pathology
Pathology – slides For the final examination
1 Myocardial hypertrophy I2
increased diameter of cells (hypertrophy, Hypertension), rectangular and enlareged nuclei, Increased cytoplasm interstitium
2 Acute fibrinous pericarditis I3
Epicardial surface is covered with fibrin, with non,specific granulation tissue underneath (INFLAMMATORY CELLS)
Very pink- hyper eosinophilic-fibrin
Enlarged cells-hypertrophy
3 Myocardial infarct (acute) I5
No nuclei (karyolysis)
Neutrophil infiltration (blue dots)
Necrotic tissue- reddish (decreased O2, cardiolysis)
Dilated Vessel
Congestion- hemorrhage lots of RBCs
Well dilineated fibers
4 Healing of myocardial infarct – scar (2 slides) I7
Scarred area- fibrin-pale-no nuclei
Hypertrophy of survived muscle
Blue stain- special staining of collagen fibers
Muscle purple, fibrin blue
Healing area-plenty of capillaries
5 Pyemic Abscesses (myocardium) I8
Pyemia: Type of septicemia that Leads to widespread abscesses of metastatic nature
Neutrophilic Infiltration
Bacterial colony surrounded by leukocytes
Disfigured myocytes
Blue-Lymphocyte
6 Myocarditis (diphteric) I9
Infection caused by Corynebacterium Diptheriae >> Inflammation of heart muscle
Albert’s Stain used in histopathological diagnosis
Frequent infiltration-blue dots
Loss of myocytes
7 Myocarditis (rheumatic fever) I10
Affects joints, skin and brain Also, etiological agent Strep. Pyogenes
Ashoff body (giant cell) – basophilic
Large cells with 2 or more nuclei
In myocardial interstitium
Nodular collection of inflammatory cells
Muscle cells are damage
8 Lipomatosis of the myocardium I12
Right ventricle common
Pure fat cells around cardiac cells (no lipid)
Decrease in muscle tissue
No necrosis fibrosis or inflammatory cell infiltration
9 Artherosclerosis (aorta) II1
Destruction of intima (thickening of cholesterol Crystals)
Atheromatous ulcer
Increased vascularisation in the wall
Principle events: fatty streak, fibrous plaque, Atheroma, ulceration, dystrophic calcification
Lumen is partially filled by red thrombus
10 Syphilitic aortitis (aneurysm) II2
Enalargement of the aorta to > 1.5 times the normal size
Tunica adventitia has lymphocytes and plasma cells (blue dots)
Pale- fibrosis of T.Media
Loss of elastic fibers (in t.Media)
Because of long lasting syphilis
11 Thrombus II4
Red dots = RBCs
Layer of fibrin and platelets, alternating with layers Of clotted blood
Red thrombus- clotted blood with all it’s constituents
Organising thrombus- red thrombus with signs of Organisation (in growth of
Fibroblasts, capillaries)
Has inflammatory cells
12 Thrombus (recanalisation) II7
Recanalisation involves Ingrowth of smooth muscle cells, fibroblasts and
Endothelium into a fibrin-rich Thrombus
Other fates of thrombi: Propagation, embolization, dissolution and organization
Slide can be artery or vein —> arteries should Have a much thicker wall
Weigert’s Elastica stain
Fusion of capillaries in granulation tissue during Organisation of thrombus
Fibrous remnants
Venous has intravascular canals
Often in lung and umbilical vein
Slit like spaces in vascular lumen
13 Haemosiderosis of the liver (2 slides) III2
Iron overload disorder, cause Of metabolic cirrhosis
Destruction of RBCs
Prussian blue stain- hemosiderin
Nodular arrangement of hepatocytes
14 Cirrhosis (primary biliary) III3
Autoimmune disease of the Liver, results from slow, progressive destruction of
Small bile ducts of the liver; Toxins build up in the liver >>> Cholestasis
Biliary plaque (yellow) in biliary duct
Fibrous tissue and leukocytes
Bile duct with bilirubin
Fouchet staining
Intrahepatic bile stasis
15 Steatosis (fatty change of the liver) III5
Etio: Excessive alcohol or Obesity, as there is interruption of fat metabolism
Lipid droplets among hepatocyte
Fatty vacuoles- are empty- dissolve in staining with Acetone
Nuclei of hepatocytes are on periphery of lipid Droplets
No fibrosis
16 Congestion of the liver III6
RBCs among hepatocytes (congestion)
Etiology-RHF
Lobular centers are more pronounced
Centrilobular steatosis and zonal fibrosis (Nutmeg Liver – Etiology is congestion)
Venostasis
17 Acute liver necrosis (hepatodystrophy) III7
Diffuse necrosis- destructive dystrophy of liver
Lipofuscin – used for lipid Containing residues
Hyper eosinophilic
18 Myeloproliferative syndrome, chronic myeloid leukaemia (Ph+), liver III8
Diffuse infiltration of leukocytes: Portal triads + sinusoids
Trabeculae of hepatocytes
Gross: hepatosplenomegaly
19 Chronic lymphocytic leukaemia, liver III9
Gross- whittish reticular pattern
Infiltration of portal triads ONLY
Congestion
CD20, CD23, CD 5
20 Suppurative Cholangitis III10
Characterised by obstruction, Inflammation and pyogenic infection of biliary tract
Infiltration around the bile duct (pus)
Biliary abcess due to obstruction
Abcess (focal) vs phlegmon (diffuse) – both are Interstitial processes
Bile- Yellow, Baaaare Polymorphonuclear Neutrophils seen
21 Atrophic (micronodular) cirrhosis III11
Septa and nodules. (nodules are subdivided into macro and Micro)
Light pink
Hepatocytes-nodular arrangement
Fibrosis
Complications: portal HTN, liver cell carcinoma, Hepatoencephalopathy
22 Diabetic Glomerulosclerosis (Kimmelstiel-Wilson)IV1
RBC are dispersed in renal parenchyma, near the glomeruli
Changes in glomeruli: thickening (hyaline arteriolosclerosis), Enlarged
Enlarged bowman’s capsule
Armani cells (glycogen accumulation)
23 Biliary nephrosis IV2
Bile in renal parenchyma
Yellow biliary plaque in parenchyma
Seen in: liver failure, Hyperbilirubinemia, cirrhosis
Secondary to severe obstructive Jaundice
24 Amyloidosis of kidney IV4
Pale pink deposit (amyloid) of renal cortex
Interstitium and glomeruli
Congo red stain…
AL (from Ig light chan, 1º) and AA (from SAA, 2º)
25 Infarct of kidney IV5
Leukocyte infiltration (blue dots)
Half are normal and half are necrotic
Coagulative necrosis (hyper-eosinophilic)
Selective necrosis of proximal tubules (most sensitive To hypoxia)
26 Nephrosclerosis IV6
Onion skin like structures (seen with special staining)
Thickening of arterial wall (intima ans tunica media)
Lumen narrows- decreased O2- infarct- fibrous tissue
Scarring- intimal fibrosis
Hyalinisation of glomeruli
Increased connective tissue in interstitium
27 Acute diffuse proliferative glomerulonephritis IV7
Narrow lumen of arterioles- thickening of hyaline by Fibrosis
Onion skin
Intimal thickening (fibrinoid necrosis)
Hypercellularity
Neutrophil infiltration (diffuse) = loops + Bowmann’s capsule
Occurs 1-4 weeks after pharyngeal infection with Strep. Pyogenes
Numerous casts in tubular lumen
28 Chronic sclerosing glomerulonephritis IV9
Global sclerosis occurs
Complete obliteration of architectural landmarks and Capillaries
Marked interstitial fibrosis and tubular atrophy
Endstage result of glomerular tubulointerstitial or Vascular disease
Crescents are Composed of proliferating epithelium
Caused by: goodpasture syndrome, SLE, vasculitis
29 Acute pyelonephritis IV12
Suppurative (purulent)- there is pus formation – pus In canals
Ascending infection
Inflammatory (neutrophil) infiltrate in the tubules And CT interstitium (blue dots)
Polymorphonuclear cells in tubules (a lot)
Damage and fragmentation of tubular wall
30 Hydronephrosis IV13
Complication of squamous cell Carincoma of cérvix, or benign prostatic Hyperplasia
Pressure atrophy of renal parenchyma
Chronic- loss of stratification and glomeruli are absent
Similar to colloid in thyroid gland (called Thyroidisation of kidney)
Hyaline casts
Thick arteries may have cysts
Fibrosis of glomeruli (if present)
31 Pseudomembranous laryngitis V1
Inflammation of the larynx Characterized by anatomical formation of false membrane
Blue infiltration of inflammatory cells
Corynebacterium Diptheriae
Involves cartilage + glands
Pseudomembrane in fibrin
32 Aspiration of amniotic fluid V3
Also known as meconium Aspiration syndrome, when meconium is present
In lungs before delivery; Meconium is first stool of infant
In fetal lung
Collapse of lung (macroscopically) + emphysematous Configuration
Keratinised cells in alveoli
Normal inter-alveolar septa
Aspiration is because of intrauterine irritation of The respiratory centre due to asphyxia
33 Silicosis V5
Black anthracotic pigment (silicotic nodule) – causes Lung fibrosis
Increased hyalinisation in the centre
Blending of alveoli (perifocal emphysema)
Fine needles seen in polarised light
Coniofibrosis has 3 stages:
1)stigmatisation with SiO2 crystals
2)formation of silicotic nodules
3)massive fibrosis
34 Pulmonary edema V6
Congestion in Interalveolar septa
Edematous fluid- Alveoli- eosinophilia
Transudate- no Infiltrate – diagnosis = edema
Exudate- has Infiltrate – diagnosis = bronchopneumonia
Hyperaemia (excess Blood) in lung tissue
35 Emphysema V7
Caused by the destruction of connective tissue; leading to also breakdown Of capillaries
Thickening of Arterial wall suggests hypertension
Septa- Destroyes/ruptured
Alveoli extended Abnormally
Types: senile, Centroacinar (just terminal bronchiole affected), paraseptal, panacinar (whole Acinus affected), bullous (blister formation)
(acinar= terminal Bronchiole + alveolar air sac)
36Venous congestion V9
Brown pigment- Cyanotic induration
Infiltration of Macrophages
Congestion-red Dots-iron
Fibrosis of septa
Edema + hemosiderin Laden macrophages
Blue in prussian Blue stain- cyanotic induration
37 Lung tromboembolism and haemorrhagic infarctV10
Completely RED – Because of hemorrhagic infarct
Alveoli in Periphery
Necrosis of septa
38 Lobar pneumoniaV11
(exudative Superficial inflammation secondary to an airborne infection)
Etio: Streptococcus Pneumonie, Klebsiella Pneumonie
1/2 – blue Dots- infiltration in alveoli- fibrin
1/2- red (normal)
Anthracotic Pigment (carbon pigment from breathing) – lung
4 stages: 1) Congestion and edema , 2) red hepatisation (alveolar spaces of an
Exudate rich in fibrin, bacteria, leukocytes and erythrocytes), 3) grey hepatisation
(usually on superior lobe), 4) resolution
39 Carnification of lung V12
(Complication of Healing of Lobar Pneumonia — > alveolar fibrosis)
Intralveolar exudates become organized as fibroblasts leads to shrunken and firm lobe
Meat like Consistency
Alveoli Containing loose small area- fibroblast
Irreversible Filling of alveoli in CT
Complication of Healing of lobar pneumonia
Myxoid Appearance
40 Bronchopneumonia V13
Etio: Staph. Aureus, Hemophillus Influenzae etc
Full Infiltration (patchy consolidation centred around bronchioloes) – Polymorphonuclear cells
Anthracotic Pigment
Exudate (neutrophils) + a little fibrin
Neutrophils in Intraalveolar septa
Main bronchi- Mucus
Peripheral bronchial Branches- pus
41 Non-suppurative interstitial pneumocystis pneumoniaV16
Caused by pneumocystis jirovecii (fungus, yeast Like) in the spumoid masses of alveoli
Most common Pneumonia in AIDS patients
Blue dot Infiltration
Alveolar septa are Thickened with mononuclear infiltrate
(spumoid mass Surrounded by plasmocytic and lymphocytic infiltrate)
Typical in Immunocompromised patients – sensitivity to uv light
Enlarged Interalveolar septa
Alveolar spaces filled with pink, foamy, amorphous material composed of
Proliferating fungi and cell debris
42 Follicular amyloidosis of spleen VI2
Congo red stain… with characteristic birefringence
Mostly white pulp Deposition (follicles)
43 Diffuse amyloidosis of spleen (2 slides)VI3
Red brick Staining
Red +white Pulp
Red pulp Without change
2nd slide- Deposition of amyloid diffuse
44 Fibrocartilaginous perisplenitis VI4
Normal splenic Tissue
Thickened Capsule – acellular hyaline (homogenous fibrohyaline)
Eosinophilic Mass (pink area) – resembles cartilage
Splenic capsule is thickened by newly formed, relatively acellular Hyaline
Eosinophilic masses, grossly resembling cartilage
45 Anthracosis VII1
Anthracotic Pigment (black dots)
Seen in Perivascular and peribronchial areas
Pneumoconiosis (disease of lung due to inhalation of dust) – inflammation
Clusters of Hemosiderin laden macrophages
Patients: Smoker, dirty environment
46 Chronic peptic ulcer VIII2
Tissue defect with raised margins
3 layers at base
(necrotic debris +leukocytes
Fibrinoid necrosis
Non specific Granulation tissue
Peripheral Fibrosis)
Thickened walls of adjacent Arteries
Hypertrophy of Nervous fibers and fibrosis in the basal part of the wall
Loss of epithelium – deep ulcer
Sharp margin (acute) – for differentiation
Mucous + Inflammatory infiltrate (margin, chronic)
47 Appendicopathia oxyurica (4 slides- top left hand= Appendicitis)VIII5
Lesion of appendical mucosa due to oxyurids (intestinal parasitic worms)
Lymphatic Follicle
Seen in children
Fibrin in Peritoneal surface
Neutrophil Exudate in lumen – spreads into submucosa- affects all layers
Inflammatory Infiltrate
48 Chronic cholecystitis VIII6
Thickened Gallbladder wall (whittish)
Rokitansky Aschoff sinus
Changes in Subepithelial area
Outpouching of Mucosa
Inflammatory Infiltrate scattered
Histology- tall Columnar cells, mucous secreting glands, longitudinal circular + oblique Muscular bundles
49 Ulcerophlegmonous Appendicitis VIII7
Segmental mucosal ulceration
purulent exudate In the lumen (diffuse neutrophilic infiltratation All the layers – best seen in muscularis -phlegmone)
Serosal layer- Fibrin
Exudative Interstitial inflammation
Diffuse Transmural leukocytic (PMN)
50 Acute catarrhal Enteritis VIII9
Oedema of interstitium with detachment of superficial epithelium from Basement membrane
Ý number of goblet cells
Neutrophils and eosinophils in mucosal stroma
Hyperaemia, Edema, hypersecretion
Exudative Superficial inflammation
No necrosis
Serous exudate
51 Fibrocystic Changes IX2
Includes: Fibrosis, Cyst Formation, Adenosis and Epithelial Hyperplasia
Breast
Dilation of duct
Changes in Ductolobular units
Apocrine Metaplasia
Irregular Dilated cyst (lined by cuboidal to columnar epithelium)
Stromal fibrosis
52 Adenomyomatous Hyperplasia of the prostate IX3
No fat, more Glands
Nodes of Hyperplastic glands (large) -Benign prostatic hyperplasia
Fibromuscular Stroma
Glands- larger- Double layer of columnar, cuboidal epithelium
Complication: Hydronephrosis
53 Acute Haemorrhagic necrosis of pancreas IX4
Two types of pancreatitis: Mild characterized By inflammation and oedema and
Severe which is characterized by necrosis of pancreas
Steatocytonecrosis
Red area- Hemorrhage
Necrotized Langerhans
Fat necrosis- Peripancreatic fat
Inflammatory Infiltrate
54 Diffuse Colloid goiter IX5
Whole thyroid appears to be enlarged due to hyperplasia other types are
Uninodular and multinodular
Etio: Iodine deficiency
Enlarged thyroid
Irregular Follicles, colloid
Benign
Regular cells
Diffuse colloid + flattened epithelium
55 Suppurative Leptomeningitis X1
Bacterial infection of the subarachnoid space that presents as fever, Severe
Headache and stiff neck
Large numbers of Polymorphonuclear Leukocytes (granulocytes) in Leptomeningeal spaces
Neutrophils in Leptomeningeal space
Brain tissue Without damage
Pus-neutrophils-blue Dots
Differential Diagnosis- encephalomalacia,- loss of brain tissue after cerebral infarction
56 Cerebral Infarct (encephalomalacia) X2
Ischaemic Colliquative Necrosis, healing by formation of a pseudocyst
Cerebral Infartion- loss of brain tissue
1/2 pale (disintegration of necrotic centre) and 1/2 dark area
Vessels are Congested
Blue Infiltration (inflammatory cells) + exudate
Foamy cells- Macrophages
Marked Collateral Oedema
57 Cerebral Hemorrhage X3
Causes: Hypertension, Atherosclerosis
Full of blood- partially washed out erythrocytes
Numerous Infiltration
Macrophages at margin contain lipids from necrotic brain tissue, UCB and Hemosiderin
Brown Deposition/pigment- hemosiderin laden macrophages
Marked Collateral Oedema
58 Poliomyelitis X4
Infectious disease caused by Polio Virus
>>> Leads to destruction of Anterior Horn Cells of Spinal Cord
Cross section of Spinal cord
Anterior portion Of horn (motor neuron) – massive edema
Spongy like
59 Multiple Sclerosis X6
Demyelinative disease of the CNS
Multifocal lesions seen, MS plaques
Early Stage: macrophage contain myelin fragments, Later Stage: contain Protein and
Lipids from degradation of myelin
Pale area- Demyelinization
Perivascular Lymphocytes
Massive edema
Globules – Remnants of myelin sheath seen
Increased number Of glial elements
60 Dysfunctional hyperplastic proliferative Endometrium XI3
Massive Bleeding-young woman- causes increased hormone production
Taking too much Contraception
Fragments- full Of blood
Proliferating Endometrial glands (columnar epithelium) (varying in size, dilated) + blood Pool
Several layers Of cells on top of each other- hyperplasia
Ischemia
61 Residua Post abortion XI4
Myxoid placenta (clear Stroma)- premature- early stage 1st trimester
Syncitium Trophoblast- accumulation
2 locations – Uterine tube (pregnancy) and separately (residua of post abortion)
Myxoid changes- Post partum
If there is a Uterine wall- extrauterine (ectopic) pregnancy
Thick layer
Placenta villi Are immature
62 Hydatidiform Mole XI5
Tumour of placental trophoblastic tissue; may be complete mole (ovum That has lost
All chromosome material) or parital mole (characterized by triploid cell 69)
Placenta- more Myxoid
Layer around the Placenta- thin/flattened trophoblast lining
Edematous Placenta
Young woman- Postpartum bleeding
Grape like tumor
Hyperplasia of Cytotrophoblast and syncitiotrophoblast
63 Chronic Salpingitis XI8
Due to STD: N.Gonorrhea, Chlamydia Trichomatis
Inflammation of Fallopian tube
Can cause Infertility
Uterine fimbriae Have a different thickness
Lymphocytes, Fibrocytes
64 Muscular Atrophy XII1
Normal- hyper Eosinophilic cytoplasm
Atrophy- loss of Eosinophilia
Fibrosis (necrosis, pale) in between the muscle fibers
Muscle fibres Decrease in size- not the same thickness
Nuclei are Concentrated- close together
65 Phlegmone XII3
Necrotizing Inflammation
Neutrophils in interstitium (purulent)
Without any Demarcation
(abcess- Demarcated with cavity)
Not circumscribed may lead to lethal sepsis
66 Psoriasis vulgaris XIII3
Autoimmune disorder, typically appears as áreas of inflamed skin
Covered with silvery-white scaly skin
Elbow (difficult keratinization, red, scaly lesion)
Thinner-atrophy
Scale of Keratin on top of the skin- detach
Abcesses Inside the epidermis- munro microabcess
Neutrophil Aggregates- epidermis
Elongation of Rete ridges (elongation + widening of basal parts of the interpapillary and Epidermal areas)
67 Caseous pneumonia XIV1
Via Porogenous spread of Tuberculosis
Large areas of necrosis with chromatin dust and scattered Langhans’ (horseshoe Shape) cells
Lung with Granulomatous inflammation
Granuloma- Epithelioid histiocytes, lymphocyte and fibroblast
Aggregation of Macrophages
68 Miliary Tuberculosis – liver XIV3
Hematogenous spread of tb through lung tissue with formation of small Military nodules
Portal biliary Tract has a horse shoe shaped cell
Nodules- Necrosis – not purely pink (bluish)
Differential Diagnosis- foreign body granuloma, osteoplastic tumour, sarcoidosis
69 Miliary Tuberculosis – lung XIV4
HIV positive
Small granulomas- Fibrous nodules
Horse shoe shaped (langhan’s cell)
Central Necrosis and a peripheral rim of epitheloid and Langhans’ cells
70 Casseous tbc lymphadenitisXIV6
Central necrosis in lymph node surrounded by rim of epitheloid cells and Langhans cells
Chromatin dust also presente from destroyed nuclei in some áreas of necrosis
Cottage cheese like
Periphery – Lymphatic tissue
Deep into lymph Node- necrotic pink tissue without any nuclei
71 Tuberculous Pericarditis XIV7
Hemorrhagic exudate In pericardial cavity
Chronic Inflammatory infiltrate in the subepicardial fat
Epithelioid Granuloma, only seen in TB
Scattered multinucleated Langhans cells
Pericardium- Surrounding the fat is muscle tissue
72 Lupus vulgarisXIV8
Chronic, direct Infection of skin with tuberculosis- causes dark red patches
Looks like Squamous cell carcinoma
Fragments of Skin are seen- lots of nodules
73 Cavitary TBC, pulmonary fibrosis XIV9
Etio: Emptying of the necrotic region through bronchi
Caverna are seen
Demarcated by Inflammation- necrosis
If the wall opens Up- bronchus
A lot of necrotic Debris that is amorphous
Fibrous tissue
Blue dots- bacteria + fibrous wall
74 TBC (small intestine) XIV10
Microvilli
Underneath the Mucosa
Langhans giant Cells (histiocytes)
75 Syphilis (tertiary stage-gumma – liver) XIV12
Morphological lesion of 3rd stage of syphilis
Inflammatory Infiltrate
Treponema pallidum (flagellar shape) – blue dots
Gumma (granuloma) In the liver- giant cells
Radiating scar around the lobular centre with incomplete necrosis
76 Rhinoscleroma XIV13
Sclerotic mass in the nasopharynx
Inflammatory Disease
Rod shaped Bacteria- klebsiella
Mikulicz cell (large foam cell with vacuolated pale cytoplasm)
77 Actinomycosis XIV14
Opportunistic Suppurative disease of oral cavity
Nodules seen Under epithelium
Disintegrated Material- pink multinucleated structures
Eosinophilic rim
Stratified Squamous non keratinised
78 Candidiasis XIV15
In diabetic Patients
White patch- Leukoplakia
In oral mucosa- Necrotic
Huge intensive Inflammation
Bluish amorphous Structure
Trachea- hyaline Cartilage
79 Foreign Body giant cells XIV16
Collection of fused macrophages which are generated in the presence of Large foreign body
Histiocytes come Together to form a foreign body
Giant cells (multinucleated, horse shoe shaped)
Pseudotumour
80 Molluscum Contagiosum XIV18
Viral infection of skin results in small, raised pink lesions with a Dimple in the centre
Irregular warts On penis or under vulva
At the area of Squamous epithelium (skin)
Blue structure- Warts
Pink (eosinophilic) – Molluscum bodies (henderson patterson bodies)
Poxvirus Infection
Gross: 2-4mm, Dome shaped, flesh coloured, form papules
81 Cytomegalovirus (inclusion bodies, parotis) XIV19
Glandular Structure + duct (dark blue lining)
Inside- Infiltrative leukocytes
Inflammation of Parotid gland
Inclusion bodies (intranuclear)
Serous glands
Males can cause Infertility
82 Non-specific
Granulation tissue
XIV22
Reparative mechanism of body, scar tissue – bleeding
Fibroblasts + some Macrophages + capillaries + proliferation
Reticular tissue With inflammatory infiltrate
Light pink
83 Fibroma XVI1
E.G. Palmar fibromatosis, keloid, neurofibroma, angiofibroma
Mesenchymal Tumor
Benign- Encapsulated tumor –ubiquitous localisation
Under the skin- Non specific granulation tissue, demarcated with borders
Ubiquitous Localisation (found everywhere)
Pink, thick- Fibrous layer, collagen fibers
Uniform slender spindle cells with minimal mitotic activity
84 Neurofibroma XVI2
Derived from endoneureum – peripheral nerve
Spindle cells with wavy nuclei of elongated cells- intermingled Cells
Benign-mesenchymal
Pleomorphic without Mitosis
Mixture- schwann Cells + fibroblasts
85 Neurinoma XVI3
Also called Schwannoma
2 types spindle Cell arrangement (antoni A and antoni B)
Antoni A: Palisading nuclei surrounding pink areas + spindle cells
Antoni B: irregular Arrangement, stroma is more loose, large cells with clear cytoplasm, cells Build- whorls and fascicules
Tumour of peripheral Nerve sheath
Long cells are Intermingled (mixed together) + long nuclei
Benign tumor- Pontocerebellar angle (VIII nerve)
86 Meningeoma XVI4
Tumour of meningothelial cells of arachnoid
Onion like Structure
Originates from Leptomeninges- benign
Roundish- well Circumscribed
Epithelioid Meningioma- whorls
spindle cells
Psamomma bodies- Calcified
87 Leiomyoma XVI5
Originates from Smooth muscle cells- spindle cells in fascicular Arrangement
Bundle of spindle Cells = smooth muscle + leiomyoma
Low mitosis
In a fascicular Arrangement
Uterus- most Frequent uterine neoplasm
Whitish Circumscribed tumour
88 Capillary Hemangioma XVI6
One of most frequent tumours of skin – nevus flammeus
Capillaries lined by swollen endothelial cells
Mesenchymal Tumor
Different sizes Of capillary lumen – swollen endothelial cells
Small vascular Spaces
Most frequent Tumour of skin
89 Cavernous hemangioma XVI7
Mesenchymal Tumor- most frequently in the liver
Thrombi in wide Vascular spaces
Fibrous septa
Hepatocytes
May cause Bleeding on liver biopsy
Large, dilated Vascular channel
90 Giant cell granuloma (oral cavity – epulis) XVI8
Large pink Circle- EPULIS
Stratified Squamous epithelium
giant cells
Schloffer’s tumour; foreign body granuloma (giant cells) around Stiches
91 Chondroma XVI9
Multiple chondroma’s- ollier’s disease
Origin from hyaline cartilage; location inside boné: enchondroma, locartion outsider: ekchondroma
Chondrocytes + Lacunar space
Red bubble cells Among chondrocytes
Hyaline + Cartilaginous matrix
Regular, rounded, Mononuclear cartilage-in pairs, quartets
92 Traumatic Neuroma XVI11
Defective Regeneration of peripheral nerves
Non homogenous Neurons
Retrograde Disappearence of axons + breakdown of myelin sheaths
Favourable Conditions- new axons and myelin grow
unfavourable Conditions- new axons do not reach the peripheral portion – form bulb like Hyperplastic nodule- called amputation nueroma
93 Fibrosarcoma XVII1
Gross: Fish meat
Less Circumscribed than fibroma
Fewer collagen Fibers between tumour cells
Spindle Shaped- bizzare
Pleomorphic Tumour
Poor prognosis
94 Malignant Lymphoma XVII3
Majority arise From lymph node
Massive Infiltration of uniform, larger lymphoid cells (lymphoblasts) – malignancy
Microstructures Are destroyed- no microsomes, no follicle
Large nuclei + Marked nucleoli, indented nuceli = centrocytes
Very pink
95 Hodgkin`s Lymphoma XVII4
Many Eosinophils, macrophages, plasma cells
Diagnostic cells:
1)binucleated REED- STERNBERG cells – Owl-eyed
2)lacunar cells- clear space
3)multinucleated reed-sternberg cells
4)Hodgkin cell ( like RS cell but has a Prominent nucleolus)
Types: Lymphocyte Rich, Nodular Sclerosis, Lymphocyte Depleted, Mixed Cellularity
Ann Arbor Staging System, CD15 CD30
96 Osteogenic Sarcoma XVII5
Gross: swelling of (usually long) bone
Microscopic- Pleomorphic cells (variability in size, shape and staining)
A lot of Intercellular ground substance- resembles pink osteoid
Malignant- has Early hematogenous metastasis
Neoplastic spindle Cells of osteosarcoma
97 Undifferentiated Sarcoma XVII6
Cells originate From a central focus
Spindle shaped Cells
Pleomorphic (fibroblasts, myofibroblasts and histiocyte like cells)
Variation in Cytoplasmic and nuclear size throughout the tumor
Gross: anterior Surface is fibrous with hemorrhagic necrosis or myxoid change
98 Plasmacytoma XVII9
Accumulation of Plasma cells
Most often in Bone
Large nuclei
Variable degree Of plasmacytic maturation
Plasmoblast -> plasmocyte
Diff diag. – Myeloma (plasma cells are usually more anaplastic)
99 Seborrheic keratosis XVIII1
Harmless skin growth that bears resemblance to skin cancer
Benign Epithelial tumour
Basal cell Papilloma
hyperkeratosis + Keratin cysts formation + thickening of basal cell + melanin pigmentation (all Of these are above epidermis)
String sign- Lesion extends to a uniform depth (parallel to epidermal surface)
100 Transitional cell papillocarcinoma XVIII3
Transitional Epithelium
Less than 6 layers- Benign
More than 7 Layers- malignant
High number of Mitosis
Cellular atypias
Increased Infiltration
101 Polypous adenoma (large intestine) XVIII4
Large nuclei (dysplasia)
Protruding Stroma- finger like structures
Normal- thinner Stroma
Dysplastic Changes in epithelium
Several types: adenoma, tubular or villous, may undergo malignant Transformation; inflammatory or hamartomous polyps (Peutz-Jehger disease) Metaplastic polyp – not malignant
For malignant epithelial polyp always examine the stalk
102 Follicular adenoma (thyroid) XVIII5
Changes without Fibrous capsule (thin)
If invasive- Adenocarcinoma
Surrounding Thyroid tissue shows signs of compression- closely packed follicles, trabeculae
Architecturally And cytologically different from surrounding glands
103 Mucinous cystadenoma of ovary XVIII6
Surface Epithelial tumour, accounts for 60-70% of ovarian tumours
Cyst adenoma
Cysts are lined By tall columnar cells
Based on serous And mucus (multicyst) cell types
With clear Cytoplasm containing mucous (PAS +ve – pink)
No papillary Formations
Mucinous cells
104 Serous cystadenoma of ovary XVIII7
Surface Epithelial tumour, accounts for 60-70% of ovarian tumours
Columnar Cells with CILIA
Cysts are lined By dark cells (serous cells)
Contains serous Fluid
Papillary Proliferation of epithelium inside the cysts
105 Pleiomorphic adenoma (salivary g.) XVIII8
Other benign: is Warthin’s Tumour
Mixed tumour- Myoepithelial cell
Not well circumscribed- Tongue like projections into surrounding glands
Stroma: Myxoid/hyaline/chondroid
Biphasic Population of epithelium and mesenchymal cells
Neoplasm= ductal Epithelium + myoepithelial cell + chondroid hyaline + myxomatous stroma
106 Fibroadenoma of breast
XVIII9
Component of fibrocystic change; others – Fibrosis, Cyst Formation,
Adenosis and Epithelial Hyperplasia
Compressed ducts Lined with cuboidal epithelium
2 forms: Intracanalicular and pericanalicular
Fibrous tissue
107 Nasal polyp XVIII10
Inflammatory Pseudotumor
Edematous stroma
Enlargement of Basal membrane
Uneven Cellularity
Infiltration With eosinophils, lymphocytes and plasma cells
Stratified Squamous epithelium
108 Branchial cleft cyst XVIII11
Lateral cyst of the neck
Lining is formed by cuboidal or by columnar epithelium
Benign large Cyst- lined by squamous epithelium
Surrounded by Lymphoid tissue (lymphocyte +follicle)
Fibrotic wall With lymphoid follicles- resembles lymph nose/tonsil
109 Dermoid cyst XVIII12
Benign (mature) Ovarian teratoma
Mature teratoma- Resembles skin
Unilocular cyst + keratin + hairs + tissue (from 3 germ layers) are in the wall of the cyst
Sebaceous gland
Ciliated Respiratory epithelium and stratified squamous epithelium
110 Carcinoid tumor (appendix) XVIII13
Benign
Submucosal Lesions
Solid alveolar Arrangement of small regular cells
Small amount of Cytoplasm (granular eosinophilic)
Arise with Mucosa bulk in muscularis propria (+fibrosis + smooth muscle hypertrophy)
Chromogranin Positive, 5-HIAA marker
111 Adenocarcinoma (solid variant) XIX1
Columns of Pleomorphic cells
Other subtypes:
1)lepidic pattern (neoplastic cells with No architectural disruption)
2)acinar pattern
3)papillary pattern
4)micropapillary pattern
Solid variant- Solid sheets and nests of tumor
Large, irregular nuclei, Prominence of nucleoli, in the cytoplasm watery clear vacuoles
112 Adenocarcinoma (diffuse variant) XIX2
113 Adenocarcinoma (cribriform) XIX3
Grows invasively Into muscularis mucosa. Serosa
Tubular shape
114 Cylindroma XIX4
Cylindromal Adenoid (pharyngeal tonsil) cystic carcinoma of the salivary gland
Signet ring cell
Gland produces Mucus
Minimal ductal Difference
No necrosis, no Solid/cribriform/papillary components
Is a rare Adenocarcinoma subtype
115 Squamous cell carcinoma XIX6
Malignant tumors Arising from surface epithelium
Keratinisation
Keratin pearls May be seen
Cells resemble Stratum basale
Finger-like protrusion = papilla
116 Small cell carcinoma XIX7
2nd most Frequent form of lung cancer (non small cell is number 1)
Highly malignant, Rapid growth, early metastasis
Low cytoplasm to Nucleus ratio
Small cells: Very little cytoplasm + nuclei are round/spindle shaped
Also called oat Cell carcinoma
Central Part of lung
117 Basal cell carcinoma XIX8
Malignant tumor From the surface epithelium
Never Metastasizes!
Solid Arrangement of cells- resembles basal layer of epidermis
Nest/trabeculae Of packed dark blue cells (cuboidal +pallisaded) – in basal layer of epidermis
First Stage: flat papilloma that enlarges over period of time
Second Stage: Surface break down, shallow ragged ulcer with pearled Edges
118 Comedocarcinoma XIX12
Breast
Debris of Necrotic cells in the lumen of ducts
Intraductal Non-invasive carcinoma
High number of Malignant cells tumor glands
119 Microalveolar carcinoma (prostate) XIX13
Prostate glands + Fibromuscular stroma
Dark blue Lymphocytes – stroma + glands
120 Astrocytoma XX1
Most common primary neurological tumour,
Low grade is slow growing and well-differentiated
Silver impregnation Of astrocytes
Form of glioma
several histological Forms: astrocytoma, anaplastic, glioblastoma multiforme (malignant – arises in Cerebral hemisphere crosses corpus callosum ‘butterfly lesion’)
Variable Cellularity + vascularisation, pink cytoplasm
Increased Pleomorphism
121 Glioblastoma XX3
Glioblastoma multiforme – most common malignant cns tumour in adults, arises in Cerebral hemisphere and crosses the corpus callosum ‘butterfly lesion’
High-grade tumour of astrocytes
Metastasizes very Rarely
Pseudopalisading Necrosis (pseudopalisading around necrosis- atypical mitosis)
Highly cellular + Pleomorphism
122 Pigmented nevus XX4
Melanocytic benign tumor – one of most common forms of hamartoma
Abnormality in migration, proliferation and maturation of neuroectodermal Cells
Types: junctional nevus, compound, intradermal, blue
Junctional – nests of naevus cells in dermo-epidermal junction
Compound – more pronounced dermal component
Dermal – only in dermis
Purely benign
From epidermis -> dermis -> deep
Classification – Clark’s and Breslow
Nevus cells form Nest
123 Melanoblastoma XX5
Malignant melanoma – Proliferation of melanocytes de novo
Four types: lentigo Maligna, superficial spreading, acral lentiginous, nodular malignant
Classification of Clark’s and breslow- prognotic importance
Pigment Melanoblasts (brown)
Dark brown cells
Fontana’s silver Stain for melanin
124 Teratoma XX6
Of ovary or testis
3 germ layers: Meso, ecto and endo
Cartilage + large Cysts + glands
Mature (Benign), Immature (Malignant)
Monodermal —–> STRUVA OVARII hyperthyroidism
125 Seminoma XX7
Germ Cell tumour in testis; highly responsive to radiotherapy, metastizes Late
Small blue round Nucleus
Seminoma cells- Clear, glycogen rich cytoplasm + large nuclei
Nests of large Cells, large and prominent nuclei
Lymphocytic Infiltration
126 Choriocarcinoma XX8
Proliferation of Trophoblastic cells
Interstitial Hemorrhage
Pleomorphic Cells
Marker ÝbhCG
127 Nephroblastoma (Wilm`s tumor) XX9
Children under Age of 10
Comprises of blastemal + primitive glomeruli + tubules + stromal cells
Malignant, fast Growing
Primitive Glomeruloid structure + cellular stroma
Undifferentiated Cells + tubular structure
Assoc. With Denys-Drash Sy and Beckwith Weidmann Sy
128 Renal cell carcinoma, conventional- RCC Grawitz’s Tumour XX10
Tumor of grawitz
Malignant, Differentiated + encapsulated
Less than 2cm is Benign —–> CLEAR CELL ADENOMA
Double staining
Empty, clear Cells (glycogen) – if greater than 2 cm- ADENOCARCINOMA
Typically invade Inferior vena cava-> typical metastasis to lung-> right heart failure
Small round Nuclei
Glomerulus + Nest of neoplastic cell (clear cytoplasm)
129 Ameloblastoma XX11
Locally malignant (tumor in jaw)
Gross: Polycystic/solid
Reticular Arrangement, loosely arranged stellate epithelium
Cells with islands Of vascularised edematous stroma
130 Ewing`s sarcoma XX13