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EQA

National Musculoskeletal Pathology (NMSP) EQA Scheme Circulation A22






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Circulation A22 - B21

Male 17 years

Lytic lesion distal phalanx right index finger.



Specimen: Curettage specimen.
IMAGING: None provided.
IHC Profile: None stated.



Macroscopic description:
Multiple fragments weighing approximately 1 g.


H&E 518093


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Circulation A22 - B22

Female 13 years

Intramedullary lesion in the spinous process of L3 vertebra.



Specimen: Resection (see macro on PDF).
IMAGING: None.
IHC Profile: None stated.



Macroscopic description:
Well circumscribed intra-osseous tumour measuring 13x10mm.


H&E 518094


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Circulation A22 - B23

Female 75 years

Large mass arising from sacrum.



Specimen: Sacrectomy.
IMAGING: (see imaging on PDF).
IHC Profile: Gelatinous component: MNF116 and S100 positive . Fleshy component: none positive.



Macroscopic description:
Tumour measuring 125x110x95mm, with a biphasic appearance; part gelatinous and part fleshy.


H&E 518095


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Circulation A22 - B24

Male 33 years

Patient has multiple osteochondromas. Now presenting with large tumour on the surface of right iliac blade.



Specimen: Hemipelvectomy.
IMAGING: See macro photo.
IHC Profile: None.



Macroscopic description:
Lobulated surface chondral tumour measuring 100x100x75mm.


H&E 518096


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Circulation A22 - B25

Male 27 years

Enlarging tumour in the left scapula. Patient has Ollier's disease.



Specimen: Scapulectomy.
IMAGING: (See Imaging on PDF).
IHC Profile: None stated.



Macroscopic description:
Intramedullary cartilaginous tumour (130x50x35mm).


H&E 518097


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Circulation A22 - B26

Male 58 years

Intramedullary tumour in right distal femur.



Specimen: Resection (see macro on PDF).
IMAGING: see macro on PDF.
IHC Profile: H3-3 G34W negative.



Macroscopic description:
Fleshy meta-diaphyseal tumour (180x80x100mm).


Circulation A22 - B27

Male 17 years

Diaphyseal cortical osteolytic lesion, left femur.



Specimen: Resection.
IMAGING: None provided.
IHC Profile: Large cells positive for S100, CD1a and CD207.



Macroscopic description:
Whitish-tan soft tissue, 30 x24x15 mm.


H&E 518224


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Circulation A22 - B28

Male 20 years

Aggressive looking tumour left proximal fibula, extending into surrounding soft tissue. Lakes of blood at surgery.



Specimen: Bone biopsy.
IMAGING: None.
IHC Profile: None provided.



Macroscopic description:
Multiple pieces of haemorrhagic soft and bony tissue, 25x25x3mm in aggregate.


H&E 518101


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Circulation A22 - B29

Male 58 years

Necrotic pelvic bone mass destroying acetabulum. ?Plasmacytoma.



Specimen: Bone core biopsy.
IMAGING: None provided.
IHC Profile: None provided.



Macroscopic description:
Multiple cores, 1 to 5mm in length.


H&E 518229


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Circulation A22 - B30

Female 37 years

Several bone lesions left leg, especially in the medullary cavity of tibia and femur.



Specimen: Bone biopsy, left tibia.
IMAGING: None.
IHC Profile: None.



Macroscopic description:
3 bone cores, 18-23 mm in length.


H&E 518103


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Circulation A22 - ST21

Male 24 years

Right forearm mass.



Macroscopic description:
Pale fleshy subcutaneous mass (55x40x25).
IHC details: Tumour diffusely positive for CD34.


H&E 518083


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Circulation A22 - ST22

Female 51 years

Osteomalacia and associated insufficiency fractures. Imaging detected mass in right pectineus muscle.



Macroscopic description:
Multiple fragments of tan and haemorrhagic tissue, 38x25x12mm in aggregate.
IHC details: Positive for CD56 with associated focal weak staining for ERG.


H&E 518195


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Circulation A22 - ST23

Male 55 years

2 months history of left neck lump.



Macroscopic description:
Multinodular mass, 95mm in maximum dimension. Lobulated fleshy cut surface with no necrosis/haemorrhage.
IHC details: Positive for CD34 & STAT6. Negative for AE1/AE3, desmin & S100.


H&E 518085


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Circulation A22 - ST24

Male 41 years

Right thigh mass.



Macroscopic description:
2 cores of tan tissue 8 & 19mm in length.
IHC Profile: EMA, CK, CD99 & BCL2 positive.


H&E 518206


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Circulation A22 - ST25

Male 25 years

Left shoulder subcutaneous lesion. ?vascular malformation.



Macroscopic description:
Haemorrhagic mass 14x33x13mm, with overlying skin ellipse.
IHC Profile: Patchy staining for CD68.


H&E 518087


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Circulation A22 - ST26

Male 58 years

Lesion in plantar fascia of right foot, present for ~10yrs. ?plantar fibromatosis.



Macroscopic description:
Core of tan tissue.
IHC details: Positive for SOX10, HMB45 & melan-A. EWSR1 rearrangement detected by FISH.


H&E 518088


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Circulation A22 - ST27

Male 32 years

Nodular lesion left lateral chest wall.



Macroscopic description:
Nodular skin lesion (7 x 4 mm), bisected.
IHC details: Positive for SMA, S100 and AE1/3. Negative for SOX 10 and Melan-A. EWSR1 gene rearrangement detected by FISH.


H&E 518220


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Circulation A22 - ST28

Male 60 years

Nasal lesion infiltrating anterior skull base and turbinate.



Macroscopic description:
Multiple fragments of fleshy haemorrhagic tissue together measuring 30 x 30 mm.
IHC details: Positive for SMA, CD34 (patchy), cyclin D1 and B-catenin (nuclear). Negative for STAT6.


H&E 518090


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Circulation A22 - ST29

Female 32 years

5 week history of voice hoarseness. Polypoid subglottic lesion detected.



Macroscopic description:
Polypoid whitish-tan lesion, 9 x9mm.
IHC details: Positive for SMA, AE1/3 (patchy) and ALK-1. Negative for desmin, h-caldesmon, 34BE12, S100, and CD34.


H&E 518091


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Circulation A22 - ST30

Female 80 years

Ulcerated left breast lesion. Has history of left breast carcinoma treated with adjuvant radiotherapy.



Macroscopic description:
Punch biopsy of skin, 10x5mm.
IHC details: None.


H&E 518092


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