Document 9L3Q0jjRV9bJO2xB2RZ9L10X3

i \ Jni! I' r I'rnnmli'Mr'l Hy Hun tii of Mir 1'inlBCt Circular A-- 3J CLINICAL RECORD iPECIMEN SUBMITTED BY SPECIMEN TISSUE EXAMINATION | DATE OBTAINEO brief clinical HISTORY (indvde tfurtflovi /ImIoh and rapidity / frcwtli. if moplotm) Patient is now dead; autopsy was not performed. 4.1--io--iiot-i PREOPERATIVE OIAGNOSIS OPERATIVE FINDINGS POSTOPERATIVE DIAGNOSIS SIGNATURE AND TITLE PATHOLOGICAL REPORT NAME OF LABORATORY ACCESSION NO(S), Surgical Pathology Section tOru dttrripfion, hintologit elimination and diofnoerei S74-415 Gross; Specimen consists of three submitted slides bearing label of St. Anthony Hospital, Louisville, Ky. and the accession no. S70-1951. Both sections are also labeled "FS". The surgical pathology report, a copy of which is attached, identifies these as sections of the liver. Also received are six slides from St. Anthony's Hospital bearing the accession no. S-71-4345. These are also sections of the liver; (Dr. Falk's notes indicate this second liver biopsy was taken after chemotherapy was given). Three paraffin blocks S-71-4345 are also received. Microscopic: Liver; The three H&E sections labeled S70-1951 are duplicate sections of an angiosarcoma of the liver. The tumor is composed of irregular vascular channels lined by endothelial cells which are neoplastic-appearing and have enlarged, elongated, hyperchromatic nuclei. There is considerable variation SIGNATURE OF PATHOLOGIST (Continue on reverae aide) Hans Popper, M. D. AGE BEX 36 __M PATIENT'S IDENTIFICATION (For typed or Written intriw 0ivo: Nan**--heat, /Iret, . mtddlo; grmdo; dot*} hooptimi or medioml iorility) RACE date ; 2/19/74 IDENTIFICATION NO. register no. 00-00-00 WARD NO. TISSUE EXAMINATION HLnnderd Form III jn-ioi BFG67370 Ii in nuclear shape and size and a few multinucleated, bizarre cells are seen. The eosinophilic cytoplasm is slight or moderate in amount. The vascular channels vary in size. Some are the size of capillaries or venules and have a hyalinized, connective tissue stroma. In most areas, however, there are small, slit-like spaces having the appear ance of poorly formed vessels lying in more solid sheets of connective tissue which is interspersed by tumor cells which do not appear to . line vascular spaces. A small amount of hepatic tissue is included in the section. Two or three portal tracts exhibit fibrosis and in one there is marked ; proliferation of bile ducts. Irregular areas of fibrosis are present between the edge of the angiosarcoma and the liver tissue. Focally, within the hepatic lobules, the sinusoidal lining cells are enlarged and hyperv chromatic and similar changes are seen in endothelial cells of portal tract venules. These endothelial changes suggest multi-focal alteration of endothelial cells. The hepatic cells exhibited moderate variation in nuclear size and occasional bi-nucleate cells are seen. The sections numbered S-71-4345 show pieces of liver altered by marked fibrosis of portal tracts. In addition bands of dense connective tissue extend irregularly between portal tracts and central vein areas forming hepatic nodules of various sizes and shapes. Some of these appear to.be regenerating nodules of hepatic cells. There is marked proliferation of bile ducts and a few focal areas of chronic inflammav tion. No angiosarcoma is noted. Activated sinusoidal lining cells are seen along hepatic sinusoids. Diagnosis: ' 1. Angiosarcoma of liver (S70-1951 7S). NOTE: .. Hepatic tissue is S-71-4345 exhibits irregular fibrosis which may be the result of compression by adjacent angiosarcoma. . Subsequent review of recuts and special stains reveal that the hepatic fibrdsis is similar to the fibrosis seen in the liver of other patients included in the VC-FVC study. Louis B. Thomas, M. D. BFG67371