020315 path Flashcards

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1
Q

endocrine cells have what features

A

big cells with lots of cytoplasm
round nuclei that are eccentrically placed
stipled chromatin-“salt and pepper”

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2
Q

anterior pituitary has what kinds of cells in terms of staining?

A

acidophils

basophils

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3
Q

reticulin stain is positive in

A

normal anterior pituitary gland architecture

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4
Q

most common pituitary adenoma

A

prolactin (is a lactotroph/acidophil)
next most common is a non-secreting (null cell) adenoma
next most common is GH, ACTH

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5
Q

what does pituitary adenoma look like as opposed to normal pituitary?

A

it has only on cell type in the adenoma and it has obliterated reticulin meshwork

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6
Q

Sheehan syndrome

A

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.

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7
Q

Rathke cleft cyst

A

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

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8
Q

craniopharyngioma

A

usually suprasellar

presenting symptoms: visual abnormalities, hypopituitarism

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9
Q

composition of normal parathyroid

A

chief cells and some oxyphil cells

large amount of intervening STROMAL FAT

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10
Q

causes of primary hyperparathyroidism

A

most common: adenoma
primary hyperplasia
parathyroid carcinoma

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11
Q

BONE disease in hyperparathyroidism

A

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)

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12
Q

parathyroid adenoma histology

A

sheets of chief cells with decrease in stromal fat (RIM OF NORMAL PARATHYROID at periphery)

involves ONE parathyroid gland

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13
Q

parathyroid hyperplasia

A

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

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14
Q

parathyroid carcinoma

A

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

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15
Q

chromaffin cells vs fasciculata cells

A

chromaffin cells are purple

fasciculata cells are clear

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16
Q

pathology of adrenal cortex

A

adrenocortical hyperplasia
adrenocortical adenoma
adrenocortical carcinoma

like the parathyroid

17
Q

adrenal medulla pathology

A

pheochromocytoma

18
Q

adrenocortical hyperplasia

A

BILATERAL thickening of adrenal cortex (diffuse or nodular)

predominantly FASCICULATA cells

micro-resembles adrenocortical adenoma, just like for the parathyroid

19
Q

adrenocortical adenoma

A

yellow in macroscopic (predominantly FASCICULATA cells)

encapsulated
functional or non-functional (most are NON functional)

20
Q

adrenocortical carcinoma

A

invasive
NECROSIS and hemorrhage
well or poorly differentiated

21
Q

bilateral hyperplasia of adrenal cortex in the context of hypercortisolism suggests

A

increased ACTH (pituitary adenoma)

22
Q

hyperaldosteronism usually comes about how?

A

adrenal cortical adenoma (aldosterone producing adenoma)

23
Q

congenital adrenal hyperplasia

A

21 hydroxylase deficiency

24
Q

pheochromocytoma

A

neoplasma composed of adrenal medullary chromaffin cells

25
Q

classic triad of pheochromocytoma

A

headache
palpitation
diaphoresis

26
Q

Zellballen (cell balls)

A

pheochromocytoma

they are nests of cells within a rich vascular network. basophilic, granular cytoplasm.

27
Q

acidophilic

A

stains pink

28
Q

how to stain for chromaffin cells

A

chromogranin, synapsophysin

in the adrenal, they’re specific for the medulla

29
Q

paraganglioma

A

extra-adrenal pheochromocytoma

non-functional