020315 path Flashcards
endocrine cells have what features
big cells with lots of cytoplasm
round nuclei that are eccentrically placed
stipled chromatin-“salt and pepper”
anterior pituitary has what kinds of cells in terms of staining?
acidophils
basophils
reticulin stain is positive in
normal anterior pituitary gland architecture
most common pituitary adenoma
prolactin (is a lactotroph/acidophil)
next most common is a non-secreting (null cell) adenoma
next most common is GH, ACTH
what does pituitary adenoma look like as opposed to normal pituitary?
it has only on cell type in the adenoma and it has obliterated reticulin meshwork
Sheehan syndrome
postpartum hypopituitarism (during pregnancy, pituitary enlarges b/c of increased lactotrophs. this enlargement makes pituitary susceptible to postpartum ischemic necrosis)
results in HYPOpituitarism in anterior pit.
Rathke cleft cyst
sella or suprasellar location
columnar to cuboidal cells with cilia and occasionally mucin lining a thin walled cyst
is a developmental remnant of Rathke’s cleft pouch
can cause stalk effect
craniopharyngioma
usually suprasellar
presenting symptoms: visual abnormalities, hypopituitarism
composition of normal parathyroid
chief cells and some oxyphil cells
large amount of intervening STROMAL FAT
causes of primary hyperparathyroidism
most common: adenoma
primary hyperplasia
parathyroid carcinoma
BONE disease in hyperparathyroidism
osteitis fibrosa cystica (erosion of bone matrix by osteocalsts, thinned cortex, fibrosis of marrow with hemorrhage and cyst formation)
brown tumor (osteoclasts, reactive giant cells, hemorrhage. like a giant cell tumor of bone)
parathyroid adenoma histology
sheets of chief cells with decrease in stromal fat (RIM OF NORMAL PARATHYROID at periphery)
involves ONE parathyroid gland
parathyroid hyperplasia
all four glands involved
morphology: chief cell hyperplasia like in adenoma so may be difficult to distinguish. DOESN’T have rim of normal tissue b/c everything is proliferating
parathyroid carcinoma
difficult to distinguish from adenomas
usually not diagnosed until INVASIVE or METASTATIC
cellular atypia is NOT a reliable feature of malignancy (in general, this is the case for endocrine organs)
capsular/vascular invasion, thick fibrous bands
chromaffin cells vs fasciculata cells
chromaffin cells are purple
fasciculata cells are clear
