Transcript National Specialist Dermatopathology EQA Circulation C

National Specialist
Dermatopathology EQA
Circulation C
Case 37
 Clinical:
Female, 49 years old.
Sebaceous cyst left scapular region
 Most
popular diagnosis…..
 Plexiform
schwannoma
48%
Case 38
 Clinical:
Female, 76 years old. Rapidly
growing skin lesion on back.
 CD20,
 CD3,
CD5 and CD23 positive.
CD10 and Cyclin D-1 negative
 Most
popular diagnosis….
B
cell CLL / SLL
86%
Case 39
 Male,
63 years old.
 Three
month history of erosions
 Most
popular diagnosis….
 Pemphigus
vulgaris
88%
Case 40
 Female,
77 years old. One year history of
chronic skin ulcer. History of bleeding.
Locally excised.
 ?BCC.
?Lentigo maligna
 Most
popular diagnosis….
 LMM
and BCC
50%
Case 41
 Female,
72 years old.
 Erythematous
papules right ankle x 6/12
?dermatofibroma ?Bowen's
 Most
popular diagnosis….

Molluscum contagiosum
100%
Case 42
 Male,
32 years old.
 Boggy
area on occipital scalp
 Dissecting
cellulitis of the scalp
32%
Case 43

Clinical: Female, 86 years. Violaceous eruption on
abdomen. Patient has myelodysplasia.

Special Stains: diffusely immunoreactive with CD43 and
focally immunoreactive to CD68 and CD117;

negative with antibodies to CD3, CD4, CD8, CD20,
CD1a and CD30.

The cells show positivity on histochemistry with
chloracetate esterase.
 Most
popular diagnosis….
 Cutaneous
myeloid leukaemia
58%
Case 44
 Male,
63 years. Rapidly growing lesion on
right shoulder. ?Pyogenic granuloma.
?SCC
 IHC
shows focal staining for S100, Melan
A and HMB45
 Most
popular diagnosis….

MM (+/- sarcomatous/rhabdoid diff.) 99%
Case 45
 Female,
 Further
40 years.
excision of infected hidradenoma
in groin.
 Most
popular diagnosis….
 Hidradenoma
50%
 Atypical
15%
hidradenoma
 Hidradenocarcinoma
10%
Case 46

Female, 84 years. Large tumour SCC,
amelanoctic melanoma or soft tissue sarcoma.

CD20, CD79a and BCl2 - diffusely positive,

BCl6, CD10 and mum-1 patchily positive.

Ki67 positivity in >80% of the cells.
 Most
popular diagnosis….
 DLBCL
63%
Case 47
 Male,
52 years.
 Tumour
right index finger adherent to skin
and fascia.
 Cytokeratin
7 positive, CK20 negative,
CEA negative, S100 focally positive
 Most
popular diagnosis….
 Digital
papillary adenocarcinoma 81%
Case 48
 Male,
62 years.
 Raised
pigmented mole on right flank
catching on belt.
 Submitted
diagnosis….
 Epithelioid
angiomatous nodule
Case 49

Female, 69 years. Raised nodule posterior
scalp. Benign. ?Basal cell papilloma.

CEA, EMA positive in ductal structures.

GCDFP15 negative.

Basement membrane material laminin and
COL4 positive.
 Most
popular diagnosis….
 Adenoid
cystic carcinoma
24%
Case 50
 Male,
36 years. Lump on back for 7
months. ?Lipoma. ??Cyst.
The tumour cells show very strong and
diffuse CD34 expression.
They are negative for S100, HMB45, SMA
and Desmin.
 Most
popular diagnosis….

Dermatofibrosarcoma protruberans
62%
Case 51
 Female,
35 years.
 Pigmented
lesion right knee.
 Most
popular diagnosis….

Spitz naevus
40%
The End