Parotid gland cyst. 30100 Telegraph Road, Suite 408, Bingham Farms, Michigan 48025 (USA) Most common benign tumor of the female breast Most common breast tumor in adolescent and young women Can occur at any age, median age of 25 years (J R Coll Surg Edinb 1988;33:16) Juvenile fibroadenoma generally occurs in younger and adolescent patients < 20 years; reported in children at a very young age (Am J Surg Pathol 1985;9:730, Jpn J Clin Oncol Ovarian theca lutein cyst Reference: Radiographics 2017;37:681. Single, unilocular cyst, usually subcapsular or in falciform ligament 2 - 40 cm with flat glistening lining Variable amounts of clear amber fluid (may contain blood, bile, mucus, pus) Usually separate from biliary tree Microscopic (histologic) description. Left adrenal, adrenalectomy Pheochromocytoma, 5.1 cm (see synoptic report) Page views in 2022 to date (this page and chapter topics): 2,126,150 Confirm or rule out epithelial nature of tissue, tumors or components of tumors (Arch Pathol Lab Med 2017;141:1014) As such, usually not performed as a standalone immunohistochemical analysis but rather used as part of a panel of immunohistochemical stains to avoid misinterpretation (Arch Pathol Lab Med 2014;138:1583) Identification of occult tumor cells 7 year old boy with epidermal inclusion cyst infected by molluscum contagiosum virus (J Dtsch Dermatol Ges 2018;16:1143) 40 year old woman with recurrent spinal epidermoid cysts with atypical hyperplasia (Medicine 2017;96:e8950) 51 year old man with squamous cell carcinoma arising in a 30 year old perineal epidermal inclusion cyst (World J Surg Oncol 2018;16:155) Ovary, left (oophorectomy): Mucinous borderline tumor Ovary, right (oophorectomy): Xray Intramedullary unilocular radiolucent lesion with symmetric expansion of cortex When a pathological fracture occurs, cortical bone fragments float within cyst fluid (called fallen leaf sign); this phenomenon is pathognomonic of simple bone cyst (Skeletal Radiol 1989;18:261) Another pathognomonic sign is presence of a gas bubble in most nondependent area of simple
21 year old man with fibrous dysplasia in a lumbar vertebral body with secondary aneurysmal bone cyst-like change (Clin Pathol 2019;12:2632010X19861109) 30 year old man with fibrous dysplasia in the calcaneus (Foot Ankle Spec 2017;10:72) 62 year old man with angiosarcoma arising in fibrous dysplasia after radiation therapy (Oral Radiol 2019 Jul 31 [Epub 39 year old woman with Cowden syndrome incidentally detected from a metachronous ovarian endometrioid carcinoma (BMC Cancer 2019;19:1014) 41 year old woman with mixed adenocarcinoma and yolk sac tumor (Int J Clin Exp Pathol 2019;12:3549) 45 year old woman with endometrial endometrioid and synchronous bilateral endometrioid ovarian cancer (Anticancer Similarly, pools of hemorrhage can be seen in cases of NOF secondary to an associated fracture. Sample pathology report. Page views in 2022 to date (this page and chapter topics): 160,691 Rule out invasion in breast tumors by determining presence of myoepithelial cells (Am J Surg Pathol 2001;25:1054) Confirm diagnosis of prostatic adenocarcinoma (p63, Am J Surg Pathol 2002;26:1161) Triple stain with P504S (AMACR) and CK903 (HMWCK) is recommended (Am J Clin Pathol 2007;127:248) Note that partial atrophy may have similar staining as carcinoma (Am J Linear trabeculae of woven bone may be seen in some cases of NOF but they are not diagnostic of this lesion, per se. Sample pathology report. Paratubal Mllerian cyst (hydatid cyst of Morgagni): Paramesonephric cyst attached to fimbria, thin fallopian tube type epithelium with small epithelial plicae projecting into the lumen, may have smooth muscle in the wall. Mucoid secretion surrounded by a bilayer of cuboidal or columnar stratified salivary duct epithelium (Oral Surg Oral Med Oral Pathol 1964;18:191) Cyst lining may have papillary folds into the lumen (Head Neck Pathol 2017;11:469) May have squamous or oncocytic metaplasia of cyst lining, especially with more severe obstruction (Oral Surg Oral Med Oral Pathol 1964;18:191) Low malignant potential tumors with unclear cell of origin and pathogenesis May be derived from pluripotent stem cells of the genital ridges that become attached to the pancreas during embryogenesis (Semin Diagn Pathol 2014;31:484) First described by V.K. Sample pathology report. Most high grade serous carcinomas of the ovary arise from the distal fimbria of the fallopian tube from a precursor lesion known as serous tubal intraepithelial carcinoma (STIC) (Pathology 2015;47:423, Mod Pathol 2015;28:1101) Low grade serous carcinomas of the ovary arise from benign or borderline serous neoplasms Sample pathology report. Comment Here Reference: Nonossifying fibroma Fallopian tubes, bilateral salpingectomy: Benign fallopian tubes with paratubal cysts Differential diagnosis.
Page views in 2022 to date (this page and chapter topics): 272,671 30100 Telegraph Road, Suite 408, Bingham Farms, Michigan 48025 (USA) Lymphoepithelial cyst: Often clinically presents as an opaque yellow-white nodule that easily ruptures upon manipulation Microscopically similar to lingual tonsil, although an enlarged cystic space is seen rather than an crypt-like invagination of D. Seminoma is the most common malignancy in the setting of cryptorchidism. Dermoid cyst Germ cell neoplasia in situ Mixed germ cell tumor Seminoma Sertoli cell tumor Board review style answer #1. This feature, however, is a diagnostic primary finding of an aneurysmal bone cyst. Common variants (Calonje: McKee's Pathology of the Skin, 5th Edition, 2019) Nodular and nodulocystic BCC Relatively circumscribed mass Epidermal or follicular attachment variably present Large basaloid lobules with peripheral nuclear palisade Lobules may be solid or show central cyst formation due to excessive mucin production
Contributed by Aditya Talwar, M.D. Skin, shoulder, biopsy: Metastatic adenocarcinoma, consistent with Skin, right elbow, shave biopsy: Well differentiated sebaceous neoplasm with severe nuclear atypia, consistent with sebaceous carcinoma (G1) Endometriotic cyst: Associated with endometrial type stroma with or without hemosiderin laden macrophages Serous cystadenoma: Histologically identical to paratubal cyst but > 1 cm in size Hydrosalpinx: 24 year old woman with an intraosseous epidermoid cyst of the skull (Dermatol Online J 2018;24:13030) 49 year old man with an epidermoid cyst of the anterior clinoid process (Clin Neurol Neurosurg 2021;200:106381) 63 year old woman with epidermal inclusion cyst of the fifth toe (Foot Ankle Spec 2017;10:470) Sometimes associated with cyst(s) or focal cystic changes Thymomas may be almost entirely necrotic, sclerosed or ossified Morphologic classification according to 2021 WHO. Frozen section description. Frantz in 1959; incorporated into the WHO classification in 1996 (Br J Surg 1959;47:334) Radiology images. Extensive sampling / complete submission of cyst for microscopic evaluation important to rule out an associated invasive carcinoma (Am J Surg Pathol 2014;38:480, Ann Surg 2016;263:162) Greater than 5 mm in diameter Incipient IPMN is a term that can be used for lesions 0.5 - 1.0 cm in size Sample pathology report. Page views in 2022 to date (this page and chapter topics): 1,332,785 Peritoneal cyst: Lined by mesothelial cells, often associated with ovarian surface adhesions. Letters based on shape of neoplastic cells (A spindled, B polygonal) Numbers in type B thymoma (B1 B3) based on: Increase in ratio of neoplastic cells to thymocytes Cyst is frequently lined by papillary projections Frequently oncocytic cells but minimal or absent lymphoid tissue No atypia, mitoses or invasion (Head Neck Pathol 2015;9:354, Oral and Maxillofacial Pathology Journal 2017;8:28, Surg Pathol Clin 2021;14:53) Microscopic (histologic) images. Radiolucent apical / periapical lesion, usually indistinguishable from periapical cyst Radiolucent lesions can range from small, barely perceptible lesions to lytic lesions > 2 cm in diameter and any lesion can be circumscribed or somewhat ill defined
Multiloculated cyst. Page views in 2022 to date (this page and chapter topics): 897,195 Pathology is most likely to be consistent with which of the following?
Endometrial polyp, endometriosis, endosalpingiosis, paratubal cyst (Reprod Sci 2020;27:1580) Endometrial adenocarcinoma (Appl Immunohistochem Mol Morphol 2011;19:293) Expression is severely diminished in mucinous variants (44%) Endocervical adenocarcinoma (Appl Immunohistochem Mol Morphol 2011;19:293) Branchial cleft cyst (Hum Pathol 2010;41:535) Endometrial tubal metaplasia (in a mosaic pattern) (seen in 15/15 cases Cell Oncol 2007;29:37 ) Board review style question #1 Mesonephric cyst:
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