21/09/2016               12:01 AM              Suffix - Tissue Types                                       HI025264F/16
          1 - Skin Biopsy                                                               
  
  Report sequence 1                           Authorised                                                                             07/10/2016 16:06
                                                                                    By     Dr T Bracey                                                             CELLPATH (Tim's laptop)
NATURE OF SPECIMEN:
Perianal biopsy.
CLINICAL DETAILS:
Longstanding recurrent perianal inflammation and ulceration.   Granuloma excised in past and biopsies x 3 suggestive of Crohn's sarcoid.   Persistent superficial erosion in perianal area, ?Cause.   ?AIN, ?Crohn's.
GROSS DESCRIPTION:
Punch biopsy of skin, measuring 4 x 4 x 2mm deep.
S1   1B. ns w     AG|AE
HISTOLOGY:
Perianal squamous mucosa/skin showing parakeratosis with underlying epidermal dysplasia accounting to at least AIN2 (high-grade dysplasia). There is diffuse lymphocytic infiltrate and well defined rounded non-caseating granulomas in the subepithelium. No organisms were identified on special stains. We note the long standing history of granulomas, however a definitive diagnosis of Crohn's   disease (or sarcoidosis) can be made only after appropriate clinico-pathological correlation.
Conclusion
Perianal biopsy - high grade dysplasia/AIN 2 and noncaseating granulomatous inflammation (see text)
Dr R Khan (SpR)/ Dr T Bracey

2016-10-07_0001.jpg


2016-10-07_0001.jpg

Author: Dr Tim Bracey

2016-10-07_0001.jpg

Author: Dr Tim Bracey