A 45 year old man with a history of renal transplant presented with lymphadenopathy. A lymph node biopsy was performed. A representative image is shown. The large atypical cells are positive for CD30 and CD15 with dim PAX5 nuclear positivity and dim and variable CD20 expression. CD3 and CD45 are negative. Which of the following is the most appropriate diagnosis?
Select an answer:
A. Classic Hodgkin lymphoma posttransplant lymphoproliferative disorder
B. Monomorphic posttransplant lymphoproliferative disorder (diffuse large B cell lymphoma)
C. Nondestructive posttransplant lymphoproliferative disorder (florid follicular hyperplasia)
D. Polymorphic posttransplant lymphoproliferative disorder
An 80 year old Caucasian woman had a thyroid mass and a 1 cm pulmonary lesion. CT guided transthoracic needle biopsy was performed to rule out metastatic tumor. Microscopic examination of core needle biopsy tissue reveals the following lesion. What is your diagnosis?
Comment – This pancreatic ductal adenocarcinoma has spread to the liver and “colonized” a bile duct in a portal tract. A separate bile duct in the same postal tract is unaffected. The malignant nuclei show loss of SMAD4/DPC4, a useful finding for this tumor (Am J Surg Pathol 2000;156:37).
This case was provided by Dr. Elizabeth Montgomery, Professor of Pathology and Vice Chair of Anatomic Pathology at the University of Miami and Editor-in-Chief of the Pathology Survival Guides at Innovative Pathology Press / Innovative Science.
A 59 year old woman had a 1.0 cm spiculated breast mass, represented below. Tumor cells express GCDFP-15, mammaglobin, S100 and calretinin. Hormone receptors (ER / PR / HER2) are triple negative. Myoepithelial markers (p63 and SMMHC) are also negative. Other negative markers include TTF1 and thyroglobulin. What is the most common molecular alteration seen in these tumors?