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Pathologists' Assistant (PathA) Presentation Posters

The following are posters produced by students in the Pathologists' Assistant (PathA) program.


Invasive Squamous Cell Carcinoma of the Cervix

Student:
Brian Chase

Mentors:
David Kirschenmann, PA (ASCP)
Pradeep K. Bhagat, MD, Lankenau Medical Center

About the Poster:
The patient is a 46-year-old female who presented with a large, exophytic cervical lesion upon physical examination by her physician. A PET-CT scan was performed to confirm the presence of the cervical lesion and positive pelvic lymph nodes. The patient underwent a total abdominal hysterectomy, bilateral salpingo-oophorectomy, and lymph node dissection to be followed by chemotherapy and radiation.

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Neuropathologic Changes of Alzheimer Disease: A Case Study

Student:
Mark Vincent C. Olorvida, MHS

Faculty:
Christos D. Katsetos, MD, PhD, FRCPath, Ahmed Abdulrahman, MD, Drexel University College of Medicine, Philadelphia, Pa.

About the Poster:
A 66-year-old Caucasian woman presented with a history of depression, anxiety, and dementia for about 2 years. She demonstrated multiple cognitive difficulties including memory deficit, and she later became more confused, agitated, and at times, delusional. She was employed at a bank, but lost her ability to do simple mathematics. For the last year of her life, her skills with a variety of motor functions declined. Her walk became unsteady and she started to have frequent falls and gait dysfunction. She frequently experienced right-sided headaches and her behavior progressively changed with psychotic symptoms.

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Alveolar Capillary Dysplasia with Misalignment of Pulmonary Veins: An Autopsy Case Report

Student:
Kevin O'Connor

Faculty:
Jeanine Chiaffarano, DO, University of Medicine and Dentistry of New Jersey
Marta Guttenburg, MD, The Children's Hospital of Philadelphia

About the Poster:
This is the case of a 13-day-old female infant delivered at 34 2/7 weeks to a 38-year-old G1P0 mother with spontaneous rupture of membranes, via cesarean section on 2/26. Prenatally, the infant was diagnosed with an omphalocele and a 17q12 duplication encompassing the HNF1B gene; the karyotype was normal female.

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An Interesting Case of Colorectal Cancer Metastasis

Students:
Molly C. Pitluck, BS, PA (ASCP)
Steve Sowers, BS, PA (ASCP)

Faculty:
Sharon L. Swierczynski, MD, PhD, The Reading Hospital and Medical Center, Reading, Pa.

About the Poster:
In January 2013, a 64-year-old white male presented with chief complaints of right tibia and ankle pain as well as open wounds in his right lower leg for the last couple of months. The patient's past medical history was significant for poorly differentiated infiltrating adenocarcinoma of the rectosigmoid colon (PT3C/D), status post partial colectomy in 2007; metastatic adenocarcinoma to the right distal tibia, consistent with a colon primary (CEA, CK20, CDX2 positive; CK7, TTF-1 negative), in 2009, status post prophylactic rodding in 2011; and metastatic adenocarcinoma to right groin lymph nodes consistent with a colon primary, status post excision in 2010. Additional PMH included hypertension, hypercholesterolemia, status post appendectomy in 1961, history of detached retina in 1990, and status post left ankle fracture in 1998.

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A Case of Extramammary Paget Disease: Determining Primary or Secondary Origin

Student:
Molly Lundy

Faculty:
Dr. Adamec and Dr. Kimmel, The Reading Hospital and Medical Center, Reading, Pa.

About the Poster:
Extramammary Paget Disease (EMPD) is a malignant and destructive skin lesion often seen in concurrence with an underlying malignancy (such as in the more common mammary type), but can also arise de novo4,6. These primary lesions are commonly found in areas rich in apocrine sweat glands such as the vulva, perianal region, axilla, mons pubis, glans penis and eyelid4 (listed in order of occurrence). There are multiple hypotheses for this presentation. Two common understandings are that it appears as an epidermotrophic metastasis from a visceral carcinoma, commonly uterine or rectal, or within the skin arising from apocrine derivation. It is important to determine the derivation of an extramammary case in order to rule out an undiagnosed underlying visceral carcinoma.

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Male Breast Cancer

Student:
Anthony Pinto, MS, PA (ASCP)

Faculty:
Suresh Majmundar, PA (ASCP)
Corrado Minimo, MD, Albert Einstein Medical Center

About the Poster:
Breast cancer is much less common in men than in women. Male patients are older and show more advanced disease at the time of clinical presentation. Furthermore, invasive ductal carcinoma predominates in men >90% of the time, while ductal carcinoma in-situ (DCIS) and lobular carcinomas are less common or rare in comparison with women.

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Malignant Paraganglioma of the Thyroid Gland: A Case Study

Student:
Alice Sedlak

About the Poster:
Paraganglia are neural crest derived cells, and as such, they are found along the embryologic migration routes of neural crest tissue from the base of the skull to the lower pelvis, not including the area of the extremities. 1,2 They are most closely associated with blood vessels, where they act as chemoreceptors, such as in the carotid body.1 Paragangliomas are neoplasms that arise from these paraganglia, usually as a benign tumor. These extra adrenal paragangliomas are histochemically non-chromaffin, and tend to be located in the head and neck region, superior mediastium, and retroperitoneum.3 Specifically, the most common locations are the carotid body, jugular bulb, Jacobson's tympanic plexus in the middle ear, and the vagal nerve.2 Overall, paraganglioma of the head and neck region are incredibly rare and constitute only 0.012% of tumors in that area, and due to their strong association with blood vessels, an overwhelming 80% of these paragangliomas arise from the carotid body.

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Metastatic Prostate Adenocarcinoma: Oh the Places It Goes

Student:
Brian Hoffman, MS, PA (ASCP)

Faculty:
Joseph A. DiRienzi, PA (ASCP)
Igor Tsimberg, PA (ASCP)
Grant Nybakken, MD, PhD
Charuhas Deshpande, MD

About the Poster:
Adenocarcinoma of the prostate is the most common form of cancer in men, typically affecting men over the age of 50. The etiology of prostatic adenocarcinoma is unclear, although there are several factors suspected in contributing to the disease such as: age, race, hormone levels and environmental influences. The tumor can be incidentally discovered with little clinical significance or it can be an aggressive and lethal cancer. Prostate cancer is graded with the Gleason system, which divides prostate cancers into five grades. The higher the grade, the poorer the prognosis for the patient. Metastasis more than likely occurs with advanced prostate cancer and has a tendency to spread to the bone via hematogenous spread.

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Case Study: Neuroblastoma of the Right Adrenal in a 17-year Old Male

Student:
Jacob Mirbegian, 2nd Year PathA, Drexel University Sacramento

Contributors
Kristin Motz, PA (ASCP), Mary Tomic, MD

About the Poster:
Neuroblastoma is the most common solid extra-cranial tumor of infancy and also the most frequently diagnosed tumor of infancy.¹ The median age of diagnosis is 18 months with approximately 40% of cases being diagnosed in infancy. Because of this, it is considered one of the most important neoplasms that may arise from the sympathetic ganglia or in close proximity to the kidneys and adrenals. A right upper quadrant mass was incidentally noted on a 17-year old male while undergoing imaging for unrelated reasons. The mass was revealed to be a neuroblastoma, despite the patient having normal urine cortisol and metanephrine levels, and a right adrenalectomy was performed. However, bone marrow biopsy later showed metastasis and the patient was subsequently started on chemotherapy.

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A Wide Excision of Nodular Melanoma

Student:
Alina Dausey, MS, PA (ASCP)

Faculty:
Joseph Horstmann, MD and Kimberly Heightchew, MD, Paoli Hospital, Paoli, Pa.

About the Poster:
Each year there are more new cases of skin cancer than the combined incidence of cancers of the breast, prostate, lung, and colon. Basal cell carcinoma is the most common form of skin cancer and squamous cell carcinoma is the second most common form. Melanoma accounts for only 5% of all skin cancers, but it is the most deadly, accounting for 75% of all skin cancer deaths.

 

Graduate students in the Pathologists' Assistant (PathA) program at Drexel University College of Medicine.