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EQA

BLPG EQA Round 18





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BLPG EQA Round 18 - Case 1

Male 80 years

Firm nodular lesion 10x20mm on right cheek with focal ulceration, growing slowly over six months. HTLV1 positive with high viral loads. Biopsy of skin lesion.

H&E


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CD03


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CD04


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Ki67 (MIB-1)


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BLPG EQA Round 18 - Case 2

Male 40 years

HIV positive. Widespread lymphadenopathy above and below diaphragm with splenomegaly. No pleural effusion or ascites. Trucut lymph node biopsy submitted.

H&E


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Mum1


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CD138


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Kappa


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Lambda


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CD20


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PAX5


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HHV8


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Epstein-Barr encoding region (EBER)


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CD03


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BLPG EQA Round 18 - Case 3

Male 53 years

Renal transplant in 2016 for IgA nephropathy. Admitted with cervical and inguinal lymphadenopathy, ? liver primary,? PTLD. CT/PET showed a 12 cm PET avid lesion in the liver and generalised PET avid lymphadenopathy. LDH 283. Trucut lymph node biopsy.

H&E


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CD79a


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CD03


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BCL-2


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MYC


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Ki67 (MIB-1)


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Bcl-6


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Epstein-Barr encoding region (EBER)


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BLPG EQA Round 18 - Case 4

Male 36 years

Known Bechet's disease, on azathioprine for 10 years. Admitted with increased ferritin and fever suspicious of HLH but with no definite evidence of HLH on bone marrow examination. Massive splenomegaly, high LDH (2700), thrombocytopenia and progressive anaemia. No lymphadenopathy. Bone marrow trephine biopsy.

H&E


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CD20


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CD05


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TCR-Delta


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CD03


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TIA-1


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CD08


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TCR-Beta


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BLPG EQA Round 18 - Case 5

Male 27 years

Pathological lymphadenopathy right groin - extensive with surrounding fat necrosis. Previous core biopsy suggests no lymphoma, but clinically this is a possibility. History of pyoderma gangrenosum in left groin. Lymph node excision biopsy.

H&E


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CD03


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CD20


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CD21


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CD30


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S100


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CD01a


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BLPG EQA Round 18 - Case 6

Male 57 years

Bulky left axillary lymphadenopathy developing over 5 weeks. No evidence of other lymphadenopathy or hepatosplenomegaly. Mild anaemia, Borderline normal LDH. Lymph node excision biopsy.

H&E


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CD45


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CD03


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CD20


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CD02


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CD138


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CD04


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CD08


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Perforin


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CD30


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ALK-1


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EMA Epithelial membrane antigen


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BLPG EQA Round 18 - Case 7

Male 60 years

Mild neutropenia and thrombocytopenia. Increased serum LDH. Abnormal MRI signal throughout the whole bone marrow. No organomegaly or lymphadenopathy. Recent radical change in lifestyle-started to exercise intensely for two hours per day, limited intake of carbohydrates, gave up dairy and meat, and lost over 10% of body mass in a few weeks. No symptoms other than weight loss and fatigue. Bone marrow trephine.

H&E


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Giemsa


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Reticulin


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Alcian Blue


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PAS Periodic acid Shiff


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CD03


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CD20


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CD34


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C-KIT (CD117)


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CD61


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BLPG EQA Round 18 - Case 8

Male 55 years

New sent pancytopaenia. No diagnostic features on the film. ?MDS, ?AML Hb91, WBC 1.1, neutrophils 0.21, monocytes 0.08, lymphocytes 0.81, platelets 24. Bone marrow trephine biopsy submitted.

H&E


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C-KIT (CD117)


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P53


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Giemsa


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Reticulin


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Myeloperoxidase (MPO) (MYEL)


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CD34


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