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SPICES, School of Medical Sciences  |  Health Campus, USM

Left Wrist Nodule : S002/2021

LEFT WRIST NODULE

Spices No: S002/2021

  • Front

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  • GROSS DESCRIPTION

    The image shows nodular, yellow-white chalky deposits within the nodule.

  • HISTOPATHOLOGY DESCRIPTION

    U177 24 10.0x gouty arthritis

    X10

    U177 24 40.0x GA high power

    X40

    Section shows nodular aggregates of acellular, amorphous, feathery, pale eosinophilic material surrounded by histiocytes and multinucleated giant cells of the foreign body type. Mild to moderate lymphoplasma cells infiltrations are seen. No features of malignancy.

  • DIAGNOSIS

    Gouty tophi

  • QUIZ

    A 54-year-old man presented with a painful swelling of the foot. A biopsy was performed. Microscopically, it revealed nodular aggregates composed of acellular, amorphous, feathery, pale eosinophilic material surrounded by histiocytes and multinucleated giant cells of the foreign body type. Under polarised light microscopy, the material exhibited needle-like crystals. What is the most likely diagnosis?

    A. Pseudo-gout
    B. Osteoarthritis
    C. Rheumatoid Arthritis
    D. Gouty arthritis
    E. Osteomyelitis

     

    ANSWER: D

  • BAHASA MELAYU

Loose Bodies : M906/92

Loose bodies

Spices No: M906/92

  • GROSS DESCRIPTION

    Numerous small hard nodules of varying sizes.

  • HISTOPATHOLOGY DESCRIPTION

    Nodules of metaplastic cartilage in the synovium of large joints such as hip and knee. The cartilage nodules may be embedded within the synovium covered by a layer of flattened synovial cells or lie freely within the joint cavity.

    https://www.webpathology.com/image.asp?n=1&Case=369

  • DIAGNOSIS

    Synovial osteochondromatosis

  • QUIZ

  • BAHASA MELAYU

    Sejenis “loose body” dijumpai di dalam sendi dan kebiasaannya akan menjejaskan lutut, pinggul atau bahu pesakit . Arthritis adalah salah satu punca. Kadangkala, ia boleh merosakkan sendi, menyebabkan osteoarthritis.

Scapula and Adjacent Soft Tissue : M1178/99B

Scapula and adjacent soft tissue

Spices No: M1178/99B

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  • GROSS DESCRIPTION

    A fairly circumscribed soft tissue mass, exhibiting a gray-white cut surface abutting the scapula bone. No hemorrhage or necrosis is seen.

  • HISTOPATHOLOGY DESCRIPTION

    • Partly infiltrative margin
    • Spindle-shaped cells are arranged in long sweeping fascicles.
    • No nuclear pleomorphism
    • The background is collagenised.
    • There are a few blood vessels in between the fascicles.

  • DIAGNOSIS

    Musculoaponeurotic fibromatosis

  • QUIZ

  • BAHASA MELAYU

    Sejenis ketumbuhan bukan kanser daripada tisu lembut yang agak agresif, boleh menembusi tulang dan agak susah untuk di buang sepenuhnya melalui pembedahan.

Retroperitoneal Tumour - M350/85

RETROPERITONEAL TUMOUR

Spices No: M350/85

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  • GROSS DESCRIPTION

    It is a soft tissue mass, fairly circumscribed, covered by thin fibrous capsule. Cut section shows solid brownish to yellowish cut-surface.Take note that the brownish area is the dedifferentiated area with an abrupt transition to a well differentiated area (yellow). The tumour abutting the kidney (left bottom). Margins are involved by the tumour.

  • HISTOPATHOLOGY DESCRIPTION

    m350 85 microscopic

    Section shows well differentiated liposarcoma (left) with an abrupt transition to the dedifferentiated component, exhibiting pleomorphic spindle shape cells arranged in vague storiform pattern (non-lipogenic component) on the right side.

    Fluorescence In Situ Hybridisation (FISH) analysis shows amplifications of MDM2.

    m350 85 comb18a

    Image shows MDM2 amplification by FISH technique

  • DIAGNOSIS

    Dedifferentiated liposarcoma

Soft tissue mass : M1135/96A

SOFT TISSUE MASS

Spices No: M1135/96A

  • Front

  • Left

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  • GROSS DESCRIPTION

    The exhibit displays well circumscribed and thinly encapsulated lobulated mass. It shows homogenous yellowish cut surface.

  • HISTOPATHOLOGY DESCRIPTION

    Lipoma is composed of lobules of mature univacuolated adipocytes. Minimal fibrous septae can be observed. Atypical hyperchromatic stromal cell should not be present.

  • DIAGNOSIS

    Lipoma

  • BAHASA MELAYU

    Penerangan kasar: Spesimen menunjukkan ketumbuhan yang mempunyai kapsul nipis dibahagian paling luar. Permukaan ketumbuhan ini adalah berwarna kekuningan.

    Penerangan histopatologi: Di bawah mikroskop, lipoma terdiri daripada sel lemak yang matang dimana hanya terdapat univacuolated sitoplasma dengan nukleus kecil terletak di tepi sel.

    Diagnosis: Lipoma

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