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EQA

North West EQA - Circulation AY 2017






   

Case AY1 Category A (scoring)

Male 72 years

Right groin sentinel lymph node biopsy. History of penile cancer. Patient is a non-insulin dependent diabetic with loose right knee replacement (in place for nine years), who had a previous glansectomy for G3 pT1 squamous ca penis. Special stains - none.


H&E 386534


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Case AY2 Category A (scoring)

Female 70 years

Right sacral bone biopsy. Adeno Ca lung 2016. Prev Ca breast 2011. New bone mets - ?primary. Special stains/IHC results - AE1/3, CK7, GATA3 and focal GCDF-15 positive, TTF1 negative.


H&E 386536


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Case AY3 Category A (scoring)

Female 71 years

Pancreatic head tumour. Whipples pancreatico-duodenectomy. Sections are from the pancreatic head tumour. Special stains/IHC results - Ductal/glandular foci stain for CK7, are negative for CK20 and CDX-2 and contain only occasional scattered synaptophysin and chromogranin positive cells. More peripheral foci with organoid tumour nests stain diffusely and strongly for MNF-116, synaptophysin and chromogranin and have a MIB-1 index of 2%.


H&E 386539


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Case AY4 Category A (scoring)

Female 9 years

Skin lesion left thigh. Four irregular pieces of skin up to 7mm MD. Special stains - none.


H&E 386541


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Case AY5 Category A (scoring)

Male 56 years

Two lesions right ear ?chondrodermatisis nodularis helicis ?epidermoid cyst. A wedge of skin 16 x 13 x 8mm bearing a pale nodule 8mm. Special stains - none.


H&E 386544


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Case AY6 Category A (scoring)

Female 39 years

Bladder nodule. Partial cystectomy. An irregular piece of pale tan tissue showing areas of diathermy artefact and measuring 45 x 35 x 18mm. Special stains - none.


H&E 386546


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Case AY7 Category A (scoring)

Female 79 years

Biopsy upper right premolar region. Red enlarged lesion R upper pre-molar region. Special stains - none.


H&E 386548


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Case AY8 Category A (scoring)

Male 87 years

Excision biopsy lesion upper back. ?Seb K ?pigmented BCC.


H&E 386551


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Case AY9 Category A (scoring)

Female 79 years

Right breast skin biopsy. Previous R Ca breast 15 years ago. WLE plus XRT. Bleeding lesion, medial aspect of scar. Special stains/IHC results - CD31 and CD34 +ve.


H&E 386553


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Case AY10 Category A (scoring)

Female 68 years

Uterus + cervix, both tubes and ovaries. Grade 1 endometrial cancer. TLH plus BSO done. Uterus with cervix with both tubes and both ovaries. Background endometrium <2mm. Background myometrium 15mm. Uterine cavity is filled with friable material 20 x 20 x 10mm which appears to invade myometrium. Fallopian tubes bear several paratubal cysts up to 5mm. Ovaries look normal. Endometrial tumour - grade 1 endometrioid Ca, FIGO IA with possible focal MELF growth pattern. Focal LVSI present. EQA section from block labelled 'Right cornu with ?fibroid'. Special stains/IHC results - Cells lining cyst/gland-like spaces are positive for AE1/AE3 and calretinin. They are negative for CD31 and CD34.


H&E 386556


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Case AY11 Category A (scoring)

Female 70 years

Right hemicolectomy. Liver mets. Obstructing caecal tumour. Right hemicolectomy. Small bowel 16cm, caecum/colon 28cm. 16cm from the distal margin there is an area of serosal puckering with a circumferential tumour 3cm long. Multiple separate polyps are identified in the colon, the largest 3cm. EQA section from block labelled 'Caecal polyp x1.' Special stains - none.


H&E 386559


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Case AY12 Category A (scoring)

Female 70 years

Lap sigmoid colectomy. ?adenoca. Anterior resection. An anterior resection specimen 305mm. 55mm from the distal end the specimen is distorted with a stenotic area. The proximal specimen shows diverticulosis. There are also appearances suspicious for a tumour 35mm in length in the distorted area. Abnormal tissue extends into the bowel wall. EQA section from tumour block. Special stains/IHC results - Postitive: CK7, PAX8, p53 (patchy), OR (patchy). Negative: CK20, CDX2, PR, WT1.


H&E 386564


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Case AY13 Category B (non-scoring educational)

Male 40 years

Small bowel mass. Small bowel resection for obstructing intussusception. PMH of melanoma. Special stains/IHC results - Tumour positive for desmin. Negative for S100, SOX10, melan-A, HMB45, MiTF, tyrosinase, AE1/3, CD34, CD117 and DOG1.


H&E 386567


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Case AY14 Category B (non-scoring educational)

Male 69 years

Right renal tumour. A well circumscribed pale brown to black tumour 57mm in diameter. Special stains/IHC results - Tumour diffusely positive for CK7, EMA, E-cadherin and CD117. Negative for CD10, vimentin, racemase, CK20 and CD15.


H&E 386571


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Case AY15 Category B (non-scoring educational)

Male 62 years

Needle core biopsy of R parotid. ?Sjogren's syndrome. Abnormal ultrasound appearance of R parotid. Special stains/IHC results - Positive: CD20 and BCL2. Background cells staining positive for CD3 and CD5. Background positivity for CD21 and CD23. AE1/3 highlights epithelial component. Negative: CD10, BCL6 and Cyclin D1.


H&E 386575


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Case AY16 Category B (non-scoring educational)

Male 45 years

Large mass D3/D4/colon. ?lymphoma. ?TB. Loop of small bowel 550mm which communicates with an irregular cavity measuring 100mm across. The lining of the cavity is dark and ragged with multiple polypoid projections. On slicing, the wall of the cavity if up to 20mm in thickness and composed of white fleshy tumour. On the outer aspect of the specimen is a segment of large bowel 240mm which is adherent to the mass but does not appear to be directly involved. EQA section from block labelled 'edge of cavity'. Special stains/IHC results - Positive: CD45/LCA. Negative: CD3, CD5, CD10, CD20, AE1/3, NSE, S100.


H&E 386577


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