Qap (Anatomical Pathology) 

QAP Peer Review

AP227
Case History: F/57, 5.5 cm esophageal submucosal mass
Intended diagnosis: Schwannoma. Contributed by:JKCC
Code Diagnosis Comment Score
anonymous Schwannoma (100%) Confirm with immunostain for S100. Also perform CD34 and c-kit to exclude gastrointestinal stromal tumour (GIST).  100
anonymous gastrointestinal stromal tumor nil  50
anonymous Schwannoma (100%) IHC: S100 (expected to be positive), C-kit (expected to be negative)  100
anonymous Schwannoma Confirm with immunostaining for S100. Also perform CD117 to exclude gastrointestinal stromal tumor.  100
anonymous Schwannoma, 70%. Gastrointestinal stromal tumor, 30%. Perform S100 and c-kit stains.  100
anonymous Neurilemmoma.(100%) Do S100 protein stain to confirm.  100
anonymous Esophagus submucosal mass - Schwannoma 100% nil  100
anonymous Neurilemmoma nil  100
anonymous SPINDLE CELL TUMOUR 100%, DDX: SCHWANNOMA, LEIOMYOMA, MYCOBACTERIAL SPINDLE CELL TUMOUR. SUGGEST IMMUNOHISTOCHEMICAL AND SPECIAL STAINS i.e. S100 PROTEIN, ACTIN, ZIEHL-NEELSEN. CYTOLOGICALLY BENIGN BUT SIZE IS RATHER LARGE, NEED TO ASSESS MORE SECTIONS TO DETERMINE NATURE/BEHAVIOUR.  65
anonymous Schwannoma. nil  100
anonymous Oesophagus submucosal mass - Spindle-cell neoplasm; differential diagnoses including schwannoma and gastrointestinal stromal tumour (please see comment). Immunohistochemical studies including S100 and CD117 are suggested for confirmation. In case of a typical schwannoma, the tumour cells should show diffuse nuclear positivity for S100 and general negativity for CD117, while the reverse occurs in case of a typical gastrointestinal stromal tumour. Smooth muscle actin can also be performed in order to rule out leiomyoma.  80
anonymous Schwannoma Differential diagnosis: gastrointestinal stromal tumor, to be differentiated by S100 and CD117 immunostaining.  100
anonymous Spindle cell tumour, favour benign nerve sheath tumour, confirm with S100, and exclude GIST by CD117 (100% probability) nil  100
anonymous Benign spindle cell tumour, differential diagnoses: 1. GIST (70%) 2. Schwannoma with ancient change (30%) 1. Perform immunostains for differentiation: GIST positive for c-kit; schwannoma positive for S100.  60
anonymous Schwannoma (100%). nil  100