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EQA

GI EQA circulation M 2007







M 01

Female 76 years

Known Barrett's - tumour at 25-28cm

Macroscopic description:
mucosal biopsies.


H&E
53674


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M 02

Female 57 years

Loose motions up to seven times per day. Sigmoidoscopy showed diverticulosis - the rest of the examination was normal.

Macroscopic description:
bx 2mm


H&E
53673


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M 03

Male 4 years

Large colonic polyp approximately 2-3cm diameter. Via colonsocopy - stalk removed at second attempt

Macroscopic description:
polypectomy polyp 2.5 x 2 x 1.2cm.


H&E
53667


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M 04

Female 49 years

?Lymphoma.

Macroscopic description:
small intestine resection - ulcerated annular tumour 3.5cm diameter.

Specials:
CD45+ CD20- CD79a- CD3- CD5- CD15- CD30- CD117+ Tdt- myeloperoxidase+


H&E
53644


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M 05

Female 80 years

Rectal polyp - TEM Previous biopsies reported as TVA. Any invasion?

Macroscopic description:
Ragged resection of raised villous polyp, 110 x 105mm pinned on cork board, up to 25mm thick. 20 blocks examined


H&E
53658


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M 06

Female 79 years

Abnormal liver function tests. Ultrasound and CT scan showed a porcelain gall bladder and likely tumour.

Macroscopic description:
Segments IV and V of liver and gall bladder. The gall bladder is attached to the segments of liver and measures 12x3.5cm. It is thick walled, contains pus and a 4x2.4cm calculus. On section the appearances are more suggestive of an abscess


H&E
53664


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M 07

Male 49 years

Recurrent nausea and vomiting. Weight loss. CT and barium FT showed multiple jejunal strictures ?Crohn's ?lymphoma.

Macroscopic description:
A segment of small bowel measuring 17 cm in length. There are 3 strictures present. The mucosal lining shows extensive irregular surface ulceration. The wall is thickened.


H&E
53677


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M 08

Female 37 years

?Cyst between stomach and spleen

Macroscopic description:
Partial gastrectomy / mass /splenectomy, block from one of hundreds of gastric polyps.


H&E
53672


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M 09

Male 38 years

Sigmoid polyp

Macroscopic description:
single pedunculated polyp measuring 0.8 x 0.5 x 0.5cm with stalk 0.2cm in length. Bisected.


H&E
53670


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M 10

Male 45 years

Oesophageal neuroendocrine tumour: endoscopically resected.

Macroscopic description:
irregular roughly bean- shaped piece of mucosa measuring 1.6 x 0.7 x 0.3cm with pale tan surface.

Specials:
s100 strongly positive, calretinin focally positive, sma, desmin melan A CD117 and CD34 negative


H&E
53669


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M 11

Female 75 years

Laparotomy - acute appendicitis with pelvic abscess.

Macroscopic description:
appendix 60 x 10mm with attached fat. it appears inflamed with a serosal purulent exudate.

Specials:
tumour cells positive with ck7 ca19.9 weak positive staining for CEA negative staining for CK20 CA25 TTF1 and WT1


H&E
53761


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M 12

Male 60 years

Abdominal pain ?5 days - acute appendicitis

Macroscopic description:
appendix received in two parts - overall measurement 110mm long and up to 20mm in diameter. There is a fibrinopurulent exudate at the tip. The mesoappendix is adherent and appears congested. On slicing the tip appears fibrosed with diverticula present 30mm from the tip.

Specials:
tumour cells positive with AE1/3, EMA, CK20, CEA and CK19. Patchy reactivity with CD56 and chromogranin. Negative immunostaining for S100 ck7 and ttf1. No grimelius positiivity seen


H&E
53772


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M 13

Female 38 years

Gall bladder polyps diagnosed on ultrasound - underwent cholecystectomy.

Macroscopic description:
Gall bladder 60mm x 20mm with multiple small mucosal polyps 0.2- 0.3mm in diameter.

Specials:
all epithelial elements (including spindle cells) AE1/AE3 positive. Very occasional cells positve for synaptophysin and chromogranin. Even fewer positive for S100.


H&E
53776


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