The First Taiwan-Japanese Conjoint Slide Conference

Case T01 (02-7650)

Provider:  Dr. Ying-Tai Jin, Surgical Pathology Section Chief, National Cheng Kung University Medical Center

This 72 year old male was found to have a throat lump in July, 2002, due to the hoarseness clinically. Excisional biopsy was done in the hypopharyngeal area (the mass measures 4x2x1.5 cm.) and the pathology report was “fibrolipoma”. Medical history was not contributory except patient recall a “benign laryngeal tumor” excised around age 62. This lesion recurred with similar symptom in April, 2006 and a biopsy was performed. Radiographs were obtained (2006). Your slide is the biopsy of 2002.

CT images

Microscopic images

Case T02 (90-18393)

Provider:  Dr. Shih-Sung Chuang, Chi-Mei Foundation Hospital

Male, 56 y/o

The patient presented with fever and left inguinal lymphadenopathy. The initial diagnosis of the lymphadenectomy was follicular lymphoma. Staging procedure by chest and abdominal CT scans showed multiple bulky lymphadenopathy in the carotid space, bilateral submandibular and cervical regions, and suspicious hepatic involvement. His white count was at 5190/μl with 30% lymphocytes and LDH level was elevated at 314 (reference: 95-205). The staging result was stage IVB. No treatment was given until 13 months later when bilateral axillary lymphadenopathy emerged. The bilateral axillary lymphadenectomy specimens were diagnosed as consistent with mantle cell lymphoma. There was no peripheral blood involvement during the disease course. He received 6 courses of CEOP chemotherapy and 4 courses of promacytabam (cyclophosphamide, epirubicin, and VP-16) and died of neutropenic fever with sepsis, 25 months after diagnosis. 

Case T03 (S9519961C)

Provider: Dr. Fang-Yi Li, Taichung Veterans General Hospital

A 34-year-old woman was referred to our general surgical department on August 2006, because of a two-year history of anterior neck mass. She ever received mass aspiration at other hospital half month ago, and the pathology report was malignancy. The physical examination revealed a well-defined mass over left neck without palpable lymphadenopathy. Thyroid function revealed euthyroidism with free T4: 7.56 pg/ml (7-18 pg/ml) and T3: 1.0 ng/ml (0.6-1.9 ng/ml); but elevated TSH: 7.33 uIU/ml (0.25-4 uIU/ml) and thyroglobulin: 249 ng/ml (< 50 ng/ml). Thyroid gland aspiration cytology was performed in our hospital, but the cellularity is too scanty to make a definite diagnosis. The thyroid scan result showed a cold nodule of left thyroid lobe. Therefore, under the impression of a nodular goiter, partial thyroidectomy was performed. 

Case T04 (S2006-59376T2-10)

Provider:  Dr. Ren-Chin Wu, Chang-Gung Memorial Hospital – Linkou

A 46-year-old male smoker complained of cough for several months.  Chest plain film disclosed a mass in the right upper lobe, which was well defined and round with homogeneous enhancement on CT scan.  Right upper lobectomy was performed and the surgical specimen showed a well-delineated, soft tumor measuring 5 cm in diameter.

Case T05 (06-3614)

Provider:  Dr. Hsuan-Ying Huang, Chang-Gung Memorial Hospital - Kaohsiung

This painful lesion, arising form the buccal mucosa of a 42-year-old male, had been noted for two months. It measured 2.0 x 1.5 x 1.5 cm and revealed whitish cut surface.