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21st European Congress of Pathology
Istanbul, Turkey, September 08-13, 2007
http://www.ecp2007istanbul.org/
ESP/SLAP Joint Meeting:
Once in a Pathologist´s Lifetime
Chairpersons: Fernando Schmitt (Portugal) and Marcello Franco (Brazil) |
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Dear Colleague,
This session is open to all participants.
Please review the slides and take notes of the diagnoses. When you are
finished, you can Submit your answers here
The pathologist with most correct diagnoses was awarded at the congress, info will be added soon.
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Case 1
Presented by: Sérgio Gonzales (Chile)
Clinical History
56 year-old male with a lump on his back of several month of evolution.
Macroscopic findings: a 2 cm in diameter skin sample with a dermal cystic and hemorrhagic nodule is examined.
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Case 2
Presented by: Gianni Bussolati (Italy)
Clinical History
27 years old female, with “goiter” which grew up in recent times. At scintigraphy, cold areas were detected. Thyroidectomy was performed (size 11 x 9x7).
On section, poorly defined whitish areas were diffusely present.
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Case 3
Presented by: Saul Suster (USA)
Clinical History
An 80 year old man presented with a soft tissue mass in his right foot, measuring 8.0 cm in greastest diameter. The lesion was well-circumscribed, unencapsulated, and showed a homogeneous gray-white cut surface. There was no previous significant history. The lesion was completely resected
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Case 4
Presented by: Emilio Pereira (Brazil)
Clinical History
A 59 year-old man presented with pain in the right flank and a right renal mass was detected. He then underwent a nephrectomy.
Macroscopic findings: The right kidney weighed 740 g and measured 12 x 7 x 5 cm. The cut surface revealed an 11.5 cm in diameter mass comprised by a friable, brownish tissue. The tumour invades the renal pelvis.
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Case 5
Presented by: Fátima Carneiro (Portugal)
Clinical History
Man, 35-year-old, with long lasting dyspepsia. In January 2005 the patient was submitted to gastric endoscopies on two occasions at the Hospital of Coimbra University, Portugal. He was found to have multiple, non-healing, gastric ulcers that failed to respond to Proton Pump Inhibitors (PPIs) therapy. Helicobacter pylori infection was not diagnosed and no antibiotic therapy was prescribed. Consecutively, diffuse gastric mucosal thickening was observed raising suspicion for a neoplastic process. A distal gastrectomy was performed on the patient at the same hospital.
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Case 6
Presented by: Mariella Rondán (Uruguay)
Clinical History
32 year-old male, farmer. Non-smoker, without previous respiratory symptoms.
November 2004 long standing fever with severe headache.
May 2005: convulsion. CT: peri-lesional oedema.
June 2005: neurosurgery is done. Biopsy shows granulomas, without necrosis or caseum. Microbiology tests were not performed.
During the evolution skin lesions appear. Lab tests are normal.
HIV negative (twice).Fever persists. Adds severe deafness.
Referred to neumology department.Cervical adenomegalies.
No visceromegalies. Normal torax exam. CV : normal.
Normal neurological exam. Respiratory function: normal.
Endoscopy with bronquial washing: negative for bacteries, mycobacteries, fungus
Upper respiratory tract: without lesions. Audiogram severe deafness.
LP normal. Presence of multiple small nodules in both lungs which are biopsed.
Pdf presentation
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Case 7
Presented by: Mike Wells (UK)
Clinical History
27 yrs old female – sudden onset of right sided hemiparesis, headache and vomiting, 12 weeks after spontaneous miscarriage of a 24 week fetus.
Pdf presentation
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Case 8
Presented by: Pierre Bedossa (France)
Clinical History
A 35 years-old Caucasian female with no past medical history. Oral contraception for 15 years. The patient was admitted for abdominal pain. An ultrasound examination revealed a 7 cm liver lesion in an otherwise hyperechoïc liver. She is overweighted (BMI: 28 kg/m2). Laboratory finding are as follows: AST 45 UI/L, ALT 40 UI/L (N<40), GGT: 170 U/l, Alk. Phos. 120 UI/L. AFP: 10 ng/l (N<20). In addition, a biologic inflammatory syndrome was present with Erythrocyte Sedimentation Rate: 60, CRP : 549 U (Nl< 40). A left hepatectomy was performed. Inflammatory syndrome disappeared after surgery.
Gross finding: A single round liver nodule, well-delineated but without capsule. At cut section, the lesion was soft, fleshy, heterogeneous, of tan color with foci of congestion and hemorrhage but without central stellate scar. Outside the nodule, liver was steatotic. Section is from the nodule.
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