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Department of Pathology and Laboratory Medicine

Department of Pathology and Laboratory Medicine

Residency Program - Case of the Month

March 2013 - Presented by John Rodrigo, M.D.

Clinical history:

The patient is a 75 year old male who presented with dysphagia and epigastric discomfort. CT scans demonstrated a large distal esophageal mass and suspicious lymphadenopathy.  An EGD at a later time confirmed this mass of the distal esophagus. Biopsy confirmed a high grade dysplasia. PET/CT around the same time demonstrated an enlarging intramuscular hypodense soft tissue mass in the right proximal thigh with interval development of internal dystrophic calcifications. The mass previously measured 2.8 x 2.8 cm but was now 5.6 x 4.4 cm.

 

PET scan:

Case of the Month, Mar. 2013: PET Scan

 

Gross description:

Received was multiple cylindrical tan brown fragments from the right thigh soft tissue mass ranging in size from 1.2 cm in length by 0.1 cm in diameter to 1.5 cm in length by 0.1 cm in diameter with an aggregate of 0.9 x 0.3 x 0.2 cm.

 

Microscopic pictures:

Case of the Month, Mar. 2013: Figure 1 Case of the Month, Mar. 2013: Figure 2 Case of the Month, Mar. 2013: Figure 3  
Case of the Month, Mar. 2013: Figure 4 Case of the Month, Mar. 2013: Figure 5    

 

Immunohistochemistry stains:

CK7                    Positive (figure 1)

CK20                  Negative (figure 2)

Her-2/neu           2+

 

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