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EQA

GI EQA circulation W 2013







W 01

Male 67 years

Small intestine. Large small bowel mesenteric mass, previous colonic adenocarcinoma.

Macroscopic description:
Small bowel mesenteric mass 85x70x63mm smooth surface and bosselated. Cut surface pale with myxoid and fibrous areas. No direct connection to the small bowel wall.

Special stains: Immuno. vimentin +ve, SMA weak patchy +ve, B-catenin +ve (nuclear). Cytokeratins, DOG-1, CD117, h-caldesmon, S100 all negative


208489


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W 02

Female 47 years

Gall bladder. Melanoma, right knee, excised 7 years ago. Gallbladder polyp suspect for metastasis.

Macroscopic description:
The gallbladder is 11.3 cm x 3.5 cm x 3.0 cm in greatest dimensions. The cystic duct amputation margin is sutured closed; the sutured region is shaved away and the immediately adjacent gallbladder neck is sampled. The gallbladder is opened longitudinally, using scissors, from cystic duct orifice to apex, releasing several mL of green-tan, clear, glairy fluid mingled with brown-green sandlike sludge and dark red blood clot. The red-tan, velvety gallbladder mucosa bears several red, polypoid masses on slender, short stalks; of the three largest, 2.8 cm, 2.3 cm, and 1.2 cm in greatest dimensions, only the smallest.

Special stains: HMB45 expressed


208491


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W 03

Female 75 years

Gall bladder. Laparoscopic cholecystectomy.

Macroscopic description:
None.

Special stains: None


208492


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W 04

Female 63 years

Stomach. GIST in antrum.

Macroscopic description:
None.

Special stains: CD34+, CKIT-, DOG1-


208494


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W 05

Male 51 years

Stomach. Prepyloric gastric lesion diagnosed as a GIST.

Macroscopic description:
Two specimens received in one container. One specimen was a grey coloured nodule 15mm across with attached piece of stomach including a staple line. The larger specimen is the anastomosis consisting of a crescentic shaped piece of stomach wall with a staple line running along one edge. The section is of the nodule.

Special stains: CD117 and Dog-1 both negative. Desmin, SMA and S100 negative. CD34 and CD31 positive


208495


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W 06

Female 17 years

Small intestine. Right hemicolectomy for Crohn's disease.

Macroscopic description:
Thickened small and large bowel wall with extensive ulceration.

Special stains: None


208496


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W 07

Male 86 years

Large intestine. No clinical information.

Macroscopic description:
Received three pieces of tissue, the largest 2 x 2 x 2 mm. P 1B AE.

Special stains: Warthin starry special stain


208497


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W 08

Male 72 years

Small intestine. Small bowel perforation, ?cause.

Macroscopic description:
Small bowel segment with serosal exudate. There is a large ulcerated lesion, 30mm in maximum dimension with thickening of the underlying wall. No enlarged mesenteric lymph nodes are seen.

Special stains: The lesional cells are positive for CD3, CD7 and TIA-1. They are negative for CD2, CD4, CD5, CD8, CD25, CD56, CD30 and B cell markers


208498


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W 09

Male 19 years

Large intestine. Ileocaecal mass ? carcinoid appendix ? acute appendicitis.

Macroscopic description:
The specimen measures 160mm long, comprises 70mm terminal ileum plus caecum and ascending colon. The serosa is purple and puckered around the caecum and the terminal ileum. There is a bulge in between the caecum and terminal ileum measuring 30 x 30mm. On slicing, this bulge appears to correspond to the appendix. The lumen shows areas of necrosis as it approaches the colon. This appendix is encased in very hard white fibrous tissue. The mucosa of the caecum and terminal ileum is congested and shows areas of cobblestone appearance.

Special stains: Submitted section for EQA is from Ileo-caecal valve. Section of appendix showed similar fibroinflammatory reaction, but the section submitted for EQA (from ileocaecal valve) is more representative and diagnostic of the disease.. ZN and PASF were negative


208500


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W 10

Female 49 years

Large intestine. Acute ileocolic intussusception.

Macroscopic description:
A right hemicolectomy with an intussusception into the caecum/right colon. The intussusceptum comprised a superficially necrotic mass measuring 55 x 45 x 45mm. The mucosa of the intussuscipiens was oedumatous but otherwise unremarkable. The appendix was not identified.

Special stains: None


208501


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Cases W11-14 are educational / non scoring cases

W 11

Male 28 years

Large intestine. Previous pouch for UC. Pouch necrosis, chronic pelvic sepsis, pouch excised. Now excision of anal canal.

Macroscopic description:
Part of anal canal and perianal skin 49mm in length and 38 mm in length.

Special stains: None


208502


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W 12

Female 43 years

Large intestine. Pouch for UC 17 years previously. Pouchitis.

Macroscopic description:
Pouch and anus 190mm in length. Pouch shows multiple polypoid projections.

Special stains: None


208503


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W 13

Female 20 years

Small intestine. Pouch 18 months previously for UC. Now pouch-vaginal fistula. Pouch and prpouch small bowel removed.

Macroscopic description:
Part of Pouch 40 x 15 mm small bowel 90mm, with focal ulceration and thickening.

Special stains: None


208504


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208505


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W 14

Female 21 years

Large intestine. Pouch for UC. non-function and then defunctioned. Now removed.

Macroscopic description:
Pouch 230x50mm.

Special stains: ZN, DPAS negative


208506


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208509


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