Difference between revisions of "Case 5"

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===Clinical history===
===Clinical history===
68 year old woman, cerebellar mass.
68 year old woman, cerebellar mass.  


===Primary image===
===Primary image===
[[Image:Metastatic adenocarcinoma - cerebellum - very low mag.jpg|500px|link=|center|]]
[[Image:Metastatic adenocarcinoma - cerebellum - very low mag.jpg|500px|link=|center|]]
<center>Very low magnification. [[H&E stain]].</center>
<center>Very low magnification. [[HPS stain]].</center>


{{hidden|Intermediate magnification|[[Image:Metastatic adenocarcinoma - cerebellum - intermed mag.jpg|500px|link=|center|]]
{{hidden|Intermediate magnification|[[Image:Metastatic adenocarcinoma - cerebellum - intermed mag.jpg|500px|link=|center|]]
<center>Intermediate magnification. [[H&E stain]].</center>}}
<center>Intermediate magnification. [[HPS stain]].</center>}}


{{hidden|High magnification|[[Image:Metastatic adenocarcinoma - cerebellum - high mag.jpg|500px|link=|center|]]
{{hidden|High magnification|[[Image:Metastatic adenocarcinoma - cerebellum - high mag.jpg|500px|link=|center|]]
<center>High magnification. [[H&E stain]].</center>}}
<center>High magnification. [[HPS stain]].</center>}}


===Differential diagnosis===
===Differential diagnosis===
Line 20: Line 20:


====Ask a friend====
====Ask a friend====
{{hidden|Ask a friend|<center>Reminds me of a [[TA|tubular adenoma]].</center>}}
{{hidden|Ask a friend|<center>Reminds me of a [[TA|tubular adenoma]]. You'll need to do IHC.</center>}}


====Stains====
====Stains====
Line 72: Line 72:
| afp=  
| afp=  
| alk1=  
| alk1=  
| amacr=
| amacr=  
| b2microgl=  
| ar=  
| b723=  
| b2microglobulin=
| b72_3=
| bcatenin=  
| bcl2=  
| bcl2=  
| bcl6=  
| bcl6=  
| bclxl=  
| bclxl=  
| c3=  
| c3=  
| calcit=  
| calcitonin=  
| calponin=  
| calponin=  
| calretinin=  
| calretinin=  
| cam5p2=
| cd10=  
| cd10=  
| cd117=  
| cd117=  
| cd138=
| cd15=  
| cd15=  
| cd1a=  
| cd1a=  
Line 96: Line 100:
| cd4=  
| cd4=  
| cd43=  
| cd43=  
| cd45=
| cd45=  
| cd45=  
| cd5=  
| cd5=  
Line 104: Line 109:
| cd8=  
| cd8=  
| cd99=  
| cd99=  
| cdx2= '''POSITIVE'''
| cea=  
| cea=  
| chromo=  
| chromo=  
| chromo=
| ck17=
| ck19=  
| ck19=  
| ck20= '''POSITIVE'''
| ck20= '''POSITIVE'''
| ck34be12=  
| ck34be12=  
| ck5_6=
| ck7= '''NEGATIVE'''
| ck7= '''NEGATIVE'''
| cmv=  
| cmv=  
| cmyc=  
| cmyc=  
| cyclind1=  
| cyclin_d1=  
| desmin=  
| desmin=  
| dog1=
| ebv=  
| ebv=  
| ema=  
| ema=  
| erpr= '''NEGATIVE'''/'''NEGATIVE'''
| erpr= BOTH '''NEGATIVE'''
| f_viii=
| f_xiiia=
| fascin=  
| fascin=  
| fsh=  
| fsh=  
| fviii=
| fxiiia=
| gastrin=  
| gastrin=  
| gcdfp=  
| gcdfp=  
| gfap=
| gh=  
| gh=  
| glucag=  
| glucagon=  
| hbme1=  
| hbme1=  
| hbvc=  
| hbv_core=  
| hbvs=  
| hbv_surf=
| hcaldesmon=  
| hcg=  
| hcg=  
| helicobacter=
| hepatocyte=  
| hepatocyte=  
| her2=  
| her2=  
| hhv8=
| hmb45=  
| hmb45=  
| hnf1beta=
| hpv=  
| hpv=  
| hsv1=  
| hsv1=  
| hsv2=  
| hsv2=  
| Idh-1=
| inhibin=  
| inhibin=  
| insulin=  
| insulin=  
Line 140: Line 156:
| ki67=  
| ki67=  
| lambda=  
| lambda=  
| lca=
| leu7=  
| leu7=  
| lga=  
| lga=  
Line 147: Line 162:
| lh=  
| lh=  
| lysozyme=  
| lysozyme=  
| melanina=  
| mammogl=
| melanin_a=
| mitf=  
| myleoperox=  
| myleoperox=  
| myod1=  
| myo_d1=  
| myog=  
| myog=  
| myog=  
| myog=  
| nf=
| nse=  
| nse=  
| oct3_4=
| p16=
| p53=  
| p53=  
| p63=  
| p63=  
| panker=  
| panker=  
| pax2=
| pax5=
| pax8=
| pcna=  
| pcna=  
| pdgfr=
| plap=  
| plap=  
| pnl2c=  
| pnl-2c=  
| prolac=  
| prolactin=  
| psa=  
| psa=  
| psap=
| s100=  
| s100=  
| sma=
| sma=  
| somatsat=  
| somatsatin=  
| synapto=  
| synapto=  
| tdt=  
| tdt=  
| tfe3=
| thyrogl=  
| thyrogl=  
| toxopl=  
| toxopl=  
Line 172: Line 198:
| ubiquitin=  
| ubiquitin=  
| uchl1=  
| uchl1=  
| ulexeurope=  
| ulex_europe=  
| vim=  
| vim=  
| vip=  
| vip=  
| vzv=  
| vzv=  
| wt1=
}}
}}


===Diagnosis===
===Diagnosis===
{{hidden|Diagnosis|<center>[[Metastatic]] [[colorectal adenocarcinoma]].</center>}}
{{hidden|Diagnosis|<center>[[Metastatic]] [[colorectal adenocarcinoma]].</center>}}
<br>
===Other cases===
{{Cases navigation|state=collapsed}}


__NOTOC__
__NOTOC__
Line 186: Line 216:
[[Category:Cases in neuropathology]]
[[Category:Cases in neuropathology]]
[[Category:Cases difficulty 3]]
[[Category:Cases difficulty 3]]
[[Category:Cases in neuropathology - junior]]

Latest revision as of 03:48, 8 February 2016

Clinical history

68 year old woman, cerebellar mass.

Primary image

Metastatic adenocarcinoma - cerebellum - very low mag.jpg
Very low magnification. HPS stain.
Intermediate magnification 
Metastatic adenocarcinoma - cerebellum - intermed mag.jpg
Intermediate magnification. HPS stain.
High magnification 
Metastatic adenocarcinoma - cerebellum - high mag.jpg
High magnification. HPS stain.

Differential diagnosis

Differential diagnosis 
adenocarcinoma - lung adenocarcinoma, colorectal adenocarcinoma, breast adenocarcinoma, ovarian adenocarcinoma

Additional tests

More history

More history 
Patient has had really bad headaches and vomiting. Constipated. Smoker since teens - 1 ppd.

Ask a friend

Ask a friend 
Reminds me of a tubular adenoma. You'll need to do IHC.

Stains

Alcian blue/PAS to Bilirubin
Test Result
Alcian blue/PASDr T would ask why!
Alican blue pH 1.0Dr T would ask why!
Alcian blue pH 2.5Dr T would ask why!
AuramineDr T would ask why!
BielchowskyDr T would ask why!
BilirubinDr T would ask why!
Colloidal iron to Fontana-Masson
Test Result
Colloidal ironDr T would ask why!
Congo redDr T would ask why!
Cresyl violetDr T would ask why!
DieterleDr T would ask why!
Diff QuikDr T would ask why!
Fontana-MassonDr T would ask why!
Gallyas to Gremelius
Test Result
GallyasDr T would ask why!
GiemsaDr T would ask why!
GMSDr T would ask why!
Gomori's trichromeDr T would ask why!
GramDr T would ask why!
GremeliusDr T would ask why!
JMS to Mucicarmine
Test Result
JMSDr T would ask why!
JonesDr T would ask why!
KinyounDr T would ask why!
Luxol fast blueDr T would ask why!
Masson trichromeDr T would ask why!
M-MASDr T would ask why!
MovatDr T would ask why!
MucicarmineDr T would ask why!
Oil red O to Prussian blue
Test Result
Oil red ODr T would ask why!
OreceinDr T would ask why!
PASDr T would ask why!
PASDDr T would ask why!
PASFDr T would ask why!
PTAHDr T would ask why!
Prussian blueDr T would ask why!
Reticulin to Ziehl-Neelsen
Test Result
ReticulinDr T would ask why!
Sudan black BDr T would ask why!
Toluidine blueDr T would ask why!
VerhoeffDr T would ask why!
Von KossaDr T would ask why!
Warthin-StarryDr T would ask why!
Ziehl-NeeslenDr T would ask why!

IHC

Alpha-1 AT to Cathepsin K
Test Result
alpha-1 AT Dr T would ask why!
ACTH Dr T would ask why!
AE1/AE1Dr T would ask why!
alpha-fetoprotein Dr T would ask why!
Alk-I Dr T would ask why!
AMACRDr T would ask why!
ARDr T would ask why!
ATRXDr T would ask why!
Beta2-microglobulin Dr T would ask why!
B72.3 Dr T would ask why!
Beta-cateninDr T would ask why!
BCL2 Dr T would ask why!
BCL6 Dr T would ask why!
BCLxL Dr T would ask why!
C3 comp Dr T would ask why!
CA9Dr T would ask why!
Calcitonin Dr T would ask why!
Calponin Dr T would ask why!
Calretinin Dr T would ask why!
CAM5.2Dr T would ask why!
Cathepsin KDr T would ask why!
CD10 to Chromogranin
Test Result
CD10 Dr T would ask why!
CD117 Dr T would ask why!
CD138Dr T would ask why!
CD15 Dr T would ask why!
CD1a Dr T would ask why!
CD20 Dr T would ask why!
CD21 Dr T would ask why!
CD23 Dr T would ask why!
CD3 Dr T would ask why!
CD30 Dr T would ask why!
CD31 Dr T would ask why!
CD34 Dr T would ask why!
CD35 Dr T would ask why!
CD4 Dr T would ask why!
CD43 Dr T would ask why!
CD45 (LCA)Dr T would ask why!
CD5 Dr T would ask why!
CD56 Dr T would ask why!
CD57Dr T would ask why!
CD68 Dr T would ask why!
CD7 Dr T would ask why!
CD79a Dr T would ask why!
CD8 Dr T would ask why!
CD99 Dr T would ask why!
CDX2POSITIVE
CEA-m Dr T would ask why!
Chromogranin Dr T would ask why!
CK17 to Glypican 3
Test Result
CK17Dr T would ask why!
CK19Dr T would ask why!
CK20 POSITIVE
CK34betaE12 Dr T would ask why!
CK5/6Dr T would ask why!
CK7 NEGATIVE
CMV Dr T would ask why!
c-MYC Dr T would ask why!
Cyclin D1 Dr T would ask why!
D2-40Dr T would ask why!
Desmin Dr T would ask why!
DOG1Dr T would ask why!
EBV Dr T would ask why!
EMADr T would ask why!
ER and PR BOTH NEGATIVE
Factor VIII Dr T would ask why!
Factor XIIIa Dr T would ask why!
Fascin Dr T would ask why!
FHDr T would ask why!
FSH Dr T would ask why!
Gastrin Dr T would ask why!
GATA3Dr T would ask why!
GCDFP-15 (BRST2)Dr T would ask why!
GFAPDr T would ask why!
GH Dr T would ask why!
Glucagon Dr T would ask why!
Glypican-3Dr T would ask why!
HBME-1 to IgM
Test Result
HBME-1 Dr T would ask why!
HBV core Dr T would ask why!
HBV surface Dr T would ask why!
H-caldesmonDr T would ask why!
HCG Dr T would ask why!
HelicobacterDr T would ask why!
Hepatocyte Dr T would ask why!
HER2/neu Dr T would ask why!
HHV-8Dr T would ask why!
HMB-45Dr T would ask why!
HNF1betaDr T would ask why!
HPV Dr T would ask why!
HSV-I Dr T would ask why!
HSV-II Dr T would ask why!
IDH-1Dr T would ask why!
Inhibin Dr T would ask why!
INI1 (BAF47)Dr T would ask why!
Insulin Dr T would ask why!
Kappa Dr T would ask why!
Ki-67 Dr T would ask why!
Lambda Dr T would ask why!
Leu 7 Dr T would ask why!
IgA Dr T would ask why!
IgG Dr T would ask why!
IgM Dr T would ask why!
LH to PDGFR
Test Result
LH Dr T would ask why!
LIN28 Dr T would ask why!
Lysozyme Dr T would ask why!
mammoglobinDr T would ask why!
MAP2Dr T would ask why!
MCVDr T would ask why!
Melanin A Dr T would ask why!
MHC class I Dr T would ask why!
MITFDr T would ask why!
MUM1Dr T would ask why!
Myeloperoxidase Dr T would ask why!
MYO D1 Dr T would ask why!
MyoglobinDr T would ask why!
NapsinDr T would ask why!
NFDr T would ask why!
NKX3.1Dr T would ask why!
NSE Dr T would ask why!
OCT3/4Dr T would ask why!
p16Dr T would ask why!
P501SDr T would ask why!
p53 Dr T would ask why!
p57Dr T would ask why!
p63 Dr T would ask why!
PankeratinDr T would ask why!
PAX2Dr T would ask why!
PAX5Dr T would ask why!
PAX8Dr T would ask why!
PCNA Dr T would ask why!
PDGFRDr T would ask why!
PLAP to WT1
Test Result
PLAP Dr T would ask why!
PNL-2C Dr T would ask why!
Prolactin Dr T would ask why!
PSA Dr T would ask why!
PSAPDr T would ask why!
RCCDr T would ask why!
S-100Dr T would ask why!
SALL4Dr T would ask why!
Smooth muscle actin Dr T would ask why!
Somatostatin Dr T would ask why!
STAT6 Dr T would ask why!
Synaptophysin Dr T would ask why!
TdT Dr T would ask why!
TFE3Dr T would ask why!
TFEBDr T would ask why!
Thyroglobulin Dr T would ask why!
Toxoplasma Dr T would ask why!
TSH Dr T would ask why!
TTF-1 NEGATIVE
Ubiquitin Dr T would ask why!
UCHL1 (PGP9.5)Dr T would ask why!
Ulex Europaeus Dr T would ask why!
VimentinDr T would ask why!
VIP Dr T would ask why!
VZV Dr T would ask why!
WT-1Dr T would ask why!


Diagnosis

Diagnosis 
Metastatic colorectal adenocarcinoma.


Other cases