MEETING N. 27, JANUARY 17th, 2001, ISTITUTO NAZIONALE TUMORI, MILANO

Case 1
Case 2
Case 3
Case 4

Case 4

"MEDIASTINAL MASS IN A 45Y.O. MAN"
E. SCHIAFFINO - San Carlo Hospital - Milano
(Pictures by dr. Crippa; the quality of the pictures is not good because of the original sub-optimal histological slides, due to the numerous micro-calcifications in the specimen).

Clinical history: a 45y.o. man presents with a large mediastinal mass. The patient undergoes surgery and a frozen section examination is performed but the diagnosis is uncertain and it is decided to wait for the histological paraffin sections.
Macroscopic description: an 8.5 cm, round, apparently capsulated mass, which is in relation with the pleura. On cut section the mass consists of hard-elastic tissue with large necrotic areas.
Microscopic description: sections show comedocarcinoma like nests and nodules surrounded by lymphocytes. There are diffuse sclerosis and necrosis (pict. 1) - (pict. 2) - (pict. 3) - (pict. 4) - (pict. 5).
At the periphery of the lesion thymus is still recognizable (pict. 6).
The tumor is positive with immunohistochemical staining for S100 (pict. 7), NSE (pict. 8), CK (pict. 9) and Chromogranin (pict. 10).

Diagnosis

pict. 1	pict. 2
pict. 3	pict. 4
pict. 5	pict. 6
pict. 7	pict. 8
pict. 9	pict. 10

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