Liver EQA Scheme Circulation D1 Summer 2011



Liver EQA Scheme Circulation LU - Summer 2019

Draft answer sheet:

• You can use this Word document to draft and save your responses, then copy and paste each one into the EQA lite response boxes to submit them on line.

• For the sake of the organiser, Please keep responses brief!

Where there are special stains, this is indicated in the text for the case. Please view the special stains using the digital slides, there are no small photos of additional stains in the slide boxes for this circulation.

|Case number: | |

|LU1 (ID 1653) | |

| | |

|Clinical Information: | |

|Deranged LFTs, increased serum ACE level. | |

| | |

|Specimen: | |

|Liver biopsy | |

| | |

|Age: | |

|45 | |

| | |

|Sex: | |

|Male | |

| | |

|Macroscopic description: | |

|Two cores 18mm and 16mm | |

| | |

|Immunohistochemistry: | |

|None | |

| | |

Morphological assessment:

Clinicopathological diagnosis:

|Case number: |LU2 (ID 1516) |

|Clinical Information: |Patient presented with jaundice and diagnosed with AIH. Trial of steroids 0 no improvement. This is|

| |a follow up biopsy. |

|Specimen: |transjugular liver biopsy |

|Age: |66 |

|Sex: |Female |

|Macroscopic description: |4 cores, 19,8,7 and 3mm |

|Immunohistochemistry: |EPSR |

Morphological assessment:

Clinicopathological diagnosis:

|Case number: | |

|LU3 (ID 1444) | |

| | |

|Clinical Information: | |

|liver transplant for autoimmune hepatitis | |

| | |

|Specimen: | |

|liver explant | |

| | |

|Age: | |

|59 | |

| | |

|Sex: | |

|Male | |

| | |

|Macroscopic description: | |

|explant liver 1316g, cirrhotic appearance, no focal lesions seen. | |

| | |

|Immunohistochemistry: | |

|retic, vg, shikata | |

| | |

Morphological assessment:

Clinicopathological diagnosis:

|Case number: | |

|LU4 (ID 1697) | |

| | |

|Clinical Information: | |

|New acute hepatitis ? cause. Persistently elevated ALT 330 and bilirubin 150 with pruritis/jaundice/headache for several weeks. ? viral ? | |

|autoimmune. USS no duct dilatation. | |

| | |

|Specimen: | |

|liver biopsy | |

| | |

|Age: | |

|22 | |

| | |

|Sex: | |

|Male | |

| | |

|Macroscopic description: | |

|One core 27mm long | |

| | |

|Immunohistochemistry: | |

|Shikata, CK7, retic, EVG | |

| | |

Morphological assessment:

Clinicopathological diagnosis:

|Case number: |LS5 |

|Case number: | |

|LU5 (ID 1674) | |

| | |

|Clinical Information: | |

|NAFLD. Fibroscan 12. Moderate fibrosis? on Humira for rheumatoid arthritis. | |

| | |

|Specimen: | |

|Liver biopsy | |

| | |

|Age: | |

|55 | |

| | |

|Sex: | |

|Male | |

| | |

|Macroscopic description: | |

|tan core 31mm | |

| | |

|Immunohistochemistry: | |

|HVG | |

| | |

Morphological assessment:

Clinicopathological diagnosis:

.

|Case number: | |

|LU6 (ID 1626) | |

| | |

|Clinical Information: | |

|Liver cirrhosis, mass lesion in segment VIII/IVa, ?HCC | |

| | |

|Specimen: | |

|Sement VIII/IVa segmentectomy | |

| | |

|Age: | |

|80 | |

| | |

|Sex: | |

|Female | |

| | |

|Macroscopic description: | |

|Segment of liver 70 x 68 x 35 mm containing a mass lesion 22 x 22 x 18mm | |

| | |

|Immunohistochemistry: | |

|none | |

| | |

Morphological assessment:

Clinicopathological diagnosis:

| |Case number: |

| |LU7 (ID 1824) |

| | |

| |Clinical Information: |

| |Portal hypertension. being assessed for TIPPS; ? cirrhosis |

| | |

| |Specimen: |

| |liver biopsy |

| | |

| |Age: |

| |24 |

| | |

| |Sex: |

| |Male |

| | |

| |Macroscopic description: |

| |tan core 12mm |

| | |

| |Immunohistochemistry: |

| |add stains ? which - being scanned |

| | |

Morphological assessment:

Clinicopathological diagnosis:

|Case number: | |

|LU8 (ID 1825) | |

| | |

|Clinical Information: | |

|Cirrhosis. Left lateral lesion, ?HCC. Ferritin 1708. AFP 5, CEA 2, CA19-9 42. MRI liver: Established cirrhosis with associated portal | |

|hypertension. Diffuse relative high signal on in-phase sequences suggests an underlying depositional process. Segment II lesion demonstrates | |

|radiological features which are considered suspicious for HCC. Multiple further small hypervascular lesions as described - may represent | |

|regenerative/dysplastic nodules but remain indeterminate. | |

| | |

|Specimen: | |

|Lesional liver biopsy, left lobe, presumed taken at ablation clinic | |

| | |

|Age: | |

|73 | |

| | |

|Sex: | |

|Male | |

| | |

|Macroscopic description: | |

|Two cores of cream tissue measuring 10mm and 11mm in length. Embedded in 1A. | |

| | |

|Immunohistochemistry: | |

|reticulin, Perls, van Gieson, Hepato, Arginase, glutamine synthetase, | |

| | |

Morphological assessment:

Clinicopathological diagnosis:

|Case number: | |

|LU9 (ID 1672) | |

| | |

|Clinical Information: | |

|History of COCP | |

| | |

|Specimen: | |

|Left lateral liver resection | |

| | |

|Age: | |

|30 | |

| | |

|Sex: | |

|Female | |

| | |

|Macroscopic description: | |

|Incidental 13 mm well-circumscribed haemorrhagic lesion in resection for larger lesion | |

| | |

|Immunohistochemistry: | |

|Nil | |

| | |

Morphological assessment:

Clinicopathological diagnosis:

|Case number: | |

|LU10 (ID 1671) | |

| | |

|Clinical Information: | |

|A1AT ?extent of fibrosis | |

| | |

|Specimen: | |

|Liver biopsy | |

| | |

|Age: | |

|74 | |

| | |

|Sex: | |

|Male | |

| | |

|Macroscopic description: | |

|single tan core 28mm bisected | |

| | |

|Immunohistochemistry: | |

|PASD, HVG | |

| | |

Morphological assessment:

Clinicopathological diagnosis:

|Case number: | |

|LU11 (ID 1696) | |

| | |

|Clinical Information: | |

|Abnormal LFTs. ANCA positive. Imaging normal. ? inflammation ? cirrhosis. Additional information - presented 3 weeks ago with 2 day history | |

|of nausea and vomiting; found to have derancged liver function tests. Had taken 2 courses of flucloxacillin from GP. Usual medications: | |

|levothyroxine, simvastatin, atenolol, ranitidine. Bili 100, ALT 8787, Alk phos 193. | |

| | |

|Specimen: | |

|liver core biopsy | |

| | |

|Age: | |

|66 | |

| | |

|Sex: | |

|Male | |

| | |

|Macroscopic description: | |

|2 cores 10mm and 8mm | |

| | |

|Immunohistochemistry: | |

|retic, van Gieson, PASD | |

| | |

Morphological assessment:

Clinicopathological diagnosis:

|Case number: | |

|LU12 (ID 1584) | |

| | |

|Clinical Information: | |

|Two lesions LLS, left lateral segmentectomy laparoscopically. Larger ?FNH ?adenoma. Smaller ?haemangioma. | |

| | |

|Specimen: | |

|Left lateral laparoscopic segmentectomy | |

| | |

|Age: | |

|45 | |

| | |

|Sex: | |

|Female | |

| | |

|Macroscopic description: | |

|Specimen weight: 187g. Specimen dimensions: Supero-inferior 129mm, Medio-lateral 80mm, Antero-posterior 43mm Capsule intact and shows an area of bulging on | |

|the posterolateral aspect inferiorly which measures 44 x 38 x 25mm. This is intact with a cream, tan, congested appearance. On the anterior aspect 20mm | |

|superior to this area is a second area of bulging 13 x 11mm. Larger lesion segment II, smaller lesion segment II/III. | |

| | |

|Immunohistochemistry: | |

|Glutamine synthetase, Keratin 7, van Gieson | |

| | |

Morphological assessment:

Clinicopathological diagnosis:

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download