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EQA

National Musculoskeletal Pathology (NMSP) EQA Scheme Circulation B24






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Images for Bone Cases - Circulation B24  pdf document symbol

Circulation B24 - B71

Female 10 years

? ABC. Curettage, left proximal fibula.



Macroscopic description:
Fragments of bony tissue, 15 x 20 x 25 mm in aggregate.

IHC staining details: None.


H&E 581168


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Circulation B24 - B72

Male 70 years

Large tumour with a pathological fracture in proximal femur. Metastases, on imaging. Palliative resection.



Macroscopic description:
Prox femur, 300 mm in length plus surrounding soft tissue and muscle, 210 x 120 x 80 mm. On cut sections, tumour present in bone up to 140 mm, with associated fracture.

IHC staining details: None.


H&E 581169


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Circulation B24 - B73

Male 48 years

History of chondrosarcoma (clear cell), left femur. Now multiple skeletal lesions. Core biopsy from right 10th rib.



Macroscopic description:
Core of bony tissue, 10 mm in length, plus fragments.

IHC staining details: None.


H&E 581170


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Circulation B24 - B74

Female 14 years

Pathological fracture through right tibial lesion, Right above knee amputation.



Macroscopic description:
See PDF for X-ray image.

IHC staining details: None provided.


H&E 581171


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Circulation B24 - B75

Female 74 years

Lesion left proximal humerus ? Nature. Left humerus bone biopsy.



Macroscopic description:
Fragments of bony tissue, 7mm in aggregate.

IHC details: Positive for CD138, and CD56 with lambda light chain restriction; negative for CD3, CD20.


H&E 581172


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Circulation B24 - B76

Male 32 years

Previous history of lymphoma and steroid treatment. Left proximal femur resection.



Macroscopic description:
See PDF images.

IHC staining details: None provided.


H&E 581173


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Circulation B24 - B77

Male 13 years

C6/C7 vertebral lesion bracing nerve root and vertebral artery. Curettage.



Macroscopic description:
33 x 26 x 28 mm right pedicle lesion on imaging.


H&E 581174


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Circulation B24 - B78

Male 24 years

Left hip pain, multilobulated cystic lesion left proximal femur. ?ABC ?Telangiectatic osteosarcoma.



Macroscopic description:
3 bony cores 5, 9 and 10mm in length, plus fragments 5mm in aggregate.

IHC staining details: G34W positive.


H&E 581175


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Circulation B24 - B79

Female 19 years

Chondroid lesion, arising in the cortex of right tibial shaft. Open biopsy and curettage.



Macroscopic description:
Fragments of soft and bone tissue, 4 x 10 x 15 mm in aggregate.

IHC staining details: Scattered cells positive for AE1/3 and MNF116, no cell clusters.


H&E 581176


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Circulation B24 - B80

Male 28 years

L4 spinal lesion, looks like ABC. Had surgery in India at same site 3 years previously, reported as possible hamartoma. L4 Bone core biopsy.



Macroscopic description:
2 bony cores 31 and 44 mm in length, together with haemorrhagic fragments 25 mm in aggregate.

IHC staining details: None.


H&E 581177


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Circulation B24 - ST71

Male 67 years

11 cm soft tissue mass in left supraspinatus muscle.



Macroscopic description:
Core biopsy.

IHC details: Diffusely positive for p63. Negative for AE 1/3, EMA,, SOX10, SMA, desmin, and GFAP. NGS analysis detected EWSR1::NR4A3 fusion.


H&E 581189


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Circulation B24 - ST72

Female 74 years

Nasolabial fold/cheek lesion ? Sarcoma. Incisional Biopsy.



Macroscopic description:
Ulcerated skin, 13x7mm.

IHC details: Positive for CD31 ,and ERG. Negative for CD34, AE1/3,synaptophysin, S-100, and HHV8.


H&E 581193


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Circulation B24 - ST73

Male 27 years

Long-standing lump right anterior shoulder, now rapidly progressive. Biopsy, followed by wide local excision.



Macroscopic description:
Skin ellipse with underlying mass, 51 x 30 x 25 mm.

IHC details: Positive for CD99 and EMA, with focal faint staining for AE 1/3. Negative for S-100, SMA, desmin, CD34 and CD31.


H&E 581180


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Circulation B24 - ST74

Male 57 years

Intra abdominal tumour ,? Sarcoma. Excision.



Macroscopic description:
Lobulated fatty mass weighing 14.7 kg and measuring 3 60 x 3 30/1/50 mm, encasing kidney. Cut sections show areas of myxoid change.

IHC details: FISH studies showed MDM2 amplification.


H&E 581181


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Circulation B24 - ST75

Female 61 years

Large rounded lung mass, looks benign on CT. Right Middle and lower lobe resection.



Macroscopic description:
Bi-lobectomy specimen with a 110 mm tumour which appears to originate from the non-lobe. Tumour has a homogenous, beige cut surface with necrosis covering approximately 5% of the surface. Tumour abuts the middle lobe, without invading into it.

IHC details: Diffusely positive for STAT 6 and patchily positive for CD 56. Negative for AE 1/3, SMA, TTF-1, desmin, and S100.


H&E 581182


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Circulation B24 - ST76

Male 46 years

Anterior chest wall lesion, increasing in size. Excision.



Macroscopic description:
Ellipse of skin bearing, a dermal and subcutaneous fleshy lesion measuring 63 x 42 x 45 mm. No necrosis, haemorrhage or ulceration is seen.

IHC details: Positive for CD34. Negative for STAT6.


H&E 581183


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Circulation B24 - ST77

Female 85 years

PMB. Polypoid endometrial lesion suspicious for malignancy. TAH and BSO.



Macroscopic description:
Polypoid uterine tumour 85 x 50 x 60 mm with foci of cystic change and necrosis.

IHC details: Positive for WT1, ER, PR, with associated focal staining for CD10, cyclin D1 and AE 1/3. Negative for desmin, SMA, inhibin, HMB-45, and CD 117. JAZF1::PHF1 fusion detected.


H&E 581202


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Circulation B24 - ST78

Female 28 years

Lt upper arm lesion, excision.



Macroscopic description:
Nodular lesion , 54mm in maximum dimension.

IHC details: Non provided.


H&E 581185


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Circulation B24 - ST79

Male 54 years

Obstructive sleep apnoea, using CPAP. Nasal Polypoid lesion.



Macroscopic description:
Multiple fragments of tan tissue 10mm in aggregate.

IHC details: Positive for SMA, cyclin D1, CD34 (patchy), and LEF1. B-catenin provided.


Circulation B24 - ST80

Male 73 years

Neck lump.



Macroscopic description:
Encapsulated mass measuring 20x16x11mm.

IHC details: Positive for CD34; negative for STAT6 & EMA.


H&E 581188


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