Circulation AN Spring 2011 - Virtual Pathology



Circulation AR Autumn 2013

Histories

Category A:

AR1 49 year old female. Clinical details: “TVA 15cm rectosigmoid – anterior resection.” Gross description: upper rectum/distal sigmoid, 150mm long. Sessile polyp 37mm max diam present on anterior wall, 30mm from distal margin. Section taken from polyp and underlying bowel. Immuno: Surface epithelium: positive for CDX-2 and CK20; negative for CK7 and ER; Glands within bowel wall: epithelium positive for ER & CK7, negative for CDX-2 and CK20; surrounding stroma positive for ER and CD10.

AR2 67 year old male. Clinical details: “2 week history of keratotic nodule on lower back. ?BCC".

Gross description: skin ellipse 45 x 19 x 5mm deep bearing a central pale raised nodule 11 x 9 x 4mm high.

AR3 57 year old male. Clinical details: "Gl 4+3 CaP. PSA 9.2ng/ml." Gross description: radical prostatectomy specimen, including parts of the seminal vesicles, the prostate weighing 35g.

AR4 30 year old female. Gastric antral lesion.

AR5 48 year old female. Lung biopsy for ground glass shadows. Heavy e-cigarette user. Special stains/IHC results: S100 & CD1a positive in lesions.

AR6 68 year old female. Multiple lung nodules. Special stains/IHC results: AE1/AE3, pax-8 & CD10 positive. CK7 negative.

AR7 48 year old male. Cyst right arm.

AR8 60 year old female. Unilateral nasal swelling. Macro- grey oedematous polypoid pieces tissue measuring up to 2.5cm.

AR9 23 year old female. Incisional biopsy to rash left arm. Special stains/IHC results: disrupted fibres in mid dermis highlighted by EVG and Von Kossa.

AR10 23 year old male. Epidermal cyst in scrotum.

AR11 48 year old female. Right nipple wedge biopsy ? Paget’s disease. Known right LIQ carcinoma.

AR12 33 year old female. Previous ruptured IPP implants right axillary node.

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Category B (non-scoring):

AR13 44 year old female. 44 year old woman with a breast lump. Previous FNA: C4.

Previous core biopsy: B3/B4, ?malignant phyllodes tumour. Current specimen: wide local excision breast lump weighing 35g, containing a well-circumscribed lesion about 15mm diameter.

AR14 60 year old male. Nodule RUL of lung.

AR15 82 year old female. Small bowel resection. PUO 3/52. Free air on CT. Ten small bowel perforations. Normal arterial supply. ?vasculitic process ? lymphoma. Macro- multiple well defined perforations with associated mucosal ulceration. Bowel in between perforations appeared normal.

AR16 71 year old female. Left ovarian solid mass ? metastatic disease. Previous mastectomy one year ago. Special stains/IHC results: EMA, ER and GCDFP positive. PR negative.

Please note

Answers to this EQA scheme should be e-mailed by 8th November 2013 to the scheme secretary, Samantha Holden (Samantha.Holden@cmft.nhs.uk) using the scheme MS Excel spreadsheet designed specifically for this purpose. Please see the spreadsheet for further details. Please do not send answers to the scheme organiser.

Answers may still be accepted after the closing date but cannot be marked if received after overall response analysis has begun.

If you have not already received a copy of the answer spreadsheet by e-mail, would like to find out about joining the scheme or wish to enquire about any other matter, please contact the scheme secretary, as above.

(Organiser: Stephen M McGrath, Stephen.McGrath@cmft.nhs.uk)

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