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EQA

North West EQA - Circulation AT 2014






Circulation AT Autumn 2014 Histories  word document symbol   AT answer sheet  excel document symbol

Case AT1 Category A (scoring)

Female 75 years

Appendix. Recurrent RIF pain for a few months. CT scan - distended appendix. ?Mucocoele. Representative section.

Immunohistochemistry:
None.


H&E 278720


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Case AT2 Category A (scoring)

Male 59 years

Right hemi-hepatectomy. Large HCC R lobe. Abridged macro: 15cm part necrotic, part haemorrhagic mass within liver. Possible satellite nodules noted. Metal embolisation coils visible within vessels. Background liver normal. Section of mass.

Immunohistochemistry:
Tumour cells show cytoplasmic positivity for HepPar1 and canalicular staining with CD10 but not pCEA.


H&E 278722


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Case AT3 Category A (scoring)

Female 56 years

Aorto-caval tumour resection. Aorto-caval paraganglioma. MIBG+ Non-secretory. Resected from between aorta and vena cava above bifurcation. Previous histology elsewhere 'neuroendocrine tumour'.

Macroscopic description:
Fibrofatty tissue 6 x 4.7 x 2.5cm. O/S there is a well defined rounded mass 2.6 x 2 x 2.5cm with a mixed pale and haemorrhagic cut surface. Representative section.

Immunohistochemistry:
Diffusely positive for CD56, chromogranin and synaptophysin. Negative for AE1/AE3. Reticular staining with S100 in many but not all areas. Ki67 nuclear proliferation rate variable; up to 15%.


H&E 278724


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Case AT4 Category A (scoring)

Male 68 years

Gelatinous cyst excised + naevus.

Specimen: Sebaceous cyst chest wall.

Immunohistochemistry:
IHC: Negative with CD31, CD34, SMA, Desmin, S100, HMB-45, Melan A, EMA, MNF-116, AE1/AE3, CK5/6.


H&E 278726


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Case AT5 Category A (scoring)

Female 33 years

Left knee arthroscopy tissue sample ?multiple chondromatosis.

Immunohistochemistry:
None.


H&E 278727


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Case AT6 Category A (scoring)

Male 61 years

Known recurrent parotid acinic cell carcinoma. New left pleural effusion.

Specimen: Left pleural biopsy.

Immunohistochemistry:
None.


H&E 278728


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Case AT7 Category A (scoring)

Male 80 years

?BCC left temple.

Immunohistochemistry:
None.


H&E 278729


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Case AT8 Category A (scoring)

Male 24 years

Lesion left temple.

Immunohistochemistry:
None


H&E 278730


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Case AT9 Category A (scoring)

Male 62 years

?Calcified olecranon burse, calcified lesion left elbow.

Immunohistochemistry:
None.


H&E 278732


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Case AT10 Category A (scoring)

Male 58 years

Solitary left thyroid nodule, well circumscribed 35mm in maximum dimension with a gritty yellow and grey cut surface.

Immunohistochemistry:
positive staining with calcitonin, TTF1, CEA and chromogranin.


H&E 278734


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Case AT11 Category A (scoring)

Male 27 years

Right neck lump 300mm in maximum dimension.

Immunohistochemistry:
mainly positive staining with chromogranin and synaptophysin. Separate population of cells show S100 positivity.


H&E 278735


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Case AT12 Category A (scoring)

Female 34 years

Anterior mediastinal mass 85mm in maximum dimension with a solid grey-white cut surface.

Immunohistochemistry:
None.


H&E 278737


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Case AT13 Category B (non-scoring educational)

Male 44 years

Left colon and ileum resection. SMAD4 deficiency. Previous R hemi-colectomy for Dukes C cancer. Mass in transverse colon with no neoplasia on mucosal biopsies - mass excision.

Macroscopic description:
12cm of ileum + 35cm colon. Starting at the anastomotic line there is 10cm length of circumferentially abnormal colonic mucosa covered by finger-like polypoid projections. The background colonic and ileal mucosal surfaces appear normal. Representative section of 'mass' in transverse colon.

Immunohistochemistry:
Half of the thirty-one retrieved lymph nodes contain tiny non-caseating granulomas, one of which contains neutrophils. Special stains for fungi and bacteria, including AFB, are negative.


H&E 278738


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Case AT14 Category B (non-scoring educational)

Male 14 years

4 x 5mm lump removed from left ring finger.

Specimen: Biopsy left ring finger.

Immunohistochemistry:
None.


H&E 278743


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Case AT15 Category B (non-scoring educational)

Male 75 years

?Infected hard lump left axilla. US/MRI ? collection.

Macroscopic description:
Firm yellow/white tissue 90mm and skin 65mm.

Immunohistochemistry:
large cells positive for CD20, 79a, bcl2, bcl6, CD30. Negative for AE1/3, S100, Cd15, cyclin D1, CD21, CD23, Ki67 high.


H&E 278744


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Case AT16 Category B (non-scoring educational)

Female 57 years

Bilateral salpingo-oophorectomy and hysterectomy. Section from right ovarian tumour 70mm in maximum dimension with rounded, smooth surface. It has mainly solid, partly cystic, grey-yellow cut surface.

Immunohistochemistry:
tubular cells strongly positive with WT1, inhibin, cytokeratin cocktail (AE1/3, MNF116, CAM5.2) and CD99. Weak staining with calretinin. Negative for synaptophysin and chromogranin. Separate population of cells strongly positive with CD00, inhibin and calretinin. Negative staining with WT1, synaptophysin, cytokeratin cocktail and chromogranin.


H&E 278745


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