Qap (Anatomical Pathology) 

QAP Peer Review

AP145
Case History: M/92, developed a right upper lip mass over 2 months.
Intended diagnosis: Upper lip: Merkel Cell Carcinoma. Contributed by:FML
Code Diagnosis Comment Score
anonymous Merkel cell carcinoma (95%) Metastatic small cell carcinoma (5%) Merkel cell carcinoma is positive for CK20 and negative for Thyroid Transcription Factor (TTF-1).  100
anonymous Merkel cell carcinoma (100%) Immunohistochemical study to exclude metastatic small cell carcinoma. Merkel cell carcinoma is CK20 positive. Metastatic small cell carcinomas are almost always CK20 negative.  100
anonymous Small cell carcinoma, consistent with Merkel cell carcinoma. Need to rule out metastatic small cell carcinoma. 100% nil  100
anonymous Merkel cell carcinoma Confirm by positive staining for CK20 and synaptophysin. Exclude lymphoma/leukemia by LCA negativity.  100
anonymous Merkel cell carcinoma. 100% nil  100
anonymous Merkel cell carcinoma. (100%) nil  100
anonymous Skin - Merkel cell carcinoma (100%) Covering skin also features verrucous hyperplasia resembling a wart. Immunostain CK20 positivity confirms the diagnosis.  100
anonymous Merkel cell carcinoma, 100% To be confirmed with cytokeratin 20 (CK20) immunohistochemically. Merkel cell carcinoma is CK20 positive.  100
anonymous Merkel cell carcinoma 100% nil  100
anonymous Neuroendocrine carcinoma (Merkel cell carcinoma), margins involved. (100%) Immunostaining for CK20 and neurofilament will differentiate Merkel cell carcinoma from metastatic small cell carcinoma. It is also necessary to exclude other primary sites of neuroendocrine carcinoma (small cell carcinoma), in particular the lung.  100
anonymous Merkel cell carcinoma (100%) nil  100
anonymous Merkel cell carcinoma, would perform CK20, also other markers to exclude leukaemia and lymphoma. Probability: 100% nil  100
anonymous Merkel cell carcinoma (100%) Confirm by immunostain for CK20.  100
anonymous Merkel cell carcinoma TTF1 and CK20 to exclude a metastatic small cell carcinoma and LCA to exclude lymphoma  100
anonymous Merkel cell carcinoma nil  100