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SPUC December 15, 2008 [email protected] CASE 1. CASE 1 Diagnosis: Coccidioidomycosis. Coccidioidomycosis. Diagnosis Coccidioidomycosis - Endemic fungal infection of the desert southwestern United States - Generally a self-limited illness in healthy persons.

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SPUC December 15, 2008 [email protected]

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Spuc december 15 2008 francisco larosa ucdenver

SPUC

December 15, 2008

[email protected]


Spuc december 15 2008 francisco larosa ucdenver

CASE 1


Spuc december 15 2008 francisco larosa ucdenver

CASE 1 Diagnosis: Coccidioidomycosis


Spuc december 15 2008 francisco larosa ucdenver

Coccidioidomycosis


Spuc december 15 2008 francisco larosa ucdenver

Diagnosis Coccidioidomycosis

- Endemic fungal infection of the desert

southwestern United States

- Generally a self-limited illness in healthy persons.

- Immunosuppressed persons who contract it

are at increased risk for disseminated infection

Janis E. Blair, MD; Jerry D. Smilack, MD; Sean M. Caples, DO. Coccidioidomycosis in Patients With Hematologic Malignancies

Arch Intern Med. 2005;165:113-117


Spuc december 15 2008 francisco larosa ucdenver

Histoplasmosis


Spuc december 15 2008 francisco larosa ucdenver

Cryptococcosis


Spuc december 15 2008 francisco larosa ucdenver

CASE 2


Spuc december 15 2008 francisco larosa ucdenver

Case 2 Diagnosis: Leiomyoma


Spuc december 15 2008 francisco larosa ucdenver

  • Mesenchymal tumors of the gastrointestinal tract are less frequent than epithelial neoplasms but they are by no means rare.

  • Gastrointestinal stromal tumors (GISTs):

  • Most common mesenchymal tumor of the GI tract

  • Histopathology:

    • cellular spindled

    • epithelioid

    • pleomorphic lesions

    • express KIT (CD117) and CD34 proteins


Spuc december 15 2008 francisco larosa ucdenver

  • True leiomyomas of the muscularis propria:

  • Common in the esophagus and rare in the gastric body and antrum

  • Most frequent mesenchymal tumor of the esophagus:

    • Leiomyomas outnumber GIST by a ratio of 3 to 1


Spuc december 15 2008 francisco larosa ucdenver

CASE 3


Spuc december 15 2008 francisco larosa ucdenver

Case 3 Diagnosis: Thymoma AB


Spuc december 15 2008 francisco larosa ucdenver

Thymoma Type B1


Spuc december 15 2008 francisco larosa ucdenver

CLASSIFICATION OF THYMOMAS


Spuc december 15 2008 francisco larosa ucdenver

CASE 4


Spuc december 15 2008 francisco larosa ucdenver

Case 4 Diagnosis: Giant Cell Tumor of Tendon Sheet


Spuc december 15 2008 francisco larosa ucdenver

CASE 5


Spuc december 15 2008 francisco larosa ucdenver

Case 5 Diagnosis: Fibrous Dysplasia


Spuc december 15 2008 francisco larosa ucdenver

Fibrous dysplasia, benignt tumor (developmental arrest)

Components of normal bone are present, but they fail to

differentiate into mature structures.

Occurs as one of three clinical patterns:

1. involvement of a single bone (monostotic)

2. involvement of multiple bones( polyostotic)

3. Polyostotic disease, associated with cafe au lait skin pigmentations and endocrine abnormalities, precocious puberty (McCune- Albright syndrome). Somatic, not hereditary. Skeletal, skin, and endocrine lesions from G protein that constitutively activates adenyl cyclase with resultant cyclic adenosin monophosphate overproduction and cellular hyperfunctioning.


Spuc december 15 2008 francisco larosa ucdenver

CASE 6


Spuc december 15 2008 francisco larosa ucdenver

Case 5 Diagnosis: Chemical / Reactive Gastropathy


Spuc december 15 2008 francisco larosa ucdenver

  • CHRONIC, REACTIVE (CHEMICAL) GASTROPATHY

  • - Very common in current clinical practice.

  • Changes usually more prominent in the prepyloric region

  • The usual underlying causes include chronic bile reflux and long-term NSAID intake.


Spuc december 15 2008 francisco larosa ucdenver

CHRONIC, REACTIVE (CHEMICAL) GASTROPATHY

  • The histopathologic features:

  • mucosal edema

  • congestion

  • fibromuscular hyperplasia in the lamina propria

  • foveolar hyperplasia with a corkscrew appearance in the most severe forms

  • The foveolar epithelium characteristically: reactive nuclear features and reduction of mucin.

  • The epithelial changes occur with little background chronic inflammation.

Arch Pathol Lab Med—Vol 132, October 2008


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