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| [[Category:Cases difficulty 4]] <!-- difficulty 1-7 -- should roughly correspond to the PGY level --> | | [[Category:Cases difficulty 4]] <!-- difficulty 1-7 -- should roughly correspond to the PGY level --> |
Revision as of 04:25, 24 September 2015
Provided clinical history
36 year old pregnant woman with multiple polypoid lesions on the vulva
Site
Vulva
Primary image
Low magnification. H&E stain.
Intermediate magnification
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Intermediate magnification. H&E stain.
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High magnification
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High magnification. H&E stain.
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Differential diagnosis
Differential diagnosis
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THE DDx GOES HERE
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Additional tests
More history
More history
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MORE HISTORY HERE
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Ask a colleague
Ask a colleague
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COLLEAGUE'S ADVICE HERE
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Stains
Alcian blue/PAS to Bilirubin |
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Test | Result |
Alcian blue/PAS | Dr Torres would ask why! |
Alican blue pH 1.0 | Dr Torres would ask why! |
Alcian blue pH 2.5 | Dr Torres would ask why! |
Auramine | Dr Torres would ask why! |
Bielchowsky | Dr Torres would ask why! |
Bilirubin | Dr Torres would ask why! |
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Colloidal iron to Fontana-Masson |
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Test | Result |
Colloidal iron | Dr Torres would ask why! |
Congo red | Dr Torres would ask why! |
Cresyl violet | Dr Torres would ask why! |
Dieterle | Dr Torres would ask why! |
Diff Quik | Dr Torres would ask why! |
Fontana-Masson | Dr Torres would ask why! |
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Gallyas to Gremelius |
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Test | Result |
Gallyas | Dr Torres would ask why! |
Giemsa | Dr Torres would ask why! |
GMS | Dr Torres would ask why! |
Gomori's trichrome | Dr Torres would ask why! |
Gram | Dr Torres would ask why! |
Gremelius | Dr Torres would ask why! |
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JMS to Mucicarmine |
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Test | Result |
JMS | Dr Torres would ask why! |
Jones | Dr Torres would ask why! |
Kinyoun | Dr Torres would ask why! |
Luxol fast blue | Dr Torres would ask why! |
Masson trichrome | Dr Torres would ask why! |
M-MAS | Dr Torres would ask why! |
Movat | Dr Torres would ask why! |
Mucicarmine | Dr Torres would ask why! |
|
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Oil red O to Prussian blue |
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Test | Result |
Oil red O | Dr Torres would ask why! |
Orecein | Dr Torres would ask why! |
PAS | Dr Torres would ask why! |
PASD | Dr Torres would ask why! |
PASF | Dr Torres would ask why! |
PTAH | Dr Torres would ask why! |
Prussian blue | Dr Torres would ask why! |
|
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Reticulin to Ziehl-Neelsen |
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Test | Result |
Reticulin | Dr Torres would ask why! |
Sudan black B | Dr Torres would ask why! |
Toluidine blue | Dr Torres would ask why! |
Verhoeff | Dr Torres would ask why! |
Von Kossa | Dr Torres would ask why! |
Warthin-Starry | Dr Torres would ask why! |
Ziehl-Neeslen | Dr Torres would ask why! |
|
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IHC
Alpha-1 AT to Cathepsin K |
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Test | Result |
alpha-1 AT | Dr Torres would ask why! |
ACTH | Dr Torres would ask why! |
AE1/AE1 | Dr Torres would ask why! |
alpha-fetoprotein | Dr Torres would ask why! |
Alk-I | Dr Torres would ask why! |
AMACR | Dr Torres would ask why! |
AR | Dr Torres would ask why! |
ATRX | Dr Torres would ask why! |
Beta2-microglobulin | Dr Torres would ask why! |
B72.3 | Dr Torres would ask why! |
Beta-catenin | Dr Torres would ask why! |
BCL2 | Dr Torres would ask why! |
BCL6 | Dr Torres would ask why! |
BCLxL | Dr Torres would ask why! |
C3 comp | Dr Torres would ask why! |
CA9 | Dr Torres would ask why! |
Calcitonin | Dr Torres would ask why! |
Calponin | Dr Torres would ask why! |
Calretinin | Dr Torres would ask why! |
CAM5.2 | Dr Torres would ask why! |
Cathepsin K | Dr Torres would ask why! |
|
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|
CD10 to Chromogranin |
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Test | Result |
CD10 | Dr Torres would ask why! |
CD117 | Dr Torres would ask why! |
CD138 | Dr Torres would ask why! |
CD15 | Dr Torres would ask why! |
CD1a | Dr Torres would ask why! |
CD20 | Dr Torres would ask why! |
CD21 | Dr Torres would ask why! |
CD23 | Dr Torres would ask why! |
CD3 | Dr Torres would ask why! |
CD30 | Dr Torres would ask why! |
CD31 | Dr Torres would ask why! |
CD34 | Dr Torres would ask why! |
CD35 | Dr Torres would ask why! |
CD4 | Dr Torres would ask why! |
CD43 | Dr Torres would ask why! |
CD45 (LCA) | Dr Torres would ask why! |
CD5 | Dr Torres would ask why! |
CD56 | Dr Torres would ask why! |
CD57 | Dr Torres would ask why! |
CD68 | Dr Torres would ask why! |
CD7 | Dr Torres would ask why! |
CD79a | Dr Torres would ask why! |
CD8 | Dr Torres would ask why! |
CD99 | Dr Torres would ask why! |
CDX2 | Dr Torres would ask why! |
CEA-m | Dr Torres would ask why! |
Chromogranin | Dr Torres would ask why! |
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|
CK17 to Glypican 3 |
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Test | Result |
CK17 | Dr Torres would ask why! |
CK19 | Dr Torres would ask why! |
CK20 | Dr Torres would ask why! |
CK34betaE12 | Dr Torres would ask why! |
CK5/6 | Dr Torres would ask why! |
CK7 | Dr Torres would ask why! |
CMV | Dr Torres would ask why! |
c-MYC | Dr Torres would ask why! |
Cyclin D1 | Dr Torres would ask why! |
D2-40 | Dr Torres would ask why! |
Desmin | POSITIVE |
DOG1 | Dr Torres would ask why! |
EBV | Dr Torres would ask why! |
EMA | Dr Torres would ask why! |
ER and PR | Dr Torres would ask why! |
Factor VIII | Dr Torres would ask why! |
Factor XIIIa | Dr Torres would ask why! |
Fascin | Dr Torres would ask why! |
FH | Dr Torres would ask why! |
FSH | Dr Torres would ask why! |
Gastrin | Dr Torres would ask why! |
GATA3 | Dr Torres would ask why! |
GCDFP-15 (BRST2) | Dr Torres would ask why! |
GFAP | Dr Torres would ask why! |
GH | Dr Torres would ask why! |
Glucagon | Dr Torres would ask why! |
Glypican-3 | Dr Torres would ask why! |
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|
HBME-1 to IgM |
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Test | Result |
HBME-1 | Dr Torres would ask why! |
HBV core | Dr Torres would ask why! |
HBV surface | Dr Torres would ask why! |
H-caldesmon | Dr Torres would ask why! |
HCG | Dr Torres would ask why! |
Helicobacter | Dr Torres would ask why! |
Hepatocyte | Dr Torres would ask why! |
HER2/neu | Dr Torres would ask why! |
HHV-8 | Dr Torres would ask why! |
HMB-45 | Dr Torres would ask why! |
HNF1beta | Dr Torres would ask why! |
HPV | Dr Torres would ask why! |
HSV-I | Dr Torres would ask why! |
HSV-II | Dr Torres would ask why! |
IDH-1 | Dr Torres would ask why! |
Inhibin | Dr Torres would ask why! |
INI1 (BAF47) | Dr Torres would ask why! |
Insulin | Dr Torres would ask why! |
Kappa | Dr Torres would ask why! |
Ki-67 | Dr Torres would ask why! |
Lambda | Dr Torres would ask why! |
Leu 7 | Dr Torres would ask why! |
IgA | Dr Torres would ask why! |
IgG | Dr Torres would ask why! |
IgM | Dr Torres would ask why! |
|
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LH to PDGFR |
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Test | Result |
LH | Dr Torres would ask why! |
LIN28 | Dr Torres would ask why! |
Lysozyme | Dr Torres would ask why! |
mammoglobin | Dr Torres would ask why! |
MAP2 | Dr Torres would ask why! |
MCV | Dr Torres would ask why! |
Melanin A | Dr Torres would ask why! |
MHC class I | Dr Torres would ask why! |
MITF | Dr Torres would ask why! |
MUM1 | Dr Torres would ask why! |
Myeloperoxidase | Dr Torres would ask why! |
MYO D1 | Dr Torres would ask why! |
Myoglobin | Dr Torres would ask why! |
Napsin | Dr Torres would ask why! |
NF | Dr Torres would ask why! |
NKX3.1 | Dr Torres would ask why! |
NSE | Dr Torres would ask why! |
OCT3/4 | Dr Torres would ask why! |
p16 | Dr Torres would ask why! |
P501S | Dr Torres would ask why! |
p53 | Dr Torres would ask why! |
p57 | Dr Torres would ask why! |
p63 | Dr Torres would ask why! |
Pankeratin | Dr Torres would ask why! |
PAX2 | Dr Torres would ask why! |
PAX5 | Dr Torres would ask why! |
PAX8 | Dr Torres would ask why! |
PCNA | Dr Torres would ask why! |
PDGFR | Dr Torres would ask why! |
|
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PLAP to WT1 |
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Test | Result |
PLAP | Dr Torres would ask why! |
PNL-2C | Dr Torres would ask why! |
Prolactin | Dr Torres would ask why! |
PSA | Dr Torres would ask why! |
PSAP | Dr Torres would ask why! |
RCC | Dr Torres would ask why! |
S-100 | Dr Torres would ask why! |
SALL4 | Dr Torres would ask why! |
Smooth muscle actin | NEGATIVE |
Somatostatin | Dr Torres would ask why! |
STAT6 | Dr Torres would ask why! |
Synaptophysin | Dr Torres would ask why! |
TdT | Dr Torres would ask why! |
TFE3 | Dr Torres would ask why! |
TFEB | Dr Torres would ask why! |
Thyroglobulin | Dr Torres would ask why! |
Toxoplasma | Dr Torres would ask why! |
TSH | Dr Torres would ask why! |
TTF-1 | Dr Torres would ask why! |
Ubiquitin | Dr Torres would ask why! |
UCHL1 (PGP9.5) | Dr Torres would ask why! |
Ulex Europaeus | Dr Torres would ask why! |
Vimentin | Dr Torres would ask why! |
VIP | Dr Torres would ask why! |
VZV | Dr Torres would ask why! |
WT-1 | Dr Torres would ask why! |
|
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Molecular testing
Chromosomal translocations
Translocations Chr 1-10 |
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Test | Result |
t(1;13) PAX7-FKHR | Dr Torres would ask why! |
t(2,13) PAX3-FKHR | Dr Torres would ask why! |
t(8;14) MYC-IGH | Dr Torres would ask why! |
t(9;22) BCR-ABL | Dr Torres would ask why! |
t(9;22) CHN-EWS | Dr Torres would ask why! |
|
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Translocations Chr 11-13 |
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Test | Result |
t(11;14) CCND1-IGH | Dr Torres would ask why! |
t(11;22) EWS-WT1 | Dr Torres would ask why! |
t(11;22) FLI1-EWS | Dr Torres would ask why! |
t(12;15) ETV6-NTRK3 | Dr Torres would ask why! |
t(12;16) FUS-ATF1 | Dr Torres would ask why! |
t(12;16) CHOP-TLS | Dr Torres would ask why! |
t(12;22) EWS-ATF1 | Dr Torres would ask why! |
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Translocations Chr 14-22 |
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Test | Result |
t(14,18) IGH-BCL2 | Dr Torres would ask why! |
t(15;17) PML-RARA | Dr Torres would ask why! |
t(16;21) FUS-ERG | Dr Torres would ask why! |
t(17;22) COLA1-PDGFB | Dr Torres would ask why! |
t(21;22) EWS-ERG | Dr Torres would ask why! |
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|
Translocations Chr X & Y |
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Test | Result |
t(X;1) PRCC-TFE3 | Dr Torres would ask why! |
t(X;17) TFE3-ASPL | Dr Torres would ask why! |
t(X;18) SYT-SSX | Dr Torres would ask why! |
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Other molecular tests
Molecular tests (A-B) |
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Test | Result |
ALK sequencing | Dr Torres would ask why! |
B cell clonality Southern / PCR | Dr Torres would ask why! |
BCL2 PCR | Dr Torres would ask why! |
BRAF sequencing | Dr Torres would ask why! |
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Molecular tests (C-H) |
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Test | Result |
EBV PCR | Dr Torres would ask why! |
EGRF sequencing | Dr Torres would ask why! |
H3F3A sequencing | Dr Torres would ask why! |
HHV-8 PCR | Dr Torres would ask why! |
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Molecular tests (I-J) |
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Test | Result |
Identity testing PCR | Dr Torres would ask why! |
IDH1/2 PCR | Dr Torres would ask why! |
JAK2 V617F ARMS | Dr Torres would ask why! |
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Molecular tests (K-Z) |
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Test | Result |
KIT sequencing | Dr Torres would ask why! |
LOH 1p/19q PCR | Dr Torres would ask why! |
T cell clonality Southern / PCR | Dr Torres would ask why! |
|
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Diagnosis
Diagnosis
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FIBROEPITHELIAL POLYP WITH ATYPICAL CELLS OF THE VULVA (PSEUDOSARCOMATOUS FIBROEPITHELIAL STROMAL POLYP) These are unusual polyps that occur in patients on hormone therapy (Tamoxifen or progesterone) or in pregnant patients. They can be highly celluar with mitotic activity and atypia. The multinucleate cells are characteristic as is the absence of a grenz zone. The young age is also typical. The can recur but do not metastasize.
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Other cases
|
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| Number | |
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| Subspecialty (Difficulty) |
Autopsy pathology (jr,sr, f/e)
Breast pathology (jr,sr, f/e)
Cardiovascular pathology (jr,sr, f/e)
Cytopathology (jr,sr, f/e)
Dermatopathology (jr,sr, f/e)
Endocrine pathology (jr,sr, f/e)
Forensic pathology (jr,sr, f/e)
Gastrointestinal pathology (jr,sr, f/e)
Genitourinary pathology (jr,sr, f/e)
Gynecologic pathology (jr,sr, f/e)
Hematopathology (jr,sr, f/e)
Head and neck pathology (jr,sr, f/e)
Lymph node pathology (jr,sr, f/e)
Medical kidney pathology (jr,sr, f/e)
Molecular pathology (jr,sr, f/e)
Neuropathology (jr,sr, f/e)
Pediatric pathology (jr,sr, f/e)
Pulmonary pathology (jr,sr, f/e)
Placental pathology (jr,sr, f/e)
Soft tissue pathology (jr,sr, f/e) |
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| Difficulty | |
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|