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EQA

Head and Neck Histopathology National EQA V - Spring 2025







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Case 01

Male 7 years

Patient presents with generalised hypomineralisation of primary and permanent teeth. ?Amelogenesis imperfecta.

Specimen: Deciduous molar tooth.

Macroscopic description:
Two teeth: primary incisor 12x5x3mm for ground section, and permanent molar with two roots and brown.

Immunohistochemistry:
N/A.


H&E 1


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Case 02

Male 70 years

Wide local excision of dysplasia. Present 3 months. Ex-smoker.

Specimen: Tongue.

Macroscopic description:
Rectangular shaped oral mucosa 29x18x3mm.

Immunohistochemistry:
N/A.


H&E 2


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Case 03

Male 59 years

Cyst between roots of lower lateral incisor and canine.

Specimen: Enucleation.

Macroscopic description:
Cyst, bisected.

Immunohistochemistry:
None.


H&E 3


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Case 04

Male 30 years

Mobile pedunculated swelling on palatal attached gingivae UL1/UR1 region.

Specimen: Gingivae.

Macroscopic description:
Pedunculated polyp 11x10x8mm.

Immunohistochemistry:
AE1/3, S100, Sox10 negative. Very focal expression for SMA.


H&E 4


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Case 05

Female 16 years

UL123 palatal excision biopsy of cyst / calcifying odontogenic cyst/ odontome.

Specimen: Excisional biopsy right maxilla.

Macroscopic description:
Ruptured cyst measuring 17 x 7 x 9 mm deep. Trisected.

Immunohistochemistry:
N/A.


H&E 5


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Case 06

Female 4 days

Polypoid swelling noted on upper alveolus at birth. Normal delivery, child well; no other findings.

Specimen: Oral mucosal polyp.

Macroscopic description:
Fleshy pink polyp 12 x 9 x 6 mm.

Immunohistochemistry:
None performed.


H&E 6


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Case 07

Male 43 years

Lower right 8 tooth previously extracted. Complains of numbness in distribution of right lingual nerve since. Surgical exploration of site.

Specimen: Soft tissue biopsy LR8 region.

Macroscopic description:
Soft tissue 7 x 5 x 4mm.

Immunohistochemistry:
N/A.


H&E 7


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Case 08

Male 53 years

4 month history of maxillary tumour. Non-smoker.

Specimen: Maxillectomy.

Macroscopic description:
Partial maxillectomy and oribital floor.

Immunohistochemistry:
N/A.


H&E 8


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Case 09

Male 6 years

Sebaceous cyst left lower neck.

Specimen: Skin.

Macroscopic description:
Ellipse of skin 17 x 8 mm with underlying tissue to 14 mm. Slicing reveals a 10-mm diameter cyst.

Immunohistochemistry:
None.


H&E 9


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Case 10

Female 41 years

Multiple white patches ?lichen planus ?dysplasia. Patient has diagnosed cutaneous pemphigus vulgaris with detectable high-levels of anti-desmoglein 3 antibodies on indirect immunofluoresence.

Specimen: Biopsy from lower left buccal gingiva.

Macroscopic description:
Pot contains elliptical mucosa 4 x 3 x 2 mm.

Immunohistochemistry:
None.


H&E 10


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Case 11

Male 53 years

Lower lip swelling - 2cm, large, midline, present for years, slow growing, no previous paraesthesia of lip, soft, mobile, non-painful/tender. Overlying mucosa normal. Vascular++ on biopsy. Medical history: fit & well.

Specimen: Deep lingual biopsy.

Macroscopic description:
Piece of soft tissue 9 x 8 x 5mm.

Immunohistochemistry:
n/a.


H&E 11


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Case 12

Male 20 years

5 mm raised, soft lump upper right lip ?traumtised fribopeithelial polyp.

Specimen: Biopsy upper right lip.

Macroscopic description:
Polypoid mucosa 4 x 4 x 2 mm, bisected.

Immunohistochemistry:
N/A.


H&E 12


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Case 13

Male age unknown

Lump nasal septum. Previous history of broken nose.

Specimen: Nasal cavity.

Macroscopic description:
Mucosa 18x10 mm with polypoid tissue 7x7mm.

Immunohistochemistry:
N/A.


H&E 13


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Case 14

Male 62 years

Anterior skull base lesion presenting as a nasal mass.

Specimen: Skull base.

Macroscopic description:
Irregular grey brown tissue 12x12x7mm.

Immunohistochemistry:
GFAP and Neu-N positive.


H&E 14


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Case 15

Female 29 years

Branchial cyst left neck.

Specimen: Soft tissue from neck.

Macroscopic description:
Soft tissue 37 x 20 x 9 mm with a collapsed thin-walled cyst approx. 10 mm in diameter.

Immunohistochemistry:
None.


H&E 15


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Case 16

Male 76 years

Right nasal mass.

Specimen: Nasal cavity.

Macroscopic description:
Pot contains multiple partly friable tissue pieces in aggregate 30 x 25 x 8 mm.

Immunohistochemistry:
CD3+ CD56+ EBV+.


H&E 16


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Case 17

Male 50 years

Right ear canal bone lesion.

Specimen: Ear canal.

Macroscopic description:
Grey nodule 5x5x3mm. Decalcified.

Immunohistochemistry:
N/A.


H&E 17


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Case 18

Male 80 years

Background of lymphoma 2015. Anterior commissure and left true cord smooth lesion ? lymphoma.

Specimen: Left vocal cord biopsy.

Macroscopic description:
Multiple polypoid fragments, the largest 15 x13 x13mm.


H&E 18


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