日 本 病 理 学 会 中 国 四 国 支 部 学 術 集 会 ( 第 114 回 スライドカンファレンス) 診 断 投 票 結 果

Transcription

1 日 本 病 理 学 会 中 国 四 国 支 部 学 術 集 会 ( 第 114 回 スライドカンファレンス) 診 断 投 票 結 果 平 成 26 年 6 月 14 日 高 知 大 学 医 学 部 臨 床 講 義 棟 第 3 講 義 室 S2509 頬 粘 膜 腫 瘍 *Speaker's diagnosis Solitary fibrous tumor 12 Solitary fibrous tumor and Fordyce spots/granules (2) Extrapleural solitary fibrous tumor* (1) Solitary fibrous tumor with sebaceous glands (1) Myxofibrosarcoma 9 Low grade myxofibrosarcoma (4) Myxofibrosarcoma, low-grade with Fordyce granules (1) Liposarcoma 6 Myxoid liposarcoma (3) Atypical lipomatous tumor (2) Oral focal mucinosis 6 Fibroma 6 Sclerotic fibroma (1) Fibroma durum (1) Pleomorphic fibroma (1) Giant cell fibroma (2) Neurofibroma 5 Solitary neurofibroma (1) Neurofibroma + Fordyce granules (1) Myxoma 6 Odontogenic myxoma (4) Superficial angiomyxoma 5 Spindle cell/pleomorphic lipoma 4 Fat-free spindle cell/pleomorphic lipoma (1) Low grade fibromyxoid sarcoma 3 Low grade fibromyxoid sarcoma and ectopic sebaceous gland (1) Fibromyxoid tumor, low-grade malignancy (1) Fibromatosis 2 Nodular fasciitis 2 Deep benign fibrous histiocytoma 1 Giant cell angiofibroma + Fordyce spot 1 Desmoplastic fibroblastoma 1 Superficial fibromyxoma and Fordyce disease 1 Myxofibroma 1 Nerve sheath myxoma 1 Myxoid perineurioma 1 Neurothekeoma 1 Pleomorphic adenoma 1 Sebaceous adenoma 1 Aggressive angiomyxoma 1 Low-grade myofibroblastic sarcoma 1 Fibroepithelial polyp with myxoid change 1 No answer 4

2 S2510 頸 部 皮 下 腫 瘍 Spindle cell lipoma 31 Neurofibroma 8 Neurofibroma, plexiform type (1) Neurofibroma, encapsulated (1) Angiofibroma 5 Cellular angiofibroma (1) Angiofibroma of soft tissue (3) Solitary fibrous tumor 5 Extrapleural lipomatous solitary fibrous tumor (1) Myxoid solitary fibrous tumor (1) Superficial angiomyxoma 4 Liposarcoma 2 Atypical lipomatous tumor (1) Cellular angiolipoma 2 Angiomyolipoma 2 Myofibroblastoma 2 Dermatofibroma 2 Low-grade fibromyoid sarcoma 2 Myxofibrosarcoma 1 Fibrosarcoma 1 Angiomyofibroblastoma 1 Desmoplastic fibroblastoma 1 Desmoid type fibromatosis 1 Dendritic fibromyxolipoma 1 Fibromyxoma 1 Elastfibroma 1 Schwannoma 1 Nerve sheath myxoma 1 Neurothekeoma 1 Perineurioma 1 Lymphangioma 1 Epithelioid hemangioendothelioma 1 Retiform hemangioendothelioma 1 No answer 3

3 S2511 後 腹 膜 腫 瘤 *Speaker's diagnosis Dedifferentiated liposarcoma 18 Dedifferentiated liposarcoma with epithelioid change* (1) Dedifferentiated liposarcoma with epithelioid features (1) Dedifferentiated liposarcoma with osteosarcoma and RCC-like tumor (1) Dedifferentiated liposarcoma with alveolar soft part sarcoma-like differentiat (1) Angiosarcoma elements of dedifferentiated liposarcoma (1) Liposarcoma 15 Pleomorphic liposarcoma (4) Epithelioid pleomorphic liposarcoma (1) Liposarcoma with feature of the other types sarcoma (1) Liposarcoma with epithelial morphology (1) Liposarcoma, epithelioid type (1) Recurred liposarcoma with component of epithelioid variant of pleomorphic liposarcoma (1) Collision tumor 13 Dedifferentiated liposarcoma + seminoma (1) Dedifferentiated liposarcoma + alveolar soft part sarcoma (1) Dedifferentiated liposarcoma with osteosarcomatous elements + malignant PEComa (1) Liposarcoma + seminoma (1) Liposarcoma + carcinoma (1) Well differentiated liposarcoma + alveolar soft part sarcoma (1) Paraganglioma + liposarcoma (1) Composite pheochromocytoma + liposarcoma (1) RCC + liposarcoma (1) Clear cell renal cell carcinoma and liposarcoma (1) Liposarcoma associated renal cell carcinoma (1) Angiosarcoma + osteosarcoma (1) Pheochromocytoma + MPNST (1) Renal cell carcinoma 11 Chromophobe renal cell carcinoma (1) Xp11.2 translocation renal carcinoma with osseous metaplasia (1) Sarcomatoid renal cell carcinoma (1) Renal cell carcinoma, metastatic (1) Multilobular clear cell renal cell carcinoma (1) Alveolar soft part sarcoma 5 Alveolar soft part sarcoma arising from liposarcoma (1) PEComa 5 Malignant PEComa (2) Carcinosarcoma 4 Clear cell carcinoma 1 Synovial sarcoma 2 Osteosarcoma 1 Angiosarcoma 1 Mixed germ cell tumor 2 Malignant germ cell tumor of more than one histological type, mixed forms 1 Testis? 1 No answer 3

4 S2512 鼠 径 部 皮 下 腫 瘤 *Speaker's diagnosis Lipoma 26 Spindle cell lipoma (16) Fibrolipoma (4) Fibrous lipoma (1) Myxolipoma (2) Pleomorphic lipoma (1) Liposarcoma 18 Atypical lipomatous tumor (4) Well differentiated liposarcoma (3) Myxoid liposarcoma (2) Dedifferentiated liposarcoma (2) Cellular angiofibroma 8 Cellular angiofibroma (spindle cell lipoma-like) * (1) Angiomyofibroblastoma 5 Angiolipoma 3 Solitary fibrous tumor 3 Angiomyxoma 3 Superficial angiomyxoma (1) Aggressive angiomyxoma (1) Angiomyolipoma 2 Angiomyxolipoma 1 Neurofibroma 1 Schwannoma 1 Ganglioneuroma 1 Desmoid 1 Lipofibroma 1 Low grade myofibroblastic tumor 1 Mammary-type myofibroblastoma 1 Ischemic fasciitis 1 No answer 6

5 S2513 皮 膚 腫 瘍 *Speaker's diagnosis Cylindroma 39 Cylindroma due to Brooke-Spiegler syndrome (2) Malignant cylindroma (1) Eccrine cylindroma (1) Cylindroma + Eccrine spiradenoma* 1 Trichoblastoma 19 Trichoblastoma,invasive (1) Trichoepithelioma 10 Multiple trichoepithelioma (1) Basal cell carcinoma 6 Sebaceoma 4 Sebaceous epithelioma 1 Eccrine spiradenoma 1 Porocarcinoma 1 Trichilemmal carcinoma 1 No answer 1 S2514 後 縦 隔 嚢 胞 性 病 変 *Speaker's diagnosis Bronchogenic cyst 37 Bronchogenic cyst with papilloma (3) Bronchogenic cyst with epithelial hyperplasia (1) Bronchial cyst 5 Bronchial cyst with focal tubal metaplastic epithelial proliferation (1) Mullerian cyst* 7 Mediastinal cyst, the Mullerian origin (1) Hattori s cyst (Cyst of Mullerian differentiation) (1) Foregut cyst 6 Foregut cyst with tubal metaplasia (1) Gastroenteric cyst 5 Papillary adenoma arised in gastroenteric cyst (1) Esophageal cyst 4 Endosalpingiosis 3 Florid cystic endosalpingiosis (1) Cystic lesion with endosalpingiosis (1) Mature teratoma 3 Mature cystic teratoma (2) Choroid plexus papilloma 2 Thymic cyst with papillaty epithelial proliferation 1 Tracheoesophageal cyst 1 Pulmonary cyst 1 Papilloma in epithelial cyst 1 Heterotpia 1 Serous cyst adenocarcinoma 1 No answer 5

6 S2515 右 大 腿 部 多 発 性 皮 下 結 節 Subcutaneous panniculitis-like T-cell lymphoma 44 Panniculitis-like T cel lymphoma (8) Subcutaneous panniculitis-like T cell lymphoma, mimicking fat necrosis (1) Primary cutaneous gamma-delta T-cell lymphoma 26 Cutaneous gamma/delta T-cell lymphoma (5) Gamma-delta T-cell lymphomas (3) Subcutaneous gamma delta T-cell lymphoma (1) Cutaneous γδ T-cell lymphoma showing panniculitis-like features (1) Subcutaenous pannilucitis-like T cell lymphoma, gamma delta type 1 T-cell lymphoma 3 Cutaneous T-cell lymphoma (1) Malignant lymphoma 1 Subcutaneous panniculitis like tumor 1 Weber-Christian disease 1 Cytophagic histiocytic panniculitis 1 Necrotizing panniculitis 1 Erythema induratum 1 No answer 3

7 S2516 下 腿 部 腫 瘍 *Speaker's diagnosis Giant cell tumor 22 Giant cell tumor of bone (5) Giant cell tumor of soft tissue (3) Tenosynovial giant cell tumor, diffuse type (3) Tenosynovial giant cell tumor (1) Diffuse type giant cell tumor (1) Giant cell tumor with chondroid metaplasia (1) Malignant giant cell tumor 6 Malignant giant cell tumor of soft tissue (1) Osteosarcoma 19 Giant cell-rich osteosarcoma (6) Giant cell-rich osteosarcoma, extraskeletal (1) Osteosarcoma, giant cell type (1) Extraskeletal osteosarcoma (1) Parosteal osteosarcoma (1) Chondrosarcoma 8 Dedifferentiated chondrosarcoma (2) Dedifferentiated chondrosarcoma with mimicking a giant cell tumor compone (1) Dedifferentiated chondrosarcoma, giant cell variant (1) Pigmented villonodular synovitis 6 Pigmented villonodular synovitis with chondroid metaplasia* (1) Chondroblastoma 5 Chondroblastoma with secondary aneurysmal bone cyst (1) Brown tumor 3 Aneurysmal bone cyst 2 Malignant melanoma 2 Giant cell type melanoma (1) Giant-cell reparative granuloma 1 Phosphaturic mesenchymal tumor 1 Clear cell myomelanocytic tumor with stromal calcification 1 Osteonecrosis 1 No answer 6

8 S2517 HLA 半 合 致 末 梢 血 幹 細 胞 移 植 後 の 下 部 消 化 管 病 変 Graft versus host disease (GVHD) 18 Acute GVHD (3) GVHD after allogeneic stem cell transplantation (1) Graft versus host reaction (1) GVHD with vasculitis (1) GVHD + amyloidosis (1) Thrombotic microangiopathy (TMA) 18 Intestinal thrombotic microangiopathy (2) Thrombotic microangiopathy following hematopoietic stem cell transplantatio (2) Thrombotic microangiopathy with cytomegalovirus infection (1) TMA+Viral infection (1) Transplantation associated microangiopathy (TAM) 10 Transplantation associated microangiopathy, intestinal type (1) Intestinal type of transplantation associated microangiopathy (1) Transfusion associated microangiopathy (1) TMA or TAM 5 Transplantation-associated thrombotic microangiopathy (2) Intestinal transplant-associated thrombotic microangiopathy (1) Post transplantation thrombotic microangiopathy (1) Transplant vasculopathy (1) Amyloidosis 8 Amyloidosis + ischemic colitis (GVHD?) (1) Amyloidosis + ischemic colitis (2) Ischemic colitis 3 Ischemic colitis due to post-transplant thrombotic microangiopathy (1) Ischemic colitis due to drug induced arterial hyalinosis (1) Ischemic colitis due to vasculitis, GVHD? (1) Virus infection 3 BK virus infection? (1) Enteritis induced by BK virus infection (1) Vasculitis / Angiitis 3 Polyarteritis nodosa associated with peripheral stem cell transplantation 1 Amyloid angiopathy 1 Non-occlusive mesenteric ischemia (NOMI) 1 Acute rejection 1 Necrosis of tunica media 1 Herpesvirus enteritis 1 Fuluminant colitis 1 Hemorrhagic colitis 1 No answer 7

9 S2518 膵 腫 瘤 *Speaker's diagnosis Plasma cell myeloma 23 Multiple myeloma (6) Extramedullary pancreatic involvement of plasma cell myeloma (3) Myeloma (2) Myeloma invasion (1) Plasma cell myeloma ( anaplastic ) (1) Invasion of plasma cell myeloma with plasmablastic change (1) Plasmablastic plasma cell myeloma (2) Plasmablastic myeloma (1) Plasmacytoma 15 Extramedullary plasmacytoma (1) Plasmablastic plasmacytoma (1) Plasmablastic extramedullary plasmacytoma (1) Plasmablastoma 1 Plasma cell neoplasm 5 Metastatic plasma cell neoplasm of pancreas* (1) Plasma cell neoplasm (compatible with multiple myeloma) (1) Plasmablastic lymphoma 2 Malignant lymphoma + Multiple myeloma 1 Anaplastic large cell lymphoma 1 Diffuse large B-cell lymphoma 1 Lymphoproliferative disorder 1 Neuroendocine carcinoma 1 Neuroendocine carcinoma, large cell 1 Undifferentiated carcinoma 1 Rhabdomyosarcoma 1 No answer 29

10 S2519 膵 腫 瘍 Neuroendocrine tumor 28 Neuroendocrine tumor (NET), Grade 1 (7) Neuroendocrine tumor (NET), Grade 2 (2) Sclerosing neuroendocine tumor, serotonin-producing (1) Pancreatic NET sclerosing type (1) Neuroendocrine tumor with scar (1) Neuroendocrine tumor with massive degeneration (1) Neuroendocrine tumor, well-differentiated, benign/uncertain (1) Neuroendocrine carcinoma (1) Neuroendocrine carcinoma, low-grade (1) Endocrine tumor/neoplasm 10 Well differentiated pancreatic endocrine neoplasm (1) Endocrine tumor or solid pseudo-papillary neoplasm? (1) Pancreatic endocrine carcinoma (1) Islet cell tumor 9 Islet cell adenoma (1) Islet cell tumor and acinic cell carcinoma (1) Solid-pseudopapillary neoplasm/tumor 21 Solid pseudo-papillary tumor, malignant (1) Solid-pseudopapillary tumor with sclerosis (1) Solid cystic tumor (1) Pancreatitis 3 Chronic pancreatitis (1) Mass-forming pancreatitis (1) Paraganglioma 3 Gangliocytic paraganglioma 1 PEComa 1 Carcinoid 1 Calcifying fibrous tumor 1 Hamartoma 1 No answer 4

11 S2520 肺 腫 瘤 *Speaker's diagnosis Alveolar adenoma* 35 Lymphangioleiomyomatosis 8 Lymphangioma 6 Cystic adenomatoid transformation 7 Congenital cystic adenomatoid malformation (4) Clear cell tumor 4 PEComa (2) Clear cell sugar tumor (1) Pulmonary sequestration 2 Pulmonary sequestration, intralobar (1) Cystic mesenchymal hamartoma 1 Benign cystic lesion 1 Multicystic pneumocytic tumor, benign 1 Atypical adenomatous hyperplasia 1 Micronodular pneumocyte hyperplasia 1 Tumorous lymphangiectasis 1 Eosinophilic granuloma 1 Pulmonary tumorlet 1 Pulmonary adenofibroma 1 Pulmonary solitary capillary hemangioma 1 Adenocarcinoma 2 Serous cystadenocarcinoma 1 Metastatic renal cell carcinoma 1 No answer 7

12 S2521 乳 腺 腫 瘍 *Speaker's diagnosis Invasive ductal carcinoma 16 Invasive ductal carcinoma with focal micro papillary pattern (1) Invasive ductal carcinoma with cystic change (1) Papillotubular carcinoma 5 Papillotubular carcinoma with invasive micropapillary feature (1) Papillotubular carcinoma with invasive micropapillary carcinoma (1) Invasive ductal carcinoma, pap-tub + invasive micropapillary (1) Invasive cribriform carcinoma 2 Invasive cribriform carcinoma with micropapillary component (1) Secretory carcinoma 7 Cystic hypersecretory carcinoma (1) Invasive micropapillary carcinoma 6 IMPC (1) Mucinous carcinoma 7 Columnar mucinous carcinoma (1) Columnar cell mucinous adenocarcinoma (1) Mucinous carcinoma, micropapillary variant (1) Mucinous carcinoma and carcinomas with signet-ring-cell differentiation (1) Mixed mucinous carcinoma with signet-ring cell differentiation (1) Mixed mucinous carcinoma with components of cystic papillary mucinous carcinoma and micropapillary variant* 1 Mucin-producing adenocarcinoma 1 Breast carcinoma with mucinous metaplasia and invasive micropapillary carcinoma 1 Mucinous cystadenocarcinoma with invasive micropapillary pattern 1 Mucoepidermoid carcinoma 6 Metastatic adenocarcinoma 7 Metastasis of mucoepidermoid carcinoma (1) Metastatic adenocarcinoma to breast (colon cancer) (1) Adenocarcinoma, NOS 2 Metaplastic carcinoma 2 Invasive carcinoma 1 Invasive carcinoma with ductal, metaplastic, and micropapillary feature 1 Ductal carcinoma 1 Apocrine carcinoma 1 Neuroendocrine carcinoma with mucinous differentiation 1 Mixed adenoneuroendocrine carcinoma 1 Carcinoma with medullary features 1 Tubulolobular carcinoma 1 Glycogen-rich clear cell carcinoma 1 Signet-ring cell carcinoma 1 Adenoid cystic carcinoma 1 Acinic cell carcinoma 1 Carcinosarcoma 1 Myoepithelial carcinoma 1 Goblet cell carcinoid 2 No answer 3

13 S2522 子 宮 内 容 物 *Speaker's diagnosis Epithelioid trophoblastic tumor* 34 Choriocarcinoma 21 Placental site trophoblastic tumor (PSTT) 15 Trophoblastic tumor 1 Malignant trophoblastic tumor 1 Exaggerated placental site 1 Mixed germ cell tumor (choriocarcinoma + yolk sac tumor) 1 Clear cell adenocarcinoma 3 Embryonal carcinoma 1 Endometrioid carcinoma G3 + decidual reaction 1 No answer 3 S2523 卵 巣 腫 瘍 *Speaker's diagnosis Microcystic stromal tumor* 24 Yolk sac tumor 14 Granulosa cell tumor 12 Juvenile granulosa cell tumor (9) Thecoma 3 Luteinized thecoma (2) Thecoma with micro sex-cord elements (1) Sexcord-stromal neoplasm 1 Signet-ring stromal tumor 1 Stromal tumor with luteinization 1 Sertoli - Leydig cell tumor, moderately differentiated 1 Leydig cell tumor 2 Steroid cell tumor, NOS 2 Immature teratoma 1 Carcinoid tumor 1 Adenomatoid tumor 3 Wolffian (duct) tumor 2 Ependymoma 1 Lipid cell tumor 1 Neuroendocrine tumor 1 Chordoma arising in teratoma 1 Hepatoid carcinoma 1 No answer 10

14 S2524 左 母 指 軟 部 腫 瘍 *Speaker's diagnosis Digital papillary carcinoma 38 Cutaneous digital papillary adenocarcinoma* (1) Digital papillary adenocarcinoma (11) Papillary digital eccrine adenocarcinoma (4) Papillary digital eccrine carcinoma (2) Digital papillary carcinoma and hydrocystoma (1) Digital papillary carcinoma a/w hidrocystoma (1) Digital papillary carcinoma arising from eccrine cystadenoma (1) Digital papillary carcinoma with adenoma component (1) Aggressive digital papillary adenocarcinoma (5) Aggressive digital papillary adenoma (1) Hidradenoma 5 Poroid hidradenoma (2) Hidradenoma, malignant? (1) Eccrine hidradenoma (1) Adenocarcinoma, NOS 4 Adenocarcinoma with epidermoid cyst (1) Adenocarcinoma arising in mixed tumor (1) Synovial sarcoma 3 Monophasic epithelial synovial sarcoma (1) Synovial sarcoma, monophasic (1) Porocarcinoma in situ 2 Porocarcinoma in situ arising in poroid hidradenoma (1) Porocarcinoma in situ arising in poroid cell tumor (1) Syringocystadenocarcinoma 1 Eccrine adenocarcinoma 1 Spiradenocarcinoma 1 Apocrine carcinoma 1 Apocrine cystadenocarcinoma 1 Papillary adenocarcinoma 1 Metastatic adenocarcinoma 1 Adenosquamous cell carcinoma 1 Sebaceous carcinoma 1 Sweat gland duct tumor, borderline 1 Eccrine acrospiroma 2 Apocrine hidrocystoma 2 Glomus tumor 2 Papillary eccrine adenoma 2 Syringocystadenoma papilliferum 1 Proliferating trichilemmal tumor 1 Synovial cyst 1 Cutaneous ciliated cyst 1 No answer 9

15 S2525 腎 生 検 *Speaker's diagnosis Amyloidosis / Amyloid deposition 11 AL amyloidosis (1) Light chain deposition disease 10 Monocolonal immunoglobulin deposition disease 7 Immunotactoid nephropathy* 4 Myeloma kidney 3 Myeloma kidney with glomerulosclerosis (1) Dense deposit disease/glomerulonephritis 2 Cryoglobulinemic glomerulonephritis 2 Proliferative glomerulonephritis with monoclonal gammopathy 1 Monoclonal gammopathy of renal significance 1 Mesangial proliferative glomerulonephritis 1 Membranoproliferative glomerulonephritis 1 Diffuse endocapillary proliferative glomerulonephritis + nodular glomerulosclerosis 1 Crescentic glomerulonephritis 1 Diabetic nephropathy 1 Necrotizing glomerulonephritis 1 MGN 1 Glomerulonephritis 1 No answer 34 S2526 腎 腫 瘍 *Speaker's diagnosis Glomus tumor * 26 Glomus tumor (with focal nuclear atypia) (1) Symplastic glomus tumor (1) Glomangioma 7 Renal cell carcinoma 13 Mucinous tubular and spindle cell carcinoma (9) Renal cell carcinoma associated with Xp11.2 translocation (1) Chromophobe renal cell carcinoma (1) Angiomyolipoma 10 Epithelioid angiomyolipoma (3) Hemangiopericytoma 6 Juxtaglomerular cell tumor 5 Oncocytoma 3 Oncocytoma, tubulocystic type (1) PEComa 3 Myopericytoma 3 Epithelioid hemangioendothelioma 2 Clear cell sarcoma 1 Medullary carcinoma 1 No answer 3

16 S2527 前 立 腺 病 変 *Speaker's diagnosis IgG4-related disease/lesion 50 IgG4-related prostatitis* (14) IgG4-related sclerosing prostatitis (6) IgG4-related sclerosing disease (4) IgG4-related disease (eosinophilic angiocentric fibrosis) (1) Inflammatory myofibroblastic tumor 15 Inflammatory pseudotumor 8 Inflammatory pseudo tumor, IgG4-related disease? (1) Autoimmune prostatitis 2 Autoimmune prostatitis, IgG4-related? (1) Granulomatous prostatitis 2 Eosinophilic prostatitis 2 Sclerosing prostatitis, suspicious of IgG4 related disease 1 Malignant lymphoma 2 Small lymphocytic lymphoma (1) No answer 1