EQA014 for the May 2018 Workshops. Final analysis of responses received with diagnoses
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1 EQA014 for the May 2018 Workshops Final analysis of responses received with diagnoses
2 CASE 1: 36 yrs. F. Maxilla lesion. Odontogenic fibroma 1 Angiofibroma 1 Odontogenic myxoma 1 Arteriovenous malformation (carvernous haemangioma) 1 Granulation tissue/inadequate 1 Haemangioma 1 Neurofibroma 1 Fibromatosis 1 Solitary fibrous tumour 6 Neurofibroma (myxoid) 6 Fibroma 4 No answer 3 Odontogenic fibroma 2 Fibromyxoma 1 Angiofibroma 1 Ameloblastoma 1 Central granular cell odontogenic fibroma 1 Fibrocollagenous/scar tissue 1 DIAGNOSIS: Odontogenic fibroma 35
3 CASE 2: 51 yrs. F. Maxilla lesion. DIAGNOSIS: Plexiform ameloblastoma 35 Ameloblastoma (follicular variant) 9 Ameloblastoma (plexiform, follicular, multicystic variant) 19 Pleomorphic adenoma 5 Polymorphous low grade adenocarcinoma 1 Sebaceous adenoma 1
4 CASE 3: 36 yrs. F. Maxilla lesion. DIAGNOSIS: Plexiform ameloblastoma 35 Ameloblastoma (plexiform variant, follicular variant, peripheral) 9 Ameloblastoma (plexiform, follicular, acanthotic variant) 18 Polymorphous low grade adenocarcinoma 6 Cystadenoma 1
5 CASE 4: 23 yrs. M. Mandible lesion Adenomatoid odontogenic tumour 3 Ameloblastoma (papilliferous-keratotic, follicular variant) 2 Adenoid cystic carcinoma 1 Primary intra-osseous carcinoma/malignant ameloblastoma 1 Calcifying epithelial odontogenic tumour 1 Pleomorphic adenoma 1 Adenoid cystic carcinoma 12 Odontogenic keratocyst 2 No answer 3 Ameloblastic carcinoma 2 Squamous cell carcinoma - adenoid variant 1 Kerato-ameloblastoma 1 Basal cell adenoma 1 Dentinogenic ghost cell tumour 1 Trichoepithelioma 1 Ameloblastoma 1 Craniopharyngioma 1 DIAGNOSIS: Keratoacanthomatous ameloblastoma 35
6 CASE 5: 42 yrs. M. Mandible lesion DIAGNOSIS: Keratin, probably cyst content. Suggestive but not diagnostic 35 No answer 3 Keratinous cyst 2 Keratin debris? Keratocyst 1 Haemorrhage (with sickled red cells) 1 Mycosis 1 Inflammatory/necrosis 1 No answer/inadequate 8 Odontogenic cyst 7 Myxoma 3 keratinous cyst (of the mandible) 2 Odontogenic keratocyst 1 Scanned slide 1 Simple bone cyst 1 Fibroma 1 Plasmacytoma 1 Odontogenic fibroma 1
7 CASE 6: 25 yrs. F. Mandible lesion Ameloblastic fibroma 8 Squamous odontogenic tumour 1 Ameloblastic fibroma 10 Metastatic adenocarcinoma 6 Odontogenic fibroma 4 Desmoblastic ameloblastoma 2 Ameloblastoma (fibroblastic) 2 Craniopharyngioma 1 DIAGNOSIS: Ameloblastic fibroma 35
8 CASE 7: 67 yrs. M. Mandible lesion DIAGNOSIS: Odontogenic keratocyst 35 Odontogenic (keratinous cyst) keratocyst 4 Ossifying fibroma 2 Odontogenic cyst 1 Osteogenic fibroma (chronically inflamed) 1 Keratocystic odontogenic tumour 1 Odontogenic keratocyst 6 Radicular cyst 5 Melanoma 3 Basal cell carcinoma 2 Dentigerous cyst 2 Ossifying fibroma 2 No answer 2 Chronic sialadenitis 1 Squamous cell carcinoma 1 Odontogenic cyst 1 Lymphoepithelial cyst 1
9 CASE 8: 12 yrs. F. Mandible lesion Radicular cyst 2 Dentigerous cyst 1 Acute suppurative dermatitis 1 Ameloblastoma (cystic) 1 A reactive lesion (epulis) 1 Squamous cell carcinoma arising in odontogenic cyst 1 Pyogenic granuloma 1 Squamous cell carcinoma 7 Pyogenic granuloma/lobular capillary haemagioma 5 Dentigerous cyst 3 Squmous odontogenic epithelium 2 Lichenoid dermatitis 2 Ameloblastic carcinoma 1 Focal epithelial hyperplasia (Beck's disease) 1 Periodontal cyst 1 Ossifying fibroma 1 Chronic inflammation 1 Fibrous epulis (ulcerated) 1 DIAGNOSIS: Radicular cyst 35
10 CASE 9: 42 yr old F with anterior neck swelling, clinical diagnosis of Colloid goiter Papillary (thyroid) carcinoma 6 Papillary hyperplasia with degenerative changes 1 Adenomatoid hyperplasia (toxic goiter) 1 Basal cell adenoma (background multinodular goiter) 1 Papillary thyroid carcinoma (follicular variant) 20 Canalicular adenoma 2 Follicular adenoma 1 Papillary hyperplasia 1 Hashimoto thyroidits 1 DIAGNOSIS: Papillary thyroid carcinoma 35
11 CASE 10: 34 yr old F with anterior neck swelling Chronic granulomatous inflammation 3 Ruptured thyroglossal duct cyst 2 Necrotising sialometaplasia 1 Hashimoto thyroiditis 1 De Quervain's thryoiditis (background multinodular goiter) 1 (Subacute) granulomatous thyroiditis/de Quervain's thyroiditis 7 Carcinoid 6 Follicular carcinoma (with necrotising acute on chronic inflammation) 4 Hashimoto thyroiditis/autoimmune thyroiditis 3 No answer 2 Branchial cleft cyst 1 Subactue thyroidits 1 Chronic lymphocytic thyroiditis 1 Tuberculosis 1 DIAGNOSIS: Ruptured thyroglossal duct cyst (granulomatous thyroiditis) 35
12 CASE 11: 87 yr old M, left painless parotid mass of 8 years duration Basal cell (monomorphic) adenoma 4 Myoepithelioma 4 Basal cell (monomorphic) adenoma 14 Myoepithelioma 6 Benign lymphoepithelial lesion 1 Adenocarcinoma (low grade) 1 Pleomorphic adenoma 1 Pleomorphic malignant tumour of the salivary gland 1 Adenocystic carcinoma 1 DIAGNOSIS: Basal cell adenoma 35
13 CASE 12: 38 yr old M, right parotid mass,? Parotid adenoma DIAGNOSIS: Pleomorphic adenoma 35 Pleomorphic adenoma 7 Mucoepidermoid carcinoma 1 Pleomorphic adenoma 20 Carcinoma ex-pleomorphic adenoma 4 No answer 2
14 CASE 13: 48 yr old F, progressive right thyroid lobe swelling deviating the trachea Hurthle cell adenoma 3 Follicular adenoma 3 Medullary thyroid carcinoma 1 Oncocytoma 1 Oncocytic (Hurthle) carcinoma 1 Medullary thyroid carcinoma 10 Hurthle cell adenoma 4 Oncocytoma 3 Neuroendocrine tumour of thyroid (grade II) 2 Follicular adenoma 2 Parathyroid adenoma 1 Thyroid carcinoma 1 Follicular thyroid carcinoma 1 Poorly differentiated (insular) carcinoma 1 DIAGNOSIS: Follicular adenoma 35
15 DIAGNOSIS: Pleomorphic adenoma 35 CASE 14: 40 yr old with right parotid swelling Pleomorphic adenma 6 Adenoid cystic carcinoma 1 Cellular mixed tumour 1 Basal cell adenoma 1 Pleomorphic adenoma 9 Myoepithelioma 7 Mucoepidermoid carcinoma 4 Not found/no answer 4 Hyaline myoepithelioma 1 Cellular pleomorphic adenoma 1
16 CASE 15: 40 yr old F who had thyroidectomy Follicular adenoma 3 Papillary Thyroid Carcinoma (follicular variant) 3 Follicular hyperplasia 1 Giant cell tumour 1 Adenoid cystic carcinoma 1 Follicular adenoma 11 Colloid goiter/multinodular goiter 7 Papillary Thyroid Carcinoma (follicular variant) 5 Follicular hyperplasia 1 Follicuar carcinoma of the thyroid 1 DIAGNOSIS: (follicular variant) Papillary thyroid carcinoma 35
17 CASE 16: 52 yr old F, painful parotid swelling with mild paresis of the buccal branch of the facial nerve. Mucoepidermoid carcinoma (high grade) 3 Adenoid cystic carcinoma (solid variant) 2 Salivary duct carcinoma 1 Adenosquamous carcinoma 1 Tuberculous sialadenitis 1 Mucoepidermoid carcinoma (high grade) 9 Adenoid cystic carcinoma 7 Salivary duct carcinoma 5 Carcinosarcoma 1 Medullary carcinoma 1 Malignant 1 Pleomorphic adenoma 1 DIAGNOSIS: (High grade) Mucoepidermoid carcinoma 35
18 CASE 17: 30 year old male. Right thyroid lobe 70 mm nodule. THY3F. No answer 3 Follicular carcinoma 3 Follicular adenoma (with Hurthle cell changes) 2 Hyalinised trabecular follicular adenoma 1 Hyalinizing trabecular adenoma 10 Medullary thyroid carcinoma 3 Follicular carcinoma 3 Nodular goiter 2 No answer 2 Hurthle cell adenoma 2 Papillary carcinoma of the thyroid 1 Follicular adenoma 1 Neuroendocrine tumour 1 Malignant 1 DIAGNOSIS: Follicular carcinoma of the thyroid 35
19 CASE 18: Gingival swelling in 12 year old female. Giant cell tumour 3 Giant cell epulis 2 Peripheral giant cell tumour 1 Giant cell fibroma 1 Giant cell granuloma 1 Central giant cell (reparative) granuloma 7 Giant cell tumour of bone 5 Giant cell tumour 5 Giant cell epulis (peripheral giant cell granuloma) 4 Giant cell granuloma 2 No answer 2 Dermatofibroma 1 DIAGNOSIS: Giant cell epulis (peripheral giant cell granuloma) 35
20 CASE 19: 53 yr old F with jaw swelling. Mucoepidermoid carcinoma (low grade) 8 Mucoepidermoid carcinoma (low grade, intermediate grade) 20 No answer 2 Ameloblastic fibrosarcoma 1 Metastatic clear cell carcinoma (possibly from kidney) 1 Mucocoele 1 Sebaceous adenoma 1 DIAGNOSIS: (Low grade) Mucoepidermoid carcinoma 35
21 CASE 20: 6 yr old boy, painless right eye proptosis for 9 months right supra-orbital tumour. No associated visual loss. Cementifying fibroma 2 Meningioma (psammomatous) 2 Fibroblastic tumour 1 Cemento-osseous dysplasia (Cemento-ossifying fibroma) 1 Ossifying fibroma 1 Cementoma 1 Juvenile (psammomatous) ossifying fibroma 8 Psammomatoid ossifying fibroma 7 Fibro-osseous lesion/dysplasia 3 (Psammomatous) meningioma 3 Cemmentoossifying fibroma 2 Ossifying fibroma 1 Cementifying fibroma 1 DIAGNOSIS: Probably psammomatous meningioma - IHC required 35
22 CASE 21: Male 36yrs. Headache, neck pain, nasal obstruction, weight loss and poor appetite. MRI showed mass in the nasopharynx. Angiofibroma 4 Cavernous haemangioma 2 Reactive chronic inflammation/inflammatory polyp 2 Cavernous haemangioma 9 Angiofibroma 6 MALT lymphoma 6 No answer 2 Polymorphous low grade adenocarcinoma 1 Haemangioma 1 Inverted papilloma 1 DIAGNOSIS: Nasopharyngeal angiofibroma 35
23 CASE 22: Adult male, occipital scalp lesion. IHC: lesional cells are (22b) TTF-1 and (22c) thyroglobulin positive. Metastatic follicuar carcinoma of the thyroid 6 Metastatic papillary carcinoma 2 Metastatic (follicular, papillary) carcinoma of the thyroid 16 Ectopic/heterotopic thyroid 3 No answer 3 Spiradenoma 1 Benign follicular neoplasam 1 Follicular adenoma 1 Langerhan cell histiocytosis 1 DIAGNOSIS: Metastatic thyroid carcinoma 35
24 CASE 23: Adult female with slowly growing lesion in palate 5 mm greatest dimension? pleomorphic adenoma. IHC: (23b) p63 marks squames, no myoepithelial cells with (23c) SMMHC, (23d) Ki-67 index about 1%. Mucoepidermoid carcinoma (low grade) 5 Polymorphous low-grade adenocarcinoma 2 Well differentiated squamous cell carcinoma 1 Mucoepidermoid carcinoma (low grade, high grade) 16 No answer 3 (Basaloid) Squamous cell carcinoma 1 AIDS related lymphadenopathy 1 Granular cell tumour 1 Adenoid cystic carcinoma 1 Salivary duct tumour 1 Basal cell adenoma 1 Necrotising sialometaplasia 1 DIAGNOSIS: (Low grade) Mucoepidermoid carcinoma 35
25 CASE 24: Male 3yrs. Left orbital mass. Patient had symmetrical masses involving orbits, lacrimal glands and adherent to extraocular muscles. IHC: epithelioid histiocytes express (24b) CD68 and (24c) S-100. (24d) CD21 marks the FDC meshworks. Follicular dendritic cell tumour 2 Langerhans cell histiocytosis 2 No answer 2 Rosai-Dorfman's disease 1 Malignant fibrous histiocytoma/lymphoma NHL 1 Non-Hodgkin's lymhoma 1 Inflammatory pseudotumour (IgG4 sclerosing related disease) 9 Langerhans cell histiocytosis 5 No answer 4 Histiocytosis (X) 3 Retinoblastoma 1 Rosai-Dorfman disease (extranodal) 1 Chronic granulomatous lesion 1 Non-Hodgkin's lymhoma 1 Warthin tumour 1 DIAGNOSIS: Extra-nodal Rosai-Dorfman disease 35
26 CASE 25: Female 13 yrs. Lymph node biopsy from submandibular salivary gland. Bilateral parotid and submandibular gland swelling with associated bleeding gums. IHC: (25b) AE1/3 marks epithelial cells, germinal centres are (25c) BCL-2 negative, (25d) HIV p24 is positive. NHL Burkitt lymphoma 2 No answer 2 HIV-associated lymphadenitis 1 High grade non-hodgkin's lymphoma 1 Chronic sialadenitis 1 Reactive hyperplasia 1 Chronic lymphadenitis 1 Bcl 2 negative lymphoma 6 Non-Hodgkin's lymphoma (possibly mantle cell lymphoma, DLBCl, Burkitt)(HIV-associated) 6 No answer 5 Reactive lymphoid hyperplasia 4 Lymphoepithelial cyst 2 Sinus histiocytosis 1 Sialadenitis 1 Follicular lymphoma 1 DIAGNOSIS: HIV-associated Mikulicz disease (benign lymphoepithelial lesion) 35
27 PARTICIPANTS Sayo1999 Onye Nkuzi 2018 nas On point Emitems OII0 deqa sola ROKSMAL 11 fb SOS UBE DM JIN Asonyi Yaya2018 STATES Bayelsa North Adamawa Anambra Enugu Sophie Ife atlantica17 Jewel (GHANA) Anonymous (GHANA) Dennis PDP Maverick01 Walter007 Lexycom Eh Ngadasel Eldottore29 05IEU DeeDee84 Kasiemobi Uchime luth Akwa Ibom Oyo Abia Kaduna
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