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EQA

North West EQA - Circulation AZ 2018






   

Case AZ1 Category A (scoring)

Male 64 years

Excision lesion left shin ?pyogenic granuloma. Skin 15 x 10 x 10mm with a translucent pale plaque 8 x 7mm which is 1mm from the nearest margin.

Special stains/IHC results:
None.


H&E 408975


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Case AZ2 Category A (scoring)

Male 84 years

?BCC left nose. Marker 12'oclock. Skin 18 x 15 x 5mm with a central ulcerated macule measuring 7 x 5mm which is 5mm from the 9 o'clock margin.

Special stains/IHC results:
CD10 strongly positive. MNF, p63, CK5/6, Melan-A, Sox-10, S100, Ber-EP4, EMA, AE1/AE3, vimentin all negative.


H&E 408976


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Case AZ3 Category A (scoring)

Male 39 years

Erythematous papules. ?Dermatitis herpetifomis, ?eczema, ?psoriasis. (A) Punch of skin 4mm in diameter. (B) IMF sample. Punch biopsy 4 x 4 x 6mm.

Special stains/IHC results:
IMF - strong granular IgA positivity in dermal papillae.


H&E 408977


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Case AZ4 Category A (scoring)

Male 65 years

Right lateral temporal bone resection. A piece of tissue measuring 42 x 30 x 28mm. It is predominantly bone but includes the external ear canal 20mm diameter and 15mm long.

Special stains/IHC results:
D/AB/PAS; most lumina contain Alcain blue positive material, a few PAS positive material.


H&E 408978


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Case AZ5 Category A (scoring)

Male 76 years

Previous R upper lobectomy for pT2 M0 R0 poorly differentiated squamous cell carcinoma. Suspect NSCLC L upper lobe. An irregular piece of brown tissue 30 x 12 x 9mm bearing a white nodule 12mm in maximum dimension.

Special stains/IHC results:
Positivity for calretinin and cytokeratin 5/6, focal weak positivity for WT1, but negativity for Ber-EP4, TTF-1 (8G7G3/1) and CEA.


H&E 408979


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Case AZ6 Category A (scoring)

Male 55 years

Progressing LLL nodule. History of colorectal carcinoma. A wedge of lung measuring 95 x 60 x 35mm covered by pleura with three staple lines. There is an irregular mass, measuring 20mm in diameter, which extends close to the staples.

Special stains/IHC results:
The tumour cells are strongly positive for CDX2 and CK20. CK7 and TTF1 are negative.


H&E 408980


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Case AZ7 Category A (scoring)

Female 61 years

Postmenopausal bleeding. Polyp protruding from cervix. Hysterectomy. Polyp arising from upper body/fundus measuring 16 x 10 x 8mm.

Special stains/IHC results:
None.


H&E 408981


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Case AZ8 Category A (scoring)

Female 78 years

Left upper back ?seb cyst. Skin ellipse. Well demarcated nodule measuring 8mm.

Special stains/IHC results:
None.


H&E 408982


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Case AZ9 Category A (scoring)

Female 65 years

Cholecystitis. Open cholecystectomy.

Macroscopic description:
The gallbladder wall measures up to 10mm and is firm within the body.

Special stains/IHC results:
AE1/3, CK7, CD10, p504s, p53; positive. CDX2, mCEA, CK20; focally positive. GATA3; negative.


H&E 408983


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Case AZ10 Category A (scoring)

Female 49 years

Emergency laparotomy for sigmoid obstruction. Large left pelvic cystic mass invading sigmoid and appendix. Subtotal hysterectomy then mass and sigmoid colon removed en block. Right hemicolectomy specimen comprising colon 190mm, terminal ileum 95mm and appendix 80mm long. There is a fibrosed nodule in the wall of the small bowel which extends into attached fibrofatty tissue.

Special stains/IHC results:
None.


H&E 408984


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Case AZ11 Category A (scoring)

Male 25 years

Scar from left earlobe. Skin excision 25 x 20 x 15mm. The external surface bears a dark grey roughened area.

Special stains/IHC results:
None.


H&E 408985


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Case AZ12 Category A (scoring)

Male 88 years

Small bowel obstruction. Small bowel ?metastatic tumour mid jejunum. Known previous malignant melanoma. Small bowel 200mm long containing 100mm diameter intraluminal mass. On sectioning, the mass has soft haemorrhagic cut surface.

Special stains/IHC results:
MNF116 -, LCA-, Melan A +, S100+.


H&E 408986


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Case AZ13 Category B (non-scoring educational)

Female 52 years

Large polypoid lesion on cervix removed by loop excision. Cervical loop measuring 20 x 17 x 10mm.

Special stains/IHC results:
None.


H&E 408987


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Case AZ14 Category B (non-scoring educational)

Female 83 years

Anterior slow growing mediastinal mass. A lobulated mass weighing 56g and measuring 75 x 60 x 30mm. On the outer surface there is some attached serosa/membranous tissue which is taken as the posterior margin. The mass does not appear to breach the capsular surface. On slicing, the mass has a homogenous white colour. It appears well circumscribed with no necrosis.

Special stains/IHC results:
Epithelioid cells positive for DAE1/AE3, lymphoid cells positive for CD20.


H&E 408988


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Case AZ15 Category B (non-scoring educational)

Female 62 years

Area of breast asymmetry on Mammo. With ?two nodules. Recent core Bx: B3. Biopsied four years ago: B2 "fat necrosis". Lesion persisted and slowly enlarged.

Special stains/IHC results:
Foamy cells are positive for CD68 & CD163. Negative for AE1/AE3, S100, CD1a.


H&E 408989


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Case AZ16 Category B (non-scoring educational)

Male 65 years

Left pleomorphic adenoma submandibular gland on cytology. Single piece of nodular tissue 35 x 35 x 25m and weighing 13gm. On sectioning, the cut surface shows a solid grey-white mass measuring 30mm in maximum dimension.

Special stains/IHC results:
CD117+, somatic cancer, NSG Mutation not identified.


H&E 408990


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