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EQA

Head and Neck Histopathology National EQA M - Spring 2020







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Case 01

Female 27 years

Intermittent pain and swelling from 38 region over the last six months. Radiograph shows well demarcated radiolucency at distobuccal aspect of partially erupted mandibular 3rd molar.

Specimen: Enucleation of cyst associated with lower left wisdom tooth.

Macroscopic description:
-

Immunohistochemistry:
-


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Case 02

Female 35 years

Raised lesion lateral border of tongue.

Specimen: ORAL MUCOSA.

Macroscopic description:
-

Immunohistochemistry:
-


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Case 03

Female 47 years

? mucocele lower lip.

Specimen: oral mucosa.

Macroscopic description:
-

Immunohistochemistry:
-


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Case 04

Female 36 years

8cm swelling maxilla with proptosis and blocked nose, present for several years.

Specimen: ODONTOGENIC.

Macroscopic description:
-

Immunohistochemistry:
-


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Case 05

Male 14 years

Spontaneous swelling of the lower lip and mucosa generally. Unresponsive to antivirals. No other relevant medical history.

Specimen: Left buccal mucosa.

Macroscopic description:
punch biopsy 4x3x3mm.

Immunohistochemistry:
D/PAS negative.


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Case 06

Male 50 years

1 cm diameter white/red patch on both right and left buccal mucosae. Adjacent to heavily restored molar teeth. Never smoker, no meds; medically fit and well. Punch biopsy from left buccal mucosa submitted. ?Lichenoid reaction.

Specimen: Mucosal biopsy.

Macroscopic description:
5 mm punch biopsy, bisected and submitted in total.

Immunohistochemistry:
No fungal hyphae seen with PASD stain.


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Case 07

Female 62 years

Mass in floor of mouth.

Specimen: SALIVARY.

Macroscopic description:
-

Immunohistochemistry:
-


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Case 08

Male 24 years

Mass on palate.

Specimen: ORAL.

Macroscopic description:
-

Immunohistochemistry:
-


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Case 09

Female 61 years

Sessiloe swelling in right buccal mucosa. 8mm diameter.

Specimen: Soft tissue.

Macroscopic description:
Spherical nodule of yellow soft tissue.

Immunohistochemistry:
None.


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Case 10

Female 49 years

Branchial cyst vs lymphoma.

Specimen: Right neck, carotid bifurcation.

Macroscopic description:
Nodular soft tissue 30x28x20mm.

Immunohistochemistry:
None.


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Case 11

Female 2 years

2 years 6 months old. Three preauricular skin tags, query hemifacial microsomia.

Specimen: Skin.

Macroscopic description:
A polypoid nodule covered by skin measuring 17 x 6 x 6 mm (this case). Two additonal nodules included (histology shows similar appearances as this section).

Immunohistochemistry:
N/A.


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Case 12

Female 89 years

Life-long smoker 60 pack years. T2N1 SCC of premolar region lower right alveolus treated surgically 3 months ago; excised but dysplasia at margins. Now new ulcer left retromolar region. ?SCC.

Specimen: Grand biopsy oral mucosa.

Macroscopic description:
Ellipse of mucosa 15 x 6 mm to a depth of 3 mm; linear ulcer 10 x 3 mm. Blocked serially across narrower axis and submitted in total.

Immunohistochemistry:
None performed.


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Case 13

Female 83 years

Mass in nasal cavity encroaching right orbital space.

Specimen: Right nasal biopsy, frozen section.

Macroscopic description:
A piece of tan and pink soft tissue measuring 16 x 8 x 4 mm. Processed whole for frozen section.

Immunohistochemistry:
Tumour cells express S-100 protein (strong) and cytokeratins AE1/3, CK8/18 (weakly). Negative for brachyury.


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Case 14

Female 36 years

Left parotid lesion. Pleomorphic adenoma.

Specimen: Left parotid tumour.

Macroscopic description:
Pot labelled "left parotid tumour". This is a lobulated piece of salivary glandular tissue that measures 40 mm x 35 mm x 25 mm and weighs 14 g. The cut surface reveals a well-defined white tumour that measures 25 mm x 28 mm x 20 mm. It abuts the outer surface but does not infiltrate it. Compressed salivary glandular tissue is seen at the periphery. Block ID one piece in each A1 - A5 Tissue left.

Immunohistochemistry:
N/A.


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Case 15

Female 19 years

Skin nodule right neck.

Specimen: Skin right neck.

Macroscopic description:
Skin tissue in which there is a circumscribed chalky white tumour measuring 20 mm in maximum diameter; this appears completely excised.

Immunohistochemistry:
N/A.


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Case 16

Male 52 years

Mass submental region, ? salivary gland neoplasm. Biopsy non diagnostic, no other medical history.

Specimen: salivary - submandibular.

Macroscopic description:
-

Immunohistochemistry:
-


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Case 17

Male 19 years

Mass in right parotid, ? Non necrotising granulomata.

Specimen: PAROTID.

Macroscopic description:
Not provided.

Immunohistochemistry:
N/A.


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Case 18

Male 58 years

Immediate regrowth of midline upper lip lesion removed 5 weeks ago.

Specimen: Upper lip lesion.

Macroscopic description:
A soft cream/grey nodule measuring 15 x 10 x 8 mm. On sectioning, the cut surface is homogeneously tan in colour. Bisected and all embedded.

Immunohistochemistry:
N/A.


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