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EQA

Head and Neck Histopathology National EQA U - Autumn 2024







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Case 01

Female 29 years

Surgical removal of radiopaque lesion left mandible.

Specimen: Left angle of mandible.

Macroscopic description:
Pot contains 4 pieces bony tissue 17 mm x 15 mm x 6 mm, 16 mm x 13 mm x 7 mm, 10 mm x 9 mm x 6 mm, 14 mm x 7 mm x 3 mm. For decal and trim.

Immunohistochemistry:
N/A.


H&E 1


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Case 02

Male 13 years

Left lateral tongue lesion.

Specimen: Biopsy lateral tongue.

Macroscopic description:
Ellipse of mucosa 7 x 5 x 6 mm, bisected.

Immunohistochemistry:
S100+, CD68+.


H&E 2


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Case 03

Female 25 years

Swelling left buccal sulcus LL23 region radiolucency with dense island inside. Well demarcated.

Specimen: Biopsy lower left quadrant of mandible.

Macroscopic description:
Irregular hard tissue pieces with part smooth surface 17 x 6 x 5 mm and 6 x 5 x 5 mm. Bone and surrounding tooth socket 8 x 5 x 4 mm. All bisected and submitted following formic acid decalcification.

Immunohistochemistry:
none.


H&E 3


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Case 04

Female 76 years

Displaced roots of LL34 and para symphysis of LL lip and chin. No root resorption. Expansive 17 mm lesion on CT mandible from LL1 - LL5. Teeth remain vital on electric pulp testing. Expanded buccal + lingual cortices and perforates both buccal + lingual cortex.

Specimen: Enucleation mass left mandible.

Macroscopic description:
Pot contains a nodular piece of soft tissue with no obvious surface mucosa. This measures 20 mm x 13 mm x 6 mm. The outer surface is inked entirely black. Specimen bisected revealing a? Cystic space.

Immunohistochemistry:
none.


H&E 4


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Case 05

Male 36 years

Incisional biopsy cyst right maxilla. Differential keratocyst / dentigerous cyst.

Specimen: Maxilla.

Immunohistochemistry:
Grey tissue with crusted white nodules 24x15x3mm.

Immunohistochemistry:
N/A.


H&E 5


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Case 06

Male 59 years

Lesion posterior dorsum of tongue ? FEP.

Specimen: Biopsy posterior tongue.

Macroscopic description:
Soft tissue 5 x 5x 5mm.

Immunohistochemistry:
N/A.


H&E 6


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Case 07

Male 37 years

Lump left submandibular gland.

Specimen: Submandibular gland.

Macroscopic description:
Submandibular gland measuring 75 x 45 x 15mm. On slicing there is a well circumscribed pale nodule 35 x 24 x 24mm.

Immunohistochemistry:
n/a.


H&E 7


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Case 08

Female 89 years

Traumatic tissue lost during RR insertion.

Specimen: Biopsy left nostril.

Macroscopic description:
Polypoid tissue 59x22x12mm.

Immunohistochemistry:
Primary IHC panel- MNF116, CD45 negative and S100 positive.


H&E 8


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Case 09

Female 50 years

Cyst in neck.

Specimen: Cyst in neck.

Macroscopic description:
Thick walled cyst.

Immunohistochemistry:
p16 slide available to interpret.


H&E 9


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Case 10

Female 24 years

Right parotidectomy.

Specimen: Right parotidectomy.

Macroscopic description:
Pot contains unorientated salivary gland with tumour showing a smooth encapsulated surface measuring 30 mm in maximum dimension x 22 mm x 17 mm and the tumour nodule measures 12 mm in maximum dimensions. Surface inked: tumour surface inked blue, salivary surface inked black. Serially sliced into 5 slices.

Immunohistochemistry:
CK7+ p63 abluminal cells, Mib 1%.


H&E 10


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Case 11

Male 53 years

Multiple facial subcutaneous and submucosal lesions. Slow growing. ?granulomatous ?lymphoid ?dysplastic.

Specimen: Deep soft tissue right cheek.

Macroscopic description:
Fibrofatty tissue measuring 10 x 6 x 4 mm.

Immunohistochemistry:
N/A.


H&E 11


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Case 12

Male 49 years

Previous treated EBV driven plasmablastic lymphoma with R Chop and IT methotrexate. New onset right zygomatic mass. FNAC non diagnostic.

Specimen: Biopsy right zygomatic mass.

Macroscopic description:
Tissue cores measuring 17mm and 2mm.

Immunohistochemistry:
N/A.


H&E 12


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Case 13

Male 64 years

Rapidly growing mass right parotid. Facial nerve palsy. US -hypoechoic irregular mass right parotid. Section from radical right parotidectomy.

Specimen: Parotidectomy.

Macroscopic description:
-.

Immunohistochemistry:
CK7+, TTF-1-, p40-, CDX2- , S100-, Androgen receptor+, HER2- (FISH).


H&E 13


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Case 14

Male 16 years

Large right sided sinonasal mass with infratemporal and parapharyngeal extension.

Specimen: Sinonasal mass.

Macroscopic description:
1 large slightly irregular nodule 45 x 35 x 17 mm and multiple fragments of firm fibrous tissue in aggregate 80 x 65 x 15 mm.

Immunohistochemistry:
N/A.


H&E 14


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Case 15

Female 58 years

Right tonsil tumour.

Specimen: Right tonsil biopsy.

Macroscopic description:
Pot contains slightly oedematous piece of mucosa measuring 19x10x4mm. The specimen is trisected along the longest axis.

Immunohistochemistry:
p16 +.


H&E 15


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Case 16

Male 74 years

3 month history of hoarse voice. Fullness left false cord, inflamed right arytenoid.

Specimen: Larynx (arytenoid).

Macroscopic description:
Three pieces of yellow tissue, largest 3 mm in maximum diameter.

Immunohistochemistry:
N/A.


H&E 16


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Case 17

Female 22 years

Neck cyst ? thyroglossal duct cyst.

Specimen: Neck soft tissue.

Macroscopic description:
Pot contains strip of soft tissue 40 x 15 x 16 with ellipse of skin 23 x 8 mm at 1 aspect. Bone at one pole. Left inked green, right inked black. Specimen sliced from pole-to-pole into 6 pieces.

Immunohistochemistry:
N/A.


H&E 17


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Case 18

Female 82 years

Tissue from right sphenoid. Sinusitis.

Specimen: R sphenoid sinus.

Macroscopic description:
Soft tissue fragments 6 x 4 x 3mm.

Immunohistochemistry:
N/A.


H&E 18


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