21 September 2021: Image Quiz #65

Author: Pablo Zoroquiain, M.D.

What finding in this sample is characteristic of pterygium?

Select an answer:

A. Bowman’s layer fragmentation

B. Elastosis of the lamina propria with corneal invasion

C. Epithelial atrophy with goblet cell loss

D. Neovascularization of the stroma

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7 September 2021: Image Quiz #64

Authors: Vikas Mehta, M.D., Maria M. Picken, M.D., Ph.D.

What is the immunohistochemical staining pattern of adenovirus in adenovirus nephritis?

Select an answer:

A. Cytoplasmic

B. Dot-like

C. Nuclear

D. Nuclear and cytoplasmic

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24 August 2021: Image Quiz #63

Author: Raul S. Gonzalez, M.D.

A patient presents with fever, jaundice and abdominal pain. Liver enzymes are elevated and a liver biopsy is performed. You see the following finding. Based on this, which of the following steps may be included in the patient’s therapy?

Select an answer:

A. Antibiotics

B. Bile duct excision

C. Platinum based chemotherapy

D. Steroids

E. Ursodeoxycholic acid

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10 August 2021: Image Quiz #62

Authors: Kieran Doyle, M.D.Jian-Hua Qiao, M.D.

A middle aged man underwent a right hemicoloectomy for cecal adenocarcinoma. Grossly, the ileocecal valve was prominent and diffusely thickened but no tumor was noted. What is your diagnosis?

Select an answer:

A. Crohn’s disease

B. Lipoma of the ileocecal valve

C. Lipomatosis of the ileocecal valve

D. Non-Hodgkin lymphoma

E. Normal ileocecal valve

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27 July 2021: Image Quiz #61

Author: Bin Xu, M.D., Ph.D.

A 45 year old man presents with a nasal cavity mass. A representative H&E of the mass is shown in the picture. Which of the following statements is true?

Select an answer:

A. Differential diagnoses include adenoid cystic carcinoma of salivary gland origin and HPV related multiphenotypic sinonasal carcinoma

B. Tumor is consistently negative for myoepithelial markers, e.g. SMA, calponin and S100

C. Tumor may be positive for EBV

D. 80% are positive for EWSR1 fusion

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13 July 2021: Image Quiz #60

Authors: Rong Xia, M.D., Ph.D.Xuchen Zhang, M.D., Ph.D.

Which of the following is true about this liver tumor?

Select an answer:

A. Most commonly seen in adults with a male predominance

B. Grossly characterized by large, poorly defined or infiltrative masses, with variable calcifications

C. Histologically characterized by nests of spindled and epithelioid cells surrounded by a desmoplastic stroma with occasional psammomatous calcification and ossification

D. Often shows vascular invasion with high tumoral recurrence rate

E. Positive for AE1/AE3, vimentin, HepPar1 and AFP

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29 June 2021: Image Quiz #59

Authors: Ayana Suzuki, C.T.Andrey Bychkov, M.D., Ph.D.

A 70 year old man underwent FNA for the nodule of the thyroid right lobe. A cytological image of the lesion is shown. Which marker would most likely show positive staining?

Select an answer:

A. PAX8

B. Calcitonin

C. GATA3

D. Thyroglobulin

E. TTF1

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22 June 2021: Image Quiz #58

Disclaimer: This Image Quiz was originally emailed to our e-newsletter subscribers on 15 June 2021.

Authors: Farres Obeidin, M.D.Borislav A. Alexiev, M.D.

A 45 year old man presents with a 1.2 cm mass on the right subcutaneous forearm. The mass is diffusely positive for S100 and CD68. Which of the following is true about this lesion?

Select an answer:

A. Cells are filled with PAS+, diastase resistant granules

B. It’s likely reactive in nature and will regress without treatment

C. Lesion is associated with multifocal lymphadenopathy

D. Overlying epithelium is usually ulcerated and thinned

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1 June 2021: Image Quiz #57

Authors: Andréanne Gagné, M.D., M.Sc.Philippe Joubert, M.D., Ph.D.

A 55 year old woman had a lower left lobectomy showing a well circumscribed flesh colored tumor. Histologic details are shown in the image below. Regarding this entity, which of the following statements is true?

Select an answer:

A. CDX2 is usually negative in the lung and is useful to differentiate from a metastasis of an intestinal origin

B. Ki67 proliferative index is essential to grade this tumor

C. Rb expression is typically lost in this tumor

D. TTF1 is always positive

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18 May 2021: Image Quiz #56

Author: Mehmet Kefeli, M.D.

Which of the following is diagnostic for parathyroid carcinoma in a parathyroid lesion?

Select an answer:

A. Tumor cells within the capsule

B. Perineural invasion

C. Increased mitotic activity (> 5/50 HPF)

D. Broad fibrous bands

E. Parafibromin loss

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