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

See the answer

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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

See the answer

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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

See the answer

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11 May 2021: Image Quiz #55

Disclaimer: This Image Quiz was originally emailed to our e-newsletter subscribers on May 4, 2021.

Authors: Sharon Song, M.S., M.D., M. Carolina Reyes, M.D.

Which laboratory marker may be elevated with struma ovarii?

Select an answer:

A. Alpha-fetoprotein (AFP)

B. CA125

C. CEA

D. hCG

E. PLAP

See the answer

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20 April 2021: Image Quiz #54

Author: Borislav A. Alexiev, M.D.

Which of the following is true about composite hemangioendothelioma?

Select an answer:

A. Harbors WWTR1-CAMTA1 fusions

B. Harbors ZFP36-FOSB fusions

C. HHV8+

D. Typically does not recur after excision

E. Distinguishing from other vascular neoplasms largely lies in finding different histologic vascular patterns within 1 lesion

See the answer

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13 April 2021: Image Quiz #53

Disclaimer: This Image Quiz was originally emailed to our e-newsletter subscribers on April 6, 2021.

Authors: Hatem Kaseb, M.D., Ph.D., M.P.H., Stanley David Hudnall, M.D.

A 57 year old man presented with fatigue, splenomegaly and hepatomegaly. A complete blood count demonstrated anemia and thrombocytosis. A bone marrow aspirate and biopsy were ordered (shown below). What is the most likely diagnosis?

Select an answer:

A. Acute myeloid leukemia

B. Chronic myelogenous leukemia

C. Myelodysplastic syndrome

D. Primary myelofibrosis

See the answer

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23 March 2021: Image Quiz #52

Authors:  Nathan Lee, D.M.D., Tony Ng, M.D., Ph.D.

Which of the following is true about this adenoid cystic carcinoma of the larynx?

Select an answer:

A. Immunohistochemical staining for CD117 will be negative in tumor cells

B. Perineural invasion is extremely rare in this type of tumor

C. The cystic spaces contain mucoid or hyalinized material

D. The primary site of laryngeal adenoid cystic carcinoma is the vocal cords themselves

E. This tumor is clinically aggressive, reflected by the high mitotic rate and basaloid cells

See the answer

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9 March 2021: Image Quiz #51

Author: Ana Belén Larqué, M.D., Ph.D.

What is the most likely diagnosis on this biopsy?

Select an answer:

A. Focal segmental glomerulosclerosis

B. Minimal changes disease

C. Myeloma cast nephropathy

D. Pauci-immune necrotizing and crescentic glomerulonephritis, ANCA associated

See the answer

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23 February 2021: Image Quiz #50

Authors: Zachary Dong, M.D., Kimberley J. Evason, M.D., Ph.D.

Which of the following is true about this liver lesion?

Select an answer:

A. It usually communicates with intrahepatic bile ducts

B. The epithelium is usually CK20+

C. The stroma is usually ER / PR-

D. There is a strong female predominance

E. These lesions are most commonly multifocal

See the answer

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9 February 2021: Image Quiz #49

Authors: Jennifer Pors, M.D., Lynn Hoang, M.D.

Which immunohistochemical staining profile would you expect in the cervical neoplasm depicted in this image?

Select an answer:

A. PAX8-, ER-, GATA3+, AMACR+

B. PAX8+, ER-, GATA3+, napsin A-

C. PAX8+, ER+, GATA3-, napsin A-

D. PAX8+, ER-, napsin A+, AMACR+

See the answer

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