Liver EQA Scheme Circulation LN – Spring 2016

Draft answer sheet:

·  You can use this Word document to draft and save your responses, then copy and paste each one into the EQA lite response boxes to submit them on line.

·  For the sake of the organiser, Please keep responses brief!

Where there are special stains, this is indicated in the text for the case.

Small photos are included in the slide boxes, but for connective tissue stains for stage, the virtual images on the website are recommended.

Case LN1 Age 45, Female

Alk p'ase elevated 3 x normal; ALT mildly elevated; positive AMA; IgM elevated. IgG normal

Morphological assessment:

Clinicopathological diagnosis:

Case LN2 Age 35, Male

large mass on liver ultrasound. Clinically ?? HCC fibrolamellar, patient clinically well

Morphological assessment:

Clinicopathological diagnosis:

Case LN3 Age 60, Male

Fatty liver on ultrasound scan. Raised ALT, raised BMI (32), Type 2 diabetes. NAFLD, fibrosis score 1.81. Fibroscan 35.3kPa.

Also Sirius red, retic

Morphological assessment:

Clinicopathological diagnosis:

Case LN4 Age 31, Female

Hepatitis C Virus

Also - masson trichrome, reticulin

Morphological assessment:

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Case LN5 Age 34, Male

Hydatid Cyst from liver Dark Mass measuring 5.8 x 4.8 x 3.2cm. the cyst is intact and contains soft yellow tissue wihin a thin wall of firm white tissue. there is a tiny amount of attached liver tissue

Morphological assessment:

Clinicopathological diagnosis:

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Case LN6 Age 34, Male

Hydatid cyst 4B (NB this is an incidental lesion discovered during resection of the cyst)

A wedge of liver tissue measuring 1.7 x 1.3 x 0.8cm, bearing capsule on two aspects. contains nodule 1.1cm maximum

Morphological assessment:

Clinicopathological diagnosis:

Case LN7 Age 63, Male

right liver abscess drained. residual solid tissue in wall ?? abscess wall. Rule out tumour. No previous histroy of malignancy

Morphological assessment:

Clinicopathological diagnosis:

Case LN8 Age 31, Female

Background childhood AML. Initially presented under cardiology with heart failure and ascites. Found to have multiple liver masses. Biosy to confirm diagnosis.

Also: Reticulin, van Gieson, PAS

Morphological assessment:

Clinicopathological diagnosis:

Case LN9 Age 57, Male

Elective laparoscopic cholecystectomy, sub-capsular liver lesion noted

Morphological assessment:

Clinicopathological diagnosis:

Case LN10 Age 32, Male

Renal transplant 6 months ago. Presented with ascites ?cirrhosis. ?Amyloid please do staining for amyloidosis.

Also: Retic, Perls Congo red, Picro Sirius red

Morphological assessment:

Clinicopathological diagnosis:

Case LN11 Age 27, Female

portion of liver measuring 60x50x25mm from yellow circumscribed tumour 30mm across

Morphological assessment:

Clinicopathological diagnosis:

1

Case LN12 Age 73, Male

Colorectal liver mets. Laparoscopic left liver lobectomy.

Liver resection measuring 170 x 90 x 50 mm. Single 15mm circumscribed yellow lesion 20 mm from surgical margin.

Morphological assessment:

Clinicopathological diagnosis:

1