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EQA

Head and Neck Histopathology National EQA N - Autumn 2020







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Case 01

Male 58 years

Leukoplakia present 3/12.

Specimen: Incisional biopsy right side of tongue.

Macroscopic description:
Mucosa 11 x5 x3mm.

Immunohistochemistry:
none.


H&E


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Case 02

Male 37 years

? Mucocele.

Specimen: Lesion lower lip.

Macroscopic description:
An ellipse of mucosa 10 x 4 mm with underlying nodule 6 x 4 x 3 mm. Bisected. Two detached fragments measure 2 mm and 3 mm in maximum dimension. All processed for 2 levels.

Immunohistochemistry:
POSITIVE: CD31, CD34, SMA (patchy). NEGATIVE: HHV-8, Desmin, S100, MelanA.


H&E


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Case 03

Male 59 years

Clinical Diagnosis: cT1 N0 SCC (R) buccal sulcus. Underwent WLE + buccal fat pad (illegible). Most medial aspect of the tumour is the alveolus, marked w/ long stitch. This was removed in subperiosteal plane.

Specimen: Right upper buccal sulcus.

Macroscopic description:
Wide local excision right upper buccal sulcus: An ovoid piece of mucosa received with orientation provided by short suture (anterior) and long suture (alveolus, taken as medial). The specimen measures 46 mm (antero-posterior), 27 mm (medio-lateral), and up to 14 mm in depth (supero-inferior). Centrally, there is a sutured lesion overlying a palpable submucosal nodule. The sutured area measures ~ 17 mm in maximum dimension. MacroPath photographs (x 2). Inked black (medial) and blue (lateral). Central coronal slices are taken through the sutured area. They show firm tumour extending through four consecutive slices with maximum dimension of 17 mm.

Immunohistochemistry:
N/A.


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Case 04

Female 37 years

3/12 history of nodular lesion right lower lip; clinically pyogenic granuloma.

Specimen: Right lower lip, excision.

Macroscopic description:
An ellipse of mucosa measuring 11 x 8 x 2 mm with a raised, crusted, friable lesion 8 x 9 x 3 mm. Bisected. Both halves embedded.

Immunohistochemistry:
N/A.


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Case 05

Male 27 years

Swelling lower lip.

Specimen: Biopsy lower lip.

Macroscopic description:
Soft tissue nodule 6x5x4mm.

Immunohistochemistry:
N/A.


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Case 06

Female 82 years

Denture hyperplasia? Excisional biopsy upper anterior mucosa.

Specimen: Anterior maxillary gingiva.

Macroscopic description:
Mucosal nodule 8 x 6 x 3 mm, longitudinally bisected.

Immunohistochemistry:
N/A.


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Case 07

Female 31 years

Large painless lesion right ear canal.

Specimen: Ear canal biopsy.

Macroscopic description:
Polypoid piece of skin, 8 x 6 x 4 mm, blocked serially & submitted in total.

Immunohistochemistry:
None performed.


H&E


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Case 08

Female 78 years

Previous scalp primary. Slide is a parotid nodule.

Specimen: From parotidectomy.

Macroscopic description:
Not available.

Immunohistochemistry:
None available.


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Case 09

Female 53 years

Clinical Diagnosis: Parotid mass. Previous T cell lymphoma left forehead. Parotid lump. ? Malignant.

Specimen: Left parotid excision.

Macroscopic description:
An irregular piece of parotid tissue with fibroadipose tissue. The specimen measures 26 x 24 x < 16 mm. No orientation is provided. The surface is inked green. Serially sliced. All embedded.

Immunohistochemistry:
Non-viable cells show retained expression of CD3 and CD30. Patchy expression of CD10. Admixed CD79a-positive cells.


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Case 10

Male 47 years

Cyst right neck level II ? Branchial cyst.

Specimen: Neck biopsy.

Macroscopic description:
Soft tissue 12x10 x10mm.

Immunohistochemistry:
None.


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Case 11

Female 52 years

Right parotid mass.

Specimen: Right parotid.

Macroscopic description:
Right parotid mass. A nodule of soft tissue with surrounding fibroadipose tissue together measuring 19 x 15 x 16 mm. The nodule appears completely encapsulated. The surface is inked blue. Serially sliced. The cut surfaces show a well-circumscribed pale brown nodule extending throughout the specimen.

Immunohistochemistry:
Tumour cells express: CK7, S100-protein, CK14. Focal SMA. p63 and Calponin negative.


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Case 12

Male 37 years

(L) middle turbinate medial surface, ? mucocele.

Specimen: Left nasal cavity.

Macroscopic description:
A polypoidal fragment of light brown soft tissue 28 x 25 x 12 mm. Serially sliced. All processed.

Immunohistochemistry:
N/A.


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Case 13

Male 29 years

Mass in nose.

Specimen: Nasal biopsy.

Macroscopic description:
4 membraneous soft tissue fragments.

Immunohistochemistry:
none.


H&E


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Case 14

Male 49 years

Large cyst left side vallecular/tongue surface/epiglottis. Burst on removal.

Specimen: Biopsy of oropharynx.

Macroscopic description:
Piece of soft tissue measuring 14 x 7 x 4 mm, blocked serially & submitted in total.

Immunohistochemistry:
None performed.


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Case 15

Male 39 years

Large post-nasal space mass ? nasopharyngeal Ca.

Specimen: Post nasal space.

Macroscopic description:
Pedunculated bosselated nodule measuring 2.8 x 2 .5 x 2.5 cm, weighing 12 g, presenting a sessile base.

Immunohistochemistry:
HE.


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Case 16

Female age unknown

Polyp right posterior tongue.

Specimen: Tongue biospy.

Macroscopic description:
Nodule of soft tissue 5x4x4mm.

Immunohistochemistry:
N/A.


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Case 17

Male 75 years

Long standing parotid nodule with recent change and invasion of skin.

Specimen: Salivary.

Macroscopic description:
None.

Immunohistochemistry:
None provided.


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Case 18

Female 33 years

Large multinodular goitre.

Specimen: Total thyroidectomy.

Macroscopic description:
Total thyroidectomy. Right lobe. Weighs 50.3 grams. Measures 82 mm x 58 mm x 30 mm. Multiple nodules at cut surface ranging from 4 mm to 25 mm in maximum diameter.

Immunohistochemistry:
(On block submitted): patchy expression of CK19. CD56 shows retained expression. HMBE-1 is negative.


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