--""' •

CALIFORNIA TUMOR TISSUE REGISTRY

"TUMORS OF THE KIDNEY & BLADDER"

Study Cases, Subscription A

February 2007

California Tumor Tissue Registry c/o: DepartlDent of Pathology and BWDan Anatomy

Loma Linda University Scllool of Medicine llOll Campus Avenue, AH 33S LolDa Linda, California 92350

(909) 558-4788 FAJC: (909)55~188

E-mail: ct!!@linldine.com

2

Target audieac:e: Practicing palhologjSIS and pathology residents.

Goal: To acquaint lhc participant wilh lhe.histologjc features of a variety of benign and

malignant ncoplosm8 and 'tumor-like conditions.

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

and malignant neoplasms and tumor-like conditions and relate lhose proeesses to pertinent refereoces in lhe medicalliteTature.

Edut2tional methods and media: Review of representative glass slides wilh associated histories. Feedback on consensus diagnoses tiom participating palhologists. Listing of selected references from lhe medical litcmrture.

Principal faculty: Donald R. Chase, MD

CMECredit: Lorna Linda University School of Medicine designates this continuing medical

education activity for up to 2 hows of Category I oflhe Physician's Recognition A ward of the American Medical Association.

CME credit is offered for lhe subscription year only.

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

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

Study Cases, February 2007, Subseription A

Contributor: Carol Solomon, M.D. Case No. 1 - February 2007 A San Diego, CA

Tissue from: Urinary Bladder Accession #30272

Clinical Abstract: A 57 year old man presented with a six month history of intermittent hematuria. Cystoscopy

showed a large tumor within the bladder.

Gross Pathology: The 15.5 x 13.7 x 9.5 em bladder was filled by an 8.0 x 4.3 x 3.7 em fungating papillary tan­

pink mass, circumferentially adherent to the lower two-thirds of the posterior and anterior bladder walls. ·

Contributor: Lorna Linda Pathology Group (np) Loma Linda, CA

Tissue from: Urinary Bladder

Clinical Abstract:

Case No. 2 - February 2007 A

Accession #30203

This 83 year old man presented with gross painless hematuria. He had no elevation of his PSA. Cystoscopy showed a large tumor within the urinary bladder.

Gross Pathology: The specimen consisted of an 8 x 6 x 1.5 em aggregate of transurethrally removed tumor chips.

Study Coses, February 2007, Subscription A 3

Contributor: Lester Thompson, M.D. Case No.3 - February 2007 A Woodland Hills, CA

Tissne from: Urinary Bladder Ac:cession #30250

Clinic:al Abstract: This 32 year old woman presented with vague lower abdominal pain, associated with a history

of urinary tract infection. Antibiotics failed to resolve the symptoms and urinalysis showed microscopic hematuria. Colonoscopy was normal and intraoperative evaluation of ovaries, uterus and appendix showed no abnormalities.

Gross Pathology: Not available.

Contributor: Mark Janssen, M.D. Case No. 4 - February 2007 A Anaheim, CA

Tissue from: Right kidney Accession #30147

Clinic:al Abstrac:t: After two months of worsening right flank pain, this 73 year old woman was found on cr scan

to have a right renal mass. She had had no hematuria or weight loss.

Gross Pathology: The kidney resection specimen was received in fragments. In addition to grossly apparent renal

parenchyma, several of the pieces, ranging from 2.7 to 3.2 em in greatest diameter, bad flOD tan-white cut surfaces. Other fragments were largely fatty and yellow.

Special Studies: Tumor cells positive: Tumor cells negative:

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vimentin, smooth muscle actin, muscle specific actin, desmin, HMB45 pankeratin

SIUdy Cases, February 2007. Subscription A

• q

Contributor: Jin Wang, M.D. Case No.5 - Februa.ry 2007 A Bangzhou, People's Republic of China

Tissue from: Right kidney Accession #30115

Clinical Abstract: A 35 year old woman presented with vague pain in the right lumbar region and a 20 day history

of low grade fever. Work-up found a right kidney mass.

Gross Pathology: The kidney resection specimen was 14 x 8 x 8 em and contained a 9 x 7 em well-defined mass

in the lower pole. The cut surface was variable, ranging from gray, to pink-tan to dark red. There was extensive necrosis.

Special Studies: Strongly positive: Focally positive: Negative:

Desmin, SMA, vimentin Actin Cytokeratin, EMA, MyoD-1

Contributor: Anne Drejet, M.D. Santa Barbara. CA

Tissue from: Kidney

Clinical Abstract:

Case No. 6 - February 2007 A

Accession #30289

A 58 year old woman was found to have cystic masses involving the right kidney and adrenal gland.

Gross Pathology: Not available.

Study Cases, Fcbtuary 2fXrl, Subscription A 5

Contributor. MKlbele Cosgrove, M.D. Case No. 7 - February 2007 A Glendale, CA

Tissue from: Left Kidney Accession #30364

Clinical Abstract: Follow up of a 51 year old diabetic man in renal failure revealed a mass in his left kidney.

Gross Patl10logy: In the mid portion of the 190 gram kidn.ey was a 4.3 x 4.0 x 3.0 em well-circumscnl>ed hard

pale tan mass.

Special Studies: Positive: CD99, CD34, Vimentin Negative: AE I I AE3, CD 117, Desmin, actin

Contributor: Anne Drejet, M.D. Case No. 8 - February 2007 A Santa Barbara, CA

Tissue from: Kidney Accession #30290

Clinical Abstract: A 41 year old woman had a right kidney mass.

Gross Pathology: The right kidney resection specimen with perinephric fat was 1210 grams. It was distorted by a

14 x 12 x 10 em tumor which left a thin rim of kidney at one pole. The tumor penetrated the renal capsule, extending into surrounding fat. The cut surface was lobulated dense white parenchyma with focal yellow necrosis.

Special Studies: Positive: Negative:

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CD99, vimentin, SMA (focal), CDlO CK-7, CK-20, CAM52, EMA, Ber-EP4, myo-01, CD56, HMB-45, FLI-1, S-100, desmin, CD23, CD I17, Estrogen & Progesterone receptors

Study Cases, February 2007, Subscription A

Contributor: Phillip Gordon, M.D. Case No.9 - February 2007 A Winter Haven, FL

Tissue from: Left kidney Accession #30185

Clinical Abstract: A 69 year old woman had a left renal mass.

Gross Pathology: The 244 gram resection specimen included a 2.5 x 2.3 x 1.5 em fleshy dark red-brown mass in

the upper pole of the kidney, filling one of the calyces. The mass was diffusely hemorrhagic, weU encapsulated and confined to the kidney.

Contributor: Dawn Ellerson, M.D. Case No. 10 - February 2007 A San Luis Obispo, CA

Tissue from: Kidney Accession #30233

Clinical Abstract: An 86 year old woman presented with hematuria. Imaging studies showed a right renal pelvic

mass involving the collecting system extending into the mid portion of the kidney.

Gross Pathology: The 284 gram kidney contained aS x 4 x 3.5 em ill-defmed infiltrating mass that extended

nearly to the renal capsule.

Srudy Cases, February 2007, Subscription A 7

CALIFORNIA TUMOR TISSUE REGISTRY

TUMORS OF THE KIDNEY AND BLADDER PATHOLOGY

Minutes - Subscription A

February, 2007

S UGGESTED READING (General Topics from Recent Literature):

Lymphoma Is the Most Common Malignancy of the Ocular Adnexa. Feny JA, Fung CY, et al. JmJ Surg PaJhol 2007; 31:170-184.

Women More Likely to Have New or Missed CRC After Colonoscopy. Bressler B, Paszat LF, et al. GasJroenJerol 2007; 132:96-102.

Mammaglobin Is o Specific Marker for Breast Cancer. Sosaki E, Tsunoda N, et al. Mod Patlto/2006; 22. TLEI Is a Sensitive & Specific Marker for Synovial Sarcomas. Terry J, Saito T, et al. Am J Surg Patho/2007; 31:240·

246. Clear Cell Sarcoma. Clinical Featu=, Therapy, & Prognosis. Kawai A, Hosono A, et al. Cancer2007; 109:109·116.

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

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

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

E-mai l: c!!r@linkline.com Web site & Case of the Month: www.cttr.org

FILE DIAGNOSES

(Preferably submitted on website at www.cttr.org. Click "subscriptions", then submit answers".)

Case I :

Case 2:

CTTR Subscription A

Papillary urothelial carcinoma, bladder T-71 000, M-80503

February,2007

Carcinosarcoma (sarcomatoid high grade urotbeUal carc:inoma with chondrosarcoma and osteosarcoma, bladder

T-77100, M-92203

Case3:

Case 4:

Case 5:

Case 6:

Case 7:

Case 8:

Case 9:

Mucinous adenocarcinoma, bladder T-71000, M-81403

Angiomyolipoma, kidney T-71000, M-88600

Leiomyosarcoma, kidney T-71000, M-88903

Mixed epithelial and strOmal tumor, kidney T-71000, M-81003

Solitary fibrous tumor, kidney T-71000, M-90510

High grade sarcoma, (NOS), kidney T-71000, M-88103

Renal cell carcinoma with papillary and tubulocystic features, kidney T-7JOOO,M-83123

Ca~e l.O:

2

Collecting duct carcinoma, kidney T-71000, M-83123

ClTR, FebruiU)' 2007 "Minu«i" (Subscription A)

Case No. 1, Accession No. 30272 February 2007

Alameda CAiame!la County Me!lical Center) • Papillary urothclial carcinoma, low grade foptana CKalsq Pennauente) - Transitional cell carcinoma, grade 213 Granada Hms • Invasive tJmSitional cell can:inoma, no muscle involvement Long Beach • Invasive papillary urolhelial can:inoma, high pe Lon• Beach a.ong Bsach Vcternns Hogpjtall • Papillary urothelial carcinoma, WHO 213 Los Angeles .. Transitional cell carcinoma Monterey CComnmnitv Hosnjml of Monterey Peninsula) • Papillary urolhelial carcinoma, high grade(2); Low gl'lldc ( l) ~ • Low grade papillary carcinoma Qranoe COranoc County Pathology Medical Gmuol · Papillary transitional cell careiooma, low 8t"de Oxnar<l !St. John's Regjonal Medical Center>· Papillary tr1Uisitional cell carcinoma, grade 1111, low gl'llde papillary ean:inoma ( I);

Papillary crnnsitional cell carcinoma (2) San Dieoo • Papillary transitional cell carcinoma, fOO>lly invasive, grade I, bladder S!l!! Djeeo <Naval MO(Jjcal Center San Djeoo) • Infiltrating urothelia! carcinornu San Diego (Sqipos Heal!hl • Low grade papillary umlhelial earcinoma San Dieoo IUCSP) • Papillary and sessile urolhelial carcinoma, low grade San Frandso <San francisco General Ho.o;pi(Ol) ~ Low grade urothclial carcinoma. Santa Bnrbam • Low gl'llde papillary urothclla! carcinoma Santa Ros <Santa Rosa Memorial Hospital) • 'l'rW1SitionaJ cell carcinoma (I); Papillary uroUtellnl carcinoma, low grade (I)

Papillary transitional cell carcinoma, low grade (papillary urothclial tumor) (I) Woodland Bills IXaiser PmP!!!!en!e) • Non-invasive papillary urolhelial au;:inoma, low g111dc Woodland Hil!s ISuda's Soldjm) - Urothelial carcinoma, grade 2, (non-invasive) Arkan~a, OJnjvcrsity ofArkAA$as for Medical Sciences) · Non-invasive papillary urothelial carcinoma. high grade. urinary bladder Georgia. DeC!IJUr • Papillary urothelial carcinoma lllinojs, Buq Ridge • Papillary urolhelial =inoma (I); Urothcllal carcinoma, grade 1-11. oOl\·invnsivc or microinvasive (1) Ulinois <Loyola Upjvqsirv Medical CCQ!erl • Dilfusc large !Hell lymphoma !ndjana flfol!'l!l! RCI!ional Me!lical Center) • Low grade papillary neoplasm Marvland fNonhwcst Hospital Center) • Hi&J> grade papillary urothetial can:inom~t Maryland CUnlyersirv ofMnryiMd) - lntiltratlng urolhelial can:inoma, higb grade Ma~chusetL, (Berkshjre Modital Cc~gter) - Papillary carcinoma, non-invasive Mas$!lChU.lC!!S <Beverly Hospj!J11) • Non-invasive low grnde papillary urothelitll Cllfcinoma Micbigng £Oakwood Hosoita)> - PapiH:uy urothclial carcinoma, non-invasive Minoeso!a (foirvicw Rid!!C$ Hosoital) - Papillary urothelial Cltcinoma, low-g18dc Hebra.<ka CCrcjJ!hton Unjversitx School ofMedjcjne) • Low grade papillary uro!helial carcinoma New Mcxjeo 1!/njversitv ofNcw Me.xico) • Papillary urothelia! carcinoma New York II ,ong Island Jewjsh Medical Center) • Invasive low grade papillary urothelial carcinoma New York INassau Universltx Medical Cente[) • Urolhelial carcinoma, papillary New Yodc <Srony Brook Uniymity Hosniral> - Transitional cell carcinoma, carciJtoma in .. situ New Yodc lSI/NY DoW!!S!JJe Medical Center! • Papillary rransiliooal cell au;:lnoma N9r!h Carolina (Mountain Area Pathology) • High gl'llde papillary transitional cell carcinoma (I): Transitional cell carcinoma, low

grade(!) Objo IMcCu!!pugh-Hvde Memorial ffosplta!) • Papillary urothclial carcinoma Oklahoma Thlsa • J>apillary urolhelial carcinoma, low gl'llde Pennsylvania ffirexel !Jnivmjty College ofMoc!ieinc) • Non-invasive papillary urothelial carcinoma, low grade Pennsylvania a.ehigh Valley Hospital) • Papillary transitional cell carcinoma. grade Will Pcnnsvlvanlo !Magee Women's Hospital) • Low grade papillary uro!hclial carcinoma. non-invasive Pennsylvani•IMt Nittany Me<lieal CCQte[) • Low grade papillary urothelial carcinoma pennsylvanjn (pcnnsylyMja Hospital Residents) • Low grudc tmnsitional carcinoma Puerto Rjco 11/niversitv ofPueno Rico) • Invasive urotbelial C41"Cinoma, hiS)l gl'llde Sorrth Dakota OJniversirv ofSoulh Da!coJa 1\qjdcnts) • Papillary umthelial carcinoma, gl'llde Ill TeDI'CW"' Kingsport • Low gnsdc, superliela!ly invasive papillary transitional cc1J c:arcinoma Iexa.• !Scott & White Memorinl Hospital) • Low grade papillary uro!helial carcinoma Texas. Hous(on • Papillary transitional au;:inoma, higb grade Texas. Lubbock - Low gl'llde papillary urothelial carcinoma in-situ Washjngton £Madigan AnnY Me4ical Center) • Papillary urolhclia! carcinoma. low gl'lldc (9); l~igb grdde (3) WcsJ. VirgipjaiOreenbrier Va)lcy Me!lica! Comer) • Papillary noo-infiltl31ivc urot:helial carcinoma AUS!1'8lia1Royal Hoban Hospi!al) - Low 8t"d• papillary umlhclial carcinoma with a partially inverted gro\\1h pattern Australia !Boval Prince Allied Hospital) • Non-Invasive papillary urolhelia! carcinoma, low gn~de AuslnlliaiSy!ljvan Nicolaides Pat!wlogy) • Papillary urothellal carcinoma, low gMlde Brazii<Labpnuodo Anatomja Patologica Ecltolpgia • Papillary urolhelial lesion oflow gl'llde potential

CTTR. Fcbruory 2007 "Minulcs" (Subscription A) J

Brazil Sao Pay!o • Popil!ary urothelial carcinoma, high gntdc Canida IJ>asqya HospjiJ!ll · Inverted papilloma Gonada. Sa•lwoon • Popillary urolhe!ial (transitional ceU carcinoma) can:inoma. low grade Canada ISbcJ!!rookc Uniymity HOS!ljtal) • Low gntdc papillary invasive carcinoma !ndiL KI!Dl!!Jk• • Pllpillary urothe!ial neoplasm of!ow malignant potential h-e!ond !Keay Gegm! Hospilal) • Transitional cell CIIICinoma of bladder Jamaica CThe Upjvcrsity of West Indies) · Low grade urothellal CIIICinoma Jgpng CK.yoJo Unjyersity H()l)1?\tal> - Urothclial carcinoma. noo··invasivc. papillary, Low grade Oman !Khou!a Hm!pjta!) • Non invasive popillary urothelial ean:inomn, low grade Oa!ar <Hamad Modjca! Comorarion) . Popillary urothc!ial ean:inoma, low gntde, non-invasive Saudi Ambja {Kjno Fohad Natiogal Guard Hospi!al) • Non·invMivc papillary urothelial carcinoma (low-grade) Saudi ArahioiMB)emjty and Children's Hospjtal) · Papillary urothclial Clli'Cinoma, tow grade The Nether!And:i. Ams!elveen • Low grade urothclial cell carcinoma Unj)ed Kinsdqm COx ford Study Group) • Low grade pupillary urothclial carcinoma

Case 1 - DlagnMis: Papillary urothelial carcinoma, bladder

T • 71000, M·80503

Case 1 - References: Choi YL. Lee SH. Kwon OY. et al. Ovcmq>ression ofCD24. Association with Invasiveness in Urolhelial Carcinoma of the

Bladder. Arch Pmhol LabMed2001; 131(2):27>281. Malkowiez SB, van Poppe! H. Mickisch G, ctal. Muscl.,.lnvasive Urolhelial Careinoma of !he Bladder. Uro/2001; 69:3·16. RagbaYitl D, Shipley WU, GamickMB, er al. Biology and MBM&ement ofDiadder Cancer. N EngJ Med 1990; 322:1 129-1138. Hmhon RH, Vonderriet P, Erorom YS, et at Brief Report. Molecular Biology ond Early Detection of Carcinoma oflhc Bladder.

The Case of Hubert Humphrey. N Eng J Med 1994; 330:1276-1278. Mostofi FK and Sesterhenn lA. Pathology of Epithelial Tumors nnd Cw-cinoma ln·Silu of the Bladder. Prog Clin Bioi Res; 1984:

162A:~~·74.

Case No. 2, Ac:cession No. 30203 February 2007

Alameda IA!wneda Count)! Medical Center) · lnfutruting urothclilll carcinoma, sarcomatoid varian~ with hetcrolo&ous elemenrs Fontana (KaLter Pmnaptptcl .. Sarcoma vs. carcinosarcoma Qrpnada Hills - Can:inosarcoma vs. reiomyosarcoma Long Beach • Can:inosan:oma with cartllagenous elcrocnlS Lops "Wh CLons ll<o!;h Vcrc:nms Hosoital) • Careioosan:oma Lo3 Angeles • Undi!Tcn:ntiatod urolheliaJ carcinoma Montqpy <Communjty Hospital of Monterey Peninsula> - Sarcoma1oid urothelial careinoma ~ • Careinosan:oma

Orange (011!QVC County Pathology Mes!ica! GrouPl • lnvosivc hiah·gradc urotheliaVmctaplastic =inoma Oxnard IS!. lohn'• Regional Medical Center) • High grade lnlnSitionol cell carcinoma (2); Papillary lmitionol cell cw-cinomo (I) San pjeso • Urothclial carcinoma, sareomatoid, bladder San Qjegg <Nuynl Medjcnl Center San Dieso) - H.igh grudc snrcomo Snn Dlcoq !Scrlnps HeoUh) • Carcinosarcoma San Pieao CVCSPl • SlllCOmatoid carcinoma San Ernnci:;co <Snn fmocisco Gcncral liospitn]) - Rhabdomyosarcoma SJl!l!A Burb1101 • Poorly differentiated small cell carcinoma Santa Ro:;a /Santa Rosa Memorial tlo:mjta!) · Careinosarcoma (3) Woos!l!!lld t!il!s fKaiw Pennanente) · High grade urothclial carcinoma, sarcomatoid variant (with heterologous elements) Woo<lland Hms !Syda's Soldjjl!lj) · Careinosan:oma (chondrosarcoma)

Mw!sas OJoivcaitv of Mmnm for Medical Sciences! • Urothdial carcinoma. sarcomatoid variant (heterologous), urinary bladder Geo11ia. Decatw • Urolhelial carcinoma ..,itb sarcomatoid change l!!jnojs. Byrr RjdJ!S · Urothclial carcinoma, bigb gntdc with 53tCOmatoid fe:uurcs (I); lnfillrlllins umthclial ean:inoma, grade m (I) Illjnoi! CLoyola lJnjyqsily Medica) Cenlu) - Mtdullwy thyroid carcinoma lndillllt fHowac4 Resjqnal Medical Center) · High grade papillary urothclial carcinoma

4 CTI'R.J'ebrumy 2007 "Minutes• (Sub,;criprion A)

Maryland !Northwest Ho~pitlll Center) • Sarcomatoid urothelial carcinoma MaryiW!d 1\Jniversitv ofMarvJand) • Sarcomatoid carcinoma with high .l!;rnde urothclial carcinoma component MassacltW!CI!S ffiet!cshjre Msdjcal Ccnrcrl · Sarcomatoid and small cell oarclnorna with heterologous clcmcnl$ (chondrosarcoma

and OStcoS8I1X>ma) Massachusetts CBeverly tlosoital) · CW'Cinosarcoma vs. pure sarcoma with sarcoma elements of c:hoodrosan:oma Micbi•an <Oakwood Hospital) • Sarcomatoid carcinoma, with bucl\ground transitional cell in-situ Minnc:;ota (fairview Rid&es Hosoi!aJl • Urothclial carcinoma, high grade, with sarcomatoid diffcrcntiation Ncb!J!Skl CCreigltton Unjymitv School of Medicine) • Carcinosan:oma New Mcxjco <University oCNew MexjcO) · Sareomatoid variant of urothelial corcinoma with heterologous elements New York l!,ong Island Jewjsh Medical Center) • Sarcomatoid transitional cell careinoma with heterologous elements New York !Nassau Uni)'C!liity Medical eenlerl • Urothclial carcinoma, snrcomAIOid New Yod; fS19nv Brook University Hospital) · Transitional ceil oarclnoma (high grade) New York ISVNY DowuS!ale Medical Center) · Sareomatoid carcinoma vs. san:oma with rhabdoid differentiillion North CQ(I)lina IMounmjn Area Pathology) · High grade transitional ec!i carcinoma and CIS ( I); Sarcomatoid cnroinoma (I) Ohjo IMcCI!!ioush-Hydc Memoria! Hospital) • ChondrosnrooiDJl Q!(Jahoma. Tulsa · Urothctial carcinoma heterologous saroomatoid type (carcinosarwma) PenoiNiyaniafDisxel !lnjversitv College of Medicine) • Sa=matoid (spindle cell) carcinoma of bladder with choodrosnroomatous

differentiation (carcinosarcoma) Pennsyll'!lJ)ja Cl&hig!J VAlley Hosoilall • SIU'COIDllloid carcinoma PcnnsyJyMia CMagee Women's Ho!pital) - Sarcom&toid carcinoma Pgmsy!yaoja IMt Ni!W!y MMical Center) - Urothe!ial careinoma, heterologous sarcomatoid type

Pennsvlyania (pennrtlyania Hosnita] ResideptSl - Carcinosareoma Puerto Rico 11/nivemjtv ofPyerto Rico) • SIU'Comatoid (metaplastic) carcinoma South DM,ota aJniveajtvofSoyth Dak,pta Resjdent$) • Carcinosarcoma Trnneyys Kjngmon - Rmal s:areomatoid carcinoma Texas (Scott & White Memorial Hgsnjtal) - Cardn()Sru"CCma Texas, Houston · Spindle ccU carcinoma, poorly diOerentiated Texas. Lubbock - Metap1&1ic urothelial carcinom11 Washineton !Madi•M Anny Mes!ical Center) • Urothe!ial careinoma with heterologous san:omatous clcmcniS (12) West Vjrainia IGIW!hrier Valley Medical Center) • lnliltrarive careillOIIIlllOid urothctial can:inoma Al!.<tralja !Royal Hobart Hosoital) • Sarcomatoid variant ofurothelial carcinoma with heterologous differentiAtion (ehondroS<lrcoma) AyS)m!la {Royal Prjnco Alfred Hospjl!ll) • Urothcllal cw'Cinoma, sareomatoid voriant with heterologous elements AUS1rJija ISuliiVliD Nicolaides Pathology) - Merzplasric oarclnorna Bry;jl 0.4hora!<Jrio Ana!omia Pa!o!ogjca fci!Q!oBial • High~ sarcoma(osteosan:oma?) Brazjl. Sao Paulo • HlaJ> grade urothelial carcinoma, sarcomatoid varian~ with heterologous elements (chondrosarcoma) Canada CPasoua Hospjtal) - Carcinosarcoma vs. sllt'Coma Cen'd• Saskatoon • Papillary urothclial (transitional cell) carcinoma, high grade C8na4a ISherbrooke Upjvqsitv Hosohal) • Sarcomatoid carcinoma with hcteroloaous elemcnrs India. Komataka • Can:inosareoma Ireland IKmy General Hospital) • Transitional cell <m<:inoma of bladder Jamajeo COle Univcr5jty of West lndles) - Sarcomatoid renal cell carcinoma Ja,nsn CK'l()lo Universi!Y HospjtaJ) . Invasive urothe!ial carcinoma, S8tCQmatoid variant, with heterologous elements Oman IKboula Homital) • Infiltrating urothelial carcinoma, sareomatoid variant with heterologous element Oatar <Hamad Medjcal Corooration) · Invasive transitional cell carcinoma. high grade with snreomatoid areas Saudi Ambja /Kino fahad Natioru!l Guard Hospital) • Sarcomatoid carcinoma of the urinruy blndder "ith heterologous

differentiation Saudj A[lbia!Matemjty apd Children's Hospj!aJ) • Sarcomatoid (metaplastic) carcinoma The Netherlands Amstclvcen - Sarcomatoid variant of an urothclia1 cell carcinoma United Kjnsdom (Qxfo!!l Study Grouo) • Carcinosnrooma bladder

Cue 2. Diagnosis:

bladder Carcinosarcoma (sarcomatoid high gn~de urothelial carcinoma with chondrosarcoma and osteosarcoma),

T-77100,~-92203

CTTR. FcbNJ<y 2007 "Mlnulcs- (Subocriplioa A)

•

Case 2 - References: Hoshi S, Sasaki M, Muto A, et al. Case of Carcinosarcoma of Urinary Bladder Obtained u Pathologically Complete

Response by Neoadjuvant Cbemoradiotherapy. lnt J Uro/2001; 14(1):79-81. Shah SK, Lui PO, Baldwin 00, et al. Urothelial Carcinoma After External Beam Radiation Therapy for Prostate

Cancer. J Uro/2006; 175(6):2063-2066. Rogers CG, Palapattu GS, Shariat SF, ct al. Clinical Outcomes Following Radical Cystectomy for Primary

Nontransitional Cell Carcinoma of the Bladder Compared to Transitional Cell Carcinoma of the Bladder . .I Urol 2006; 175(6):2048-2053.

Jayamoban Y, Urs L, Rowland RG, eta!. Pmurethral Carcinosarcoma. A Repon of2 Cases with a Review of the Literatwe. Arch Pathol LabMed2005; 129(4):e91-93.

McKenney JK. An Approach to the Classification of Spindle Cell Proliferations in the Urinary Bladder. Adv in A nat Patho/ 2005; 12(6):312-323.

Case No. 3, Accession No. 30250

Alameda (Alameda County Modica) Center)- Adcnocarcinomn. ll\Ucinous type Pontana (Xujsr 'Jlennaneolel - UrachaJ adenOCN'cinoma Qranad!l Hills - Mucinous odcnocan:inoma Lone Beach - Mucinous adenocarcinoma "itb si)plet rin~ Long Beach ct...ona BeaclJ VetCRns HosnjtaJl- Mucinous adeoocw-einoma with signet ring ceUs Los An•clcs - Mucinous slflllct ring cell carcinoma Mon[erey CCommunitv Hosnital of Monterey Penin$U)a) - Mucinous (colloid) carcinoma Oaklaoc! - Signet ring mucinous can:inoma On!noe CQranoe Cougtv Pathology Medical G!ll!Jnl - Adenocarcinoma Oxnard 1St. lobo's Regional Moclical Center) - Mucinous adenocarcinoma (4) San Diego - Adenoearcinomo, mucinous, bladder Sao Qjcgo (Nayol Medical Cepter San Diego) · Mucinous adenocarcinoma San Diego CScrj!!!!S Health) - Poorly diffcra>tillted •ignet ring c:c!l adenocarcinoma San Diego O!CSDl - Mucinous ~inoma San Franci!iGQ <San francisco GencrsJ Hospical) - Mucinous CIV'Cinoid Santa BarbMI - Mucinous adenocarcinoma

February 2007

Santa Rosa CSonta Rosa Memorial Hospital)- Mucin secreting adenocarcinoma (colloid carcinoma) (I); Mucinous/colloid ~ocan:inoma(l): Colloid carcinoma(!)

Woos!!!!nd Hills !Kaisq Pqmanente)- Mucinous odCOocatCinoma Wooc!lans! HH!s !Suda"s Soldiers)- Mucinous odcnOC8lcinoma (colloid carcinoma) ArkMSSS (Uniyersity of ArkMw for Medical Sciences) - Uruchnt carcinoma. mucinous type, urinary bladder Georgia, Decotur - Mucinous adenocarcinoma !lljnois, Burr Ridge - Mucinous carcinoma. si)plct cell(!); Adeoocan:inoma with signet ring features and prominent mucin

acaunulation, rule out Gl origin (I) Illinois fl,ovola Univernitv Moclica! CepteO- Insular carcinoma Indiana !Howard Regional Me!lical <&ntq)- Mucinous adenocarcinoma (si)plet ring) Marvland (Nonhwe!':t Ho>viwl Center> - Mut inous adenocarcinoma Maryland !UnjversiN of Maryland)- Mucinous adenocan::inoma M"S!'£husct!S !!ler!ss!Jirc Me!llcal Center)- Mucinous adcnocareinoma with sianet ring feanm:s Massachusctv; CBeveriy Hospjtal> - Adenocarcinoma, mucinous variant Michigan (Qokwood Hospjud) - Mucinous adenocarcinoma Minnesota (fairyicw Ridges Hospital) - Mucinous adenocarcinoma. urachal Nebraska <Crtjghton Univemjtv School of MesJjcine) .. Mucinous adenocarcinoma New Mexico <UniversitY oCNsw Mexico)- Urachal carcinocna New Yorlc ILon&lsland Jcwjsb Modica! Centq) - Mucinous adenocarcinoma New VOrk CNa.uau University Medical Center) .. Mucinous adenocarcinoma New York CStpny Brook Uniyec;Hy Hosoital> - Urachal carcinoma (mucinous 1ldenocarcinonu.)

6 CTTR. Fcbruuy 2007 'Millllles' (Subscriplion A)

New York !SUNY J)ownstute Medical Center)· Mucinous adenocnrcinoma. primary North CaroUna (Moumain Area Plllhpio"Y) - Mucinous adenocarcinoma. urachal origin {2) O!Jjo (MeCu!loueb·Hvde Memorial Hospital) • Adenocarcinoma. mucinous typo

Oklahoma, Tulsa • Mucinous adcnocan:inoma, urachal origin Pennsvlynoia CDrexel Uojvmnv Collt:ge ofMedjdnc) · Mucinous adenocarcinoma (urachal carcinoma) Pennsylvania !Lebi•h valley Hospital) · Mucinotts adenocarcinoma, bladder Pennsylyania(Myee Womcn*s t.fomjta1) · Adenocarcinoma, mucinous type

Pennsylmia (Mt Nj!W!y Medjcal Ccntql • Adenocarcinoma, mucinous and sianet ring type Pennsy!vaoja (pennsylvania Hosoi(AI Rqidmtt;) .. Mucinous adcnoc:arcinoma Puerto Rjco CUnivcO)iLy ofPucrto Rjoo) - Mucinous udenocarcinorna/signet .. ring cell adenocarcinoma South Dakota fUniyersjty of South Dakota Re~idcnts) • Mucinous adenocarcinoma T"'Y'S'8'$ Kin2SJ)()rt • Me18S181ic mucinous {colloid) catcinoma Texas !Scott & White Memorial Hosojta!l - Mucinous adenocarcinoma Texa.". Houston - Mucinous adenoCIU'Cinoma Texn.t Lubbock - Mucinous adenocarcinoma WashinR!oo (Madil!8!! Army Medical Ccntq) - MuoUious adenocarcinoma of the bladdet (12)

We.<t Vjra!nja <Greenbrier Val lev Medical Ccntq) - Mucinous produ<tioo urothclial adc~inoma Australia <Royal Hoban Hosnita!l - Mucinous ade.>ocarcinoma, probably urachal oustrnlia !Royal Prince Alfred Hosnjla!l • Adenocarcinoma (mucinous variant) Aystm!ja !Sullivan Nicolaides Patllology) • Mucinous adcnoasccinoma of bladder Bn¢1 a ,homorio Anatoaria Parologjca F.citologia) . Mucinous adenocareinoma of the bladdCT BwJL Sao Paulo - Mucinous adenocan:inoma (modccalely dlJTecentiatcd) likely to be W'll<hal adenocarcinoma Canada Q>a.squa HosnUa!) .' Colloid carcinoma Cang Saskatoon - Vesical adenocarcinoma c.nada !Shgbrooke !Jnjymitv Hospijal) - Invasive mucinoltS adenocarcinoma India. Kl.\mataka - Mucinous carcinoma Ireland (K.eny Geneml Hosoital) · Mucinous adenocarcinoma Jamaica (]be Un!yersjty of West lndjts) - Urotbelial adenocarcinoma J8DIU) CKyoto Uni\'qSjty Hosoitan- Mucinous adenocarcinoma Oman IKboula Hospital) • Adenocarcinoma (mucinous typo) urachal carcinoma Oatar CHnmad Medjcnl Comoratiog) - Mucinous/colloid adenocarcinoma Saudi Ambia <King fAbnd National Guard Hospj!ul> - Mucinous adenocarcinoma. primary Saudi A!ibia (Matc:mjiY and Children's Hosoilall • Adcnoasccinoma The Nc!hcdaods, AJNtclyeen - Mucinous adcnocarc,inoma (depending upon localization, urachal or nonumcbal typo

United Kjngdom !Oxford Srudv Groyp\ - Bladder mucinous adenocan:inoma

Cue 3. Diagnosis; Mucinous adenocarcinoma, bladder

T-71000, M-81403

Cal;e 3 - References;

Lauren! S. Mosca A. D'Aifonso V, et al Primitive Mucinous Adenocarcinoma of the Bladder. A Case Rcpon. Arch !tal Uro/ Andro/2006; 78(1 );32·34.

Zag)>loul MS, Nouh A, Navny M, eta!. Long-Term Results of Primary Adenocarcinoma of the Urinary Bladder. A Report on 192 Pallent•. Uro/ Onco/2006; 24{1):13·20.

TaylorS, BOA:Cbini P and Bertoni F. An Isolated Vertebral Metastasis of Urachal Adenocarcinoma. Arch Palh<>l LGb Med 2004; 128(9):1043-1045.

M1122Uecbelli R, Scarpelli M and Monlironi R. Mucinous Adcnocan:inoma with Superficial Stromal Invasion and Villous Adenoma of Urachal Remnants. A Case Report. J C/in Patho/2003; S6(6):46S-467.

Case No. 4, Accession No. 30147 February 2007

Alameda !Alameda Coynty Medical Center) - Angiomyoliporno

C1TR. Fc!>nwy2007 "Mirn ... • (SubscripeioaA) 7

fontana (Kaiser Pennancnte) · Anglomyolipoma Gr411ada Hilb - Anglomyolipoma lone Beach - Ang;iomyolipoma Lons Beach <Long Beaoh Vctcmo~ Hosni!nl) - Angiomyolipomu Los Angeles .. Ang.iomyolipoma Monterey <Communitv li()Spital of Monterey Peninsula) - Angiomyolipoma ~ - Anglomyolipoma O!JW•• COtw!ae County P!l!lJology Medical Orouol- Angiomyollpoma OX!\!ICd {St. John's Resjooal Medical Center}- Angiomyolipoma (4} San Diego - Angiomyolipoma, kidney Sao Diego <Naval Medical Center San Djcso) - Angiomyolipoma San Diego <Scripps Heal!hl - Angiomyolipoma San Diego CUCSD> - Angjomyolipoma san Francisco (Sag Francisco General Ho,;nitall - Aogiomyolipoma Santa Rarbnm ~

•• Angiomyolipoma. kidney

- Moderately-differentiated neuroendocrine tumor - Spindle cell satCOma (?leio)

Maryland /Nonhwq H()Spj!al Center) - Aogiomyolipoma Marvland Glojvqsjtv gf Maryl8J)d) - Angiomyolipoma MIL'!Sachuscm !Berkshire Medical Center) - Angiomyolipoma Mgc~ecbusens CBeverty Hospital> - Angiomyolipoma Mjchigan <Ookwooc! HC!SDital}- Aogiomyolipoma Mjnnesota CFajrview Ridges Hospital} - Angiomyo!lpoma Nebrruka CCrcjghton \/ojversjty School ofMedjcine) - Angjomyolipoma New Mexico !Univmjty of New Me;xioo} - Angiomyolipoma New Yorlc Ikons Island Jewish Me4ical Center} - Angiomyolipoma Now York iliossau llnjyc::rsitr Mcc!ical C<'Dfet) - Cellular leiomyoma New York (Stony Brook Univmjty HOS!>ita!) - Angiomyo!ipoma New Yor!r, <S\JNY J)ownswe Mcc!ica! Center) - Angiom)'Olipoma North CarolinA IMountnin Area Pathology! - Angioyolipoma (2) Ohio <McCUllough-Hyde Mernorial ttospitull - Leiomyoma V$. leiomyosurcoma Olclahoma. 'D!Isa - Angiomyo!ipoma Ponosv!YMia!Drexel !!ojvcrsitr CoUege o(Medicjnc) - Angiomyoliponm Pron.wlvaoia O,.ebigh valley Hospj!al) - Angiornyollporna Pennsylvania <Magee Women's Hospital) - Angiomyolipoma Penosylvanja fML Ninany Medical Center) • Angiomyolipoma Pennsylvania CPennsvlvania Rospital Resident<;;) · Angiornyolipoma Puerto Rico /University of Puerto Rlco) - Angiomyo!lpoma Sou(h Da!rota aJnivrnjty of South [)akola Residents) - Angiomyolipoma Teones!!ee. Kjn(!S!!Ort - Angjomyolipoma Tcxos <Scott&. White Memorial Hospilill) - Angiomyo!ipoma Texas. Hous1on - AnglomyoUpoma Trras Lubbock · l...ciomyosarcoma Wasbjngton IMadi!!l!!J Arrnv Medjcal Conwr) - Angiomyolipoma (12) Wosl Virginia CGreep.brjcr Yalloy Medical Center) - Angiomyollpoma Ays!ll!lja !Roval Hoban HosoitaJ) - Aagiomyolipoma. kidney Ausqalia (Royal Prince Alfred Homj(al) - Angiomyolipoma Australia !SuWvan Nicolaides Pn1ho!ogy} - Angiomyolipoma Bmii!Laborotodo AnOlorrua J>ato!ogica Ecitologia) - Angiomyolipoma, smootb muscle predominant Bmjl Sao Paulo - Angiomyolipotna CaoP!la <Pa.o;qya Hosoi!llll - Angiomyolipoma CMada. Sas!mtoon • Angiomyolipoma Cana4a CShqbrooke Unjversity Hospi(al) - Angjomyolipoma lgdia. Karoe?nk' · Anglomyolipoma Ireland fKcrry Gencra) Hosnilal) - Aogiomyolipoma Jamaica (The Universjty ofWestlnd!es) - Renal angiomyolipoma Japan (f(yoto UniversiiY Hospital) - Angiomyolipom4

8 CTTR, February 2007 "Minures" (Subscription A)

Oman CKhoula Hospjta!l • Angiomyollpoma Oatar (Hnmwl Medical COiporation) • Angiomyolipoma §endi Arabia (King fehqd National Guard Hospital) .. AngiomyoUpoma Saudi Arabia !MII!mlity and Cbildrm's Hospital) • Angiomyolipoma The Netherlands. Amsulyeen • Angiomyoliporoa of the kidney. nonwachal~ype IJnjted Kjnodom !Oxford Study Grouo) • Angiomyolipoma

Case 4 . Diagn05ls: Angiomyolipoma, kidney

T-71000,~·88600

Case 4 • References: Baluami A. Schwartz MR, Ayala AG, el al. Coneuncnl Angiomyolipoma and Two Onoocytomas in the Same Kidney. Ann Diagn

PaJho/2001; 11(2):132-136. Roma AA. MagHlalluzzi C and Zhou M. Differential Expression ofMelaoOcytie Markers in Myoid, Lipomatous, and Vascular

Components of Renal Angiomyolipomas. Arch Pat!Jol l.Ab Med2001; 131(1):122-125. Khan MS, !ramS, O' Brien TS, etal. Renal Perivas<:ular Epitheloid Ccii-Omas'. BJU lnt2006; 98(6):1146-1147. Gould Rothberg BE, Grooms MC and Oharnidhlll1ca VR. Rapid Growth of a Kidney Angiomyolipoma After Initiation of Oral

Contraceptive Therapy. 0/utet Gyn.co/ 2006; 108(3 Pt2);734-736.

Case No. 5, Accession No. 30115 February 2007

Alameda !Alameda County Medieel Center) • Lciomyosan:oma Fontana <Kniser Pennanentc) • Leiomyosarcoma Granada Hills · Leiomyoma Lon• Beach • Degcneraling leiomyonto Long Bcacb O..ong Beoch veterans Hospilal) • Leiomyoma with degenerotive changes l..os Ansclcs - Leiomyosarcoma Monwev !Community Hosoital of Monterey Psnjnsula) · Leiomyoma(2); Leiomyosarcoma (I) Oakland • Leiomyoma sateoma Orange IOn!noe County Pathology Modjcal C'rroup) • l,eiomyosarcomn Oxnard !St.John's Recjonal Medical Center) • Angiomyolipoma (4) San Di<go • Lciomyosarwma, kidney ruk: out angjomyotipoma San Dieoo <Naval Medical Center S!ln Pi•&o) • Lciomyo=colllll San Djeoo CSoripps Heol!hl · Leiomy-=ma San Djegq CUCSDl - Smooth muscle lumor of uncertain malignant potential (S"I'UMI') San f'!l!ll•isco <San Fnmeisco General Hospital! • Partially infracled cellulat leiomyoma Saom Bamora - Leiomyoma Santa Roa !Sanra RO<jl Memorial Hosoiral) • Leioyosarcoma (3) Woodland Hills !Kaiser Pennanentc) • Leiomyosatcoma Woodland Hills ISuda's Soldiers) • Leiomyosarcoma Arlsansas fiJpivqsiiV of Arlcansa,• for Medical Scienced - Leiomyoma, kidney Gcorgja. Qccatur • Leiomyosarcoma Illinois. Burr Ridge • Leiomyoma (I); Leiomyosarcoma (I) Illinois ll&yola llnivemjty Mes!jcal Ccnt<;r) • Wcll-dilferentiated neuroendocrine twnor !ndjana !Boward Regjonlll Medical Center) • Leiomyosarcoma Mary!Md <Northwest Hosnjta! Center) - Leiomyosarcoma Marv!and f!Jnjve!Sity o{Marvi!!Odl • Leiomyosarcoma Mttreshusctts ffieWbim Medical Center) • Leiomyosarcoma MMSachusett, <Beverly Hosnital) .. t..eiomyosarcom.a MichigM (Qa)<wood Hospjtal) • Lciomyosarcomo Minnesota CFairVjew Rld&cs Hospital) • Leiomyosarcoma Nrlxe<k' <Creighton Universitv School of Medicine> .. Leiomyosarcoma New Mexjco flJniversity orNew Mesko) - Leiomyosarcoma New Yor!s O..ong Island Jewish Medical Center) · Leiomyosarcoma New York CNac;sau Uniyersjtv MediCAl Center) .. Leiolnyosarcoma New York !Stony Brook Universjty Hosnilal) · lnRwnmatory(pseudotumor) myo!ibroblastic tumors New Yrut !SUNY DOIIDSU!!e Medical Center) • Leiomyoma North Carolina !Moontain Area Pathology) • Angiomyolipoma ( I); Leiomyoma (I) Ohio (McCy!!ouoh-Hvde Memorial Hosplral) · Angiomyolipoma Oklahoma. Tulsa · Leiomyoma

9

Pennsvlvania CDrexel University College of Medicine) - LciomyomB with infurclion . PerY!sylvania CLchl!!h Valley Hosnitall - Smooth muscle neoplasm favor low gr~~de leiomyosan:oma Pcwylvanja <Magee Women '• Hospital) - Mesoblastic nephroma Pennl!ylvania (ML Nittanv Mcc!ical Center) • Lemmyosan:oma Pennsylvania <Pcnnsvlvania Hosnital Resjdent(i) - Leiomyosarcoma Puerto Rico <Unjycrsjtv ofPueno Rico) .. Leiomyosarcoma South Pakota<Unjvcrsity of South Da!som Residents) - Leiomyosarcoma TmnQS'i£, Kingman - Leiomyosarcoma Texas ISeot! &. White Mem<!riAI Hospila!l • Leiomyoma Texas, Houston - Leiomyosarcoma Texgs. Lubbock .. Leiomyosarcoma Washington (M8di•an Anny Ms<fical Ccnterl - Leiomyoma (5}; Smooth muscle tumor, unknown malignant (4); Leiomyosarcoma

(3) West Yiminia <Greenbrier Vn!Jey Medical Center) • Sarcomatoid renal ce11 carcinoma Aus!T!Ilia IRova! Holwt Hosplml) - Leiomyosarcoma, kidney AUS!!lllia!Rowl Prince Alfrsd Hospila!) • Smooth muscle tumour ofunccnain nulignant potential (angiomyotipoma) Au.ma!ia <Sum van Nioolajdq Pathology> • Leiomyoma Rmzjl flaboreJodo Ana19mja Patolo!!ica !lcitologjal - Leiomyosarcoma, n:nal Brpzj!. Sao Paulo - Smooth muscle tumor, lelomyo,urcoma vs. anglornyo!iponta vs !eiomyon>a CanadaiPasoua 1-!osojta!) - Leiomyosarcoma CAnada. Sasf.:gloon .. LeiomyoS.1J'COma Ganada !Shqbrooke llniv@!Y HOl!pi!al) · Angiomyolipoma with predominant leiomyon:m10us component lndjo. Kama!aka - Inflammatory myo(ibroblastic tumor/leiomyosarcoma Ireland !Kerry General Hosol!nl) - Leiomyosarcoma larnAjca !The Uojvcrsity of West Indies) - Chronic pyelonephritis, malakoplalds. (diffc:rcntial diagoosis, !eiomyosan:oma) J3!!j!!l (Kvoto Universjtv Hosp!!aO - Leiomyosan:oma OmQll CKhoula Hospital) - Leiomyosarcoma Qatar !Hamad McdjcaJ Co!l)Q!lJ!ion) - Leiomyoma Sayd! Arabi• CK!oa fahad NaJlonal Guard tloSpitall • Leiomyoma with infarction Saydj Arabia !Maternity and Children's Hospital) - lnflarnm310ry myofibrob!astic: tllmor The NC!beri8J!d.\ Amstelvcep • Leiomyosarcoma Unjted Kinsdqm (Oxford S(Udy Group) - Leiomyoma

Case 5 - Diagnosis: Leiomyosarcoma, kidney

T-71 000, M-88903

Case 5 - References: Kendal WS. The Comp;ntivc SuiYivalofReoal Leiomyosan:oma. CanJ Uro/2001; 14(1 ):3435-3442. Sharma D, Pradhan S, Aryya NC, 01 a!. Leiomyosarcoma of Kidney. A Case Report with Long Tenn Result After Radiotherapy nod

Chemotherapy. lnt Urol Nephro/2007. Kartsanis G. Douros K, Zolota V, et al. Case Report. Leiomyosarcoma of the Renal Pelvis. /111 Urol Nrplrro/2006: 38(2):21 J-213. Komiyama M. A Case of Leiomyosan:oma Involving the Rcoal llilus. Jpn J Clin O..Co/2006; 36(2): 122.

Case No. 6, Accession No. 30289

Alamedll CA!amcda County Me!lical Cen(Crl • Multiloculu cyst (cystic nephroma) Fontana O<aiser Perrnanente) - Mixed epithelial, stromal tumor of kidney G!liOuda Hills - Cystic nephroma l,ono Bea&h • Benign polycystic disease Lono ~ <Long Beach VCIC!'!!JlS RospjtAD - Polycystic disease, benign MoDJercyfCommunity lipmjtAL of Monterey Peninsula) - Cystic nephroma QakJllWI - Multicystic nephromn Orange !Orange County Pathology Medical Group)- Cystic nephroma Oxnan! (SL John's Regional Medical Center) - Multic:yslic nephroma (4) San Diego - Chronic pyelonephritis, spindle cell lesion leg, solitary fibrous tumor San Djego INayol Medical Center San Djeop) • Cylo1ic nephroma San P iego /Scripps Hea)th) • Benign mullilocular cyst San piego fUCSPl - Cystic nephroma San f!llneisco !San Francisco Gene!l!l Hosnital) - Adult polycystic disease Santo Barbara • Cystic nephroma

tO

February 2007

C1TR. February 2001 "Minutes" (Subscriptiao A)

Santa Rosa (Santa Rosn Memoriull·lospitaD - Cystic nephroma (Z); Multilo<:ulllt renal cy.st (cystic nephroma, "mlticystic nephroma")( I)

Wooclland Hills <Kaiser Pcrmanen!el - Cystic nephroma Woodland Hjl!sfSuda'sSo!dion) • Cystic nephroma Arl<anw !University of Ar!cansas for Medjca! Scienc<s) - Cystic nephroma, kidney Geor&j!l, Decatur - Mixed epithelial and stromal tumor !llinois. Burr Ridge • Cystic nephroma (2) Ulinojs C!.pyola Univm!tv Medjca) Ccotor) - Small cell carcinoma Indiana CHoward RcgjO!!!!I Medieal C-enter} - Multieystic nep!lroma Maryland CNot!frwest Hospital Center) • Renal cystic disease vs. cystic ocp!lroma Maryland <UnlvO!Sitv of Maryland} • Cystic nephroma M8SS8chusett.• <Berkshire Medical Center) • Cystic nephroma (multilocular cyst) Ma.'!S!!Chusetts <Beverly Hosoital) • Cystic kidney disease Mjehign !Qakwood Homitatl - Mixed epithelial and suoma! tumor Minnesgq. Cfairvjew Ridges Ho:mi!AI) - Mixed epid>c:!ial Sb'Omai!Umor of kidney Nebraska !Creighton Uojywity School of Medicine) • Multilocular cyst (cystic nephroma) New Mexico CUnjversilY of New Mexico) ~ Cystic nephroma New York (Long Island !ewish Medlen! Center) - Cystic nephroma New Xor!c CNassau Uniymity Medical Center) - Cystic nephroma New York !Stony Brpok \/njversity Hospj!Ail • Dysplastic kidney New York !SUNY Doymstatc Medical Center> • Multieystic nephroma vs. benign cystic disease North Carolina <Moun!Ain Area Patbo!pgy) - Multicystic nephroma (2) Ohio fMcCu!lough-Hyde Memorial HospitAl) - Cystic nephroma O!c!aboma. Thlsa - Polycystic kidney disease PcnnM·vania <Dre-xel Unjvm-ily College of Mqiiejnel - Cyslie nephroma Pcnnsy!yania <Lehigh valley Hosoital> • Mixed epithelial stromal rumor of kidney Pennsylyrudn £Magee Women's Homji!U) · Multicyst:ic nephroma Penpsylyaoio <Mt Ni!1lJny Medical C.ntcr) - Medullary sponge kidney Pennsylvania CPcnnsy!yania Hosoita! Reyiden!s) - So!itaJy multilocular cyst Puerto Rico OlniYC!l!itv of Puerto Rico) • Cystic nephroma South Oa]<ota Cllniyroity of South Dai<ota Residents) • Cystic nephroma Tenpew;o. Kingsport • Multicystic nephroma (multilocular cyst) Texas <Scott & While Memorial Hospj!!l!) • Renal multilocular •')1st Te.as. HOUS!op - Polycystic kidney disease Tm'l, Lubbccl< - Cystic IQlaJ cell carcinoma Washjng!Op <Madigan Army Medical Center) • Multilocular cyst (12) West Viminjll !Greenbrier valley Medical Center) • Adult type renal polycystic disease Austm]ia !Royal HobArt Hospital) - Cystic nephroma Austmlia <Royal Prince Alfred HospiJAII • Cystic nephroma Australia !Sullivan Njco!ajdes Pathology> • Multicystic nephroma fliazilll.abor!!Jorio Apa]omia Pat9losica Eci!O!osjal - Mixed epith<lial and Sb'Omal cell rumor of kidney B!ll&il· Sop Paulo - Cystic nephroma Canada (Pa.wua HosojtaJ) • Multilocular cyst Canada. SI)Skl!(oon • Mixed epithelial and stromal tumor Canada CShabrool;e llpivmitv HospjW) • Endomeuiose India. Kama!Aica • Cystic oephroma Ireland <Kerry C'.encral Hosnjtal) • Cystic nephroma Jamaica <The Ugiywjty of West Indies) • Inherited renal cystic dise!IS<l VHL, type 2 Jaoan CKvoto University Hosoital) - Cystic nephroma Oman <Khoula !folmiJ.a!l - Cystic nephroma Oa!ar <Hamad Medical Co!!)O!l!!iogl - Cystic oephroma (4); Mixed epithelial and stromal tumo<(4) Saudi Ambia <King f!!h!!d National Guard H!lSOilll!) • Cystic nephron"' Saudi Ambia !Maternity and Children's Hosnjtall • Cystic nephroma The Netherlands. Am<ltlyecn - Multilocular cystic renal cell carcinoma Uni!ed Kjngdom <Oxford Smdv Grouo) • Multicystic nephroma

Case 6 • Diagnosis; Mixed epithelial and stromal rumor, kidney

T-71000, M-81003

ConsultA!jop: SU!Ilford University, Richard Kempson, M.D., "Mixed Epithelial and Stromal Tumor of Kidney".

Case 6 - References:

CITR, F<bruory2007 "MinUICS" (S..bicriptiunA) II

Bis<leglia M, Galliani CA, Senger C, et al. Renal Cystic Diseases. A Review. Ad~;,. Anal Potho/2006; 13(1):26-56. Antic T, Perry KT, Harrison K, ct al. Mixed Epithelial and Stromal Tumor oftl1e Kidney and Cystic Nephroma Share Overlapping

Fe<Liurcs. Reappraisal of 15 Lesions. Arch ofPathol & Lab Med2006; !30(1):80·85. Micbal M, cs 0, Bisceglia M, eta!. Mixed Epithelial and S1tomal Tumo<s oflhe Kidney. A Report of22 Cases. Virchqw• Archiv

2004; 445(4):359-367. Pierson CR, Schober MS, WallisT, et al. Mixed Epithelial and Stromal Tumor of the Kidney Lacks the<rt:netic Alterations of

Cellular Congenitul Mesobla;1ic Nephroma. /fum Path()/ 2001 ; 32(5):513·520. Adsay NV, llble JN, Srigley 1R, ct al. Unique ldcnUtled. Mixed Epithelial and Stromal Tumor of the Kidney. Am J ofSurg Pathol

2000: 24(7):95&-970. Michal M and Syrueck M. Benign Mixed Epithelial and Stromal Tumor of the Kidney. Pathol, Ru & Prac 1998; 194(6}:445-448.

Case No. 7, Accession No. 30364

Alameda !Alameda County Medical Cmteil • Solitary fibrous tumor Fontana CKaiscr PcrmMC!JlC) • Solitary fibrous tumor Granado Hills· Sclerosing heamglofibroma Lono Beaeh • Solitary fibrous tumor Long Beach !Long Bcacb VctC!l!!!S Ho:;pital) · Solinuy fibrous tumor Los Anoeles • Sclerosing fibrous tum<M'. NOS MontereY (Communjtv Hospjta) of Monterey fcpim1da) - Solitary fibrous tumor QJ!!sl!!!l!l • Solitary fibrous tumor Orange (Orange County Pathology Medical Grouo) • Solitary fibrous tumor Oxnaa:! (St. John's Reoional Mes!ical Center) - Angiomyolipoma (4) San Dicao • Solilary fibrous IWnor. kidney San Dieso !Naval Medical Center Sao Djerol • Solitary fibrous tumor San Picoo !Seriops Heulthl • Solitary fibrous nunor SM Picoo IUCSD) • Solitary fibrous tumor San Franeim !San Francisco General HoSpital) • Endstagc kidney with reactive fibrosis Santa Barbara • Solitary fibrous tumor Santa Ross !Santa Roy Memorial Hospital) • Solitary fibrous tumor (3) Woodlaod Hms (Kaiser Pel1!ll!!lcntc) - Solitary fibrous tumor Woodlaod Hills (Sudn's Soldiers) - Solitary fibrous tumor (amyloid in lddoey) Arkansas !University ofi\r!cansas for Medical Sciences> • Solitary fibrous tumor CleOtJjL Orgm'r - Solitary fibrous rumor nlinois. Burr Ridge • Solitary fibrous tumor (2) lllinojs CLgyola (Jnjycrnitv Medical Center) - Well-differentlalcd neuroendocrine (umor (pdi!IQII CHowar<l Rcgjonnt Medical Comer) · Old Infarct with pscudosarcomntous reaction MarviWJd !Northwest Homital Ceni+Tl • Renomedullary interstitial cell tumor MarviB!Jd <University ofMa!ylaodl • Solitary fibrous rumor M!m!!fbusetts ffierlssbire Medical Center) - Solitary fibrous tumor Massachusetts CBc.ycr!y Hospital) .. Solitary fibrous tumor MichigM !Oakwood Hosnital) • Solitary fibrous tumor Minnesota (fairview Rjdges Hospjta!) • Solitary Bbrous tumor Nehp!k• (Creighton Vniymitv School of Medicine) - Solitary fibrous wmor New Mejoo CUnivcrsj!l! oCNcw MejDO) • Solitary fibrous tumor New Yods, !Long Island Jewish Mes!jcal Center) • Solitary fibrous 1\Jmor New Yodc <Na.w~u University Modjcal Centi:r) .. Solitary fibrous tumor New Yodc CStony Brook University lipsoitaD • Solitary fibrous tumor

February 2007

New YC!dc CSUNY Downstate Mec!ica! Center) • Solinuy fibrous wmor vs. desmoplastic DCSl$ spindle cell tumor Nonh Carolina (Moon!ain Are;! Pathology> · Solinuy fibrous tumor (2) Ohio fMcCullough-Hyde Memorial Uosnital) • Solitary fibrous tumor Okl!!hom!l. Tulsa • Ronomedullary Interstitial cell tumor Pennsylvania <Drexel Unj\·ersitv Cgllege of Medicine)~ Solitary fibrous tumor Pennsvlvaoja<Lehigb Valley HospjmO • Solituy fibrous tumor PennsylyMia (Magee Women's Hospital> - Solitary fibrous tumor Pennsylyanja <Mt Njnany Medical Cen!er) • Solitary fibrous tumor Pcnosylyooia !Pcnnsy!vBDiD Hospital Residen~ • Solitary fibrous rumor Puer19 Rico IUniveajty of Puerto Rjco) • Solitary fibrous tumor South Dakota IUnivsrsiiY of South Dakota Residen!!l • Solitary fibrous tumor Tcnno* Kingsnoa · Solitary fibrous tumor Texas (Scott & W!Jjle Memorial Hpmjl'!l) · Solitary fibrous rumor Texns, Houston - lntlnmmntory myofibrob1...,1ic pseudotumor

12

Texas. I .!!hhock - Solitaly fibrous tumor Washinwn CM!ldhmn Anny Medical Center) - So!iwy fibrous tumor (12) We.<t Virginia (Orccnbrjer Valley Mcslical Center) - Solililry fibrous tumor Australia CRoval Hobart Hospitill) - So!italy fibrous tumor Australia CRoya! Prj nee Alfrt:d Hosnj!AI) - Solitary fibrous tumor Ayma!ia ISumVM Njco!ajdes Patho!on> - So!italy fibrous tumor Brazjl a.ahon!torio An8IOJDia Pato!ogjq Eatolooial - Solitary fibrous rumo< of the kidney Brazil. Sao Paulo - SolitaJ}· fibrous rumor Qmada (pasoua tlospjtall - So!itaty fibrous rumor Canada. Sasklltoon • Medullary fibroma (tenomedu!!ary Interstitial cell tumor) Canada ISherhrookc Univcrsjty Uosnjtal) - Solitaty fibrous lumor India. Kama!llka - Soliwy fibrous tumor !rel!!!Jd CKmy Ococm! Hospital) • Solitaly fibrous tumour Jamaica !Jbe \Jnjycrsitv ofWes! lndjq) - Cbrooic pyelonq>hritis Iaoan CKyoto Unjyersitv Hosoital) • So!iwy fibrous rumor Qman (Kboula Hospj!aD • Solitaly fibrous tumour Oatar !Hamad Medical Comoration) - So!iUu')' fib.rous rumor Saudi Ambja !King Fahad National Oyard Hospilal) - lnflammalory pseudOIUmor Saudi Ambia IM!I\eQ)ity and Children's 11osnitall - Kaposi sarcoma The Ne!herlands. Ams!ch·em - Soli!Ary fibrous rumor United Kinodom IOxfonl Study Oroypl - So!italy fibrous bJmOr

Case 7- Diaanosls: Solitary fibrous tumor, kidney

T-71000, M-90510

Case 7 References: Gengler C and Ouillou L. Soliw'y Fibrous TUmour and H""!llll!lgiopcriq1oma. Evolution of a Concept. Hlstopmho/2006;

48(1):63-74. Fine SW, McCarthy OM, ChanTY, ct ol. Malignant So !italy fibrous ·rumor of the Kidney. A Report of a Case and Comprehensive

lteview oflhc Literature. Arch Pat hoi Lab 1)d 2006; 130(6):857-86!. Kohl SK. Mathews K and Baker I. Renal Hilar Mass in an 8S-Year-Old Woman. Solitary Fibrous Tumor. Arch !'athol Lab Med

2006; 130(1):1 17-119. Yamagucbi T, Taltimoto T, Yamashita T. etal Fat-Con!Ai4ing Variant ofSoli!Ary Fibrous Tumor (Lipomatous

Hemangiopericytoma} Arising on Surface: of Kidney. C/ro/2005; 6S{ I): 175. WangJ, Arber DA, Frankel K, eta!. Large Solitaly Fibrous Tumor of the Kidney. Report of Two Cases and Review ortbe

Literature. Am J Sarg Patho/2001 ; 25(9}:1 \94-1 199.

Case No. 8, Accession No. 30Z90 February 2007

AlamcdJ! IA!amgl;! County Medical Center) • Primitive nCIJti)OCt!!dermalrumor fonlana lKaisq Pe!l!l!!!1<:ntel - Ewin& sorcoma/PNET Granada Hills - Sarcomatoid renal cell carcinoma Long Beach - Adults Wilms' tumor l..ong Beach !Long Beach Velcrnns HOsojU!l) - Adull Wilms' tumor(2); Mesoblastic nephroma(!) l&s Angeles · Primilive neuroectodermal tumor Monterey <Community HOS!?i!J!l of Monterey Peninsula) • Syno•ial san:oma Oaldand • Primitive neurocdodennal rumor vs. rbabdomyosarcoma On!!!•• COransc Coyn(Y Pa!holocy Medical Group) - Synovial sarroma Oxnard !St. John's Regional Mcs!jcal Cenlcr) - Leiomyosarcoma (4) San Diego - Small blue cell tumor (metanephric stromnl tumor vs. mesopla.•tic nc{phroma S311 Dicoo fNaynl Medica! Center San Djego) - Small round blue cell lumor; Ewings sarcoma (3); Wilms' tumor ( I} SAP Pieco (Scripps Health) - Monophasic S)'llovial sorcoma Son Diego CUC~Ql - Primitive neuroectodermal tumor (PN£'1) San Francisco CSon fmncisro General HosojJa!) - Adult Wilms' rumor Santa Batbi!rn - LciomyosaKOma Sanlil Rosa !Santa Rosa Memorial Homital) - Ewing's san:oma (!'NET)(!}; Primitive neuroectodermal tumor (2) Woodland Hills CKnjs.;r Pennanenlc) - Primitive neuroeccodcrmal tumor/Ewing's sarcoma Woodland Hills <Suda's So!djm) - Primitive ncuroectodennal rumor Arkansas <Uniyersity of Arkansas for Medica! Sciences) • Synovial SSKOma. kidney Georgia. Dccarur - Suggestive of metasl8tie endomettial sttomal sarcoma

CITR. Fcbrull)' 2007 "Minutes• (Subs<riptico A) 13

lllinoi; Buq Ridee - Primitive neurocctodennnl tumor (I); Synovial sarcoma (I) Illinois !Lovoln University Mes)jcnl Cent!!t) - PheochromO<:ytoma Indiana lltoward Regionql Mes)jcal Center) - Solitary fibrous tumor Maryland fNonll~t Hospital Center) - Primitive neuroeClodcrmal tumor MeMand Nnivrnity of Maryland) - Solilaly fibrous lllmo<, malignant

• •

Mpssachusetts fficrkshire Mocfjcal Center> - Wilms" tumor, blastema predominant (\'s. endotn~rriaJ stromal sarcoma vs. metattepluic stromal tumor vs. monophasic synovial sarcoma)

Massachuscm <Beverly Hospl!all - Prio.nitivc neuroectodcnnal tumor Michiean IOnkwood Hospital) - Sarcoma, favor monophasic synovinl sarcoma Minnesota CfajMew Ridges tlospital) - Synovial sarcoma Ne!nsl;a CCn:j@ton Univgsity Sebonl ofM<djeine) - Undifferentillled ocoplasm (probably san:oma) New Mexico CUniversjty o(Ncw MexiCO) - Synovial sarcoma New Yort (Lone Island /cwish Medical Center) - Monophasic synovial sarcoma New York <Nassau Univcc!jty Medical Cent~(.) - Primitive neuroectodermal tumor New York CStony Brook Vojvcrsitv HospltpU - Synovial sarcoma New Yoris ISVNY DoWIIS!ate Me<!ical Center) - Monophasic synovial san:oma vs. endometrial suomal sareoma Nonll Ganllina (Mountain Ami l'!!thology)- Cellular mesoblastic nephroma (2) Ohio <McCu!lou&h-Hvde Memorial Hospjtal) - Synovial souwma Oklahoma. Tulsa - Primitive neuroeelodcrmal tumor/Ewing's PcnnsylyaniaiDrexel Uniycl'l)ily College ofMedjcine) - Synovial sarcoma Pennsylvania <Lehigh Vn!ley Ho:mital) - Monophasic synovia! sarcoma Pennsv!vanja (Magee Women'• HoS!ljJa!) - Blastema dominant Wilms' rumor Pennsylvanjo (ML Nittany Mc<lica! Center) - Primitive oeuroeaodennal tumor Pennsy!yaola CPennsvlvania Hospital Residents) - Spindle cell souwma Puerto Rico (University ofPueno Rico) - Endometrial stromal sarcoma South DpkoJa IUniveQity ofSmuh Dakota Residents) - PPNET Tennessee. Ktngsoort .. Metnstatic endometrial stromal sarcon\0 Texas <Scon & White Memofia! HosniJa!} - Monophasic synovial sarcoma TC1!8S, Houston - Spindle cell neoplasm Teocas. Lubb9ck - SarcomBioid renal cell carcinoma Washington !Madigan Annv Mc<Jieal Center) - Synovial sW'Coma (12) West Virginia (Greenbrier Ynlley Medical Center) - Fibrosarcoma Australia <Royal Hobart Hoonjtal) - Monopho.sic synovial sarcoma Au.'!!JJ!lja <Royal Prince Alfred Hosni1al) - Monophasic synovial sa=ma AUS!!1!)ia csumyan Nicolaides PalhoJogy> - Synovial sarcoma Bnml fLabo!PlOrio Anatomia Patologica Ecjtgloo!a) - Monophasic synovial so.rcoma of the kidney Brazil Sao Poulo - Stromal endometrial sorcoma; DDx: Synovial sarcoma Canllda (p!I!Hlua Hosoita!) - Synovial sarcoma Canada Saskatoon - Eodonw:trial stromal sarcoma metastalic to the kidney Canalfa CSbqb!'09ke Univmity Hosnital) - High gr.>de san:oma (synovial san:oma) tndja Kametth · Primitive synovial san:oma, kidney Ireland fKmy Genera] Ho;;pi!aJ) - Primitive neurOCClodennaltumour Jamaica <The University of West Indies) - Cellular mesoblastic nephroma (adult) vs. solitary fibroid tumour, MJ::ST Jarum IKwto llnlven.itv Hosollnll - Synovial sarcoma Omlln CKJ10ula t l!lSPitaJ) - Synovial sarcoma Oa!ar Oiama4 Mc<Jjeal Corpomtion) - Synovial san:oma(4); Lciomyosareoma (4) Saugj Arabia <King Fahad NNionaJ Guard HospjtaU · Monophasic synovial sarcoma SI!Udi Arabia <Maternity and Children's HosnjiAJ) - Primitive neuroectOdermal rumor The Nct!Jcr!aods, Amstelvccp - Stromal cell sarcoma United Kingdom COxford Study Group> . Synovial sarcoma

Ca$e 8- Dia1nosis.: High grade sarcoma (NOS). kidney

T-71000, M-88103

Directors Note: "Tumor bas slriking similarity to monophasic synovial sarcomu, but is keratin negative. Molecular studies were not done. • (dre)

Consultation: Stanford University, Anne E. DrejCI, MD, "lfi&h Grade Sarcoma. NOS"

Case 8 - References:

t4 C!iR. Fcbruory 2007 "MmutC$" (Subscriprion A)

Dotan ZA, Tal R, Golijanin 0, Snyder ME, ellli. Adult Genitourinary Sarcoma. The 2S-YellT Memorial Sloan-Kettering Experience. J Uro/2006; 176(5):2033-2038.

Oali'Oglio MP, Lieberknechl M Gouveia V, et al. Sarcomatoid Differentiation in Renal Cell CW'Cinoma. Prognostic lmplicatioiU. lm Bra: J Uro/ ZOOS; 31 (I): I 0-16.

Oeyrup AT, MontgOmery I! and Fisber C. Leiomyosarcoma of the Kidney. A Clinicopaihologic Study. Am J Slug Palho/2004; 28{2):178-182.

Chen PC, Chang YH, Yen CC. ct al. Primary Renal Synovial Sarcoma wilh Inferior Vena Cava and Right Atrium lnvusion. lnt J Uro/2003; 10( 12):657-660.

Case No. 9, Accessjoo No. 30185

Alameda IA!nn>e4a Counl>' Medical Center) • Renal cell cftreinoma Fontana !Knjser Perroancnte) • Renal cell cun:looma, chromophobe type Granada Hills • OncocytOma Long !leach • Onc:ocytoma Long Beach fLono Rey=h Veterans Hasoioal) - Oncocytie neoplasm, fuvor onc:ocytoma LoS Anoeles • OncocytOma Monterey CC>mmunity Hospitnl of Montcre:y PeninSula) ~ Papilla.t)' renal cell carcinoma ~ • Onc:ocytomn Orsnoe lOran•• Coun'Y Pathology Me!lical Group) - Onc:ocytoma Oxnard CSL John's Regional Medical Center\ • Renal cell can:inoma (4) San Diego • ()nrocytoma vs. n:nal a:ll catcinoma San Diego INava] Medical Cemer San Diego) • Papillary renal cell carcinoma San Diego !ScriPPs Heahbl • Renal cell carcinoma, papillaTY type San Diego IUCSDl - PapillaTY renal cell carcinoma, type 2 San Francisco !San Fr:mcisco General Hospital) • l!osinophilic cbromophobc renal carcinoma Santa Bad!p • OncocytOma Santa Rosa ISan!a Rosa Memorial Hosni!8!l - Onweytoma (3) Woodland Hjlls (Kaiser Perroanente) • Oncocytoma Woodland tlil!s CSudn'• Soldiers) - Oncocytoma Arkansa• £Univcr.;ity of Arlgmsa,:; for Medical Sciences) · Oncocytoma, kidney Qeorgia. Decatur - Tubulocystic carcinoid lllioois Burr Rjdoe - Papillary carcinoma (2) llljoois £Lovo!a Uni-.ity Mc!ljcal Center) - P~anglioma Indiana fHoWAJ'd Regional Medical Center) • PapillaTY renal carcinoma Maryland <Northwest Horoi!lll Cemer) • Papillary renal cell carcinolllll Maryland IUnjveQjty ofMwylwjd) - Papillary renal cell careinoma. oncocystic variant Messerhu.s<m <Bevertv Ho.~pitaJ> - Renal oncocy1oma Michigan <Oakwood HOS!!i!ll!l • Renal cell comnoma, clear cell type Minnesota (folryiew Ridges Bomjta!) • Renal cell carcinoma. papillaTY Nebrallgl CCrsj&hton Univepdty School of Medicine) · Renal cell careinoma. onc:ocytic type New Mexico aJnlvcrsity of New Mexico) - Renal cell carcinomn, clear cell or cl~ical type New York CLong Island Jewish Medical Ccntql - Chromophobe renal cell carcinoma, eosinophilic vwiant New York CNo,ssau Univensjty Medica! Centq\ - Renal cell carcinoma New YO!t !Stony Brook llnjymi!>' Rospj!Al) • Oooocytoma New York IS\JNY Downstate Mcc!ica! Centq) - PapillaTY renal carcinoma. type U vs. renal onweytoma North Carolina (MounJ!Ijn Area Pathology)· Oncocytoma ('l) Ohio (McCulloush-Hvdc Memorial Hospital) • Oncoc}10trul Oklahoma. Tulsa • Renal cell carcinoma. granular cell type Pennsvlvan!a fDrexellJnivmity Collese of Mc!ljcine) - Renal oell papilbuy carcinoma, oncoeytic type Pcnnwllllll!ja l!.d!igb Valley Hosoi!Al) • OncoeytOma Pcnnsvlvani• CMagec Women•3 Hospital) • Oncocytoma Pennsylvania CMI. Njttany Medical Cemer) • OncOCytoma with hemorrhage PennsylyMia (pcnnsvlvanio Hgspital Resident$) • PapiJJruy renal cell carcinoma l'uerto Rico !Upjvec;ity ofPycM Rjco) • Papillkry renal cell carciooma Solllh DakotJ! CUniversity ofSoulh Dakota R;sjdonts) • OncocytOma Tcnnrntt Kjngsport • Oncocytoma Texas <Scon & White Mgnori&! tiO<pitaD - Ooc:ocytoma Texas. Houstgn - Renal cell carcinoma Texas. Lybbock • Renal oell caTCinoma, oneoeytic type Washington !Madisan Anny Medical Center) • PapillaTY renal cell ( 10); Oncocytoma (2) West Virginja !Greenbrier Vo!ls;y Me<lical Cguq) · Chromophobe rena! cell can:i11onta

crrR. fcbrult)' 2007 "Minutes" (Subscription A)

February 2007

IS

AUS!rj!lia !Royal Hoban Hosnital) • Papillary n:nal cell carcinoma, type 2 Austnllia !Royal Pdnce Alfred Hospital) • Papillary renal cell carcinoma Austnllia <Sulljvan Njcolaides Patholoayl · Renal OD<'O<')'IOma Rfll7.il O,aboratodo Anntomia Pa!Ologica !lcitologial • Papillary renal cell carcinoma. type 2 B!!WI. Sao Paulo • Renal cell carcinoml!. type 2/papillary variant C!lnadafPasoUJ! Hospital) • l'apillary renal cell carcinoma C~ MarMO • Hemangioma Gan&da (Shc:rbrookc Uni\•ersity Hospital) • Om:oc)10111ll India. Kamata!m • Papillary rcnal cell carcinoma Ireland CKem Geneml Hosoital) • Papillary renal cell carcinom,._ type 2 Jamaica Cll!e Unlycrsjty of West Indies\ • Papillary renal cell carcinoma Jnpan <Kyoto !JnjyerniiY Hosoital) • Oncocytoma Oman fKhoula Hospital) • Oncocytoma 0amr <Hamad Mg!ica! Corporation\ • Rcoal cell carciooma Saudi A!abia OOno F!!had National Guaa! Hosnital) • Papillary n:nal cell carcinoma Saudi Arabia (Maternity and Chilc!ren's llosnital) · Oncocytoma The Netherlands. Am>1elveen • Oncocyloma lin ired Kingdom <Oxfiud Study Groun) - Oncocytoma

Case 9 - Diagnoslo: Renal cell carcinoma wilh papillary and tubulocystic featureS, kidney

T-71000,~·83123

Case 9 - References: ~lz.utani Y, Nakru>IShi H, Li YN, eta!. Overexpression ofXIAP Expression in Renal Cell Carcinoma l're<iicts a Worse Pro&~~osis.

lnl J Onco/2007; 30(4):919-925. Antonelli A, Cozzoli A, Zani D, o:t a!. The Follow-Up ~anagcment ofNon-~ctastntic Renal Cell Can:inoma. Definition of a

Surveillance Protocol BJU ln/2001; 99(2):296-300. M!cl.ennan GT and Bostwick DG. Tubulocystic Can:inoma. Mucinous Tubular and Spindle Cell Can:.inoma and Other Recently

Described Rare Renal Tumors. Clln fn lAb Med 2005; 25(2):393-416.

Case No. 10, Accession No. 30233

Alameda (AIIl!!!Sda Countv Medical Centq} • Collecting duct carciooma Eon!Ma <Kaiser Pqm!lll!!!!te) • Mucinous tubular aod spindle cell carcinoma of kidney Granada Hills • Collecting duct carcinoma Lone Beach · Invasive urotbelial curti11omn, high grade

February 2007

Long Beach <Long Beach Veterans Hnso.il!ll) · Collecting duct carcinoma (2); lligl> grade transitional (urothe!ial) carcinoma (I) Los Angeles .. Carcinosarcoma Monterev <Coromunirv Hosnital of Monterey Peninwla) • Urotbelial cell carcinoma (2); Carcinom:~ of collecting duct of Bellini (I) ~ • AIYCOiar rllabdomyosarcoma Otln•e fOnmge Couo!\1 Patbo1ogv Mg!lcaJ Group) • Invasive high grade urothellal carcinoma Oxnard (St. John's ReiDonal ~edical Ccoter) • Sarcomatoid carcinoma (1 ); Collecting duct carcinoma (3) Sgn Dieco • Renal cell carcinoma, collecting duct type Son Diego (Naval ~e!llca! Ceotor San Diego) • Transitional cell carcinoma of the renal pelvis San Diego (ScriPPs He!!lthl • Collecting duct carcinoma San Diego <UCSDl • Collecting duct carcinoma San fnlnejsco <San fmnc:im Gcna11l tlosnjJAl) • Collecting duct carcinoma Santa Bll!bara • Collecting duct renal cell carcinoma Santa Ro.., <Saara Rosa Mcmorial!iowjtaO • Transitional cell carcinoma (2); Urotbclial carcinom11, invading kidney (I) Woodland Hills <Koj:;q Perroaru;ntol • Sarcomatoid renal cell carcinoma Woodland Hills !Suda's Soldiers) • Synovial sarcoma vs. collecting duct cnrcinoma Arkan<as (Uoiycrsitv of Ar!glnsas for Medical Scjence;;) • Collecting duct carclooma, kidney Geoatla. Decatur • Collecting duct can:! noma Illinois. BUJT Rid as • Collectiog duct carcinoma(!); Mucinous tubular and spindle cell carcinoma (I) Ulinois <Loyola Unjvcrsity Me!lical Center) • Merlcel cell rumor Mruyland (Nonhwest Hospital Center) • Collecting duct rumor Maryland (!Jniyersily of Maryland) • Collecting· duct caroinoma Ma.<M£husetts fBcycrly Hospital) • Collecting duct n:nul cell carcinoma Michigan (Qakwogd HoSpital) • lnvnsiveurothelial carcinoma, high grade Minnesota (fajryjew Ridees Hospitpl · Collecting duct carcinoma

16 CTIR February 2007 "Minutts" (Subscription A)

Nebrnska CCrsjsbton UniversiiV School ofMedjdnc) - Collecti~g duct carcinoma New Mexico C\lnjyersi!V of New Mexico) - Carcinoma of the collecting ductS of Bellini New York O.nng Island lewisii Medical Center> - Carcinoma of the collecting duct ofiiellini New York <Nassau llnivasi[)l Medical Cancel - Urothelial carcinoma, high grade, invasive New Yod< !Stooy B!9Qk Univcrsjty Hosnital\ - Carcinoma of the collecting ductS of Bellini New X ork !SUNY Do"n:;r.am Medical Center) - Angiosarcoma vs. eoUeaing duct carcinoma North Carolina !Mouo!ain Area Pathology)- Collecting duct ~inoma {2) Ohio IMcCullouAA-Hvs!e Mcmoriu! Hosni1l!l) - Collecting duct renal cell carcinoma OklabomR. D1IS.' - Urothelial can:iooma, high grade PennsylvMI• !Drexel Unjvec;jty College of Medicine) - Mucinous tubular spindle cell carcinoma Pe!!nsylvanja l!.ehi!!h Valley !iospi1l!l\ - Collecting duct carcinoma Pcnnsylyanja IMA&ee Women's Hospjtal\ - San:oma10id variant of transitional cell cmcinoma Pennsylvania !Mt. Ni!!MV Medical Center) - Xanthogranulomatous pyelonephritis PennsviVlllliA (pennsvlvania Hospital Residen!Sl - Collecting duct carcinoma Puc!'!9 Rico IUojyersity ofPyC£!o Rico) - Collecting duct carcinoma South D!!!cota (Universitv of South Dakota Rc.<idcntsl - Collecting duct carcinoma Tenn"''"" Kinpnort - Collecting duct carcinoma Texas !Scott & Wbite Memorial Hospital) - Mucinous rubulor and spindled cell carcinoma Texas, Houston - Sarcomatoid renal cell careinoma -Texas. Lubbock - High grade urothelial carcinoma Washington IM!Kijgan Anny Mcdjcal Center\ - Collecting duel carc.inoma ( 12) West Viminja CGreepbrier Valley Mec!ieal Center> - Collecting duct renal cell carcinoma Aus!raJja !Royal Hobart llospita!l - High grade invasive urothellal careinoma Australia CRowl Prince Alfisd Hospital) - Invasive urothelial can:inoma Austmlia <Syl!iyan Nicolaides Pathology) - Collecting duct can:inoma BrWI <Lol!oanorio Amuomla Patologica Eci!Oio•ia) - High grade urothelial carcinoma Brazil Sao Paulo - High grude urothelial curclnoma vs. ciltCinoma of the collecting ducts Cana!la <Pasoua Hospital) - Urothelial carcinoma Canada. Sa,hroon - CoUectios duct renal cell carcinoma Canada !Sbgl!rooke UniveJlliiV Hosnitall - Collecting duct c:an:inoma India. Kamatlllsa - Urothelial carcinoma renw pelvis Ireland (!(my Ocnern! Hospjt.all - Collecting duct cascinoma JamajcalllJQ University ofWcg Indies) - Collecting duel carcinoma 1!!P8l! (Kyoto University Hospila!) - Collecting duct carcinoma Oman CKhoula Hospital) • Infiltrating urothclial carcinoma, high grade Oa!ar IHama<l Medical Como!J!jon) - Collecting duct carcinoma Saudi Arabi• CKing Fab!KI N!!ljonal Guard Hospilal) - Collecting duct carcinoma Saudi Arnbja (Maternity and Children's Hospi!n!) - Metanephric !Kienosarcoma The Netherlw•ds. Amsrelveen - Coliecting duct carcinoma United KinRdom (Oxford S[udy Group) - Collecting duct carcinoma

Case 10- Diagnosis: Collecting duct can:inoma, kidney

T-71000, M-83123

Case 10 - References: Swan:z MA, Kanh J. Scl!neidcr PT. et al. R<nal Medullary Carcinoma. Clinical, Pathologic, lmmunohistoch=ical and Genetic

Analysis with Pathogenetic Implications. Uro/2002; 60(6):1083-1089. Steele EL Wid M!lCLeonan OT. Renal Medullary Carcinoma. J o/Uro/1005; 174(4 Pt 1):1449. Assad L, Resctkova E, Olivel.m VL, et al. Cytologic Features of Renal Medullary Carcinoma. Cmu;" 2005; 105( 1):28-34. Vargas-Oonzalcz R, Sotelo-Avila C and Coria AS. Renal Medullary Carcinoma in A Six-Year-Old Boy with Sickle Cell Trnit.

Parlrol Onco/ &s 2003; 9(3):193-195. Peyro1lllltm: M. Thiouon N, Sc:oue F, et al. Collecting Due! Carciooma of the Kiclncy. A Clinjeopathological Study or9 Cases. J of

U>-o/2003; 170(4 Pt I ): 11 38-1 140. Polasdk TJ, Bostwick DG and Cairns P. Molecular Genetics w1d Histopathologic Features of Adult Distal Nephron Tumors. Urol

2002; 60(6):941-946.

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