The Fifth Arkadi M. Rywlin International Pathology Slide Seminar Symposium in Anatomic ...

198 Pages·2012·4.05 MB·English

Berzeliussymposium 86
The Fifth Arkadi M. Rywlin
International Pathology Slide Seminar
Symposium in Anatomic Pathology
14–16 June 2012 in Stockholm · Sweden
• Programme
• General information
• Cases
THE 5TH AMR SLIDE SEMINAR IN ANATOMIC PATHOLOGY · JUNE 14–16, 2012 IN STOCKHOLM · SWEDEN
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THE 5TH AMR SLIDE SEMINAR IN ANATOMIC PATHOLOGY · JUNE 14–16, 2012 IN STOCKHOLM · SWEDEN
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Welcome to the 5th International AMR Slide Seminar!

The 5th Arkadi M. Rywlin (AMR) slide seminar in anatomic pathology
will be held at the Swedish Society of Medicine in Stockholm Sweden.

The AMR is a non-profit organization created in 1991 to promote and
advance exchange of ideas among academic and clinical pathologists
throughout the world in a spirit of cooperation and collegiality.

The format of the symposium will be an extended slide seminar.

A total of 73 selected cases will be presented and discussed by the faculty.

The symposium will focus mainly on diagnostic problems and contro-
versies in surgical pathology utilizing a case study format and will be
of interest to general surgical pathologists and trainees in pathology.
Course Directors
Saul Suster, M.D. and Göran Elmberger, M.D., PhD
CME
program
The symposium is arranged by
The Swedish Society of Medicine · The Swedish Society of Pathology
Karolinska University Hospital · The Arkadi M. Rywlin International Pathology Slide Seminar
Medical College of Wisconsin
THE 5TH AMR SLIDE SEMINAR IN ANATOMIC PATHOLOGY · JUNE 14–16, 2012 IN STOCKHOLM · SWEDEN
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contentS
Programme 5
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Participating faculty 8
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The Arkadi M. Rywlin, M.D. International Pathology Slide Seminar 9
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General Information 11
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Cases 21
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Who was Berzelius? 193
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Brief history of the SSM 194
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Presentation of the SSM 195
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History of the building 196
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THE 5TH AMR SLIDE SEMINAR IN ANATOMIC PATHOLOGY · JUNE 14–16, 2012 IN STOCKHOLM · SWEDEN
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PRoGRAMMe
thursday, 14 June 2012
07.30–7.40 Welcome addresses
Peter Friberg, the Swedish Society of Medicine
Göran Elmberger, M.D., PhD, Introduction to the symposium
07.40–8.00 Short History of the AMR Club. Saul Suster, M.D.
MoRnInG SeSSIon – thoracic Pathology:
chairs: t. colby and t. Krausz
08.00–08.15 Case 1 – Placental transmogrification of lung (Colby)
08.15–08.30 Case 2 – Multifocal epithelioid hemangioendothelioma of lung (Krausz)
08.30–08.45 Case 3 – Rhodococcus equi infection of lung (Colby)
08.45–09.00 Case 4 – BAC-like invasive adenocarcinoma of lung (Marchevsky)
09.00–09.15 Case 5 – Sarcomatoid malignant mesothelioma (Krausz)
09.15–09.30 Case 6 – Follicular bronchiolitis due to exposure in popcorn factory (Marchevsky)
09.30–10.00 Coffee Break
10.00–10.15 Case 7 – Mature teratoma of thymus with colloid carcinoma (Marchevsky)
10.15–10.30 Case 8 – Pseudosarcomatous “metaplastic” thymoma (Suster)
10.30–10.45 Case 9 – IgG4 sclerosing lung disease (Colby)
10.45–11.00 Case 10 – Basaloid carcinoma of thymus (Falconieri)
11.00–11.15 Case 11 – Collision tumor of lung (met. LMS + prostate CA) (Suster)
11.15–11.30 Case 12 – Synovial sarcoma of pleura (Falconieri)
11.30–11.45 Case 13 – Primary cribriform adenocarcinoma of lung (Suster)
11.45–12.00 Case 14 – Angiosarcoma in lung masquerading as DAH (Elmberger)
12.00–13.30 LUNCH
AFteRnoon SeSSIon – Bone and Soft tissue Pathology:
chairs: M. Miettinen and K. cooper
13.30–13.45 Case 15 – Sclerosing epithelioid fibrosarcoma (Cooper)
13.45–14.00 Case 16 – Myxoinflammatory fibroblastic sarcoma (Cooper)
14.00–14.15 Case 17 – Pelvic chordoma (Unni)
14.15–14.30 Case 18 – Leimyosarcoma of bone (Unni)
14.30–14.45 Case 19 – Composite hemangioendothelioma (Mentzel)
14.45–15.00 Case 20 – Malignant transformation in dermatofibroma (Mentzel)
15.00–15.15 Case 21 – Familial tumoral calcinosis (Miettinen)
15.15–15.30 Case 22 – Desmoplastic small round cell tumor of peritoneum (Krausz)
15.30–16.00 Coffee Break
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16.00–16.15 Case 23 – Low-grade fibromyxoid sarcoma (Montgomery)
16.15–16.30 Case 24 – Post-radiation epithelioid angiosarcoma of skin (Zambrano)
16.30–16.45 Case 25 – Adamantinoma of bone (Wakely)
16.45–17.00 Case 26 – Mesenchymal chondrosarcoma (Wakely)
17.00–17.15 Case 27 – Intracranial Epstein Barr virus-associated smooth muscle tumor (Petersson)
17.15–17.30 Case 28 – Extraneural soft tissue perineurioma (Zambrano)
17.30–17.45 Case 29 – Desmoplastic fibroma of mandible (Zambrano)
17.45–18.00 Case 30 – Spindle cell cutaneous B-cell lymphoma (Mentzel)
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MoRnInG SeSSIon: Genitourinary Pathology and Miscellaneous:
chairs: J. epstein and I. Damjanov
08.00–08.15 Case 31 – STUMP of prostate (Epstein)
08.15–08.30 Case 32 – Nested carcinoma of urinary bladder (Epstein)
08.30–08.45 Case 33 – Acquired cystic disease-related renal cell carcinoma (Adsay)
08.45–09.00 Case 34 – Malignant epithelioid renal angiomyolipoma (Damjanov)
09.00–09.15 Case 35 – Medullary carcinoma of kidney (Epstein)
09.15–09.30 Case 36 – Mucinous and tubular spindle cell renal cell carcinoma (Damjanov)
09.30–10.00 Coffee Break
10.00–10.15 Case 37 – Sarcomatoid carcinoma of adrenal (Fedeli)
10.15–10.30 Case 38 – Epithelioid angiosarcoma of adrenal (Fedeli)
10.30–10.45 Case 39 – Lymphangiomatosis of spleen (Bisceglia)
10.45–11.00 Case 40 – Hodgkin lymphoma complicating small lymphocytic lymphoma (Ben-Dor)
11.00–11.15 Case 41 – Renal hemangioblastoma mimicking renal cell carcinoma (Bacchi)
11.15–11.30 Case 42 – ALK+ diffuse large B-cell lymphoma (Bacchi)
11.30–11.45 Case 43 – Medullary sponge kidney with arterial fibromuscular dysplasia (Bisceglia)
11.45–12.00 Case 44 – Paraganglioma of the carotid body (Familial form with SDHD mutation)
(Sobrinho-Simoes)
12.00–13.30 LUNCH
AFteRnoon SeSSIon: Gynecologic and Breast Pathology:
chairs: e. Silva and M. Fukunaga
13.30–13.45 Case 45 – High-grade ovarian carcinoma (Silva)
13.45–14.00 Case 46 – Minimal deviation adenocarcinoma of endometrium (Silva)
14.00–14.15 Case 47 – Leiomyomatosis peritonealis disseminata (Bisceglia)
14.15–14.30 Case 48 – Malignant breast adenomyoepithelioma (Bleiweiss)
14.30–14.45 Case 49 – Mixed invasive mucinous and micropapillary CA of breast (Bleiweiss)
14.45–15.00 Case 50 – Phyllodes tumor of breast with liposarcoma (Ben-Dor)
15.00–15.15 Case 51 – IgG4 sclerosing disease of breast (Bacchi)
15.15–15.30 Case 52 – Acinic cell carcinoma of breast (Lamovec)
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15.30–16.00 Coffee Break
16.00–16.15 Case 53 – Adenocarcinoma of endocervix (Silva)
16.15–16.30 Case 54 – Hypercalcemic small cell carcinoma of ovary (Fukunaga)
16.30–16.45 Case 55 – Wolffian tumor of broad ligament (Fukunaga)
16.45–17.00 Case 56 – Omental metastasis of ovarian CA in pt. with breast CA (Bleiweiss)
17.00–17.15 Case 57 – Early complete mole (Fukunaga)
17.15–17.30 Case 58 – Rosai-Dorfman disease of breast (Damjanov)
17.30–17.45 Case 59 – Metastatic melanoma to breast mimicking carcinoma (Falconieri)
17.45–18.00 Case 60 – Pancreatic type solid/papillary tumor of ovary (Fedeli)
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in Sweden.
MoRnInG SeSSIon: Gastrointestinal and Head & neck Pathology:
chairs: V. Adsay and e. Montgomery
08.00–08.15 Case 61 – Pancreatic neuroendocrine tumor (Adsay)
08.15–08.30 Case 62 – Pancreatic acinar cell carcinoma mimicking NET (Adsay)
08.30–08.45 Case 63 – Pancreatic oncocytic neuroendocrine carcinoma (Ben-Dor)
08.45–09.00 Case 64 – Metastatic GIST to the meninges (Cooper)
09.00–09.15 Case 65 – Plexiform fibromyxoma of stomach (Miettinen)
09.15–09.30 Case 66 – Succynate dehydrogenase-deficient GIST (Miettinen)
09.30–10.00 Coffee Break
10.00–10.15 Case 67 – Histoplasmosis in Crohn’s disease (Montgomery)
10.15–10.30 Case 68 – Familial polyposis coli (Montgomery)
10.30–10.45 Case 69 – Plasmablastic lymphoma of oral cavity (Wakely)
10.45–11.00 Case 70 – Sclerosing mucoepidermoid carcinoma of thyroid (Lamovec)
11.00–11.15 Case 71 – Hürthle cell (oncocytic) variant of follicular carcinoma (Sobrinho-Simoes)
11.15–11.30 Case 72 – Cribriform papillary thyroid carcinoma (Lamovec)
11.30–11.45 Case 73 – Primary small cell carcinoma of the thyroid with PNET features
(Sobrinho-Simoes)
12.00 Conclusion
THE 5TH AMR SLIDE SEMINAR IN ANATOMIC PATHOLOGY · JUNE 14–16, 2012 IN STOCKHOLM · SWEDEN
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PARtIcIPAtInG FAculty
Volkan Adsay, M.D. Jonathan epstein, M.D. elizabeth Montgomery, M.D.
Professor and Director of Professor and Director of Professor of Pathology
Anatomic Pathology Anatomic Pathology The Johns Hopkins University
Emory University School of Medicine The Johns Hopkins University Hospital Hospital
Atlanta, GA, USA Baltimore, MD, USA Baltimore, MD, USA
carlos Bacchi, M.D. Giovanni Falconieri, M.D. Fredrik Petersson, M.D, PhD
Director, Pathology Consultants Division of Anatomic Pathology Associate Professor
Botucatu, Brazil "S. Maria della Misericordia" National University of Singapore
General Hospital Department of Pathology
David Ben-Dor, M.D. Udine, Italy Singapore
Head, Department of Pathology
Barzilai Medical Center, Ashkelon, Israel Franco Fedeli, M.D. elvio Silva, M.D.
Head, Department of Pathology Professor of Pathology
Michele Bisceglia, M.D. Anatomia Patologica, Ospedale MD Anderson Cancer Center
Director of Anatomic Pathology S.Andrea, La Spezia, Italy Houston, TX, USA
Ospedale Casa Sollievo della Sofferenza
San Giovanni Rotondo, Italy Masaharu Fukunaga, M.D. Manuel Sobrinho-Simões MD, PhD
Head, Department of Pathology Professor of Pathology
Ira Bleiweiss, M.D. Jikei University School of Medicine Pathology Department
Professor and Director of The Daisan Hospital, Komae, Japan Hospital de São
Anatomic Pathology João, Oporto, Portugal
The Mount Sinai Medical Center thomas Krausz, M.D.
New York, N.Y., USA Professor and Director of Saul Suster, M.D.
Anatomic Pathology Professor of Pathology
Kum cooper, M.D. The University of Chicago, Chicago, The Medical College of Wisconsin
Professor of Pathology IL, USA Milwaukee, WI, USA
The Vermont University Medical Center,
Burlington, VT, USA Janez lamovec, M.D. Krishnan K unni, M.D.
Professor of Pathology Professor of Pathology
thomas colby, M.D. The Institute of Oncology, Medical College of Wisconsin
Professor and Chairman Ljubljana, Slovenia Milwaukee, WI, USA
Department of Pathology
The Mayo Clinic, Scottsdale, AZ, USA Alberto Marchevsky, M.D. Paul Wakely, M.D.
Professor of Pathology Professor of Pathology
Ivan Damjanov, M.D. Cedars-Sinai Medical Center The Ohio State University
Professor of Pathology Los Angeles, CA, USA Columbus, OH, USA
University of Kansas, Kansas City, KS, USA
thomas Mentzel, M.D. eduardo Zambrano, M.D.
Göran elmberger MD, PhD Dermatopathology Bodensee Director of Anatomic Pathology
Medical Director Friedrichshafen, Germany Medical College of Wisconsin
Department of Pathology Milwaukee, WI, USA
Karolinska University Hospital Markku Miettinen, M.D.
Stockholm, Sweden Department of Pathology
National Institutes of Health,
Bethesda, USA
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The Arkadi M. Rywlin, M.D. International Pathology Slide Seminar
The Arkadi M. Rywlin (AMR) International Pathology
Slide Seminar was started in 1990 by Dr. Saul Suster at
the Mount Sinai Medical Center of Greater Miami in
Miami Beach, Florida (USA), to honor the memory of
his mentor, Prof. Arkadi M. Rywlin (1923–1987). The
AMR Seminar started as an informal exchange of inte-
resting or problem cases amongst colleagues whose pur-
pose was to share their experience with other members
in a collegial environment. The opening sentence of the
letter inaugurating the Seminar read: “The purpose of
the Club is to carry out an active exchange of interesting,
unusual, or challenging cases in diagnostic pathology
on a regular basis among its members. This exercise is
meant to be conducted in a non-competitive and friend-
ly spirit, with a view towards sharing and broadening
our knowledge and experience in the different aspects of
anatomic pathology”. The club started with 9 founding
members, and currently counts with 45 members, with
more than 65 pathologists having belonged to the Club
since its inception. More than 1,000 cases have been
circulated in the club during its 20 years of existence.
More than 25 collaborative publications have been gene-
rated based on cases circulated in the Club, and selected material is centrally collated and redistributed to all
cases have been regularly published in “Advances in the members, and their comments and responses are
Anatomic Pathology” since 2001. In 2002, thanks to the transferred to a single document which is posted on the
generous support of Dr. Michele Bisceglia and his insti- official AMR Club website (http://www.amr-seminar.
tution, “Casa Solievo della Soferanza” in San Giovani org). Plans are underway to scan the slides from past se-
Rotondo, Italy, the first Arkadi M. Rywlin International minars using virtual slide imaging technology to incor-
Pathology Slide Seminar Symposium in Anatomic Path- porate them into the website. Pertinent clinical pictures,
ology was organized. This meeting was followed by imaging studies, and results of special techniques such
other highly successful international meetings in Bris- as electron microscopy and molecular studies, are also
bane, Australia (2004), Srni, the Czech Republic (2005), uploaded in the website along with each case. Dr. Juan
Mexico City, Mexico (2008), Istanbul, Turkey (2010), Rosai, one of the initial members of the club, has also
and the present one in Stockholm. Future meetings are asked for approval to scan all past AMR Slide Seminar
planned for Tel-Aviv, Israel (2013), Tokyo, Japan (2014), cases to include in the “Juan Rosai Collection of Surgical
and a half-day program at the International Academy of Pathology Seminars” sponsored by USCAP and Aperio
Pathology (IAP) Meeting to be held this year in October and that will be featured in the United States and Cana-
in South Africa. dian Academy of Pathology website.
The slide seminars are conducted through the mail. The person after whom the seminar is named, Arkadi
Approximately 3–4 exchanges take place each year. A M. Rywlin, M.D., was the Chairman of Pathology at the
complete set of glass slides for distribution to all the Mount Sinai Medical Center of Greater Miami, Miami
members is submitted by the contributing pathologists Beach, Florida and Professor of Pathology at the Uni-
on the cases of their choice, accompanied by a written versity of Miami School of Medicine from 1962 until
description of the case, including clinical history, histo- his untimely death in 1987. Professor Rywlin graduated
logic findings, results of ancillary techniques, diagnosis, medical school at the University of Geneva and took
discussion with review of the literature, pertinent re- his initial training in Pathology under Professor Rutis-
ferences, and questions posed to the other members of hauser. He immigrated to the United States in 1953 and
the club in reference to the case being circulated. This resumed his training in Pathology at the University
THE 5TH AMR SLIDE SEMINAR IN ANATOMIC PATHOLOGY · JUNE 14–16, 2012 IN STOCKHOLM · SWEDEN
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of Chicago under Prof. Otto Saphir. He transferred to only by an inch, never by a mile…”. Dr. Ackerman, in
Miami in 1962 where he was to head the Department his preface to his famous tome on “Histologic Diagnosis
of Pathology and Laboratory Medicine at Mount Sinai of Inflammatory Skin Disorders” dedicated his book ”…
Medical Center for 25 years. Prof. Rywlin was a classi- to Arkadi M. Rywlin, mentor in the science of pathology
cally trained pathologist who quickly became widely re- and in the art of life; wise, generous and loyal friend”.
cognized as one of the preeminent hematopathologists Prof. Rywlin was an outstanding educator and trained
of his generation. He single-authored the first book de- dozens of residents and fellows; his approach was
voted to bone marrow pathology (Histopathology of the straightforward and logical and stimulated his trainees
Bone Marrow, Little, Brown, Co, Boston, 1976), and con- to exercise critical judgment when approaching prob-
tributed extensively to the literature on diseases of the lems in pathology. The Club was founded to honor the
bone marrow. His paper describing a simple technique memory of this giant of pathology and to advance the
for the preparation of bone marrow smears and sections spirit of critical thinking that characterized what was
(Am J Clin Pathol 53:389–393, 1970) rapidly became the known to all those who had the privilege to train under
standard of practice for obtaining bone marrow samples him as “Rywlinian”.
and the favored technique in the United States. Prof.
Rywlin, however, was also a superb general pathologist Saul Suster, M.D.
and was able to offer an educated opinion on most areas
in pathology. As Dr. A. Bernard Ackerman, his most
prominent disciple, commented years later, “Arkadi ra-
rely ever missed a diagnosis, and when he missed it was
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