| _creationDate | August 12, 2024 |
| _modificationDate | August 30, 2024 |
| _creator | Si787 |
| _fullText | {{ServiceRequestCase
|identifier=WSI24-156-Case-2
|intent=order
|code=apdidactic
|category=409073007
|subject=MGH
|requester=Njc35
|performer=Wf7
|orderDetail=case
|locationCode=learn
|access=public
|status=active
|origin=CPOE
|priority=Routine
|basedOn=WSI24-156
|requisition=
|reasonCode=57M with l ... |
| _numRevisions | 2 |
| _isRedirect | No |
| identifier | WSI24-156-Case-2 |
| basedOn | WSI24-156 |
| intent | order |
| category | 409073007 |
| priority | Routine |
| code | apdidactic |
| orderDetail | case |
| subject | MGH |
| occurrenceDateTime | August 13, 2024 12:00:00 PM |
| authoredOn | August 12, 2024 7:34:58 AM |
| requester | Njc35 |
| performer | Wf7 |
| locationCode | learn |
| reasonCode | 57M with left neck mass |
| supportingInfo | "Malignant neoplasm • consistent with follicular dendritic cell sarcoma.
Note: This is a very unusual neoplasm which was initially difficult to classify due to its limited immunohistochemical reactivity. The tumor consists of markedly atypical epithelioid cells with moderate amounts of delicate oncocytic cytoplasm and large atypical oval hyperchromatic nuclei • some multinucleate and some with intranuclear inclusions. A very broad panel of immunohistochemical stains performed at the MGH shows that the tumor is strongly positive for the follicular dendritic cell markers CD21 • CD23 • and CD35. TdT is negative. In addition • there is overexpression of p53 and retained INI-1 and BRG-1. Other markers are predominantly negative including: smooth muscle actin • CD31 • synaptophysin • PAX8 • TTF-1 • ws keratin • MNF116 • NKX2.2 • desmin • MITF • S100 • ALK-1 • SS18-SSX • b-catenin (cytoplasmic only) • RAS Q61R • and BRAF. Ki-67 is approximately 20%. Ancillary stains performed at the referring institution are negative for CD3 • keratin 7 • CD20 • keratin 20 • CD45 • SOX-10 • and p40. Stains for keratin cocktail and pankeratin show a weak indeterminate blush. The strong expression of follicular dendritic cell markers and negativity for epithelial • other mesenchymal • and melanoma markers is compatible with the interpretation of follicular dendritic cell sarcoma." |
| specimen | null |
| bodySite | null |
| sequence | 2 |
| access | public |
| identifier | da6aa62e-0f2b-4951-97d8-ddf99438ff63 |
| basedOn | WSI24-156-Case-2 |
| partOf | WSI24-156 |
| status | completed |
| type | null |
| modality | mrxs |
| view | show |
| operator | Njc35 |
| bodySite | null |
| frames | 1 |
| content | da6aa62e-0f2b-4951-97d8-ddf99438ff63.mrxs |
| note | null |
| subject | null |
| status | active |
| identifier | WSI24-156-Case-2 |
| requester | Njc35 |
| authoredOn | August 12, 2024 7:34:58 AM |
