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EQA

National Musculoskeletal Pathology (NMSP) EQA Scheme Circulation B21






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Circulation B21 - Bone case B11

Male 15 years

Curettage specimen. Subchondral lesion in the right distal femur.


H&E 503067


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Circulation B21 - Bone case B12

Male 24 years

Left humerus pathological fracture. Malignant bone tumour? Ewings.


H&E 503359


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Circulation B21 - Bone case B13

Male 24 years

Wide excision of humerus. Previous adjuvant chemotherapy. Humerus with central tumour 122 x 65 x 40mm.


H&E 503072


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Circulation B21 - Bone case B14

Male 21 years

L2 Vertebra, posterior element. Relevant details from imaging: 3cm mineralising lesion with surrounding marrow oedema.


H&E 503361


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Circulation B21 - Bone case B15

Male 70 years

Pathological fracture of left femur. Material from fracture site.


H&E 503363


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Circulation B21 - Bone case B16

Female 73 years

Excision ganglion left wrist. Referred case. A translucent piece of cystic 10x5x4mm and a hard cream nodule 10x5x5mm. Relevant details from imaging: None.


H&E 503078


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Circulation B21 - Bone case B17

Male 48 years

Primary epithelioid haemangioendothelioma left pleura in 2018 (WWTR1-CAMTA1 fusion), treated with chemo. Now ?met in left femoral head. A femoral head 47x46x36mm with adherent neck 42x26x9mm. On sectioning, haemorrhagic cut surface with ill-defined cream nodules.

IHC details: CD31 and ERG positive.


H&E 503080


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Circulation B21 - Bone case B18

Male 61 years

Pathological fracture left proximal femur through cartilage tumour. Amputation specimen with large tumour extending from femoral head into shaft and surrounding soft tissue, 175mm in length, partly cartilaginous and partly fleshy, fracture proximal shaft through tumour. Relevant details from imaging: None.


H&E 503082


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Circulation B21 - Bone case B19

Male 27 years

Deep tissue specimen. Excision of osteomyelitis, Right femur. Previous culture Brucella. Right femur: Deep tissue. 2 pieces of soft tissue 1.0x0.9x0.2cm in total. Relevant details from imaging: N/A.

IHC details: ZN, Gram, PAS negative.


H&E 503365


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Circulation B21 - Bone case B20

Female 47 years

Curettage specimen. Giant cell tumour, right distal femur. PMH: 5 doses of neo-adjuvant denosumab. Multiple fragments of friable, but cream and gritty tissue 10.5 x 10.0 x 3.0 cm. Relevant details from imaging: Expansile lytic lesion in right lateral femoral condyle.

IHC details: H3.3G34W positive.


H&E 503086


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Circulation B21 - Soft tissue case ST11

Female 43 years

NF1 patient with neurofibroma left brachial plexus causing pain, discomfort in suprascapular distribution as well as C7 symptoms.

IHC details: Variable expression of S100 and SOX10.


H&E 503088


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Circulation B21 - Soft tissue case ST12

Male 48 years

Lump right forearm. 40 x29 x 24mm myxoid and haemorrhagic mass.

IHC details: S100 and CD117 positive. Negative for p63, p40, AE1/3, calponin and SOX10.


H&E 503776


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Circulation B21 - Soft tissue case ST13

Female 27 years

Previous sarcoma right temple 2 years ago. Now supraclavicular and mediastinal lymphadenopathy. Core Bx.


H&E 503092


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Circulation B21 - Soft tissue case ST14

Male 45 years

Lesion in the right inguinal region. An encapsulated soft tissue nodule [40x30x27mm] with a pale fibrous cut surface.

IHC details: Diffuse staining for ER & PR and focal staining for SMA. Negative for CD34.


H&E 503093


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Circulation B21 - Soft tissue case ST15

Female 25 years

Tumour from left axilla. Oval nodule [20x20x10mm] with a cream cut surface.

IHC details : CD34 positive.


H&E 503095


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Circulation B21 - Soft tissue case ST16

Female 55 years

Tumour right anterior chest wall. Subcutaneous myxoid tumour [52x25x15mm].

IHC details: N/A. FISH studies showed DDIT3 gene rearrangement.


H&E 503098


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Circulation B21 - Soft tissue case ST17

Female 38 years

?Nerve sheath tumour medial left foot. An encapsulated nodule 18x9x8mm.

IHC details: Diffuse positivity for S100. Periphery positive for CD34. Negative for EMA.


H&E 503101


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Circulation B21 - Soft tissue case ST18

Female 29 years

<1cm diameter hypothenar mass, ?Ganglion but USS is equivocal. 8mm encapsulated nodule.

IHC details: CD99 positive. Negative for CD21, CD23, CD34, SMA, desmin, S100 and EMA. FISH studies showed EWSR1 gene rearrangement.


H&E 503103


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Circulation B21 - Soft tissue case ST19

Female 43 years

Plaque of soft tissue, right arm and then a non healing ulcer ?fibromatosis ?injection site. Intramuscular and subcutaneous mass, infiltrative with necrosis; 47 mm in maximum dimension.

IHC details: Positive for CD34, AE1/3, EMA and SMA(patchy), with loss of expression of INI1. Negative for S100 and desmin.


H&E 503105


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Circulation B21 - Soft tissue case ST20

Female 83 years

Lesion in falciform ligament. Recurrent disease with multiple intra abdominal lesions [original pT4 small intestinal mass]. 28mm encapsulated mass.

IHC details: Positive for CD117 and DOG1. Negative for CD34, SMA and desmin.


H&E 503108


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