Virtual Slidebox
Presented by the MGH Pathology Service

34 year old woman with bilateral inflamed axillary nodules. Hydradenitis suppurativa is most commonly found in the axillary region but can also be found in the groin.

This woman had a history of SLE and the clinician was wondering if it was cutaneous lupus. This is a very early manifestation of LE, and shows a vacuolar interface with extravasated erythrocytes and very faint blue mucin.

51 year old man with red papules in an urticarial base on extensor forearms and upper back. He also has fever, uveitis and aseptic meningitis. The differential for a neutrophilic dermatosis with this history includes Sweet’s syndrome, Behcet’s syndrome,

Read more on Neutrophilic dermatosis…

40 year old woman from India with multiple small macules, plaques and nodules with poorly defined borders, giving a bovine appearance of the face. Characterized by groups and sheets of macrophages with a sparse lymphocytic infiltrate. The macrophages are

Read more on Lepromatous leprosy…

55 year old woman with a red-brown nodule on her right anterior thigh.

79 year old man with erythema of the lower legs.

68 y/o male, 2 months status-post allogeneic BMT for AML.

21 y/o female with history of AML, 6 months post-allogeneic BMT, now with dropping counts: WBC 0.6, Hct 25.5%, Plt 25. (Feathered edge of bone marrow aspirate is best area, also circled area of touch prep.)

Read more on Residual/relapsing AML within a hypocellular marrow…

Clinical History:

35 y/o male, incidentally found to have multiple hypodense splenic lesions on CT scan.

Immunohistochemistry:

63 y/o female with enlarged spleen (1180g). Peripheral blood: Pancytopenia. Lymph node.

63 y/o female with enlarged spleen (1180g). Peripheral blood: Pancytopenia. Splenectomy

46 y/o female with a right adrenal mass. Patient also has lung nodules. No known immunodeficiency. Outside immunostains show that large cells are CD45+, CD30+.

3 y/o male with a 17 cm abdominal mass

Findings on this slide include leiomyomatous and osseous mesenchymal componants, as well as squamous differentiation, a change probably related to chemotherapy.

2 y/o male with a 17 cm abdominal mass.

Findings on this slide include epithelial and blastemal components as well as differentiated mesenchymal componants (rhabdomyomatous).

97 y/o female with masses on both arms

53 y/o female with a subcutaneous shoulder mass

53 y/o female with a chest wall mass, remote history of Hodgkin lymphoma

Clinical history

20 y/o male with a lytic lesion of the femur

Radiology

52 y/o male with a right groin mass

13 y/o female with a mass of the foot

1 y/o male with a mass in the right tibia

58 year old with 10 cm gastric polyp

55 year old alcoholic/smoker with chronic pancreatitis and question of pancreatic head mass.

79 year old with gastric tumor and long history of gastritis and duodenitis.

65 year old with clinical picture of celiac disease, unresponsive to gluten-free diet.

61 y/o male with lung nodules and mediastinal lymphadenopathy. Bronchial biopsy

62 y/o female with splenomegaly and mesenteric lymphadenopathy. Rule out carcinoma.

43 y/o male with a lung mass extending into a bronchus

66 y/o female with a lung mass

86 y/o female with a history of lymphoma and a breast mass. Core biopsy

69 y/o female smoker with SIADH. Lung mass and mediastinal lymphadenopathy on chest CT

56 y/o male smoker with digital clubbing, no respiratory complaints, and a diffusely abnormal chest CT.

38 y/o female with an abnormal Pap smear. Cervical cone biopsy.

35 y/o female with pelvic pain, pressure, discomfort and a 12 cm unilateral ovarian mass, multicystic with solid and gelatinous appearing areas

29 y/o female with peritoneal tumor nodules

52 y/o male with history of relapsed high-grade B cell lymphoma, undergoing salvage chemotherapy. Now has prolonged neutropenia. WBC: 2.7 (2% polys, 48% lymphs, 43% monos, 1% blasts), Hct 32%, Plt 115.

Read more on Myeloid left-shift, s/p GCSF therapy…

69 y/o female smoker with SIADH. Lung mass and mediastinal lymphadenopathy on chest CT

46 y/o female with a thyroid nodule

46 y/o female with a thyroid nodule

The smear shows nuclear enlargement, variable nuclear grooves, crowding of cells, and mild chromatin clearing, suggestive but not diagnostic of papillary carcinoma.

46 y/o female with a thyroid nodule.

It is not possible to conclusively identify the subtle papillary features on this frozen. The smear is more helpful. Remember to consider follicular variant of papillary carcinoma in the differential diagnosis of microfollicular lesions.

Read more on Papillary thyroid carcinoma, follicular variant, encapsulated (frozen)…

44 y/o female with lump in axilla. History of breast cancer s/p bilateral mastectomy

23 year old woman with a history of dysplastic nevi, presents for a reexcision of dysplastic nevus on her back. Back skin can sometimes be confused with scar, keloid or even scleroderma because of the thick abundant collagen bundles.

Read more on Back skin, normal…

49 y/o female with a history of breast cancer. Pleural effusion.

49 y/o female with a history of breast cancer. Pleural effusion.

47 y/o female with a history of breast cancer and a new lump at the excision site.

47 y/o female with a history of breast cancer and a new lump at the excision site.

44 y/o female with lump in axilla. History of breast cancer s/p bilateral mastectomy

74 y/o female with left thyroid mass

45 year old female with goiter for 5 years and a suspicious FNA cytology. ? of thyroiditis versus oxyphilic neoplasm.

57y/o male with a mandibular mass