2004 Summer Meeting - Amsterdam - The Pathological Society of ...

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85 Is There Agreement Between IMF-Diagnosed And Histologically-Diagnosed Immunobullous Skin Diseases At The University Hospitals Of Leicester NHS Trust? MA Ben-Gashir , G Saladanha , A Fletcher 1 University Hospitals of Liecester NHS Trust, Leicester, United Kingdom, 2 Department of Cancer Studies and Molecular Medicine - University of Leicester, Leicester, United Kingdom Direct Immunofluorescence (DIMF) has a crucial role in diagnosing skin immunobullous diseases. At the University Hospitals Leicester (UHL) a skin biopsy is divided - one half is sent to histopathology for microscopic diagnosis and the other half sent to immunopathology for DIMF studies. An audit was carried, and the aim was to compare the reporting of histology and DIMF by different laboratories. Using SNOMED we identified all cases coded as bullous pemphigoid, bulla, dermatitis herpetiformis, epidermolysis, erythema multiforme, pemphigus vulgaris, pemphigus foliaceus, and lupus erythematosus – between January 1998 and October 2003. We were able to find complete data for 182 subjects. Complete histology and DIMF agreement was found in over 70% of cases. Discrepancies in the remaining cases were related to technical and interpretative issues. Full discussion and its implication for the service will be presented at the meeting. 86 Morphoeiform Sarcoidosis- An Enigmatic Dermatological Entity R Swamy , K M MacLaren , H Horn Departments of Pathology & Dermatology, Royal Infirmary, Edinburgh, United Kingdom We describe an unusual case of cutaneous sarcoidosis which clinically presented as localised scleroderma (morphoea). The patient was an elderly lady in the sixth decade who presented to the Dermatology department with cutaneous plaques over both forearms of three months duration. The plaques were indurated with a violaecous border and were compatible with a clinical diagnosis of morphoea. Incisional biopsies revealed a non-caseating granulomatous reaction predominantly in the deep dermis and sub-cutis. Histologically, the granulomas were characteristic of sarcoidosis and showed intracellular asteroid bodies. There were no demonstrable acid-fast bacilli. The patient had no other clinical manifestations of sarcoidosis and the biopsy findings were regarded as being inconsistent with the clinical appearances. Because of the strong clinical impression of morphoea, repeat biopsies were performed three months later which again showed sarcoidosis. Following a medical literature search, the entity of morphoeiform sarcoidosis was discovered which was best suited to describe this unusual presentation of cutaneous sarcoidosis. This case demonstrates that a discrepancy between the clinical presentation and histological features in skin disease has significant implications on patient management and requires close clinico-pathological correlation. 87 The Impact Of National Minimum Datasets On The Reporting Of BCC And SCC In A University Hospital RF Flora , AF Fletcher , GS Saldhana University Hospitals Of Leicester NHS Trust, Leicester, United Kingdom Objective : To evaluate the compliance of histological reporting of BCC and SCC with the national minimum datasets before and after their introduction in 2002. The emphasis of the audit was on the description of skin tumours rather than the administrative features of the report. Methods : 50 consecutive reports for SCC from 1998 and 2003 were analysed against the minimum datasets and the compliance for each pathological parameter, from either year was compared. This process was also repeated for 100 consecutive reports for BCC from 1998 and 2003. Results : Following the introduction of the national minimum datasets there has been an improvement in recording of most of the parameters specified by the datasets for both SCC and BCC e.g. excision margins with measurements of clearance. However there remains a deficiency in the recording of other parameters, but there are cogent reasons for this e.g. Clarks level is very rarely stated in SCC reports, however it is implied by the pathologist stating the level within the dermis to which the tumour has penetrated. Overall, the introduction of minimum datasets has led to an improvement in the reporting of key clinico-pathological parameters for both BCC and SCC. 88 Clear Cell Sarcoma – A Case Report D Faratian 1 , K M McLaren 2 1 Royal Infirmary of Edinburgh, Edinburgh, United Kingdom, 2 University of Edinburgh Division of Pathology, Edinburgh, United Kingdom Clear cell sarcoma (CCS, melanoma of the soft parts) is a rare and unusual malignancy that usually affects adolescents and young adults. It shares clinical and histological features of both melanoma and soft tissue sarcoma, and as such provides challenges in diagnosis and treatment to both the clinician and pathologist. In order to demonstrate the pitfalls that may be encountered, we present a case of CCS that had metastasised to a regional lymph node seventeen years after excision of the primary lesion. We discuss the clinicopathological features, including diagnostic immunohistochemistry and electron microscopy, of the primary tumour, the metastasis and the fine needle aspirate. Since the tumour is also characterised by a distinct chromosomal fusion product, the EWS/ATF1 oncogene, we discuss our experiences with diagnostic cytogenetics on paraffin-embedded tissue and the applicability of cytogenetics and molecular profiling to routine clinical practice. 48
89 The Prognostic Significance Of The Pattern Of Invasive Front In Malignant Melanomas I Roxanis , J Chow St George's Hospital Medical School, London, United Kingdom Malignant melanomas have a high metastatic potential. Although Breslow thickness is the single most important prognostic factor, it is common in clinical practice to encounter cases that challenge this correlation. In order to identify additional histological parameters with prognostic significance we studied the pattern of invasive front in all primary cutaneous melanomas in vertical growth phase with tumour thickness >0.76mm diagnosed in our Department between 1990-1995. Follow-up was up to 12 years. We employed an invasive front grading score (0-3) based on the histological characteristics of the tumour-host interface. Score 0 corresponded to a ‘pushing’ pattern of invasion and score 3 to a predominantly infiltrative pattern . We found a lack of correlation between pattern of invasion and Breslow thickness. However, comparison of the Kaplan-Meier survival curves showed a significant difference in the disease-free survival between cases with scores 0-2 and those with score 3 (p
Page 1 and 2: JOINT MEETING of the Pathological S
Page 3 and 4: Scientific Programme FEATURED TOPIC
Page 5 and 6: Scientific Programme GUEST LECTURES
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Page 28 and 29: 5 Melanoma suppressor responses ind
Page 30 and 31: 13 Expression Of MHC Class I And II
Page 32 and 33: 21 Immunohistochemical Subtyping Of
Page 34 and 35: 29 Regional Quality Control by path
Page 36 and 37: 37 Nuclear Morphometry, Immortaliza
Page 38 and 39: 45 Dietary Fibre Accelerates Polyp
Page 40 and 41: 53 Intestinal Tumourigenesis : Navi
Page 42 and 43: 61 Expression Of The Transcription
Page 44 and 45: 69 Id2 expression is inversely corr
Page 46 and 47: 77 A Study of Insitu Hybridisation
Page 50 and 51: 93 Recruiting Donors for Autopsy-ba
Page 52 and 53: 101 Workload Implications of Case R
Page 54 and 55: 109 Proposal for a Peer Standardise
Page 56 and 57: 117 Expression of hTERT in gastroin
Page 58 and 59: 125 Assessing Inter-observer Variat
Page 60 and 61: 133 Beta-catenin Expression In Gast
Page 62 and 63: 141 Infertile Males - Who Should Be
Page 64 and 65: 149 Papillary Mucinous Adenocarcino
Page 66 and 67: 157 Oxaliplatin Toxicity In The Liv
Page 68 and 69: 165 The Association Between Early G
Page 70 and 71: 173 Cardiac abnormalities in a paed
Page 72 and 73: 181 Intraocular Ectopic Ependymoma
Page 74 and 75: 189 The Expression of S100A6 Protei
Page 76 and 77: 197 TSLC1 Is A Tumor Suppressor And
Page 78 and 79: 205 Wnt Expression In Colonic Subep
Page 80 and 81: 213 Microarray Based Comparative Ge
Page 82: 221 IMMUNOHISTOCHEMISTRY (IHC) ON B

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