South Bay Pathology

Jan meeting highlight: 30F w fibroids 🔬Placental site nodule! 📍Placental site nodule: Ki-67 <8%, <4mm 📍Atypical placental site nodule: Ki-67 8-10%, mod-severe atypia 📍GATA-3 + in trophoblastic tissue 📍PMID: 25675185 Great case courtesy of Dr. Taylor & Dr. Zaloudek #GYNpath

Jan meeting highlight: 68F w hx of breast ca, melanoma. 4cm small bowel mass. Pos S100, Sox10. Neg CKMix, DOG1, HMB45, Desmin, Melan A. 🔬Clear Cell Sarcoma-Like Tumor of GI Tract! 📍Rare! 📍Ileum (70%) 📍Poor px 📍EWSR1-ATF1 + Great case courtesy of @JCloutierMD & Dr. Charville

Dec meeting highlight: 52M w h/o melena & hematochezia, w internal hemorrhoid 🔬Invasive Mucosal Melanoma! 📍⬆️LN/distant mets, 5yr survival 14% 📍⬆️CN & structural changes; BRAF, KIT, MAPK mutations 📍⬇️point mutation burden Great case courtesy of Drs. Lee & Menke #Dermpath

Nov. meeting highlight: 65F h/o CKD on dialysis, w dysphagia & thickening of distal esophagus 🔬Lanthanum deposition! 📍Oral non-Ca2+ based phosphate binder 📍PAS+ PASD+ 📍Vague sx, non-specific EGD 📍PMID: 28134986, 25602800 Great case courtesy of Drs. Janowski & Umetsu #GIpath

Please join us for the SBPS Annual Spring Meeting this year in beautiful Monterey on May 9th, 2020. This year's topic is GU pathology with Dr. Victor E. Reuter and Dr. Kiril Trpkov! Register now at southbaypath.org! #GUpath

Nov meeting highlight: 25M w anemia➡️ulcerated gastric lesion. CD117(C-kit) DOG-1 CD34+, desmin S100- 🔬SDH-Deficient GIST! 📍C-kit/PDGFRa mutation- 📍Peds & young adults, F>M, gastric 📍⬆️survival vs typical GIST 📍Resistant to imatinib Great case courtesy of Dr. Patel #GIpath

Nov meeting highlight: 68M w enlarged & eroding scalp mass. CD31 CD34+. CKmix EMA SMA HHV8- 🔬Epithelioid hemangioma! 📍B9, variable morph: well-formed➡️spindled cells in sheets or vasoformative 📍FOS rearrangement common Great case courtesy of @dwadamsMD & Dr. Charville #BSTpath

Nov. meeting highlight: 67F w PMB➡️TAH/BSO 🔬Ovary - Adult granulosa cell tumor! 🔬Endometrium - Complex atypical hyperplasia! 📍Ovary - FOXL2 402 C>G+ 📍⬆️estrogen production 📍Good Px 📍Px factors: stage, size, rupture, nuclear atypia Great case courtesy of Dr. Hansen #GYNpath

Nov. meeting highlight: 63M w bladder tumor 🔬Mixed small cell neuroendocrine carcinoma and High-grade papillary urothelial carcinoma! 📍Mixed tumors are not a separate category in WHO 📍Synaptophysin+, chromogranin+, NSE+ ➡️ may be neg! Great case courtesy of Dr. Grujic #GUPath

Oct meeting highlight: 50M w poorly-controlled Type II DM & ESRD, w severe thigh pain 🔬Myopathic process, favor post ischemic changes! 📍Rare complication of long-standing uncontrolled DM 📍Acute U/L LE muscle pain 📍PMID: 12502683, 31015244 Great case courtesy of Dr. Vogel

Oct meeting highlight: 66F, h/o esophageal & duodenal ulcers, now w nausea 🔬Atypical esophageal epidermoid metaplasia! 📍⬆️risk for squamous neoplasia 📍TP53 mutations may be early biomarker for HG dysplasia or carcinoma! Great case courtesy of @JCloutierMD & Dr. Martin #GIpath

Oct. meeting highlight: 65F w posterior neck mass 🔬IgG4-related sclerosing lymphadenopathy! 📍⬆️LN can occur before, concurrent w, after dx of IgG4-RD 📍No constitutional sx 📍⬆️histology patterns 📍A/w few scattered EBV+ cells Great case courtesy of Dr. Fernandez-Pol #HemePath

Oct. meeting highlight: 62F w 8cm kidney mass 🔬TFEB MiT family translocation associated RCC! 📚Rare! 📍Median age 31y,⬆️range: 3-68y 📍Indolent but may be clinically aggressive 📍Biphasic➡️papillary, oncocytic, solid/nested Great case courtesy of Drs. Fels-Elliott & Chan #GUpath

Oct meeting highlight: 65 w salmon patch lesion on conjunctiva 🔬Myeloid Sarcoma! 📚Extramedullary tumor mass of myeloid blasts 📍(+): CD45RB, CD43, dim MPO 📍(-): Ckmix, CD34, CD14, CD117, TdT, MCT, CD19, CD22, CD79a, CD3, CD138 Great case courtesy of Dr. Fernandez-Pol #HemePath

Oct. meeting highlight: 70 w ⬇️weight & ⬆️LN 🔬Whipple Disease! 📚Rare! 📍Tropheryma whipplei, in soil/sewage 📍Sx: D, malabsorption, ⬇️wt, fever, arthralgia, occ. CNS/cardiac involv. 📍Lipogranuloma in LN 📍PAS+ bacilli in histiocytes Great case courtesy of Dr. Duncan #Hemepath

Sept meeting highlight: 56M w ⬆️PSA 🔬Malakoplakia! 📚GU (bladder 70%, prostate rare)>GI tract>any site 📍Defective phagocytosis/bacteria elimination 📍Targetoid inclusions = Michaelis-Gutmann bodies 📍Mimics malignancy! Great case courtesy of Drs. Ladwig, Zaloudek, Simko #GUpath

Sept. meeting highlight: 45F w BL ⬆️inguinal LN 🔬Syphilis! 📚Quant RPR+. Rare in LN: prominent RFH. Often w hx of prior skin or mucosal lesion. Spirochetes within/around walls of venules, can be in GC. 📍Vulvar bx weeks later: Syphilis + Great case courtesy of Dr. Temmins

Sept. meeting highlight: 66F w 3cm incidental mass on XCR. 🔬Typical Carcinoid Tumor! 📚<2 mits, 🚫necrosis. Excellent prognosis. Atypical carcinoid: 2-10 mits, foci of necrosis=⬆️recur. rate & mortality. Risk fx: family history, MEN1+. Great case courtesy of Dr. Cherny #LungPath

Sept. meeting highlight: 65F w fevers, oral & arm petechiae, ⬆️LFTs, flow w ⬆️plasma cells. Recent travel to Asia. 🔬Atypical plasmacytosis a/w Dengue Fever! 📚Can mimic plasma cell leukemia! PMID: 12873179, 21091833, 28408424. Great case courtesy of Drs. Dayhoff & Fong #Hemepath

August meeting highlight: 14M w chest discomfort & SOB ➡️6cm lung mass w subcarinal adenopathy. Clinical concern for Coccidioides ➡️fluconazole w ⬆️discomfort 🔬NUT carcinoma! 📚BRD4-NUTM1+. Tx: Molebrisib (Bet inhibitor). Poor prognosis. Great case courtesy of Dr. Song #Lungpath