Qap (Anatomical Pathology) 

QAP Peer Review

AP127
Case History: F/40, Peritoneal nodule for frozen section. History of hysterectomy one year ago.
Intended diagnosis: Keratin granuloma. Contributed by:FML
Code Diagnosis Comment Score
anonymous Peritoneal keratin granuloma (100%) They represent reaction to implants of keratin from tumours of female genital tract. The granulomas by themselves have no prognostic significance.  100
anonymous Keratin granuloma, 100% nil  100
anonymous Peritoneal keratin granuloma, 100% nil  100
anonymous PILOMATRICOMA (100%) nil  50
anonymous keratin granuloma Correlate with hysterectomy pathology with may be the source of keratin granuloma e.g. endometrioid CA with squamous metAPlasia; and look for other sources e.g. ovarian teratoma.  100
anonymous Peritoneal keratin granuloma. 100% It represents a foreign body reaction to keratin. It is most commonly associated with uterine/ovarian endometrioid carcinoma with squamous differentiation, ie. consistent with the history of hysterectomy in this case.  100
anonymous keratin granuloma To correlate with clinical history, previous operative findings and the hysterectomy specimen for previous mature cystic teratoma, or less likely endometrial carcinoma.  100
anonymous Peritoneal keratin granuloma 100% Need to know what indication and histopathology of previous hysterectomy. There might be previous ruptured ovarian dermoid/mature cystic teratoma, or keratin implants originating from other neoplasms with squamous differentiation.  100
anonymous Keratin granuloma (100%) nil  100
anonymous keratin granuloma nil  100
anonymous Keratin Granuloma 100% Keratin granuloma may be associated with previous gynaecological malignancy (endometrioid carcinoma). In absence of residual malignant cells, keratin granuloma by itself does not carry prognostic significance.  100
anonymous Keratin granulomas (100%) Correlation with pathology of the previous hysterectomy specimen is needed to ascertain the origin of the keratin debris e.g. reaction to ruptured mature cystic teratoma or endometrial adenoacanthoma.  100
anonymous Foreign body reaction/granuloma nil  80
anonymous Peritoneal keratin granuloma Probability : 100% May be reaction to squamous differentiation in endometrioid carcinoma from uterus, ovary, cervix or atypical polypoid adenomyoma. Correlate with histology of hysterectomy specimen.  100
anonymous Keratin granuloma 100% nil  100
anonymous PERITONEUM - PERITONEAL KERATIN GRANULOMA. Associated with keratin derived from previous uterus or ovarian tumour (e.g. acanthoadenocarcinoma, endometrioid ca, cervical SCC, teratoma etc).  100