Male 84 years

Incisional biopsy of large ulcerated exophytic lesion left posterior ear ?SCC.

Specimen: Incisional biopsy of large ulcerated exophytic lesion left posterior ear ?SCC.

Macroscopic description:
Two cream incisional biopsies. The larger 12 x 5 x 4mm, the smaller 8 x 3 x 5mm. The larger inked blue and bisected longitudinally.

Immunohistochemistry:
Immunostaining shows tumour cell expression of MNF, CK20 (perinuclear dot positivity), CD56, synaptophysin, chromogranin A with negative staining for CK5/6, p63, CK7, CD45, CD68P, melan-A, S100.

Female 40 years

Excision ellipse Glabella. old BCC scar. ? naevus. 1mm Margin.

Specimen: Excisional biopsy of skin, from Glabella.

Macroscopic description:
Unorientated ellipse of skin measuring 16mm x 7, depth 2mm. The skin surface bears a variably pigmented papule measuring 3 x 2 x 1mm. A scar cannot be seen on the skin surface macroscopically. Resection margins inked black.

Immunohistochemistry:
The acellular basophilic material stained strongly positive for Alcian Blue PAS.

Male 4 years

1x lesion right inferior knee.

Specimen: Skin ellipse (ALK-1 sent).

Macroscopic description:
An unorientated ellipse of skin measuring 16x10mm to a depth of up to 3mm. There is a raised lesion present measuring 10x11mm to a height of up to 4mm. The lesion is present at one of the peripheral margins and is located 5mm to the closer pole. The deep margin of the specimen is inked black. The specimen is serially sliced.

Immunohistochemistry:
Alk-1 provided. Sox-10 and cyclin D1 are diffusely positive. p16 is retained in the vast majority of cells. The proliferation index (ki67) is difficult to interpret due to staining of numerous background inflammatory cells but appears appropriately low in the lesional cells.

Male 71 years

?BCC.

Specimen: Skin punch biopsy.

Macroscopic description:
5mm punch bx.

Immunohistochemistry:
None.

Female 50 years

Well defined depressed area buttock ?Dermal atrophy ?Lipoatrophy ?Cutaneous Lymphoma.

Specimen: Incisional skin biopsy left buttock.

Macroscopic description:
Incisional biopsy of skin 20x10mm.

Immunohistochemistry:
None.

Male 63 years

Excision of lesion right ring finger ? gout.

Specimen: Skin, right ring finger.

Macroscopic description:
A nodular firm piece of grey and pale yellow tissue measuring 22 x 16 x 8mm, overall. The tissue has calcified and has been decalcified after slicing.

Immunohistochemistry:
None.

Female 57 years

?Melanoma ?Tuberculosis.

Specimen: Right pinna lesion, shave excision.

Macroscopic description:
Skin shave 14x8x6mm, covered in a tan lesion. Sectioned and sampled.

Immunohistochemistry:
PAS, Giemsa, ZN, Warthin Starry and HHV-8 all negative. CD34 and CD31 both highlight endothelial cells within the lesion.

Female 27 years

Lesion right upper back ? Dysplastic naevus.

Specimen: Skin excision specimen.

Macroscopic description:
Skin ellipse measuring 15x10mm, bearing well-defined hyperpigmented lesion with irregular edges measuring 10x7mm.

Immunohistochemistry:
Melan A and PRAME provided.

Female 40 years

Lesions on trunk and limbs. Diabetic ? nodular prurigo ? perforating collagenosis.

Specimen: 6mm punch biopsy skin right leg.

Macroscopic description:
6mm punch biopsy.

Immunohistochemistry:
Nil.

Female 61 years

Skin excision upper back ? Dysplastic naevus.

Specimen: Skin excision specimen.

Macroscopic description:
Skin ellipse measuring 20x11x7mm, with a dark brown macule with slightly irregular borders measuring 6x6mm.

Immunohistochemistry:
PRAME provided.

Male 14 years

Well defined erythematous patches right leg with blistering. Recurrent episodes which heal over few days. Viral and bacterial swabs negative. Given a course of acyclovir, with no response.

Specimen: Incisional bx leg.

Macroscopic description:
-.

Immunohistochemistry:
HSV stain negative. Direct Immunofluorescence: negative.

Male 25 years

Numerous tense blisters on legs, odd shapes. Otherwise fit and well.

Specimen: Punch biopsy leg.

Macroscopic description:
-.

Immunohistochemistry:
Direct and Indirect Immunofluorescence: negative.