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EQA

Head and Neck Histopathology National EQA O - Spring 2021







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Case 01

Female 18 years

40 mm cystic swelling floor of mouth. Fluctuates in size. Originates from left sublingual gland and crosses mylohyoid with extension into neck.

Specimen: Sublingual gland.

Macroscopic description:
description: Bilobed fluctuant cyst (40x 30 x 20 mm) with sublingual gland.

Immunohistochemistry:
N/A.


H&E


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Case 02

Male 14 years

Suspected odontome over lower right third molar causing pericoronitis.

Specimen: Odontogenic.

Macroscopic description:
Nodule of hard tissue 16 x 16 x 10 mm.

Immunohistochemistry:
N/A.


H&E


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Case 03

Male 40 years

Previous surgery for PSA. Now recurrent PSA with sternocleidomastoid deposits. Superficial parotid tissue was firm and suspicious clinically.

Specimen: Right level II tissue.

Macroscopic description:
An irregular fragment of soft tissue, with no orientation, measuring 40 x 33 x up to 8 mm. Serially sliced. All processed.

Immunohistochemistry:
N/A.


H&E


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Case 04

Female 64 years

Epulis gingival margin LR4.

Specimen: Gingivae.

Macroscopic description:
Firm nodule 12 x 10 x 7 mm plus separate nodule 9 x 5 x 5 mm.

Immunohistochemistry:
N/A.


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Case 05

Female 53 years

Cyst LR5, ? dentigerous, ? radicular.

Specimen: Cyst LR5.

Macroscopic description:
Collapsed cystic structure of up to 20 mm, transected and all embedded.

Immunohistochemistry:
-


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Case 06

Male 60 years

Progressively growing lesion LL2 to LL6 with loosening teeth. Intraoral exophytic growth.

Specimen: Odontogenic.

Macroscopic description:
Rim of mandible from LR3 to LL6 overall 55 x 25 x 40 mm. Mass (25 x 32 mm) occupying LL4 edentulous space with mild buccal expansion and marked lingual expansion.

Immunohistochemistry:
N/A.


H&E


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Case 07

Female 56 years

Erythematous area left tongue.

Specimen: Biopsy left lateral tongue.

Macroscopic description:
Mucosa 9x4x3mm.

Immunohistochemistry:
N/A.


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Case 08

Male 68 years

6 mm exophytic lesion midline lower lip.

Specimen: Skin.

Macroscopic description:
Skin 6 x 4 x 3 mm.

Immunohistochemistry:
N/A.


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Case 09

Male 65 years

25 x 15 mm well defined mass left neck level II.TB several years ago.

Specimen: Lymph node.

Macroscopic description:
Lymph node 25 x 15 x 6 mm with widespread caseous necrosis.

Immunohistochemistry:
AE1/3 negative.


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Case 10

Male 51 years

Ulcer left tongue.

Specimen: Tongue biopsy.

Macroscopic description:
Not available.

Immunohistochemistry:
N/A.


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Case 11

Male 81 years

Left sided parotid tumour removed by extracapsular dissection.

Specimen: parotid.

Macroscopic description:
Intact firm nodular tissue measuring 23 x 20 x 6 mm. No orientation provided.

Immunohistochemistry:
Not performed.


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Case 12

Male 57 years

Previous melanoma left buccal mucosa.

Specimen: Lymph node.

Macroscopic description:
Radical neck dissection.

Immunohistochemistry:
Sox10 positive.


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Case 13

Male 64 years

Firm swelling left labial mucosa.

Specimen: Mucosa.

Macroscopic description:
Soft tissue 7 x 6 x 4 mm.

Immunohistochemistry:
N/A.


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Case 14

Male 40 years

Polyp left nasal cavity with history of epistaxis.

Specimen: Nasal polyp.

Macroscopic description:
Polypoid tissue 20mm maximum.

Immunohistochemistry:
N/A.


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Case 15

Male 63 years

? Benign. ? Malignant lesion. Lesion from undersurface of left vocal cord. Previous chemorad. for glottic SCC (2019).

Specimen: Left vocal cord.

Macroscopic description:
A fragment of mucosa measuring 4 mm in maximum dimension. Processed whole for two levels.

Immunohistochemistry:
N/A.


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Case 16

Male 61 years

Left side parasinusitis. Bone remodelling. Granulation tissue ++.

Specimen: Maxillary sinus.

Macroscopic description:
Fragments of hard and soft tissue 20 x 18 x 3 mm.

Immunohistochemistry:
N/A.


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Case 17

Male 61 years

Clinical Diagnosis: Left parapharyngeal mass. 4 x 3 cm left parapharyngeal mass/tumour.

Specimen: Lump left oropharynx.

Macroscopic description:
An irregular piece of tan soft tissue measuring 31 x 25 x 16 mm. There is a capsule at the surface, mostly intact with focal areas of disruption.

Immunohistochemistry:
dPAS-positive cytoplasmic zymogen granules. N/A


H&E


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Case 18

Female 35 years

Clinical Diagnosis: Multinodular goitre. Benign cystic thyroid disease. Cyst ruptured during procedure.

Specimen: Right hemithyroidectomy.

Macroscopic description:
A right hemithyroidectomy specimen measuring 45 mm (transversely), 26 mm (antero-posteriorly), and 59 mm (supero-inferiorly). The specimen weighs 27 grams. Serially sliced in transverse plane. The cut surfaces show a thickly encapsulated nodule extending through the upper, mid, and lower lobe (maximum dimension of 50 mm). The nodule is ruptured at the postero-superior radial surface.

Immunohistochemistry:
POSITIVE: Calcitonin, CEA; Chromogranin, synaptophysin, CD56; TTF-1 NEGATIVE: S100, HBME-1, CK19.


H&E


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