01 / 57-year-old woman with a complex left ovarian cyst Case 02 / 57-year-old woman with a right ovarian mass Case 03 / 59-year-old woman with bilateral adnexal masses Case 04 / 52-year-old woman with a pelvic mass Case 05 / 64-year-old woman with a left adnexal mass Case 06 / 66-year-old woman with endometrial endometrioid carcinoma, grade 1 Case 07 / 69-year-old woman with a right adnexal mass Case 08 / 57-year-old woman with bilateral adnexal masses Case 09 / 19-year-old woman with a complex left adnexal mass Case 10 / 58-year-old woman with an adnexal mass Case 11 / 68-year-old woman with a pelvic mass Case 12 / 79-year-old woman with a history of endometrial endometrioid carcinoma, grade 3, now with peritoneal carcinomatosis Case 13 / 56-year-old woman with a pelvic mass Case 14 / 65-year-old woman with a right ovarian mass Case 15 / 43-year-old woman with abdominal pain and a pelvic mass Case 16 / 57-year-old woman with a pelvic mass Case 17 / 44-year-old woman with a pelvic mass and pseudomyxoma peritonei Case 18 / 30-year-old woman with a pelvic mass
Axillary lymph node component: Case 01 / 52-year-old female with invasive ductal carcinoma, status post neoadjuvant chemotherapy; sentinel lymph node biopsy versus ALND. Case 02 / 66-year-old female with right breast cancer and biopsy proven nodal involvement, status post neoadjuvant chemotherapy; sentinel lymph node biopsy versus ALND. Case 03 / 41-year-old female with left breast cancer, status post neoadjuvant chemotherapy; sentinel lymph node biopsy versus ALND. Case 04 / 36-year-old female with multifocal invasive ductal carcinoma, status post neoadjuvant chemotherapy; sentinel lymph node biopsy versus ALND. Case 05 / 72-year-old female with biopsy-proven nodal involvement by TNBC, status post neoadjuvant chemotherapy; sentinel lymph node biopsy versus ALND. Case 06 / 28-year-old female with left breast cancer, status post neoadjuvant chemotherapy; sentinel lymph node biopsy versus ALND. Gross examination demonstrates two lymph node (2.2 cm and 1.8 cm), entirely submitted in A1FS and A2FS. Case 07 / 48-year-old female with right breast cancer, status post neoadjuvant chemotherapy; sentinel lymph node biopsy versus ALND. Break Out Case History / 02Stephanie Skala / GYN Pathology Case 1 / 72 yo with history of vulvar cancer Case 2 / 91 yo with white thickened vulvar lesion at 7 o’clock Case 3 / 63 yo with “VIN / LS, HSIL, plasma cell vulvitis, recent WLE with positive margins” per requisition Case 4 / 67 yo with history of lichen sclerosus and recent change in lesion Case 5 / 70 yo with precancer of the vulva and history of lichen sclerosus Case 6 / 86 yo with no provided clinical history Case 7 / 63 yo with history of lichen sclerosus and verruciform lesion on right vulva Case 8 / 82 yo with history of lichen sclerosus Case 9 / 68 yo woman with squamous cell carcinoma on outside biopsy Case 10 / 45 yo with no provided history Case 11 / 24 yo with vulvar lesions Case 12 / 70 yo with history of lichen sclerosus and vulvar pain Case 13 / 76 yo with history of differentiated vulvar intraepithelial neoplasia diagnosed 7 years ago Case 14 / 36 yo with non-healing vulvar lesion Case 15 / 68 yo with well-differentiated squamous cell carcinoma of the vulva Case 16 / 70 yo with vulvar mass Break Out Case History / 03Madelyn Lew & Richard Cantley / Cytopathology Case 1 / 54-year-old patient presents to the emergency department following a fall from a ladder. Chest imaging identifies incidentally a 2.5 cm peripheral right upper lobe lung lesion. A CT-guided fine needle aspiration is performed Case 2 / 45-year-old patient presents to their primary care physician with persistent cough. Follow-up chest x-ray is abnormal. The patient undergoes endoscopy and a bronchoalveolar lavage is performed. Case 3 / 56-year-old male patient with a 26-pack-year smoking history undergoes CT chest imaging, which reveals a 2.5 cm left lower lobe lung lesion in a background of emphysematous change. An endoscopic ultrasound-guided fine needle aspiration is performed. Case 4 / 50-year-old female patient with a 30 pack-year smoking history presents to her primary care physician for persistent productive cough. CT chest imaging reveals a poorly-circumscribed, 2 cm right-sided nodule. An endoscopic ultrasound-guided fine needle aspiration is performed. Case 5 / A 62-year-old patient with a history of melanoma is found to have a 4 cm right right peri-hilar mass. An endoscopic ultrasound-guided fine needle aspiration is performed. Break Out Case History / 04Kyle Conway & Sean Ferris / Neuropathology Case 1 / Cerebral toxoplasmosis Case 2 / Acute disseminated encephalomyelitis (ADEM) Case 3 / Progressive multifocal leukoencephalopathy Case 4 / Granulomatous inflammation with acid-fast bacilli (Mycobacteria) Case 5 / Active inflammatory demyelinating process Case 6 / Neurosarcoidosis Case 7 / Amebic encephalitis Case 8 / Lymphocytic hypophysitis Cases 9a & 9b / Amyloid-beta-related angiitis (ABRA) Case 10 / Diffuse large B-cell lymphoma, partially treated Case 11 / Lymphomatoid granulomatosis Case 12 / Idiopathic hypertrophic pachymeningitis
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