GI Pathology Case Conference

Division of Gastrointestinal and Liver Pathology

Case Conference

Case prepared by:	Jennifer Scudiere MD GI Pathology Fellow
Attending:	Elizabeth Montgomery, M.D.

Case 46

Clinical History:	The patient is a 65-year-old man who presents for an upper endoscopy because of reflux symptoms. On endoscopy, a 5 cm gastric mass was noted. The endoscopist noted that the lesion was suspicious for lymphoma. Subsequent imaging revealed lesions in the lung, liver, and spleen. The following images are from 5 cm gastric mass biopsy. For this case, immunohistochemistry is extremely helpful. What lesions remain in the diagnosis after the following panel is performed? CD45RA: Negative Cytokeratin AE1/AE3: Negative Synaptophysin: Negative S-100 Protein: Positive HMB-45: Positive Melan-a: Positive
Images:
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Choose the correct diagnosis:
	a. Clear Cell Sarcoma and Malignant Melanoma
	b. Gastrointestinal stromal tumor and clear cell sarcoma
	c. Lymphoma and melanoma
	d. rhabdomyosarcoma and melanoma
	e. Malignant nerve sheath tumor and clear cell sarcoma

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