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EQA

Head and Neck Histopathology National EQA L - Autumn 2019







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Case 01

Female 63 years

Bilateral reticular white pattern buccal mucosa and right tongue.

Specimen: Tongue.

Macroscopic description:
Mucosa with reticular pattern 9 x 8 x 4 mm.

Immunohistochemistry:
N/A.


H&E


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Case 02

Female 13 years

Right maxilla, premolar/canine region, tumour enucleated. Displacing 14 & 53 teeth. 14 & 53 lost due to root resorption. Buccal + palatal expansion. - 2 cm diameter.

Specimen: Right maxilla, premolar/canine region, enucleation.

Macroscopic description:
Nodule of soft tissue measuring 19 x 16 x 13 mm. Serially sliced. Representative section processed.

Immunohistochemistry:
None.


H&E


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Case 03

Female 79 years

Radiolucency right mandible. Clearance 50 years ago.

Specimen: Odontogenic.

Macroscopic description:
-

Immunohistochemistry:
-


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Case 04

Female 73 years

Large cyst anterior mandible. Cyst lining very thin and friable. Specimen sent is entire lining obtained from cavity.

Specimen: Anterior mandible cyst.

Macroscopic description:
Three pieces of tan/cream tissue, the largest measuring 15 x 2 x 1 mm. All embedded in one.

Immunohistochemistry:
N/A.


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Case 05

Male 27 years

White patches, extensive on bilateral buccal mucosa/floor of mouth, superficial keratosis, widespread. No suspicious features, asymptomatic, ex-smoker. Hyperkeratosis? Lichen planus? White sponge nevus?

Specimen: Incisional Bx right buccal mucosa 6mm punch.

Macroscopic description:
Punch 5 x 5 mm bisected.

Immunohistochemistry:
None.


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Case 06

Male 38 years

Excision of mucocele right upper lip.

Specimen: Lip.

Macroscopic description:
Mucosa 10 x 8 mm with fluctuant soft tissue 8 mm in depth.

Immunohistochemistry:
N/A.


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Case 07

Male 25 years

Left parotid tumour.

Specimen: Parotid.

Macroscopic description:
-

Immunohistochemistry:
-


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Case 08

Female 33 years

Mass right submandibular gland, 6 month history.

Specimen: Submandiular gland.

Macroscopic description:
Submandibular gland surrounding an encapsulated mass (30 x 29 x 22 mm).

Immunohistochemistry:
S100 positive. AE1/3 negative.


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Case 09

Male 56 years

HIV-positive patient. History of Kaposi's sarcoma.

Specimen: Level VB lymph node, from right neck dissection.

Macroscopic description:
Right selective neck dissection. Bulky nodes at each level.

Immunohistochemistry:
Tumour cells are NEGATIVE for AE1/3, p63, S100, MelanA, CD45, p16, EBERS.


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Case 10

Female 24 years

Lesion left forehead with a 6-8 week history of recurrent headaches. ? cause.

Specimen: Skull.

Macroscopic description:
Disc of bone covered on one surface by elevated soft tissue. Cut sections reveal a central bone cavity filled with granular material.

Immunohistochemistry:
-


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Case 11

Male 38 years

Increasing in size. Pink, fleshy on palpation. D/D: ? Salivary gland neoplasm.

Specimen: Lump (R) buccal mucosa.

Macroscopic description:
A nodule of soft tissue measuring 24 x 15 x 10 mm. Serially sliced. All processed.

Immunohistochemistry:
POSITIVE: SMA, Desmin, Calponin. NEGATIVE: Myogenin, Myoglobin; S100, MelanA; BCl2, CD31, CD34, Stat-6.


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Case 12

Female 53 years

Swelling left floor of mouth and neck.

Specimen: Left sublingual gland.

Macroscopic description:
An irregular piece of fibrofatty tissue complete with attached cystic structure together weighing 3.6 grams and measuring 57 x 22 x 6 mm. The attached cyst measures 21 x 16 x 8 mm. On slicing the cyst is filled with pale yellow mucoid material. Section is of the cyst wall.

Immunohistochemistry:
N/A.


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Case 13

Male 55 years

Left supraglottic pedunculated lesion. 3 month history.

Specimen: Left supraglottis.

Macroscopic description:
A tan encapsulated nodule measuring 21 x 16 x 11mm. The cut surface is firm and tan throughout.

Immunohistochemistry:
CD34 strongly positive in spindled and fat cells.


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Case 14

Female 11 years

Cyst from glabellar region.

Specimen: Skin.

Macroscopic description:
Skin covering an intact cyst 19 x 18 x 12 mm.

Immunohistochemistry:
N/A.


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Case 15

Male 35 years

Lump involving upper lip.

Specimen: ORAL

Macroscopic description:
-

Immunohistochemistry:
-


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Case 16

Female 21 years

Large tumour developed post ear piercing.

Specimen: Skin of left ear, shave excision.

Macroscopic description:
Two nodules of firm skin, measuring 41 x 35 x 30 mm (with base 15 x 15 mm) and 60 x 47 x 25 mm (with base 20 x 18 mm). Serially sliced. The cut surfaces are uniformly firm and fibrous. Representative sections processed.

Immunohistochemistry:
None.


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Case 17

Female 82 years

? BCC. ? C.D. nodularis.

Specimen: Excision pinna.

Macroscopic description:
A wedge of pinna measuring 8 x 8 x 13 mm. Towards the anterior rim there is an ulcer. The ulcer measures 4 x 4 mm.

Immunohistochemistry:
None performed.


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Case 18

Female 57 years

Facial nerve tumour extending into parotid gland.

Specimen: Facial nerve.

Macroscopic description:
A lobule of haemorrhagic soft tissue measuring 34 x 15 x 9 mm. Bisected both halves embedded.

Immunohistochemistry:
None on resection. Incisional biopsy had shown positive S100, CD56, and patchy factor XIIIa.


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