Virtual Slidebox
Presented by the MGH Pathology Service

MICROSCOPIC FEATURES

• Solid areas composed of monomorphic cells with eosinophilic cytoplasm and bland, sometimes grooved nuclei
• Abundant delicate vasculature
• Can exhibit prominent cystic change with necrosis and hemorrhage, leading to “pseudopapillae” (tumor nodules falling apart, with rim of viable tumor cells left attached to vasculature)
• Contains foam cells, hemosiderin-laden macrophages, and cholesterol clefts
• Tumor cells may have intracytoplasmic hyaline globules
• Infiltrative border despite gross appearance as well-demarcated

Read more on Solid pseudopapillary tumor, predominantly solid…

Clinical summary
56 y/o male with 10 days of fever, headaches, HAS, confusion, and rash. Now has diffuse erythematous macules with petechia on trunk and extremities with petechia on palms and soles.

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Clinical summary

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Clinical summary
47 y/o female with a left ovarian mass and omental caking

Clinical summary
55 y/o female with 4 days of severe abdominal pain found to have 11 cm left ovary with associated hemorrhagic fluid in pelvis and abdomen.

Clinical summary
68 y/o female with postmenopausal bleeding

Clinical summary
39 y/o female with left ovarian mass

Clinical summary
64 y/o female with a history of breast carcinoma. Hysterectomy and salpingo-oophorectomy.

Clinical summary
44 y/o male with a penile mass

Clinical summary
50 y/o female with renal mass

Clinical summary
47 y/o female with a renal mass

Clinical summary
38 y/o female with 13 cm, calcified renal mass

Clinical summary
50 y/o male with a renal mass

Clinical summary
32 y/o male with a left ureteral obstruction

Clinical summary
38 y/o female with left ovarian mass

Clinical summary
59 y/o female with congestive heart failure and a lesion in the femur.

Clinical summary
32 y/o male with an intraosseous mass in the foot

Clinical summary
55 y/o female with 4 days of severe abdominal pain found to have 11 cm left ovary with associated hemorrhagic fluid in pelvis and abdomen.

Clinical summary
68 y/o male with esophageal cancer. On endoscopy, several yellowish nodules noted proximal to cancer. FS of nodules.

Clinical history:

30 y/o female with incidentally discovered 4.8 cm liver mass. History of oral contraceptive use.

Suggested frozen diagnosis:

Benign hepatocellular proliferation with bile ductules, consistent with focal nodular hyperplasia.

Read more on Focal nodular hyperplasia (frozen)…

Clinical history:

37 y/o pregnant female with 20 cm complex cystic mass in right lobe of liver.

Suggested frozen diagnosis:

Mucinous neoplasm consistent with hepatobiliary cystadenoma. Await further sampling on permanents.

Read more on Hepatobiliary cystadenoma (frozen)…

Clinical summary
72 yo male with maxillary tumor, extending into maxillary sinus

Clinical summary
43 y/o male with an opacity in molar area.

Clinical summary
44 y/o female with left palate mass.

Clinical summary
5 month old male with a mandibular mass.

Clinical summary
47 y/o male, 4 weeks status post heart transplanation. Right ventricular biopsy. Date the infarcts.

Clinical summary
71 y/o male, autopsy. Date the infarcts.

Clinical summary
47 y/o male undergoing second heart transplant. Explant of first donor heart. Date the infarcts.

Clinical summary
55 y/o male with heart failure, explanted heart. Date the infarcts

Clinical summary
55 y/o male with heart failure, explanted heart. Date the infarcts

Clinical summary
71 y/o male, autopsy. Date the infarcts.

Clinical summary
41 y/o male with a history of finger trauma and chronic pain

MICROSCOPIC FEATURES

• Cords, nests, or single tumor cells embedded in myxoid matrix, with variable sclerosis and calcification
• Tumor cells may be dendritic (spindle- or stellate-shaped) or epithelioid, and have intracytoplasmic vascular lumina that may contain erythrocytes. These spaces should not be mistaken for signet-ring cells or glandular spaces
• Often multifocal or composed of confluent nodules
• At the edge, the tumor spares portal tracts and spread along sinusoids, causing atrophy of liver plates, and eventually obliterating central veins

Read more on Epithelioid hemangioendothelioma…

Clinical summary
12 y/o female. Large solid ovarian tumor. AFP increased

Clinical summary
12 y/o female. Large solid ovarian tumor. AFP increased

Clinical summary
45 yo with an incidentally discovered ovarian mass

Clinical summary
38 yo with large bilateral ovarian tumors

Clinical summary
38 yo with large bilateral ovarian tumors

Clinical summary
24 yo woman with hypertension, 13 cm ovarian mass, orange cut surface

Clinical summary
24 yo woman with hypertension, 13 cm ovarian mass, orange cut surface

33 yo woman, 17 cm cystic and solid ovarian mass

45 yo F. Lung explant and mediastinal lymph node. Removed for presumed rejection. Prior lung transplant 8 yrs ago.

Clinical summary
45 yo F. Lung explant. Removed for presumed rejection. Prior lung transplant 8 yrs ago.

Clinical summary
49 yo female with diffuse bilateral ground glass opacities

Clinical summary
18 month female

Clinical summary
2 y/o female born with 30 nevi, now presenting with seizures and severe pain

Clinical summary
3 y/o male with catastrophic status epilepticus

Clinical summary
14 y/o female with a brain lesion

Clinical summary
11 y/o female with a non-enhancing temporal lobe lesion

Clinical summary
7 y/o female with seizures since birth