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EQA

Head and Neck Histopathology National EQA R - Spring 2023







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Case 01

Female 66 years

White patch left ventral surface of tongue. Previous smoker. Query dysplasia. Incision. Urgent.

Specimen: Ventral surface of tongue.

Macroscopic description:
Pale mucosa 4 x 2 x 2 mm.

Immunohistochemistry:
N/A.


H&E


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Case 02

Female 89 years

Round lump midline upper lip within vermilion. Present 12 months. Excision. Non-smoker. Denture wearer no.

Specimen: Upper lip.

Macroscopic description:
Grey mucosa covering brown tissue 6 x 5 x 4 mm.

Immunohistochemistry:
N/A.


H&E


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Case 03

Male 45 years

12/12 burning sensation. Palate can go white and bleed spontaneously. Heavy smoker. Alcohol. ? Candidiasis.

Specimen: INCISIONAL BIOPSY RIGHT HARD PALATE.

Macroscopic description:
Pot is labelled, "Palate biopsy" - A round piece of mucosa measuring 6 x 6 x 4 mm, bisected.

Immunohistochemistry:
N/A.


H&E


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Case 04

Female 73 years

Asymptomatic white patch lower right alveolus. Smoker. Probably smokers keratosis + dysplasia.

Specimen: Lower alveolus.

Macroscopic description:
Ellipse of mucosa 10x2x2mm.

Immunohistochemistry:
N/A.


H&E


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Case 05

Female 89 years

Mobile lump left upper lip submucosa. Blue overlying colour. Firm, nontender. Excisional biopsy. Minor salivary gland tumour?

Specimen: Upper lip.

Macroscopic description:
Fluctuant nodule 13 x 12 x 6 mm. Cyst cavity with solid areas on sectioning.

Immunohistochemistry:
N/A.


H&E


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Case 06

Male 64 years

Upper left gingival/gum area (canine and first premolar). Discrete raised lesion. Unsure of history but has been there for the last year. Excised.

Specimen: Biopsy upper gum canine and premolar area.

Macroscopic description:
An ellipse of beige tissue measuring 10 x 6 x 3 mm.

Immunohistochemistry:
N/A.


H&E


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Case 07

Male 75 years

Previous history of extraction 47 pre-radiotherapy for tonsillar SCC. Post RT developed exposed bone lingual 47 socket. Sequestrum (sample).

Specimen: EXPOSED BONE LINGUAL TO 47 SOCKET.

Macroscopic description:
Sequestrum lower right 7 - A piece of soft and bony tissue measuring 8 x 5 x 3 mm. Processed whole for decalcification.

Immunohistochemistry:
N/A.


H&E


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Case 08

Female 80 years

Left submandibular gland tumour.

Specimen: Salivary.

Macroscopic description:
Left submandibular gland tumour.

Immunohistochemistry:
N/A.


H&E


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Case 09

Female 39 years

Small firm lobulated lesion right antero-superior nasal vestibule. Papilloma?

Specimen: Nasal.

Macroscopic description:
One pale piece of tissue 6 x 4 x 3 mm.

Immunohistochemistry:
N/A.


H&E


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Case 10

Female 63 years

Lump right parotid- Right partial parotidectomy.

Specimen: Partial parotidectomy.

Macroscopic description:
Irregular salivary gland tissue 45x28x15mm with a grey circumscribed nodule measuring 11mm.

Immunohistochemistry:
N/A.


H&E


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Case 11

Female 66 years

Skin lesion right cheek.

Specimen: Biopsy from cheek skin.

Macroscopic description:
A skin ellipse measuring 29 x 7 x 12 mm with a raised central nodule measuring 6 x 6 x 12 mm.

Immunohistochemistry:
N/A.


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Case 12

Female 1 year

Swelling right supraorbital region since birth.

Specimen: Skin.

Macroscopic description:
Fluctuant cyst 14 x 8 x 10 mm.

Immunohistochemistry:
N/A.


H&E


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Case 13

Female 62 years

Reinkes oedema secondary to smoking. Hoarseness. Biopsy ?neoplasia - macroscopically Reinkes only. Right vocal cord.

Specimen: Larynx.

Macroscopic description:
Six pieces of tissue 1-2 mm.

Immunohistochemistry:
N/A.


H&E


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Case 14

Male 59 years

Previous papillary thyroid cancer 2019, thyroidectomy followed by radiotherapy. Rising thyroglobulin. Recurrent cancer - right level VI including part of sternocleidomastoid.

Specimen: Thyroid.

Macroscopic description:
Lymph node 32 x 18 x 15 mm.

Immunohistochemistry:
N/A.


H&E


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Case 15

Male 69 years

Polyp arising posterior maxillary wall?

Specimen: Sinonasal.

Macroscopic description:
Multiple fragments of soft tissue together 30x10x8mm.

Immunohistochemistry:
N/A.


H&E


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Case 16

Male 50 years

Lesion left supraglottis.

Specimen: Supraglottic biopsy.

Macroscopic description:
Nodule of soft tissue 15x10x9mm. Slicing shows a cystic cavity.

Immunohistochemistry:
N/A.


H&E


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Case 17

Female 75 years

T2 N0 M0 carcinoma left submandibular gland. Pt has undergone left level I-IV neck dissection along with excision of lump.

Specimen: Salivary.

Macroscopic description:
Left neck dissection.

Immunohistochemistry:
N/A.


H&E


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Case 18

Female 73 years

Parathyroidectomy; PTH 20; Has CLL with some nodes on USS in neck Right lower parathyroid. ? Parathyroid adenoma.

Specimen: Right lower parathyroid.

Macroscopic description:
Lobule of soft tissue measuring 16 x 10 x 7 mm and weighing 0.6 g.

Immunohistochemistry:
N/A.


H&E


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