CALIFORNIA TUMOR TISSUE REGISTRY

"HEAD AND NECK PATHOLOGY"

Study Cases, Subscription A

October 2002

California Tumor Tissue Registry c/o: Ueparfmeot of Pathology arid Human Anatomy

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

(909) 558-4788 FAX: (909) 5SS-0188

E-mail: cnr@!inkljne com

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Target audience: Practicing pathologists and pathology residents.

Goal: To acquaint1be panicipant with the histologic features of a variety of benign and

malignant neoplasms and tumor-like conditions.

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

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

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

Printioal faculty: Weldon K. Bullcx:k, MD Donald R. Chase, MD

CMECres!it; Lorna Linda University School of Medicine designates this coniinuing medical

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

CME credit is.offered for the subscription year only.

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

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

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Contributor: Phillip C •. Gordon, M .D. Case No. 1 - October 2002 Winter Haven, FL

T issue from: Left cheek Accession #29352

Clinical Abstract: A mass developed in the left cheek, near the parotid gland, of this 64-year-old male.

Gross Pathology: The 4.0 x 2.5 x 2.0 em mass contained a multiloculated cystic structure filled with clotted

blood.

Contributor: Anthony W. Migler, M.D. Case No. 2 - October 2002 Camarillo, CA

Tissue from: Neck Accession #29122

Clinical Abstract: A 88-year-old male presented with a mass in his right neck.

Gr oss Pa thology: The 5.0 x 4.5 x 3.5 em specimen consisted of yellow adipose tissue.

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

Tissue from: Right parotid gland

CUnical Abstract:

Case No. 3 - October 2002

Accession #29108

After 10 years of noticing a small nodule in his right neck, this 54 year old male reported a l year history of slow enlargement of that mass. He denied weight loss. Physical exam showed a. minimally mobile, non-tender mass at the angle of the jaw in the right neck.

Gro..s Pathology: The 38 gram specimen was 7.0 x 4.5 x 4.0 and had a slightly gritty, yellow-tan lobular cut

surface.

Contributor: Mary Beth Sbwayder, M.D. Case No. 4 - October 2002 Pasadena, CA

Tissue from: Submandibular gland Accession #29106

Clinical Abstract: This 61-year-old male had noticed .an immobile, finn, tender right neck mass for over a month.

Gross Pathology: The ovoid 4.0 x 3.0 x 2.2 em specimen had numerous white-tan confluent nodules that formed

a central mass measuring 2.2 em in diameter.

Contributor: LLUMC:Patbology Group (drc) Loma Linda, CA

Tissue from: Right mandibular/Parotid region

Clinical Abstract:

Case No. 5 - October 2002

Accession #29438

Following resection of a right facial mass, this 9-year-old male developed a recurrence. Tissue from the region of the right mandible was debulked.

Gross Pathology: The 89 gram, 12.0 x 8.0 x 4.0 em aggregate consisted of pink-tan soft tissue fragments with a

stringy, worm-like appearance.

Contributor: Philip Robinson, M.D. Case No. 6 - October 2002 Boynton Beach, FL

Tissue from: Left Neck Accession #29544

Clinical Abstract·: A large mass was found in the left neck of this 60-year-old female.

Gross Pathology: The tumor was resected in three PQrtions measuring 5.2 x 5.3 x 2.2 em, 6.5 x 4.5 x 3.1 em and

9.5 x 5.5 x 4.5 em. The cut surfaces were gray to red with necrosis, dark red hemorrhage and cystic spaces.

SPECIAL STUDIES: Keratin S-100 GFAP Muscle specific actin Synoptophysin Thyroglobulin Chrorriogranin Mucin Desmin

positive positive negative negative negative negative negative positive negative

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

Tissue from: Right eye

Clinical Abstract:

Case No. 7 - October 2002

Accession #29443

An orbital mass developed at the lateral aspect of the right eye of this 48-year-old male, causing double vision and displacement of globe. A CT scan showed no bony erosion.

Gross Pathology: The 2.0 x 1.5 em specimen had a homogenous white-tan parenchyma.

Contributor : Wilmier Talbert, M.D. Case No. 8 - October 2002 Long Beach, CA

T issue from: Nasal cavity Accession #27740

Clinical Abstract: After experiencing nasal stuffiness for a few weeks, this 26-year-old female was found to have

a large intranasal mass. A CT scan showed extension into the anterior ethmoid air cells.

Gro~s 'Pathology: The main tumor mass was 5.0 x 3.5 x 2.0 em and had white-tan homogenous cut surfaces.

SPECIAL STUDIES (Outside faci lity): S-1 00 negative Chromogranin negative Desmin negative HHF35 negative SMActin negative CD34 positive Factor vrn negative CK-AE negative

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Contributor: Farooq Ali, M.D. Case No. 9 - October 2002 Ventura,CA

Tissue from: Nasal fossa A:ccession #28993

Clinical Abstract: Following a y~ of worsening nasal occlusion and epistaxis, this 64•year-old male was worked

up for nasal polyps. ACT scan showed opacification of the right maxillary and ethmoid sinuses along with polyps in the right nasal fossa.

Gross Pathology: In aggregate; the multiple fragments of polypoid red and pink tissue measured 6.0 x 4.0 x 1.8

em.

Contributor: Kenneth A. FTankeJ, M.D. Case No. 10 - October 2002 Glendale, CA

Tissue from: Left parotid gland Accession #29348

Clinical Abstract: This 45-year-old male was found to have a mass in his left parotid gland.

Gross Pathology: The 4.3 x 3.1 x 1.9 em well-circumscribed mass was composed of homogenous soft brown

tissue.

CALIFORNIA TUMOR TISSUE REGISTRY

HEAD AND NECK PATHOLOGY

Minutes - Subscription A

October, 2002

SUGGESTED READING (General Topics from R¢cent Literature):

Newly Described Awpocytic Lesions. Guillou Land Coindre JM. Semin Diagn Palhal 200 I; 18( 4):238-249. Myoepithelial Tumors of Salivary Glands. A Clinicopathologic, [mmunohistochemical, Ultrastructural and Flow

Cytometric Study. A los L,'Cardesa A, Bombi JA. et al. Semin Diagn Patho/1996; 13(2): 138-147. The Evolution of the /cnatomic Pathologist from Medical Consultant to lnfonnation Specialis! (Ed itorial). Murphy

WM. AmJ.Srtrg Pcrt~o/2002; 26(1):99-102. The First Hwnan Cloned Embryo. Cibelli JB, Lanza RP, West MD and Ezzell C. Sci Am 2002; 286( 1 ):44-51.

C!\lifomia Tumor Tissue Registry c/o: Department of Pathology and Human Anatomy

Loma Linda !Jniversity School of Medicine l 1021 Campus Avenue, AH 335 Loma Linda, California 92350

(909) 558-4788 FAX: (909) 5 58-Q 188

E-mail: ctrrfa\linkline.com Web site & Case of the Month: www.cnr.org

Case I:

Case 2:

Case3:

Case 4:

Case 5:

Case 6:

Case 7:

Case 8:

Case 9:

FILE DIAGNOSES

CTTR Subscription A October 2002

Pleomorphic adenoma (··mixed tumor"") with dcgcncrati\e changes. cbeek T- YOJOO, M-50030

Pleomorphic lipoma, neck T-Y0600, M-88500

Acinic cell carcinoma. parotid T-55 100, M-85501

Salivary duct carcinoma. submandibular gland T-55300. ~1-80103

Myxomatous plexiform neurofibroma, region of mandible T-10180. M-95500

Low grade malignant myoepithelioma (myoepithelial carcinoma), neck 1"· YOGOO. M-89820

Idiopathic orbital sclerosing inflammatory pscudotumor, right eye T-XJ<OIO,M-03090

Solitary fibrous tumor. nasal cavity T-21340. M-80001

Inverted Schneiderian papi lloma. maxillary s inu~ T-221 00, M-812 1.0

Case 10: Warthin"s tumor, parotid gland

T-55100. M-85610

Case Jl,o. I, Accession No. 29352 October 2002

Bakmficld - carotid body paraganglioma Baldwin Pads <Kaiw P<rmanemel - Pleomorphic adenoma {2); Monomoq>hk adenoma ( 1)

Bay An:o -Monomorphic adenoma (cannot exclude pleomorphic an:as) (3) D.Yy Chy CScton Medical Center) · Monomorphk adenoma Eoptnna (Kaiser Pcrmanente) .. Pleomorphic adenoma

tlaywardffremonl · Pleomorphic adcnornu ~. J,leomorphic adenoma

LQO!I Beech • Mixed tumor (7}

Moot\-U)' CCommunitv HO!ipjtal of MOQts;ttv PrnjnJulal - ~fixed 1urnor

MQun(l:jn Vjew (El Camjno PaJhot()gy Groupl · Mixed rumor- 'Yith degcnera.1i\'C reatures Oa!slond <Kajgr Pqmanems\ - Pleomorphic a<i<nOma (4)

Orance CVCl MedjcJI Cemer Rejjdencs\ • Pleomorphic adenoma. cheek Sacmros:mo fUC Davjs Medical c,nt;r) · Pleomorphic $denoma San Djego CNnval Medical Cemerl • Pleomorphic adc.noma Santq Batb!U'i.l CS:mta Barbaro Cottage H~J2.iW.l · Ple6morphic ndcnomn Samn Rosa <Santa Rosa Memorial Hospjwl) • Mucoepidcnnoid tumor n1lc out ~leomorphicadc.noma (I); l'leomorphic adenoma (2) Vc111ym (Unjlnbl - Mixed tumor (2)

Ala.~ka CA la~ka Native Medical Center> .. l, lcotnorphic adenoma (mixed rumor~ \\ ith promioem vascularil) Alaska /Anchorngcl .. Mixed tumor AriZ0113 CPhoenix Memorial Hosnitall • lkmgn miXed tumor (pleomorpho< a<ltMmJ I

Florida (Munroe Rel!ional Center) • Myoepithelioma Florida <Pathology Associates) - Benign mixed tumor florida C\Vjoter Haven Hospitall - Mixed tumor lndjooa tr:on Wayne) - Pleomorphic ade•\Omn1 parotid

Marylnod (Johns 1-lonkins HospjtaJ gcs!dcntsl .. Pleomorphic adenoma with prominent cystic vascular sp~1ce~ (I): Myoepithelioma ( I )

Marylqnd CNaliOO!ll Naval Medjcql ~ • Pleomorphic adenoma (10)

Marvland CNIH Pathology Resjdents) • Pleomorphic adenoma ~fi!O'land CUni>'t'l>itv ofMarvland) • Monomorphic adenoma with degenerative changes Manacbu.wss CBrigham and Womc:n·s Rgjckmslfcllows) .. PleomorphK:Dde:noma (2) Ma.ugchusens CNew En2land Medical Cmtsr Rgidents) .. Pleomorphic 1.\denorn..a Michican !Oa!swood Hospirall • Canalicular adenoma Mjcbjgan !St. Joseph Mercv Hospitall • Monomorphic adenoma (2); Pleomorphic adenoma ( 1) Nebroskn (Creighton University School of Medicine Residents) • Monon1orphic ndenoma New Jersey !Overlook Hospitnll - Benign mixed tumor (3) New York Om path) • Pleomorphic adenont> of salivary gland New york (Long Island Jewish MediCal Center) ~ Oenign saliva.ry gland neoplasm. ravor monomorphic adenoma New York (Nass3u Uniwrsitv Medjc:al Ccmcrl · Cystic mixed mmor, parotid gla11ti New Yor!; !S1onv Brook IJnj-.Cjjl' Ho<oilal RcsjdcnJ.S) - Basal cell adenoma (12) ~ew W (WtsK!J<Stq M,;djcal Centtc) • Cystic mixed tumor Oklahoma ffidsal - Pleomorphic adenoma Ptnnsytvanjll (AII(gbenv Geneml Hospital> • Pl~rphieadenoma

Pennsylvanja <Memorial Mt:dical Center) • Mucoepidermoid carcinoma Pennsylvania (Shadyside Hospital} • Mi.«d tumor (pleomorphic adenoma) with hemorrhage and blood clots organizing Pueno Rico <University ofPueno Ric:ol • f•lcomorphic adenoma Tex.a.t cprorauh Services) · Low grade muco-epidermoid carcinoma (2) leXAi ($con & White Memorial Hospitgl) · Pleomorphic adenoma West Vjrwjnja (Greenbrier ValleY Mediegl Csmcr> • Pleomorphic ildenoma Wiw>nsjn !Meriter Health Services) • llasal cell adenoma Australia !Nprtb O.:emsland Pathology\ • Plcomoq>bic adenoma Hong KMg CHong Kong BaptiS< HmoiW) • Pleomorphic adenoma

CTTR, 0<:1ob<r 2002 "Millu<ts" (Subscrlpoioo A) 3

In: land !St. Jamcl tlomjL11l • Pleomorphic adenoma Oator CHrunqd :Yh:slical Corporation) - Pleomorphic adenom3. 1nfarccion

Case l· Diagnosi!: Pleomorphic ooeooma ("mixed rumor") "ith degenerative changes. ch-eek

T· Y0300. M-50030

Case I - References: Spiro RH. Salivll)' NeoplllSms, Overview of35 YeMs of Experience "ith 2807 PatienL<. !lead Neck Surg 1986: 8{3): 177-184. Stenman G. Sahlin P, Mark J llJ1d Landys D. Structural Alterations of the c·1nos Locus in Benign Pleomorphic Adenomns with

Chromosom31 Abnormalities of8q 12. Oncogene 1991: 6(7): 1105-1108. Klijanienko J and Vieth 11• Fine-Needle Sampling of Salivary Olond l, csions. I. C)1ology and His1ology Correlation of 412 Cases of

l'leomorphic Adenoma. Diagn C)70J><>Ihol 1996; 14(3): 195·200. Takai Y. Mori M. Oardick I, MocKoy A. Leung R. et al. Myollloment Loeali,atlon ond lmmunoeleetron Microscopic Detection of

Musclc-Speci Oc Actin in Neoplastic Myoepithelial Cells in Pleomorphic Adenoma.~ and Myoepitheliomas. UlirOS/rucl P(l//lol 1994; 18(6):575-591.

Martin AR. Muntravadi J. Kotylo PK, et al. l'roliferotive Activity nud Aneuploid; in Pleomorphic Adenomas ot'tho Salivary Glands. Arch l'alilol Lnh M•d 1994; 118(3):252-259. •

Case No. 2, Accession No. 29122

Bal<eafidd • Wdl-<lifl'crentiated liposarcoma Bald)\jn Par!; IKojser Permanentel • l'leomorphic lipoma (3) Bay Area ·Atypical lipoma (3) Daly City I Seton Medical Cemerl · Spindle cell lipoma, pleomorphic lipoma f on1ana (Kajsc;r J>e;ongncme} - Atypical lipomatous tumor Hayward/l'rcmpm • Pleomorphic lipoma La Mcsa!Gros!mgm 11ospj1QI) - Pleomorphic liposarcoma kong Beach • Well-dltlerentinted liposarcoma (7) Monterey <Communjtv llospj!HI of Monlcrey Peninsula> · Atypicnllipomo Mountain View lEI Comino Pa1hology Group) • Pleomorphic lipoma Oakland IKojm Pcrmenentcl • Pleomorphic lipoma (4) Orange !UCI Medical Cemer ResideniS\ . Atypical lipomatous tumor. neck Sacnunento CUC Davis Mc<lical Cemerl · Pleomorphic lipoma San Dieoo INoql Me!lical Center! · Atypicallip0m8lous tumor (I 0): PleomO<phic lipoma (I) SanJA Barb&ra ISan!A Barbarll Comge HosPital\ · AI~'Jlic:al lipomatous tumO<

October 2002

San!JI RosA ISan!a Rosa Memorial HospjJ!IIl · Atypicallipomo, low-gtade liposlrcomo (I); Well-differentiated liposarcoma ( 1 ): Pleomorphic liposarcoma (I)

Ventura IUnilab) • Al)opieallipomatous tumor (21 Alaska !A Iasko Notiyc Medical Center\ • Pleomorphic lipoma Alaska (Anchomg~ • Atypical lipomatous tumor Ariz.ona CPhoenjx Memorial Hospital) . Pleomorphic lipoma Florida (Munroe Rcljionul Center} • Pleomorphic lipoma Floddo <Putboloyy Associates) • Atypicallipomi• Florida !Wjmcr Haven Hospital \ • Atypical lipoma !ndjana (fort Wayne) • A!ypical lipoma, riglu n"ck Mao·Jand !Johns Hopkjns tlosoita] Reside.ptsl · Pleomorphic lipoma lfleslon is ~upcrficial, wcll-<lifferentiated liposarcoma if lesion

is deep (I); Pleomorphic liposarcoma (I) Maryland {Natjooal Nawl Me!ljcal Cgnerl • Pleomorphic lipom>(IO) Mwland {NIH Pathology Residents! • Liposarcoma, \\til difTen:ntiotc<l Man>land !Unjymj(y of Maryland\ • Well-<lifferentiated liposan:om• MassacbUS<US <Brigham and Women's Residen!51Fsl!oy.]l . Pleomorphic: lipoma (2) Massachusms CNsw England Medical Center Resjdents> - Al)'l)icallipoma Michjgan (Oak woo<! Hospital) • Well-<lifferentiated liposarcoma, atypical lipoma in subcutis

C"TTR. O<:~obtr 2002 ''Minul6" (Sutx.cripllon A)

Michi&a.n CSt. Joseph Mere' Hosnital) · Pleomorphic lipoma Nebroskg CCrejgh1on Unjyersity School o(M¢icine Rssidsnts> - Atypical lipomatous tumor New Jsrscy co,,.rlook Hospital) - LipOma (I): Pleomorphic lipoma (I): Atypic•llipom• (I) New Yorl< C!mootbl - t\lypicallipoma New Yorl< (!.onolslancl Je"ish Medical Cenoer) - At)pu:allipomL Mll·chffer<nriated liposarcom• New Yods <Nassau Uoi\·rrsity Medica1 Center) · liposarcoma. neck New X Oil( !Stony Brook Universitv H05pital Residents! • Atypleallip<>nta. "ell-differentiated liposan:om• (12) New York (Westchester Medical Cemerl · Atypical lipomatous tumor Oklahomo !TulSA) - At)'pical pleomorphic lipom• Pennsylvaojg £AIIephenv General Hospitan . Ple-omorphic lipoma Pennsylvnnin CMemorjnl MediQI Cemer) - Pleomorphic liposarc.omn Peonsylyonill !Shodxsjde Bosnimll - Pleomo!]Jhic lipoma Pueno Rjco (Uojyersjw QCPueno Ricol ~ Wt ll·diflCr<:otitncd liposarcomu/pleomurphic lipoma Texas CPropa!h Scryjcesl • l'leomOI]Jhic lipoma (21 Texas !Soon & Whit< Mcmodal Hospitall - Plcomo!]>hic lipoma West virginjo !Greenbder Valley Medical Center) . Atypical lipomB WiSSjonsjn CMtdtcr Health Scryicesl - Pleomorphic lipoma \'1, v.ell-differentiat:d (hpoma·like) liposarcoma Australia CNonb Quoemland Pathology! • Atypical lipomatous nanaoor Hong Kooa CHong Kong Baptist Hospital\ · Pleomorphic lipoma h"land !St. James Hosnitoll • Plrome<phic lipOma Outar CHarnpd Medial Corporation) • Atypical hpomatous tumor

Case 2 • Diagnosis: l' lcomorphic lipoma, neck

Director's Note: Jnadvencntly omitted from the history was mention of CD34 positivity. and a superficial location (drc)

I· Y0600, M-88500

Case 2 • References: Rubin Bl' t>nd Onl Cin P. 11>< Genetics of Lipomatous Tumors. Selllin Dia:gn Pmho/ 200 !; 18{4):286-293. Pitt MA. Rob<n. IS and C\arry A. Spindle Cell and Pleomorphic Lipoma. An llltrastructural Study. Ultrastruc-t l'arloo/1995;

19(6):4 75-480. Yue XH and Liu YQ. J>leomorpbic Lipoma. Am J Swg Pathoi 1996: 20(7):898-899. V<rgbcsc: A. Smith RA, Stock D. et al. Aspiration Cytology of a Pleomorphic Lipoma-A Cautionazy Note. C)1opathoi 1999:

10(4):230·282. 0.1 Cin P. Sciot R. Polito P,"' at Lesions of 13q May Occur lndcpend.,.tly or Deletion or 16q in Spindle CciVPieomorphic

Lipomas. /luroparlrn/1997; 31(3)-.222-125.

Case No. 3, Accession No. 29108 October 2002

Bakersfield • Acinic cell carcinoma Baldwin J>ark <Kajser l)crmanemel · Metastatic lymphoepilheliAJ c.orcinoma ( I }; Metastatic carcinoma (adcnocarcinon1a) v~.

lymphoepithellnl corcinoma ( I); Lymphoepithclial enrcinum,a 7 anctostatic (1) ~a . l,ymphocplthcllal carcinoma (3) Only Cjty CSecgn Mcdjcql C&nterl - Polymocphous low g.rodc cnrcinoma; acinic cell with benign lymphoid stroma Fontana CKajscr Peananeotel · Poorly diiferenliatcd adenocarcinoma HaywardJFrejmOQ\ • Lympboepithelioma·Hkc tart inoma La Mesa !Grrusmont tlosnitall • MucoepidOillloid c:m:inoma. high gtllde. with lymphoid infiltr.lte Long Bsoch • Lymphoepithelioma-like c:an::inoma (5): Mucoepidermoid c~~tinoma (2) Monter<y CCommuniJv Hospital orMonterev Peninsula\ - L~mpho<pitbelial can:iooma Mountain Vjcw CEI Camino Pathology Grouo) • Lymphoepithelioma·likc carcinoma Oakland C!Saisrr Pronii!!Cntel • Acinic cell carcinoma (I); Adenoc:orcinomL NOS (3) Orange GJC! Me<Jjcal Center Residents! • Lymphnepithelial-likc carcinoma, porotid gland

CITR. OCtober 2002 '"Minutes•· (Subscription A) s

Sacramento (lJC' Davjs Medical Center) • Millignrult lymphoepithelial lesion San Diego <Naval Medjcal <&n_tW - Lymphoepithclial carcinoma (5}; Sebs, eous l}mphadcnocardnoma (5); Poorly differentiated

adenocarcinoma ( I) Sam a Barham (Santa Barbara Cottag~ HosojtaD - Poorly differentiated carcinoma, nasopha.ryogeaJ type Santa Rosa (Santa Rosa Memorial Hospilall - Mucoepide.nnoid carcinoma (l) Ventura runilab) . Poorly differentiated adenocarcinoma in imraparotid lymph node (2) Alaska <Alaska Natjve Medical Center! - Malignnnt lymphoepithelial lesion. malignant lymphoepitltelioma. lyropboepithclial

carcinoma Alaska (Anchoraoel - Benign lymphoepitbelial lesion Ari~ona (Phoenix Memoria] Hospit..al) - Carcinoma eJ<-J>Ieomorphic aden-omll Florjda (Munroe RegionaJ Center\ - Lymphoepitheiial carcino1na FloridA ffajhology Associates) - Mucoepidermoid carcinoma Florida (Wjnter Haven Hospital) • Undiffcn.~ntiatcd caf(inoma ex Jymphoepithetinl ksion Indiana (fon Wayne) - Lymphoepithclial carcinoma1 parotid Man1!and (Johns Hankins Hosoital Residents) - Lymphocpitflelial carcinoma. malignant lymphoepithelial Jes_ion vs. meutSHHic

nasophal)•neal carcinoma ( I ); Acinic cell adenocarcinoma ( I) Marvlan<l CNational Naval Medical Center) - Poorly differentiated cardnoma with fearures ot' lymphoephbclial-like carcinoma (9):

Carcinoma, ex pleomorphic adenoma (2) Marvland CNlR Pathology ResidentS> - Undinereotiated nas.opharyngeal ~arcinorna. lymphoepithelial cardnQ.ma Marvland (University of Maryland) ~ Acinic cell carcinoma (it could be derived from pleomorphic adCJlOtna) Ma.llsachusetts {Brigham and Women ·s Rcsidents!Fcllcwvs) • Acinic ¢~11 Cl:\rcinom~ (::!' ~1\sachti.~ettli (New EnWand Medical Center Residents) - Acinic cell C3.rCinoma. fitvontblc prognosis varianl Michigan <Oak-v.•ood Hospital) e Acinic. cell car.cinoma Michigan <St. Josenh Mercv Hospital> • Adnk cell carcinoma ~£braska (Creighton University School of Medicine ReSidentS) · Acinic Cc11 adenocarcinoma Ne\\1 Jersey £Overlook Hospital) - Acinic cell tumor ( I); ? oncocytoma (I )' Polymorphous low grade c.arcinoma ( I) New York Ompathl · Lymphoepithelioma .. fikc carcinoma of salivary ~land

New York <Long lsland Jewish Medical Center) e Carcinoma arising from benjgn lymphoepitheliaJ le.sion New YOrk <Nassau Universitv Medical Center) - Lymphoepilhellal carcinoma. parotid gland New Xort; <Stony Brook Unive.rsitv Hospital Residents) • Acinic cell carcinoma ''favorable prognosis" variant (12) New y ork <Westchester Medical Center\ e LymphoepitbcUaJ carcinoma Oklahoma <Tulsal . Acinic cell ~denocarcinoma witJt lymphoid stroma Pennsvlvania (A11eghenv General Hospital) · Adenocarcinoma Pennsylvania (Memorial Medical Center) ~ Lymphoepithelial carcinoma Pennsylvania <Shadyside Hospital) ~ Acinic ce11 adenocarcinoma· Puerw Rjco CUnjversiw of Pueno Ricol ~ Malignant. Jymphoepithelia11esion Texas CProruuh Services> • Acinic cell carcinoma (2)

Texas (Scott & Whjte MemoriaJ Hospitall . t>.·tucoepidennqid carcinoma West Virgjnja (Greenbrier Valley t~ ~edical Ce.nrer) - Lympho~pithelial carcinoma Wisconsin O··feri1er Health ~5ervice") - Non-keratioiz.ing squamous cell ca.rcinoma, lymphoepithelioma Australia <Nonh 0H~C11$ 1@ 11d pathoa~ . Lytllphoepithelial CMcinoma Hong Kong lliong Kong BaprjSJ H .>.ru>l.!llll - Mallgnam lymphoepithelioma 1reland (St. James Hospjlal) ~ Muc.)epidennoid carcinoma.. exclude acinic·cell carcinoma Oatar CHamad Medical Comorntjor~; · Mucoepidermoid c-arcinoma

Ca~e 3 . Diagnosis: Acinic Cell Carcinom:, parotid

T-55 100. M-b5501

Consultation: Mia Perez. M.D .. Loma Linda. "Acinic cell carcinoma."

Case 3 • References: Abrams AM, Cantyn J and Scofield L.S. Acinic Cell Adenocarcinoma of the Major Salivary Glands. A Clinicopathologic Srudy of

77 Cases. Clmcer 1 96~: 18: I 145-11 62.

6 CTTR, Oe$ober 2002 .;Minutes., {Subscription A)

Angeles·Angclcs A, Cabollero·Mendoza E; Tapia· Rangel B. eta!. Giant Acinic Cell Parotid Gland Adcnocorcinoma of the Papillary Cystic Type. Re> lnvesr Cliu I 998; 50(3):245.·248.

Henley JD, GearyWA, Jackson CL, cl al. Ocdilfcremiated Acinic Ceil Carcinoma of the Par<Hid Gland. A DiStinct Rarely Described Entity. Hum Par!Jo/ 1991; 28(7):869·873.

Hellquist HB, Sunde! inK, Dl Sacco A~ et at. Tumour Growth Faction and Apoptosis in Salivary Gland Acinic Ce11 Carcinomas. Prognostic Implications ofKi-67 and bel·l Expression and of ln.siru End L~be!Gng (TUNE!..) J !'athol 1997; 181(3}:323·329.

Depowski PL, Setzen G, Chui A. et al. fomilial Occurrence of A.cinie Cell Carcinoma of the Parotid Gland. Arch Parholl.ab Med 1999; 123(11 ):11 18·1120.

Case No. 4, Accession No. 29106 October 2002

Bakersfield • Salivary intraducral carcinoma Baldwin P.ark CKaiser Pennanente) • Salivary duct carcinoma(3) Bay Area • Salivary duel adenocarcinoma (3} Daly City !Seton Medical Center) • Salivary duct carcinoma Fontana CKaiser Pem1anentel • Salivary .. duct adenocarcinoma tlaywardlfremont • Salivary duel carcinoma La Me.~ <Grossmont Hospital) - Salivary duel carcinoma Long Beach - Salivary duct carcinoma (7) ;.Aonterey (C'ommuniw Hof>pital ofMomerev P<ninsula> - $alivaty duel c.arcinol\''ttl 1'' om:oc:1k) Mounmin View c El Camjno Patbologv Grouu.) - Salivary duct carcinoma Oakland Q(ajser Pennaneme) - Salivary gland duct car<:inoma (4} Orange fUCI Medical Center Residen!S\ · Adenocarcinoma. NOS. submandibular gland Sacramento fUC Davis Medical Ccnterl - Salivary ducrcartinoma San Diego <Navlil Medical Center) · Salivary duel carcinoma Santa Borbara (Santa Barbara Cottage Hospjtal) · Salivary gland duct corcinoma Santa Rosa (Ssnta Rosa Memorial Hospital> - Salivary duct carcinoma. comedo carcinoma (2); Salivary dvct carcinoma ( 1) Ventura fUnilab) • Salivary duel caroinomll (2) Alaska (Alaska ~ative Medical Center} • Salivary duct carcinoma Alaska.fAnchoraee) - Adenocarcinoma Aril..ona CPhoenix Memorial Hospital) • Salivary duct carcinoma Eforida CMunroe-Reeional Center) • Sal ivary gland duct carcinoma Florida (Pathology Associates) - Salivary duct carcinoma florjda CWinter Haven Hospitall - $.3.1ivary ductcilrcinoma fndjMa (Fon \Vavne) - Mucoepidermoid carcinom~ right submandibular gland Ml!rvlaod (Johns liopkjns liospil!\1 Residenc<) . Salivary duct carcinoma (2) ·Marvland CNatjonal Naval Medjcal Center) . Salivary duct carcinoma (ll) Marvland INIH Pathology Resjdemsl · Salivary duct carcinoma Maryland CUnivcrsity of Marylnndl · Salivary duet carcinoma Massachusclts (Brigham and Women's Resi~enis!Fellows) · Sali vary duct carcinoma (2) Mas."Sachusetts CNew Ene.!and Medical Cenll'-f Residents) · Salivary duct carcinoma Michigan (Oakwood Hospital) - Salivary duct carcinoma Michigan CSL Joseoh Mercv Hosoitan • Ductal carcinoma Nebraska <Creighton Universitv School of Medicine Residents) • ·salivary duct carcinoma, <:omedo·cype New Je.rsey COverlook Hosoital> • Cribrtform ductal adenocarcinoma (2); 'MuC-oepidermoid c-arcinoma ( J)

New York Omooth) • Salivary gland duct carcinoma New york {Long Island Je-wish Medical Center) • $ali vary duel carcinoma, comedo type. New York fNas~u UniversitY Medical Center) • Duc.t'al ca;·cinom~ submandibular gland New XOrk CStony Brook Unjversjtv Hospital Resident<>) . Salivary duct carcinoma (12) ~4w york CWesl'che~ter M~~W - Salivary duel carcil')oma Oklahoma ITulsal · Duct cell cype adenocarcinoma Pcnnsylt·tmia (AIIeghenv General Hospital> · Ducml carciuomn

CTfR_ O<tob<r 2002 .. Minutes·· (Subscription A} 7

Pennsylvaniq CMemorial Med;ea! Center) · Salh•ary duel carcinoma Pennsv!>anjo <Shadyside Hospital) - Salivary duct carcinoma Pueno Rico CUniversin. of Pucno Rjco) · Salh:ary duel can:inoma Texa.< CProna!h Services) - High grode rnuee>-epidcnnoid carcinoma (2)

Tew CScgn &: White Memorial Hnspi~ll - Solivary duct cartinomo w~· Virainia <Greeobrjer VaJiev Medico! Csmer) ~ Basa.loid squamau~ ecll enrcinoma Wjscons!n CMcritcr Health Servjces) · lnli llrnting salivary duct carcinomn whh t;ribriform pau~m Ausjralin CNot1h Queensland Pcuhology) .. lntroduct ond 1 early invasive $:\Jivnry duct carcinom~

Hong Kong (Hong Kong BspJjst I los pita!) • Carcinoma wilh c:ornedo necrosb Ireland <St. James Hospitan · SaJivary duel carcinoma Qatar <Hamid Medical Corporntjon) - Sali\'Jry duct eartrnoma

Cast 4 .. Diagnosis : Salivary duct carcinoma, ~ubmandibular gland

T-55300. M-80103

Case 4 - References: Pan CY. WrutgJ and Barnes EL. Expression of Androgen Receptor and Pro$tntic Specific Markers in Saliv(lry Duct Carcinoma. An

Immunohistochemical Analysis of 13 CU>OS and Review of the Urcruwrc. Am./ Surg l'ntho/ 2000; 24(4):579·586. Khurana KK. J>itman Jl.tB, Powers CN, Korourian S. c:.t a!. Diagnostic Jlitfill!s of Aspir3tion C~1oiO,!;) of Sslh·al') Duel Carcinoma. c.,.,.., 1997: 81(6):373-378. Wick MR. Ockner OM. Mills SE. ct al. Homologous Cardnomas oftbc Brust>. Skin. •nd S.livat) Glonds. A llistologic and

lmmunol>ista<hcmical Companson ofOuct<~l Mammal] Carcinoma. Ducurl $\\eat Gland Can:inomo. Mtd S.liv~ Duct Carcinoma. AmJC/infatho/1999; 109(1):75-84.

Moriki T, U<to S. Tala!hashi T. Mituni M. <t ol. Salivary Duct Can:inoma C~tolo~ic Charae~eristics and Application of Androgen Receptor lmmunostaining for DioJ111osis. Cmu:er 200 I; 93(5):344-350,

Regauer S. Beham A. and Mannwciler S. CK7 ExprtSsion in CareinomttS of the Waldey<r's Ring Area. Hum Parlro/2000; 31 (9): 1096.

Case No. 5, Accession No. 29438

Bakernfitld - Neurofibroma Baldwin Park I Kaiser Permancntcl - Plexifonn neurofibroma (3) Bav Arta - Pltxiform neurofibroma. possibly within a bamartoma (3) Daly Citv (Seton Medical Center) · Plexifonn neurofibroma Fontana <Kajser permanentcl - Plexiform neurofibroma Havwqcd/Frcmont ~ Plexiform neurofibromn Lo Me~o <Orossmont Hospital) · Plcxi IOnn nt urofibroma long BAAth - Plexiform neurotibroma (7) Monterey tCommuojtv HnspitaJ of Montcr~y P£ojnsula) - Plexjfomt neurofibroma Moumajo vie" CEI Camino Pathologv Groun) - Plexifonn neurofibroma Oakland CKaiwr Prnnanenu;) - Plexiform oourofibroma (4) Oramre CUCI Medical Csn~er Reoident<l - Plexiform neurofibroma. right mandibulitr. parotid region Si!C1'3!!1CD!O CUC Davis M¢jca1 Center! - Plexiform oeurofibronu SJyl pjevo <Naynl Medical Cen1erl - Plexiform neurofibroma Silma !larb;lra CSanta Barbaro Coupgc Ho•pito!l - Plexifonn neurolibroma

October 2002

Samo Roso CSnntA Rosa Memorial HospltA)) · Plexitbnn neurofibroma rule out low-grade neurofibrosarcoma ( I); Plcxifoml nturolibroma (2)

Vcpturo CUnjlabl - Amputation ncuromn (2) Alaska (A!ac;ka Native Medical Center> • Plexiform neurofibroma A1askB fAnchocagel - Myxoid nerve sheath tumor Arizona cpbocni:s Memorial Hospital) • Plcxifonn ncuroiibron\il wi1h myxoid degeneration Florid3 (MuJV'OC R£iional Cenrerl . Neurofibroma Florid• <P>thologv Asso<iate1l - Plexiform neurofibroma

8 CTTR. October 2002 '"Min,llts'' (Subscription A)

Florida fWiot¢t Haven Hospital) - Plexiform neurolibroma Indiana (f on Wamel • Plex.ifonn neurofibroma with m):<oid dcgc~ernuon Maryland (Jobn.< Hon!sins Hospital Rcsidrntsl - Plexifonn neurofibroma, p311entlikely 1m neurofibromatosis (I); Plexifonn

neurofibroma (I) Maryland CNatjonsl Na>al Medical Center\ - Plexiform n..'UJ'Ofibrocna (II) M;uyland fNII1 Patbolo•\' Residents) - Plexifonn n<urofibroma MIDland ltlni"l1ilv of Maryland> - Plexiform neurofibroma Masu!(husttLS CBrigJutm ROd Women's ResidentsJFciJo,\sl · Plexifom1 neurofibroma (2) MassachusetlS CNew England Medical Center Residents> · Plexiform neurofihromzt Mjchjggn <Oakwood Hosoitall • Plexifonn neurofibroma Michigan (St Jgscnh Mercy Hospital) · Ple.xiform neurofibroma Ncbruskn CCrcicluon Unjvcrsity School of Medicine Residents) - r,lexifbrm neurofibromatosis New Jersey /Ovcrlopk 1-!ospil• l! - l'lexiform neurofibroma 13): With focol goblet cells ( I) New York Ompnth) · J,lexiform neurofibroma of salivary gland New York <Long Island Jewish MedicaJ Center) · Neurolibrom;•. ple:xifonn 1ypc New Yort fN!!Ssnu Universitv Medical Center> · Nerve sheath myxoma. right mandibular. parmid region New Yorll IS!ony Brook Unive1'Sitv 1-!ospital Residents> - PlcJ<i fonn neurofibroma, rectJ!I'e1lt ( 11)

New Yods CWcslcbtjsttr Medical Ceruer> - Plexiform neurofibroma Oklahoma ITu!:;al - Plexifonn neurofibroma Pennsylvani• <Aikibcnv G<nerat Hosnitall - Plc:xiform neurofibroma Pennsvh•Mia CM¢morial Medical Center> - Ple~form ncurofibromtt Penmylvanja <Shashsjde Hospjtal\ - Plexiform [)('Urofibroma Pueno Rico C\Jnjvrrsjty of Pueoo Rico) - Plexifonn neurofibroma TexiLl (propA!h Secyjce1) - Plexifonn neurofibrom• (I); Plexifom1 neurofibroma (Von Recldinghausen 's) ( I) Texas /Seo!l & White Memodal Hosoitall - Plexiform neurofibroma West y !a:injo (Qregnbder VAlley Medical Center) - Necrotizing Sit\lomet4pltLSin Wisconsjn (Mcriter 1-Jegl!h Services) - Plexiform ncurofibromu AUS!!l!lia CNorth Queensland Pathology) - Myxoid neurotibromo Hong Kong CHonQ Kong Baotist Hospit.ill) - Plexjfonn neurofibroma Ireland lSJ. James Hospital) - Plexiform neurofibrom• Oausr CHamad Mcdjenl Coroomtionl · Plexiform neuroiibroma

Case 5 • Diagnosis: Myxomatous plexiform neurofibroma_ region ofmnndible

T-10180, M-95500

Case S • References: Riccardi VM. Neurofibromatosis_ Past, Prcscnl. and FuiW'e- N Eng/ o[Mrd 1991(18); J24:1283-1285-Mulvihillll, Pllll')' OM, Shonnan Jl, ct at NIH Conference. Neurofibromatosis I (Rookinghausen Disease) and Neurofibromatosis

2 (Bilateral Atoustic-Neurofibrom• tosis) an Upda!e. Anll/lllt m Med 1990: 113(1):39-52. Derckoy S and Selilli M. Plexiform Neurofibroma of the Submondibulor Gl•nd. J Laryngol Oto/2000; 114(8):643-645. Needle MN, Cnoan A_ Dattilo J, ct •t Prognostic Signs in the Stii'Rital Mnnosement of Picxifomt Neurofibromn, l'hc Children's

Hospltol of l' hllodelphia Experience 1974-!994. J l'ctllntr 1997: 13 1(5}:678-682. l'erry A, Roth KA, Jlonerjee R. e1 al. NFI Dele~ious in S-100 l' rotein-Positivc ond Negative Cells o f Sporadic and

Neurofibroma~osis l (NFI )-Associattd Plexiform Neurofibromas ond Malign31u Peripheral Nerve Sheath Tumor!. t lm J Pwlrol 200 I: I 59( I ):57·61.

Case No. 6, Accession No. 29544 October 2002

Bakersfield - Mali@ll>nt mL•ed rumor Bald,. in Part I Kaiwr Pe!!l\!1!1t:ntel - Mucoepidermoid can:inoma (I); Chordoma (I); Low grad< mucoepidermoid carcinoma (I) Bav Arr~ - Mucoepidennoid carcinoma (2); Adenocarcinoma. NOS. possibly epithelial-m}-oepithclial or c•-pleomorphle(l) Fopmnall)ajs<:r P£nnaoemel - Epithelial myoepithelial wc:ioom•

CITR. October 2002 ''MinutH" (Subscription-A) 9

Hayward/Fr-emont • Mucoepidennoid cnrcinoma. low grndt Ln Mesa <Grossmom Hospjtnn ~ Cy5tadenocarcinoma L9uo Beacl1 • Mixed wmor. predominantly myocpilhcliol (7) Montcrev <Communjty Hosoital of Monterey f,eninsula> • Myoepithelioma Mountain View <EI Camino Patholoey Group) • Monomorphic adenoma Oakland C!Caisq P<anl10e!ltel • Pleomorphic adenoma. (2): Malignant mixed rumor (I) Orange NCl M«<ical Center Residenul • Mucoepidennoid can:inoma, neck Sacramento fUC Davjs Mcdjcal Center> • Mucoepldem1oid corcinoma Snn Diego <Naval Medjcpl Ceme() ·Mucoepidermoid carcinoma (S); Pleomorphic adenoma (5); Acinic cell carcinoma (l) Santa Barbara <Sa1"1t4 Barbara CotHige llospjtall • Mucoepidtm1oid carcinoma. poorly dHTcrentiat~d San@ Rosa I Santa Ron Memorial liosili!Ail • Mueo<:pidcnnoid C41Cioolll3 (J ): M~ocpithclial dlreinoma ( 1 1 Vcocwa IUnilabl • Mucoepidennoid carcinoma (2) Alll!ka CA!a.<ka Native M«Jical Center) • Polymorphous low grad< adenocan:inoma Alas%> CAnchornw • Pleomorphic lldenoma Arizona (pho.;njx Memorial HospitAl> ~ Mucoepidem1oid ~u;cinomn Florida CMun& ReGjpnnl Center! • Myo.:pithelioma florida (J>athologv ASsociates\ • Myocpich<lioma florid:! £Winter Haxcn llospitaJl • Mixro rumor indiana <Fon Wayne> • Adenocarcinom1. fcfl neck Marvland (Johns Hopkins llosoital Residcmsl · Mucaepidennoid carcinoma ( I): Chordoma (I) Mruyland {National Naval Medical Center) - Acinic cell carcinoma (7): .A.deno)qUliHIOUS carcinoma (~)~ ~·luco<:pidcrmoid

careinoma (2); Carcinoma. NOS ( I) Maryland fNJH Pathology Rqjdenul - Mucoepidermoid card noma, low grade M11J!Ionc! fllniveRitv ofMarvlar.j! - Adenom)oepithelioma Massachuse!!S fBri•ham and Wornen'< Residents/Fellows) • Myoepith<!lioma (2) MA3sachuseus CNew England Medical Cc:ntcr Residentsl • Adenocarcinoma with myoepitheliaJ diffcren1iatioo Michigarl COaJcwood Hospjtall - MuC.otj)idemloid carcinoma. low grode Michigan CSt. Jos,ph Mercy Hospital) • Mucoepide.nnoid carcinomn Nebraska ICrci!lbcon llnjversin• School of Medicine Residents) • Mucoepidermoid carcinoma New Jersev (Qvq!oc>k llosoitlll • BcniJIJl mixed rumor (1); ConsiS!cnt "ich epidermoid metapla5ia (I): ? myoepithelioma ( 1) New York l lmoathl • Myoepithelioma (of salivary gland) New York fLong ls!qnd Jewish Mediql Center) - Myoepithelial neoplasm. uncertain malignant potentf:tl N'w YorkCNassau Unjycrsit>' Medical Cemcr) - Mucoepidermoid carcinoma,lell neck New York CStony Brpok UnjversilV Hospital RcsideniS) • Mucoepidermoid carcinollla, intem1edia1e grade ( 12) New York CWe.stchestq Medical CenLerl - Adenocarcinoma. NOS vs. acinic cell carcinoma Qklaboma crutsal · Pl<'OillOrphi<> adenom.1 Pennsy!yania CA11cgbeny General Hosn.Uil) .. Acinic cell carcinoma Pennsylvania CMemoriPI Medical Cemtcl • Polymorphous low grade adenocarcinoma (' cnnsylvania CShndysjde Hosp1ttd) • l.ow grade adenocarcinoma. NOS P:ueno Rico <UniYcrsity of J)uerto Ric9> • Mucoepidermoid carcinoma Texas CPropa!lt Scryjcesl • Mutotpidennoid carcinom• ( I) Mueo<:pidermoid Cllrclnoma high grade ( I ) Icxas ISco<t & White Memorial Hospical\ • Cellular mixed rumor Wnt Vinrinia <Greenbrier Valfev Medicql Csoter) - Synovial s.:arcoma Wisconsin <Meritcr Health Sen•icesl .. Myoepithelioma Australia (North Ouesm:tland Pathology) - Mucoepidemloid carcinoma; OiffDx: l>olymorphous low grade adenocarcinoma Hong Kong <Hong Kong Baptist Hospital\ • Mucoepidermoid CBreinoma trslaod lSL James Hwpitall - Mucoepidermoid carcinoma O.w <Hamad Medical Comonnjon) • Pleomorphi< adenoma

C••e 6 • Oiagnosi" Low grade malignant myoepithelioma (myoepithelial carcinoma). 11tck

'J'. Y0600. M-89820

Consultation: Mia Perez M.D .. Lorna Linda. "Low grade malignaru my~pithclioma."

10 CTTR. October 2002 •Minutes· (Sobscnpllon A)

Case 6- Rs;fcrenccs: EI-Naggar A. Ootsoltis JO, l.uno IIIlA. « al. DNA Content and Prolifcrnti'o Acuvity or Myoepitheliomas. J Laryrrgol Oto/1989:

103:1192-1197. Dardiek I, Cavell S. Boivin M, et al. Salivat) Oland -.tyoepilh<lioma Valiants. Histologkal. UltnlSlructur.d and lmmunOC>tolocic

Feauws. Vlrcho>o-s Arch A Pothol Anat Histopat/1011989: 416(1 ):25-12. Takeda Y. Malignant Myoepithelioma of Minor Salivary Oland Origln. Acta Pathol Jpn 1992; ~2(7):518-522. Prasad AR, Sa vern AT. Gown AM. et al. The Myoopithcliallmntunoph<IIOlype in 135 Benign and Malignant SaliVllry Olond

Tumors Other Than Pleomorphic Adenoma. Arch Pathol Lob Mod 1999; 123(9):801-806. Savcra AT, Slo•nan A. Huvos AG, et al. Myoepithelial Can:inomn oft he Salivary Glands. A Clinicopathologic Stud)• of 2S Patients.

AmJ Surg P(llho/2000; 24(6):761 -774.

Cnsc No. 7, Accession No. 29443 October 2002

Bakerstjeld • tnnam.matory pscudotumor vs. dermoid fibromato:.is Baldwin Pork Cllaiser Pcnnancntc) · lnBammatory pseudotumor (3) Bay Area ·Adenocarcinoma of the lacrimal gland (3) Dllly City !$cton Medic•l Centerl - Inflammatory pseudotumor doubt am) loid Fon!MA CKajsrr P<nnonentel - lnllammator) pseudo<umor Haywar!l!ftt!DO!lt • Hairy cell leukemia (I): Pseudo<Umor (I); M~cloma (I) La Mesa CGrwsmorn Hosoitall - Inflammatory pswdotumor (would also do am~ loid ~tain 10 nde out th:Jt po~sibilit~t l.ong Beach • lnllamm31or)' pseudorumor (7) Monterey <CommunitY Homital of Monterey Peninsula) · Eccrine e:m:inomn ( 1 t Plasmat)1oid MALTom3 \\ 11h am~ loid (I} Mountain Yiew !Iii Camjno Pathologv Group) - lnOanunatory p$cudotumor Oaldwtd IKgjser PerroancoU:l · Amyloid (3): Orbital pscudotumor (I) Orange llJC' ! MedicAl Center Residents) - Inflammatory pscudOIUnlOr, :tclerosing lype, eye Sacramento l lJC Qavjs Medjeal eemerl - ln!laml)latary pseudotumor (5); Lymphoma (5) San l)ieao CNnynl Medical Cemer> - Lnflammatory pscudotumor SanJ1l Qgrbuna (Sonia Bnrbara CoHagc HospitaiJ - Idiopathic orbitnl i1lflnmmatory (pscudotumor) Sanl• Roso !Soma Rosa Memoriol Hospital) - Plasma cell dyscntsia with amyloid { I): Orbital inflammatory pseudo tumor ( I).

Inflammatory pseudotumor of orbit (!) Ventura CUni!ab) - Inflammatory pseudorumor (2) Alas!g !Alaska Nujve Medical Cemerl - Inflammatory pseudotumor Alask.a C!lnchora&:tl - Amyloid nodule ArizQ!!l! ll'hocpix Memorial HospjJ.all · Sclerosing large cell lymphoma Florida CMunros: Regjonol Center) - Inflammatory pseudo<umor Flori® IPalho!ooy ASsocjrue(l · Inflammatory pscudorumor Florida CWjmer li•ven HMnjJ!ll) • Idiopathic sclerosing inflwnmatory orbital p<eudotumor lndjana lEon Wrwnel ~ Fibrous pscudotumor. right orbit Mnrvland Uohns !iopkjos Hospital Residents) • Inflammatory pscudotumor, rule out Graves disease (I); Orbitol pseudotumor ( l ) Mary!!l!ld <Natjoonl Navol Medical Cemcr\ - lnflanuna!Qry pseudoturnor ( I I) Marvland <NIH Pmhologv Rl>.Sidcnls) • Favor plasmacytoma, rul~ (lUI muhiple myeloma Maryland (Uojvcrsity of Maryland) • Idiopathic orbital inflonunaliOn, innummatory pseudotumor M1wacltuS(tlS (Bcjghmn and \Vomen)s Residenulfellows) • Inflammatory pseudotumor, spectrum of lMT? (l)~ lntlamnuuory

pseudoturnor ( I) Massac:huu:ns CN{'"' Engl~tnd Medical Center Resjdsmsl - [nJlrunmatory pscudonu'llor Michigon COok)lood llosllim.l) - Inflammatory pscudotumor Michigan CSt Josenb Mea;v Hosl!iJ!ll.l - Inflammatory myofobroblastic pseudotumor Neinsba CCrcjlllnon University School or Medicine Residencsl - Martina! cell lymphoma New Jrory CO,:crlool. !losoicall · Inflammatory pseudotumor (2): Sjog,tn's s)ndromc (I) New Yod< llmDAth) - Inflammatory pseudo<umor of orbit New Yod< !Lono Island Jewish Medical Center\ - Sclerosing idiopathic orbit inflammation, pseudorumor New York (Nft§t!lu Universitv Medica) Cente.rl - Hyalinized angiofibroma. right eye

CTTR.. October 2002 "'Minutes .. (Subscription A) I I

New yons CStonv Brook UnjVl'ajrv Hosnital ResidcQ!SI • Idiopathic sclerosing in0•mm31ion ofr!lt orbil (12) Ne"' yons {Wesrc.bes~er Mes!jeol Cenr<rl · lnfiamma!C><Y pscudotumor '"· lo" grade MALT l)mphorno Oklohoma <Tulsnl · Pscudorumor. idiopa!hic orbiral lnOammauon P<;onsy!yania <Allegheny Oeneml Hospital) • lnllnmmotory pscudotumor, inrlrtnmultory myofibroblsslic tumor Pennsylvania <Memorial Medical Center) ~ Orbiutl )>Studotumor Pennsylvania (ShadYSide 1-!ospjrol) • Angiofollicnlar hyperplasia (Ctls!leman'o disease) Pueno Rico <Universitv of Pueno Rico) . Inflan1matory pseudotumor Tew fi'Topa!b Services! • l..ympha<!pithelioma (I); Malignan! l)mphoepitheliallesion (I) Jsw CSeou & White Memorial Hospjtall • lnfiamrnorory pscudotumor West Virginia <Greenbrier Volley Medical Center) · Orbital inflammatol') ps"udotumor Wjsconsin CMeriter Heahh Servjccsl - Inflammatory p~cudotumor or orbit Austmlia CNorth Oueenslnnd Pmhology) - JnflttntmaJory pseudotumor of orbil Hong Kong <Hong Kong BBntisi Hospital> - Solitary fibrous twnor of orbit lrelaod CSt James Ho<oi!llll • lnOammarory pseudo!umor (consider Castleman'< lymphoma) Qatar <Hamad Mec!ical Comor•rion) • lnOammarory p..,udotun;wr

Case 7 • . Diagnosis: Idiopathic orbilal sclcrosinl?, inJl:lllunnrory pseudo rumor. righr C)C

T-XXOIO. M-03090

Cm;c 7 · References: Mombacns I. Goldschmedillg It Schlingemann RO and KoomncefL. WI'"' is Orbirol l'seudorumor'1 Suf\• Optholmol 1996:

41 (1):66-78. Nul.'""' RA. Inflammatory Pseudo<umor ofOrbiL Cli• Rat/1111 1992; 46(2): 148 Momba<rtS I. Goldscbmedina R. Scblingemann RO. era!. Idiopathic Gmnulom01ous Orbitallnllamm31ion. OphrlwlmolDgJ• 1996;

103( 12):2135-214 f. D<hn<r LP ond Collin CM. Idiopathic Fibroscleroric Disorders and Other lnOamrnJ!OrY Pseudotumoa. S<·min Di"J(" Potl:ol I 998:

15(2): 161-173. Uy HS, Nguyer QD, ;\ ri)our J, cr al. Sclerosing lnOanunutory PseudoHlmor of the Eye. ,{rch Ophtlw/mo/20(1 1; 119(4):603-6{)7.

Case No. 8, Acce.~sion No. 2 77-tO

BqkcQfic!d . Hemangioperit)1oma Boldwin Park <Kajser Permaocmcl · Solirary Rbrous tumor (3)

!lay Area · Solirary fibrous tumor (3) Only City (SciOn Me!ljcal Center) • Solirary librous rumor Fomana (Kaiser Permaneme) - Solitary fibrous Lumor HaVl!'ll!'dlfremon! · Soliwy fibrous !umor L.a Mesa <Grossmont l!O<nitall • Soliwy fibrous rumor Long Brnch • Solirary fibroos rumor (7) Moou;rev (Communitv Hospital of Monterey Pcnjnsult!} • Solitary fibrous tumor Mountpjo View <EI Camino l'atlw}Q~y Grouo) • Soliuuy fibrous tumor Ooklnod CKalser Permanclllt) • Sqli1.1ry fibrous !um<ir (4) Orqmrs NCI Medical Center Besjdents) · Solitary fJbrou~ lumor .. nasal cavil)' Socramen!o OJC Davis M£di<ol Crnrerl • Hemant:ioperic}tosna (5); Solirary fibrous rumor (5) San pjego Qia!lj!l Medical Cema> . Soliwy fibrous tumor Sima Ba!bara (San!ll Barbm Couose tlgspitall • Solirary fibrous tumor

October 2002

Samn Ro:HJ <SanJ!I Rosa Memorial Hospirall · Hemangiocodo!beliom• (2); Hemangioperieytoma-likc rumor of nasal passages ( 1)

Yemura CUnilabl · Sioonasol hcmangioperiC}1oma (2) Alaskp (Alaska Naliv< Medico! Cemcr) · Kllj)osi's sarcoma AlR~kn li\nchoraL>el · Solilary flbrous tumor Arizona CPhoenix Memorial Ho,nitall · Solitary fibrous tumor florida !Munroe Regiooal C<oterl • Remangioptri()1oma

12 CTrR. Oclobt:r 2002 "'Minutcs'" (Subscription A)

Aorida CPatbolosy Associotesl • Solitary fibroma Florida CWjntcr lla\'(Q Hosoit31> .. Syno\iat s.arcoma Indiana <Eon Wayne) • Solitnr) fibrous tumor. nasal ca,it) Marvland <JobQ.1 Honkins Hospital Residents) · fa,;or sinon.ua.J htma.naiopcricytoma vs. solituy fibrous tumor. thiS distinction may

be someY.hat anif~<:ial (I): Solitary fibrous rumor(!) Maryland <NationAl Nayal M<djcal Center! · Solitary fibrous tumor(8): Hemangioperit~1oma (4)

Maryland (NIH PA!boloey R.:sjden!Sl · Hemaogiopericytoma MaO'! and CUojversjJy of Maryland\ .. Solitary fibrous tumor

Massachuscl!s <Bri!!hqm and Women's Residents/Fellows) • Solitary fibrous tumor {2)

M3Ssachusens <New Encland Medical Center Residents) • liemooaiop<ricytoma tvfichigon COpkwood Hospital) · Solitary fibrous tlllllOt

Michigan (St. Jo:;smh Mercy Hosoitall . Solitary fibrous tult)or Nebmska CCrojwhton Univcrsitv School ofMedjcine H.esidtmtst .. Knr>Osi's snrcoma New Jersey (Ovsr!ook tlaspirnll - Solitary fibrous tumor New York C!mpathl • Solito.ry fibrol1~ tumor New York Cl.pos !sbod Jewish Medical Center) - Solitliry fibrous tumor New York CNassau Uojversil\ Medica) Ceptql - HemangJopcricytoma. nilsal C3VIl)

New York CSaooy llrpok Uoivenjry Hospjtal Rcsidcmsl - Sotitat) fibrous tumor New York CWe:uch¢$ter Medjcal Center) - Solilar) fiblous tumor Oklahoma Cfultal • Solitary fibrous tumor Peonsy!vanjo !Allegheny Gene[JII Hospital) · SolitarY fibrous tumo< Perwylvanja CMtmorial Medie3l Center) · Solitary fibrou.'i tumor Peoosylyanja fShady•id< Hospital\ • Solitary fibrous tumor Puerto Rjco OJnjvcrsjt'' of Puerto Rico) .. Solitary fibrous rumor Tex!l.l CProoo!h Seryjcr:.sl • Hemangioendothelioma (1): KAposi's hemnn&iocndothelioma (I) Texas CScou & White Memorial HospitaJl - Solitary fibrous tumor West Virginid ((jrecnbrigr V3llev Medical Center> - Neurilemmomn Wisconsin (Mcrjtcr Health Services> • Solitary fibrous 1urnor Australia <Nonh Ouecns1and Pathology) - Solitary fibrou) tumor Hong Kong <Hong Kong Bamist Hospital) - Angiofibroma Ireland /St. J3ffiS$ HOl!llim!l • SotiL'ry fibrous tumor O;:~tar <Hnmtld Medjca! Comoouionl - Hemangioendolhclioma. spmdle cell varlllnt

C!L!e 8- Oiagno,i<: Solitary fibrous tumor, nasal cavity

T-21340, M-80001

Case 8 -References: Good lad JR ond Fletcher CD. Solitary Fibrous Tumors l\ri$ing in Unu<ual Sites. A•talysis of a Series. lfistopmho/ 1991: 19(6):5 IS·

522. Wlkin GB nod llosai J. Solitnry Fibrous Tumors of the Upper Respiratory Troct. A Repon of Six Cases. Am J. Surg J'atlro/1991;

15(9):842-848. HMau C ond Micttinen tvL Solitary Fibrous Tumor. Histu!ogiettlnnd !nunw>qhlsto-:hemical Spcetmm ofBcni&'ll and Mollgonnt

Voriants Presenting at Different Sites. Hum Par/w/ 1995; 26(4):440-449. Kim TA, Brunber~ JA, !'carson P and Ross DA. Solitary Fibrous Tumor of the Par3o•asal Sinuses. C'r and M R Appearon<:c. AJNR

Am J Neur(){'adlo/1996: 17(9): 1762·1772.

Case No. 9, Accession No. 28993 October 2002

Bakersfield • Cylindrieal cell can:inoma Baldwin pj!!!s !Kaj!C£ PermaornJel · Jn,"<rt<d squamous papillomo (I); Sc:hneiderian (io''<ft<dl papilloma (2)

Bav Area • ln"en<d papilloma (3) Qa!x.Qty ISeron Medical Cemerl - Squamous cell carcinoma in-•itu Fontana <Kajscr l'ermaneme> - lnvened papilloma

Cit'R, Oc1obcr 2002 '"Minule.$,. (Subscriptioo A} 13

Havward/Frcll)C~nt - lnve-ned sinonasal papilloma La Mesa <Grossmont Hospital> -- lnvcrted papillom~ Long Beac.h • lnvened ~pilloma with focal dysplasia (7) M.Qmerev <Community HosPital of 1\•lonterev "Peninsula> · lnve~:;led papilloma Mountain View CEI Camjoo Pathology Grouo) • Papillary Squamous cc!J carcinoma vs. Schneiderian papilloma with dysplasia Oakland (Kajser Permancntcl · lnvcned Schneiderian squamous papilloma (3) With dysplasia ( l)

Orange fUCI M~dical Center Residents> - Inverted ~pi !lorna, nasal fossa Sacramento {UC pavis Medical Center} · lovert.ed papil loma with focal. areas of suspicious invasion San Diego (Naval Medical Center) • lovcrtc:d Schneiderian papilloma Santa Barbara <Santa Barbara Conage Hospital) • lnvcrted r1asal papilloma Santa Rosa fSanta Rosa Memorial Hospital) - Inverting papilloma_(!); Inverting sinonasal papilloma (2) yemura fUnilabl · lnve~ed Schneiderian papilloma· (2) Ala.::ka (Alaska Nativ~. Medjcal Center) .. Inverted St hneidcrian papilloma wilh dysplasia ~ka (Anchorage) . Papillary squamous cell carcinoma Ariz.ona £Phoenix Memorial Hospjt.aB - Squamous carcinoma in:situ in -squamous papilloma Florida {Munroe Regional Center} - Inverted papilloma with malignant transfonnation Florida (l'athologv Associates) · ~wetted 1~1pilloma with moderate dysplasia Florida CWinter Haven-Hospi,a1l · Squamous cell carcinoma in-situ !JWJula<f'on Wayne) • lnvened papi lloma, nasal fossa MaryJand (Johns Hopkins Hospital Residemsl - Schneiderian papilloma. inverted cype with carcinoma in·Situ ( l l: Inverted

papilloma (!) f'wfar.dand {Nutionnl Naval Medical Centerl .. Inverted papilloma (8): Tnmsi1ional-carcinoma en~ Carcinoma. arising in inverted

papilloma (2) l):laNiand INlH Pathologv Residents) · Inverted papilloma Maryland (University of MnryJi!ndl · Papilloma with sq~amous cell carcinoma in-situ Massachusetts <Brigham and Women's Resjdents/Eellows) . Inverted Scllneidcrian papilloma (I); lnvcried papilloma witb dysplasia

( I) Massachusetts <New England Mectical Center ResidtnJ§) · Scbneiderian papilloma, inverted Michi~an (OakWQQd Hospital) • Inverted papilloma Michigan 1St, Joscp~ lldecyy Hospital> • Papillary squamous carcinoma Nebraska <Creighton Unjversil)' School of Medicine Residents) · Schnciderinn papilloma New Jersey(Ovcrlook Hospj!l\ll - S<:hneiderian (invened) papilloma (3) Consistent with squamou~ cel! carcinoma in-situ ( I) New York Clmpathl • Inverted Schneiderian papilloma New Yorl< ILong Island Jewish Mcdjcal Center) . Inverted papilloma "t:~ew york {Nassau University Medical Ce-nte.r> - Carcinoma ofthe sinonasal trttc(. nasal fossa New Ygrk (Stony Brook University Hospjtal ResidentS) - Inverted sinonasal papilloma with severe dysplasia Ne"' York /Westchester Medical C(Snterl - lnvened papilloma consistent with dysplasia and CIS Oklahoma (Tulsa) • Inverted Schneiderian papilloma ecnnsylvania (Allegheny General Hosoiu1ll - Papillat)• carcinoma Pennsvlvania CM{mMial Medical Center) • Papillary c-arcinoma, nasal fossa Pennsylvania <Shadyside Hospital> • lnvened papilloma with focal ulcerotion Pueno Rico CUnivsrSity of Pueno Ricol .. Inverted papilloma Texas <PrOJ)ath Seaicesl · Invasive squamous cell carcinoma (l) invasive s.qlaamous c~'\rcinoma with papillomatous pattern ( I) Texas ISc.ott & Whi!~~morial Hospital) • Cardnoma arising in a S<:hneidelian papilloma West Virginia (Greenbrier V9!1ev Medical Center) • Schneidcrian papilloma Wisconsin <Meritcr Health Seryjcy.5> - -lnvened papiUoma with atypia Australia (Nonh Queensland Pa!bologyl - lovened Schneiderian ~pil!oma

I:Jllng Kong !Hong Kong Baptist !iospjJ!!I) - Sinonasal papilloma with atypia Ireland <St. James Hospitall · Nasal inverted papilloma Oatar <Hamad Medical Corooration) - inverted papillonla

Cruc 9 . Diagnosis:

t4

Inverted Schneiderian papilloma. maxillary sinus T-22!00, M-81 210

CITR, October 2002 "Minutes·· (Subscrip;ioo A)

Case 9- RcfeDlnces: Buchwald C. Frnnzmann MB. Jacobsen GK WJd Lindcbo:rg H. Hwnan Poptlloma> irus (HPV) in Sinonosal Poplllomos. A Study of

78 Cos .. Using In· Shu Hybridization a.'ld Polymerase Chatn RcoctJOn. l.ory11go.scope 1995: 105(1):66-71 . Michaels L Wid Young H. llislOgenesis of Papillomas of lhe Nose and Paran.ual Sinuses. . .frch Patholl.ob MeJ 1995: 119(9):821-

826. Ridolfi Rl.. Uebo:nnan PH. Erlandson RA and Mao<e OS. Schneidtrian Papillomas. A Clinicopathologic Stud) of 30 Cases. Am J

Surg Patlw/1917: 1(1):43-53. Califano ]. Koch W, Sidmnsky D, et a!. Inverted Sinono.sal Papilloma. A MolcculaT Genetic Appraisal of iiS l'utatlve Status as a

l'recuTSor to S<luamous C.: II Carcinoma. Am J Pat!tol 2000; I 56(1):333-337. Klimek T, Allli 1::, Schubo:n M. et al. Inverted Papilloma of the Nml Covit)' and ~aranasal Sinuses. Clinical Data. Surgieol Stmcg)'

Md Recurrence llotcs. Acta Orolal')1!gol 2000: 120(2):267-272.

Case No. 1 0, Accession No. 29348 October 2002

BakfaGe!d • Worthin's wmor Baldwjn Pad; <Kaiser rc:nnnnente) · Warthin's tumor (3) Bay Ao:a -Cystic oncocytoma with a lymphoid infiltnlte (Wanhin-like) (2). Oncoc)1oid '-.riant ofWanhin's twnor ( I) Daly Cjty !Seton M!;dical C<ntcrl - \Vanhin's rumor Fontana <Koisr PermaD£ntrl • \Varthin's tumor Hayward{Fremon• . Wanhin's 1.umor La Mesa CGrossmont Hosnitall - ~1oma "'ith lymphoid inliltr>.t< Long Beach - Wanhin's tumor (solid variant) (7) Monterey CCpmmyniLy HosPital of Monterey Peninsula) - Wat1hin 4 s tumor Mountain Yie>v (6! Camino Pathology Group> - Wanhin's tumor Oakland CKqjs&:r Pconanentel - Warthin's tumor (4) Orange <UC! Mc;d!CAI Center Residents) - Warthin's tumor Sacramento lUC pqvi:t Medical Cemer> - Wanhin's IUrnor (5)~ Oncoc)'1omn (5) San Diego CNayn! Medjcal Center> - Wanhin's tumor S@nta Barham CSamg Uarban! Cotm~pitall - Wanhln'stumor Santa Rosa <Sgot.a Rosa Memorial Hospital) - Wanhin's tumor (l) veO!U@ (\lnilabl • 0nCOC)10ma with tumOr-associated lymphoid proltftrnti()O (2) Alaska <Aieskn Nath·e MesJjqJ Cemerl · Warthin's tumor

Alaska fAnchora!!el • \Vanhin'stumor Ari¥001 Cfbqsnjx Memorial Hospitall - Warthin's twnor Florida !Munms; Recional Center) - \Vanhin's rumor Florida CPalhoJogy Associates) - Warthin's tumor~ oncocytoma Florida !Wjmer Jio,'<n llospitall - Oncot)10ma

Indiana Cfoo Wayne) - Wsrthin"s tumor. parotid Marylond (Johns llonkin< Hospital Residents) - Wanhin's tumor (2) Maryland {NaJjonol Nnvnl Medical Center) - Wanhin 's tumor {9): Oncocytoma (2) Man• land (NIH PAtholnsy Residents) - Wanhin 's tumor Marvland ClJnjyersjtv ofMnrvlandl - Warthin's tumor Massac.husenll (flr!shQIU ond Women's R~i<!eous,(Fellowsl - 1 variant of Wanhin's tumor ( I): Oneocytic adcnom.Vvariom oF

Wnnhin's tumor (I) Massachusetts CNew Englar1d ~tedical Center Residents) - WBtthin's UJmOr Mjcbiggn COqkwood Hosoitall - Oncocytoma Michigan !SJ. Jownh Mercy Hospital) - \Vanhin · s tumor Ncbrnska CCrsjghton Uoi\'Crsitv School of Medicine R~identsl • 0ncoe)10fn3 New Jcne> !Overlook tlospital) • Wanhin's rumor Now Yods Umoathl - \Vanhin'stwnor New Voris CLAng Island Jewish Medical Center) · Wanhin's tumor New Ymk <NMmy Universilv Medical Center> - Oncocy1oma, len parotid gland

C'T1'R, Oclobrr 2002 "Minutes" (Subscripoion A) I l

New Vork!Ston\ Brpok Uni..,·ersjlv Hcneitpl Residcms) - Wanhin·s tumor New york (Westch~ter Medical Cl!nterl • Oncocytoma with lymphoid strom~Wanhin"s rumor Oklnbomn /Tulsa\ • Worthin's tumor PCJmsylvania (Allegheny GeneraJ HospitnD • Wanhin's tumor Pennsylvania <Memorial Medical Ccmer) • Wanhin"s rumor l'enmrlvanja !Shadysj!k Hospitall • Oncoc)loma v.ith reacoh'l: lymphoid h~'J'<rphulo Pumo Rico CUnhrersity of Pueno Ricol • Wanttin's rumor I cKM (Prooaoh Seryjcc3\ · Warohin's tumor (2) Texg.s (Scott & \Vhjro Memorial Hospjtall · Oncocytonm West Virginia <Greenbrier Vallev Medjcpl Center) · OncocytOnlB Wjsconsin l1yferiter1Jeallh Services) · Oncocytoma involvinQ lymph node vs. Wanhm's tumor

AuS!rolia &onh ()uscmland Palhology) • Wanhln's nnnor, >ll'Oma poor type Hong Kong fHong Kong Bamist HospiYI!) • Wanhin"s tumor

!relond <So. James HQSQjlllll • Wanhin's lumor Oatarfllamad Medicnl Corporation) • Warthin's tumor

Case I 0. Diagnn~b: Warthin's 1umor. parooid gland

T-55100, M-85610

Cnse I 0 · References: Pinkston JA and Cole?. Incidence Rates or Salivury Gland Tumors. Results from o f•opuhulon·Based S1ud~. Ololarngollh:ud

Neck Surg 1999: 120(6):834·840. Yu OY. Liu XB, Li ZL and Peng X. Smokin~ and ohe DeYelopmeno ofWarohin's I umour oflhe Parooid Olond. Br J Oral

MaxillofocSwg 1998: J6(J}: J83-18S. Aauirre JM, Echebarria MA. Martin•l·Condo R. e1 al. Wanhin Twnor. A Ne" H) poohe<is Concerning ios Dc,-.:Jopmen!. Oral Surg

Oral Med Oral Pathol Oral Radio! Endod 1998: 85( I ):60-6). Gallo 0 . Is Worthin's Tumor an Epstein Barr Virus Relaoed Oisca.s.:? fm J Cancer 1994; 58(5):756· 757.

16 CTTR. ()c;,:)ber 2002 .. Mlnutts .. (SubJ(nptiOn A)