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ANTONIO SOCIETY OF PATHOLOGISTS - · PDF fileANTONIO SOCIETY OF PATHOLOGISTS SAN ANTONIO, TEXAS Twenty-Thhcl Annual TUMOR SEMINAR December 3, 1966 BROOKE GENERAL HOSPITAL Brooke Army

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ANTONIO SOCIETY OF PATHOLOGISTS SAN ANTONIO, TEXAS

Twenty-Thhcl Annual

TUMOR SEMINAR December 3, 1966

BROOKE GENERAL HOSPITAL Brooke Army medical Center

fort Sam Houston, Texas

CONDUCTED BY

S A UL KA Y, M, V,

Professor of Surgical Pathology Medical College of Virgini a

Richmond , Virginia

This Tumor Seminar is supported in part by

THE AMERICAN CANCER SOCIETY

TEXAS DIVISI ON

The meeting will be held in the Auditorium, Building 1026 (behi nd the ~~n Hospital) , at Brooke General Hospital on December 3, 1966 , beginning at 9:00 a.m.

0 00 0 0 00 0 00 00 00

The San Anton.i.o Soci.ay o6 Pa.tltol.cg.(..6u .

CASE 1

Contributed by Dr. Kay

A 30-year-old 1~hite woman noted enlargement of the right nipple for about one year prior to admission. This was associated with bl eeding and drainage from t he sur-face of the nipple , Examination showed an enlarged nip-ple which was hard and noncyst i c , No discharge was noted, The nipple was partiall y excised under local anesthesi a.

My diagnosis : --------------------------------------

Dr. Kay's diagnosis:~-------------------------------

Comment: -------------------------------------------

CASE 2

Contr i buted by Dr . Kay

A 30-year-old colored man ~~as admitted follo1~ing a gunshot 1vound of the abdomen. Free ai r 1vas f ound under the diaphra!.'ll and the patient was explored, Three per-forations of the small b01vel 1o~ere closed. An i ncidental golf-ball-sized tumor was found in the s J!'G!ll intestine which was resected. Examination of the specimen showed a segment of sma ll b01vel 8. 5 em. in l ength, Three em, from the end there was a firm , irregul ar mass approximately 2. 5 by 2 by 1.5 em. constricting the lumen. I t seemed to involve mainly the wall of the bowe l 1vith an area of mucosal u lceration,

t1y diagnosis : -----------------------

Dr. Kay ' s diagnosis : --------------------------------

Comment : ----------------------------------------

CASt: 3

Contributed by Dr. Kay

II 50-vear-old 1~hite man was admitted in 1949 Nith a tumor in the right parot id region, first noted in 1941 as a small lump behind the ear. It gradually i ncreased in size and a f acial paralysis sl01dy developed. A large , sliw1tly movable, smooth , t ense, firm , and tender mass extended to the pre- and postauricular regions. It 1~as excised and t he entire facia l nerve 1~as found to be i nfil-trated, The tumor recurred and cervical node metastases were suspected in 1953. A biopsy was foll01~ed by radical neck dissection. The slide is from the parotid area.

My diagnosis:

Dr, Kay's diagnosis:

Comment:

CASE 4

Contributed by Dr. Kay

II 41-year-old colored 1o~oman had a left mastectomy in 1961 and a hard, 3-by-2-inch nontender mass in the U0Q of the riw1t breast in 1964. After rjght simple mastectomy a circumscribed mass, 4. S by 3. 8 by 3. 7 em., of soft to slightly firm, red-br01m tiss ue , Nas found deep in the specimen , It contained small, irregular cavities lojith ragged linings containing blood and c lotted material. Two other similar nodules k

CASE 5

Contributed by Dr. Norman H, Jacob Santa Rosa Medical Center , San Antonio , Texas

A 69-year-old wanan had a right parotid gland tumor removed, It weighed 6 grams, measured Z. S em. in maximum dimension, and had a lobular cyst ic pattern.

My diagnosis : - ------------ - ---- -

Dr; Kay l s ciiagnos:i.s i - ---------------

Comment:

CASE 6

Contribut ed by Drs. A. M, Ri chmond, C. J. Farinacci, and H. c. Ford , Nix Clinical Labor atory, San Antonio, Texas

The patient, an 85-year-old spinster, was brought to a physician by her neice, A mass of unknOiofD durat ion was found in the right breast, lateral to the nipple, Because of her poor physical condition a simple mastectany was performed, The specimen consisted of an ellipse of skin 14 by 7 by 6 on. with a bulging mass l ateral to the nip-ple covered with reddish blue dusky skin. On cut section the mass was 4 on. in diameter with a gritty, granular dirty gray-1~hite surface flecked with small cysts fi lled 1~ith bloody fluid and/or friable yellowish gray material.

l~y diagnosis :

Dr, Kay' s diagnosis: ----- --------- ----------

Comment : ----------------- ------------------

CASE 7

Contributed by Col, Hugh B. Hoeffler and Capt . A. E. Roth Brooke General Hospital , Fort Sam Houston , Texas

A nodule was discovered on the left lobe of thyroid of an asymptomatic 52-yef~old white f emale oo routine physical examination. I 1 uptake was normal . The no dule was inactive to scan. The specimen 1~as a left lobe of thyroid tissue wei ghi ng 10 grams, I t contained a cen tral nodule 1.4 em. i n diameter, Areas of the nodule were quit e firm and cut with gritty sensation ; other small nodular areas had a soft gelat i nous consistency.

~ diagnosis: -----------------------------------------------

Dr. Kay 's diagnosis: --------- - - - --- ---- -

Comment: - ------------- -------- --------

------------------------------------~

CP$E 8

Contributed by Dr. George c. Mani Santa Rosa ~~dical Center, San Antonio, Texas

A 12-year -old girl 1rith a benign hemangiooa of the left neck had striking regional adenopathy, ller admis-sion laboratory work 1~as unremarkable ,

My diagnos Js :

Dr. Kay's dia&nosis: ------ - ------------

Comrr~nt : ----------------------------------

CASE 9

Contr ibuted by Dr, A. 0 . Severance and Associates Baptist Memorial Hospital, San Antonio, Texas

A 30-year- old white female 1~as aclrnitted to the hospi-tal for removal of a nonfunctional left kidney. She had experienced pain in the left costovertebral angle begin-ning one year previously and had been said to have pyuria at that time, whi'ch had been treated intermittently, She was pregnant at the time of admission and it was elected to follow her through the pregnancy before attempting surgery, A l arge 348-gram , 15-by-7,5-by-5, 3-cm. kidney containing a staghorn calculus was removed, There seemed to be essentially no normal renal parenchyma, but there ~~re multiple ragged abscesses scattered throughout the t issue. Coliform organisms were cultured fran this kidney at time of operation.

~ diagnosis: --------------------------------------

Dr. Kay's diagnosis: -------------------------

Comment : ------------------------------------

CASE 10

Contributed by Dr , James K, Lowry Santa Rosa t~edical Center, San Antonio , Texas

A 22-year-old woman had papillary tumor masses of both ovaries. One mass weighed 135 grams and measured 9 em. ; the second mass \4eighed 270 grams and measured 11 em,

My diagnosis : --------------------------------

Dr, Kay's di'a gnosis: ___________________________ _

Comment : -----------------------------------------

CASE 11

Contributed by Col. I! ugh 8 . Hoeffler and Capt . A, E. Roth Brooke General Hospital, fort Sam Houston , Texas

A 20-year-C)Jd male 1~ith a 3-month history of abdominal fullness hall a rC'tropcri toneal mass removed from the left upper quadrant. "The 560- gram, partially encapsulated specimen was composed of firm tissue in 1~hich there were large areas of cystic degeneration adjacent to soft yel-101~ tissue. Along one margi n of the mass there was dis-tinct nodul arity, with a small, 1,5-cm, nodule raised slightly above the adjacent capsul e. Also submitted ~~ere additional encapsulated soft tissue masses measuring as much as 0,8 em. in maximum dimension,

My d iagnosis : --------------------------------------

Dr. Kay's diagnosis:

Comment :

CASE 12

~"'on l r i butAd by 01". H, J , Schattenberv. , Sr. Medical Arts Building , San Antonio , Texas

A 53-year-old female who had left upper quadrant ab-dominal pain was found to have a mass in the left retro-peritoneal area. At surgery a mass was removed from the retroperitoneum, It 1~as located primarily to the left of the 4th lumbar vertebra . Grossly it measured 4 by 5 em. , was well encapsulated, and presented outer surfaces 1~ith many small nodules , The cut surface revealed solid tumor.

fly diagnosis: --------------------------------------

Dr. Kay's diagnosis : --------------------

Comment: --- - ---------------------

CASE 13

Contributed by Lt . Col. Robert w. Morrissey Wilford Hall USAF Hospital, Lackland Air Force Base

A 19-year-old white male had had a "conmon cold" for 1-1/2 wee ks when he developed pain in his r i ght eye . This pain 1~as follrn~ed by blurring of vision and finally diplopia, He was fo\md to have a right nasal tumor "

CASE 15

Contributed by Dr. Charles T. Br ierty Santa Rosa Medical Center, San Antonio , Texas

A 75-year-old woman was admitted for a large tumor in the l01~er medial portion of the right leg. Several years before she had had a chondrosarcoma of a finger .

Hy diagnosis : ----------------------------------------

Dr. Kay ' ~ diagnosis: _______________________________ ___

Comment : ---------------------------------------------

CA'.>E 16

Contributed by Dr, A, 0, Severance and Associates Baptist Memorial Hospital, San Antonio. Texas

A 44-year-old male deve loped an intrascapular mass on the back slightly to the left. lt hau r.otm :; l01dy over a two-year period, This mass had appeared at the site of removal of a sebaceous cys t ten years earlier, A piece of skin t~ith underlying tissue t~as exci~cd . There

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