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1 UUID : 10F97F63 - EE6F-448D - 98E1-8AAA21F55753 TCGA - TS-A7PB-01A-PR Redacted III II II III Date Receive III II 1 II IIIIIIIIIIIIIII 1 III 1 III ge: /ears sex: Male Access I I111IIIIIIIIIII III an c A S,ur, Ic a t o I a g' Y 11,0,0 o f f 6-'tL S)^t^ 0,5&,q I Clinical Information year old male with mesothelioma, Left Thoracotomy, Pleurectomy, PDT, Bronchoscopy IL3 Final Diagnosis 1. RIB: Section of rib with bone marrow, no tumor seen. Fibroadipose tissue and skeletal muscle, no tumor seen. 2. LYMPH NODE, STATION 10: One fragment of lymph node, no tumor seen (0/1). 3. LYMPH NODE, STATION 8: Two out of two lymph node showing small focus of metastatic mesothetioma (2/2), confirmed by CK5/6 and calretinin immunostains. 4. LYMPH NODE, STATION 6: Three out of four lymph nodes showing metastatic mesothelioma (314). 5. LYMPH NODE, PERICARDIAL; Two out of two lymph nodes showing metastatic mesothetioma (2/2). 6. LYMPH NODE, LEVEL 7: One lymph nodes showing metastatic mesotheliorna (1/1). 7. LYMPH NODE, PHRENIC NODE: One lymph node, no tumor seen (0/1). 8. LYMPH NODE, ANTERIOR HILAR: One lymph node, no tumor seen (0/1). 0. LYMPH NODE, LEVEL 2: One out of two lymph nodes showing metastatic mesothelioma (1/2). 10. LYMPH NODE, LEVEL 5: One out of four lymph nodes showing metastatic mesothelioma (1/4). Adipose tissue with focal presence of mesothelioma, epithelioid type, confirmed by CK5/6 immunostain. 11. PHRENIC NERVE: Peripheral nerve fibers, no tumor seen. Name Page 1 of 5 MR^'

2 Nam MRN: ae: years sex: Male Date R eeivet1 c Accession No i: Fibroadipose tissue with focal presence of mesothelioma, epithelioid type, confirmed by CK516 and calretinin imrnunostains. 12. POSTERIOR INTERCOSTAL: showing metastatic mesothelioma (2/2). Two out of two lymph nodes 13, PLEURA: Biphasic malignant mesothelioma (-.90% epithelioid and -10% sarcomatoid ) with focal necrosis. Tumor involves skeletal muscle and superficial lung tiss ue. See synoptic report. 14. PERICARDIAL MASS: Biphasic malignant mesothelioma (-20% epithelioid and -80% sarcomatoid ) with focal necrosis. ti ssue. Tumor involves underlying superficial lung inked pericardial margin is free of tumor. See comment and synoptic report. The case material was reviewed and the report verified by: (Electronic signature) Verification Date: Note lmmunohistochemical stains are performed with adequate controls (see disclaimer). The tumor cells are positive for CK5/6, calretinin, D2-40 and WT-1; the tumor cells are negative for TTF-1 and This immunoprofile supports the above diagnosis. Slides 1 OA, 14B and 14D reviewed with Disclaimer: The above in-vitro IHC tests may have used reagents labeled for IVD (In Vitro Diag nostic Use U.S Food O and (Investigational Drug Only) and/or RUO (Research Use Only) and have nthat been such clearance or app oval is not necessary for ASR class I tests Administration. However, the FDA has determined using IUO or uation. intended to provide pathologists with adjunctive information to assist their morphologic eval use by the luo reagents were developed and their performance characterigtir:s were validated for diagnostic his laboratory is regulated under the clinical Laboratory Improvement Amendments or 1988 (C I ) sgcapr +d to per o m iighu omplexity clinical tests. These Class I ASR tests are not intended to provide diagnostic, p 9n information that is not directly confirmed by routine histopathologic internal or external control specimens. Name MR 1'1'. Page 2 of 5

3 Loc.. Now o_ years Sex: Male : Date Received: Accession NoA Physician. g u r y l e a I p a t h o l o g y B o g a r t Synoptic Report Site: Left Histologic Type Biphasic mesothelioma Margins Cannot be assessed Lymph nodes Specify: Number examined: 20 Number involved: 12 Pathologic Staging : pt3n2mx Gross Description The specimen is received in 14 parts in formalin in a container labeled with the patient's name and medical record number. Specimen #1 received in formalin labeled "Rib" and consists of two ragged and irregular fragments of tan-white to tanbrown bone, grossly consistent with portions of rib, measuring 1.1 and 1.8 cm in greatest dimension. The largest fragment is serially sectioned and the specimen is submitted entirely in cassette 1 A following decalcification. Specimen #2 received in tormalin labeled "Station 10" and consists of a 0.8 x 0.5 x 0.2 cm gray-black, irregular soft tissue fragment, which is submitted in toto in cassette 2A. Specimen #3 received in formalin labeled "Station 8" and consists of two tan-yellow, irregular to nodular soft tissue fragments measuring 0.7 and 0.8 cm in greatest dimension. The more nodular fragment is bisected to reveal tan-white, dense cut surfaces. The larger fragment is submitted entirely in cassette 3A and the smaller, intact fragment is submitted in toto in cassette 38. Specimen #4 received in formalin labeled "Station 6" and consists of four gray-black to tan-yellow, irregular to vaguely nodular soft tissue fragments ranging from 0.8 to 1.5 cm in greatest dimension. The two larger fragments are bisected and submitted entirely in cassettes 4A and 48, respectively, and the remaining two soft tissue fragments are submitted in toto in cassette 4C. Specimen #5 received in formalin labeled "Pericardial Node" and consists of two tan-yellow to tan-white, irregular to nodular soft tissue fragments each measuring 1.2 cm in greatest dimension. Each fragment is bisected to reveal tanwhite, dense cut surfaces. The specimen is submitted entirely in cassettes 5A and 5B, respectively. Name Page 3 of 5 MRN:

4 ' Date Received: DOB: Age: 1 years Sex : Male Accession WIN Physician: 4 Specimen #6 received in formalin labeled "Level 7" and consists of a 1.5 fragment, which is bisected to reveal tan-white to gray-black, firm cut surfaces. The specimen Pecmen cassette 6A. Specimen #7 received in formalin labeled "Phrenic Node" and consists of a 2.3 x 2.2 nodular soft tissue fragment, which is bisected to reveal gray black to red-brown, submitted entirely in cassette 7A. submitted entirely in 0.8 dense cut s an-yell. The w to sgraymenck, i is Specimen #8 labeled "Anterior Hilar Node" and consists of a 2.0 x 1.3 x 1.1 cm gray-black, nodular soft tissue fragment, which is bisected to reveal gray-black to red-brown, dense cut surfaces. The specimen is submitted entirely in cassette 8A. Specimen #9 received in formalin labeled "Level 2" and consists of two tan-yellow to gray-black,s bile fed and r to modular eft tissue fragments measuring 0.8 and 1.5 cm in greatest dimension. The larger fragmen submitted entirely in cassette 9A. Specimen #10 received in formalin labeled "Level 5" and consists of two grey-black to tan-yellow, nodular soft tissue fragments measuring 1.3 and 2.3 cm in greatest dimension. The larger fragment is bisected to reveal tan-yellow to redbrown, dense cut surfaces. The larger fragment is submitted entirely in cassette 14A, and the remainder of the specimen is submitted in toto in cassette 1AB. Specimen #1 1 received in formalin labeled "Phrenic Nerve" and consists of a 2.5 x 0.8 x 0.3 cm tan-white to tan-yellow, irregular to vaguely cylindrical soft tissue fragment, which is submitted in toto in cassette 11A. t Specimen #12 received in formalin labeled "Posterior Intercostal" and consists tan-yellow gray-bl two tted ino of in cassette k, 12A. irgular soft tissue fragments measuring 0.6 cm in greatest dimension each. The specimen Specimen #13 received in formalin labeled "Pleura" and consists of a g, 21.5 x 18.4 x 7.5 cm ragged and irregular portion of tan-yellow to tan-white, rubbery soft tissue, grossly consistent with a portion of pleura. There are areas of redbrown, rubbery muscle and tan-yellow, tabulated adipose tissue attached. Focal areas are diffusely thickened and reveal tan-white, dense cut surfaces, measuring up to 19.0 cm in greatest dimension. Focal areas are calcified. Representative sections are submitted in cassettes 13A through 13F. Specimen #14 received in formalin labeled "Pericardial Mass" and consists of a 4.5 x 3.6 x 2.1 cm irregular portion of tan to tan-yellow, cauterized, firm soft tissue. One surface is covered by a 3.9 x 3.5 cm portion of tan-pink to tan-white, glistening, focally ragged soft tissue which per the surgeon denotes the deep margin facing the heart (inked black). The remaining surface displays a portion which was removed by the surgeon for research purposes. Sectioning reveals a 3.9 x 2.9 x 1.8 cm tan-white to tan-yellow, firm mass which grossly abuts the black inked deep margin facing the heart. There is only a small amount of tan-yellow to tan-white, uninvolved soft tissue identified. Representative sections are submitted in I^'ame. MRN Page 4 tit 5

5 I Date Received DOB Anc* years Sex: Male Accession No4 Physician: S i! f p l e a I P a t i a l a p y N 8 p o f f cassettes 14A through 14E. Dictated byf: Pathologist(s) Name Page 5 of 5 %IIW DiaQn Discr.p- I ri M arytufior epacy Siscr I HIP Discrepancy Prior A =ar cy 111,t :`I//SynOronou`Prirr N case is ' C1f_ Qt, ;I", r Initials /^wl`.

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