Transcript NSD EQA

Circulation F
Case 85
 Female
aged 34, previous gyn surgery.
Painful lump in middle of scar.
 ?fat necrosis.
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Diagnostic category:
1 Endometriosis
Popularity:
10.00
Score:
1.0
Case 86
 Male
aged 81.
 Cystic lump on the chin enlarging over a
few weeks.
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Most popular diagnosis:
1 Metastatic adenocarcinoma (+/- GI)
7.34
Case 87
 Female
aged 57.
 Breast carcinoma in 2006 treated by
excision and radiotherapy.
 Multiple papules and nodules on left
breast
 ?skin meastases ?angiosarcoma
?radiation injury ?irritaed seborrhoeic
keratoses
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Case submitted as Atypical Vascular Proliferation after
Radiotherapy
Case 88
 Female
aged 50 years.
 Scarring alopecia
 ?DLE ?LP.
 No DIF done - no tissue sent for DIF
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Most popular diagnosis:
(+/- discoid) Lupus erythematosus
9.23
1
Case 89
 Male
aged 64.
 Papular eruption elbow.
 Pruritus scalp and upper body.
 Immunofluorescence:Granular IgA in
papillary dermis. No significant
fluorescence for IgG, IgM, C3 or fibrinogen
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Diagnostic categories:
Dermatitis herpetiformis
Popularity:
10.00
Score:
1
Case 90
 Male
aged 32.
 Gets rash on fingers when hands wet
(periodically works at sea). Comes and
clears over 2 weeks - sore not itchy.
 Clinically erythema multiforme or
chilblains.
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Most popular diagnosis:
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Classic perniosis / Chilblains
9.46
Case 91
 Male
aged 17.
 Lesion on right little finger.
 Had from birth - catches.
 Most popular diagnosis:
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Supernumerary digit
8.59
Case 92
 Female
aged 62.
 Pigmented lesion left forearm, ?lentigo
maligna.
 Macro:
Ellipse of skin, 24x15x13mm with a
pigmented macule, 11mm diameter. It has
an irregular margin and uniform
pigmentation.
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Most popular diagnosis:
Lentigo maligna melanoma
6.75
Case 93
 Female
aged 83.
 Ulcerated lesion on scalp ?SCC ?BCC
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Most popular diagnosis:
Metastatic adenocarcinoma
5.56
Case 94
 Female
aged 30.
 Localised infiltrative plaque anterior
abdomen.
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Most popular diagnosis:
Morphoea
9.30
Case 95
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Male aged 34.
4cm firm subcutaneous plaque left buttock.
Multiple other papules on trunk and limbs.
?subcutaneous sarcoidosis.
Immunohistology: cells are Positive - CD4, CD11c, CD15, CD33, CD43,
CD45, CD68, HLA-DR
Negative- CD2, CD3, CD5, CD7, CD8, CD10,
CD20, CD23, CD34, CD56, CD123, CD128,
TdT, MPO, MNF
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Case submitted as :
Acute myeloid leukaemia of myelomonocytic lineage
Case 96
 Female
aged 3.
 Subungal lesion, little toe right foot.
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Case submitted as :
 Tungiasis
Case 97
 Male
aged 32.
 One year history of swelling behind the
nail plate of the right thumb.
 Immunohistochemistry:
 Vimentin and CD34 - positive,
 S100, Desmin and Actin - Negative.
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Case submitted as:
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Superficial acral fibromyxoma
Case 98
 Female
aged 50.
 Groups of papules and nodules,
purple/red. Previously normal skin.
 Initial differential diagnosis sarcoid versus
nodular prurigo versus lymphoma cutis.
 Biopsied (first biopsy not submitted).
 Three month follow up, nodules resolve
and scar with newer groups appearing, rebiopsied. No systemic disease.
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Immunohistochemistry:
tumour cells CD2, CD4 positive, CD30 diffuse
and strong positivity.
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CD3, CD5, CD8, CD20, CD45RA, ALK-1, EMA,
CD56, TIA-1, Granzyme all negative.
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MUM1 positive in most tumour cells.
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MIB1 staining shows high proliferation fraction.
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Case submitted as :
CD30+ lymphoproliferative disorder and came with a
history strongly suggesting LyP
Case 99
 Male
aged 27.
 Very itchy blisters on shins and dystrophic
nails ?Epidermolysis bullosa
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Case submitted as :
Dystrophic epidermolysis bullosa pruriginosa.
 The
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