Male 75 years

Large sigmoid polyp.

Specimen: Polypoid piece of tissue 32 x 28 x 23 mm. Representative section.



Special stains/IHC results:
None.

Female 43 years

Right hemi-thyroidectomy. Right thyroid U3, Thy3f.

Specimen: Hemi-thyroid 21 g, 24 x 57 x 28 mm. There is a nodule 47 mm across which abuts the capsule. The background thyroid appears normal. Representative section.



Special stains/IHC results:
CEA+, CD56+, chromogranin+, synaptophysin+, TTF1 patchy+, PAX8-, HBME1-. Pale eosinophilic material is Congo Red positive with apple green birefringence.

Female 53 years

Appendix and omentum. No other clinical details provided.

Specimen: An appendix 80 x 34 mm. The external surface is congested with a patchy exudate. On slicing, the lumen is slightly dilated up to 5 mm and contains a purulent exudate. There is a possible perforation at the tip. Section of tip provided.



Special stains/IHC results:
None.

Male 66 years

Left renal mass.

Specimen: Left radical nephrectomy: Variegated appearing tumour in the upper pole of the kidney.



Special stains/IHC results:
None.

Female 60 years

Left Breast lump. ? Carcinoma, ? fat necrosis, ? cyst.

Specimen: Core biopsy.



Special stains/IHC results:
Positive for S100. Negative for CD68, AE1/3, PR and ER.

Male 55 years

Incidentally detected rectal polyp at colonoscopy.

Specimen: Rectal polyp.



Special stains/IHC results:
Strongly positive for Pan CK, CAM5.2 and synaptophysin and weakly positive for chromogranin and CD56.

Male 38 years

Incidental finding of 1 cm lesion within deep lobe of right parotid, inconclusive FNAC. Appearance suspicious of pleomorphic adenoma.

Specimen: Right parotid. An irregular piece of fibrofatty tissue that measures 18 x 17 x 13 mm. Slicing shows slightly firm grey-white tissue within the specimen.



Special stains/IHC results:
None.

Female 68 years

Right robotic partial nephrectomy for ? RCC.

Specimen: Right renal tumour. A partial nephrectomy specimen that weighs 4 grams and measures 25 x 24 x 23 mm. The resection margin of the specimen is inked in black. Sectioning shows firm pale grey tumour.



Special stains/IHC results:
None.

Female 89 years

Indications: Melaena (Blatchford score 0, Rockall score 2). PMH: dementia, CCF, AF. Endoscopy report: Site B - Cardia: Friable mucosa with superficial ulceration within the hiatus hernia, cannot exclude a lesion, biopsies taken.

Specimen: 6 Gastric biopsies from cardia.



Special stains/IHC results:
Positive Perl's stain.

Male 12 years

? Mastocytosis.

Specimen: Punch biopsy trunk. A single fragment of tissue measuring 4 mm.



Special stains/IHC results:
CD117 positive, S100 negative.

Female 24 years

Pyrexia. Pancytopenia and B symptoms, enlarged spleen. ? Lymphoma. BM - not helpful.

Specimen: 2 x 18G cores from spleen.



Special stains/IHC results:
Gram, ZN, Geimsa, PAS and DPAS are negative. The Grocott is difficult and large numbers of organisms while appearing grey-black are not the intense jet black of the control stain.

Female 82 years

Right breast Ca, metaplastic. 2.5 cm RUOQ on mammo (1.9 cm on USS). SNB - one hot node, one non-SNB in axillary tissue.

Specimen: Breast wide local excision, right.



Special stains/IHC results:
AE1/AE3 positive in small bland spindle cells, SMA positive, Beta-catenin negative, Desmin negative, CD34 negative, S100 negative, ER and PR negative.

Male 79 years

Gastric adenocarcinoma. Completion gastrectomy (post chemotherapy). (Previous distal gastrectomy for peptic ulcer).

Specimen: Subtotal gastrectomy specimen. A length of small bowel 285 mm is attached to the stomach. There is a polypoid, ulcerated tumour present at the anastomotic site within the distal stomach measuring 52 x 32 x 12 mm. Representative section.



Special stains/IHC results:
CAM5.2+, AE1/AE3+, CD56-, chromogranin-, synaptophysin-, EBER ISH+.

Female 58 years

Postmenopausal bleeding.

Specimen: Endometrial polyp.



Special stains/IHC results:
Strongly positive for HMB45, SMA and TFE3. Negative for SOX10 , S100, AE1/3, CK7, CK20, PAX8 , WT1 and Calretinin.

Female 61 years

Adnexal mass with peritoneal and omental disease. CT abdo pelvis: 1) Large, multiloculated cystic mass, most likely originating from right adnexa. This lesion also contains solid enhancing mural nodules in particular within its right lower quadrant. Disseminated disease, metastatic deposits within the omentum and peritoneum. 2) There is suspicion of spiculated enhancing lesion in the right breast lower quadrant.

Specimen: Omental biopsy. Two needle cores of tissue measuring up to 14 mm in length.



Special stains/IHC results:
Positive: MNF116, CK7. Patchy positivity: CK20, PAX8, WT1, P53, GATA3, ER. Negative: CK5/6, calretinin, SATB2.

Female 58 years

? MM.

Specimen: Excision central back.



Special stains/IHC results:
Question for participants - What N stage would you give this?