10/19- Pathology Review Flashcards

1
Q

What is seen here?

A

Viral esophagitis (typical of herpes):

  • Margination of chromatin
  • Nuclear molding
  • Multinucleate

Also ground glass appearance of nuclei and necroinflammatory debris (ulcer)

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2
Q

What is seen here?

A

Viral esophagitis (typical of herpes):

  • Margination of chromatin
  • Nuclear molding
  • Multinucleate

Also ground glass appearance of nuclei

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3
Q

What is seen here?

A

Fungal esophagitis- Candida

  • Pseudohyphae in squamous cells
  • Yeast forms

Recall: Candida is part of flora in oral cavity; if just sitting in lumen, it’s probably contaminant. Must diagnose by seeing within tissue

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4
Q

What is seen here?

A

Barrett’s esophagitis (intestinal metaplasia)

  • Can see goblet cells
  • This is at the GEJ
  • Predisposition to developing adenocarcinoma
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5
Q

What is seen here?

A

Adenocarcinoma

  • Cells with dark nuclei with different shapes and sizes
  • Gland formation
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6
Q

What is seen here?

A

Squamous cell carcinoma

  • May be hard to differentiate adenocarcinoma and squamous sometimes, but as general rule, if you don’t have glands and do have tight junctions, think squamous
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7
Q

What is seen here?

A

Stomach (body/oxyntic) mucosa

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8
Q

What is seen here? (what cells)?

A

Stomach (body/oxyntic) mucosa

  • Pink = parietal cells; secrete acid
  • Blue = chief cells; secrete pepsinogen
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9
Q

What is seen here?

A

Antral (cardiac mucosa)

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10
Q

What is seen here?

A

Iron pill ischemia

  • Can see inflammatory cells
  • Brown material in surface of epithelium
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11
Q

What is seen here?

A

Iron pill ischemia

  • Has ulcerated
  • Brown refractile material from iron pill
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12
Q

What is seen here?

A

Autoimmune gastritis; chronic active gastritis

  • Lymphoid follicles
  • Think H pylori until proven otherwise?
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13
Q

What is seen here?

A

Autoimmune gastritis; chronic active gastritis

  • Neutrophils infiltrating epithelial cells
  • Associated with H. pylori
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14
Q

What is seen here?

A

H. pylori spiral bacilli

  • Chronic active carditis is associated with H. pylori
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15
Q

What is seen here?

A

Stomach with intestinal metaplasia

  • Goblet cells
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16
Q

What is seen here?

A

Adenocarcinoma: Intestinal (bulky) type

  • Glands present of different size and shape
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17
Q

What is seen here?

A

Adenocarcinoma: Intestinal (bulky) type

  • Many mitotic figures
  • Enlarged nuclei of different size and shape
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18
Q

What is seen here?

A

Adenocarcinoma: poorly differentiated type

  • Signet ring cells: mucin filling pushing nuclei to periphery
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19
Q

Describe prevalence of gastric cancer?

A
  • Intestinal type has decreased
  • Adenocarcinoma prevalence/incidence has not decreased
20
Q

What is seen here?

A

Small intestine mucosa

  • Villi and crypts (V:C ratio should be 3-5:1)
  • Paneth cells in base of crypts (more eosinophilic)
  • Can also see muscularis mucosa layer on the right
21
Q

What is seen here?

A

Duodenum (normal histology)

22
Q

What is seen here?

A

Ischemic colitis

23
Q

What is seen here?

A

Celiac disease

  • Increased chronic inflammatory cells in lamina propria
  • Many lymphocytes in the epithelial cells
  • Blunted villi
24
Q

What is seen here?

A

Whipple’s disease

  • Expanded villus
  • Huge macrophages
25
Q

What is seen here?

A

Whipple’s disease

  • Bacteria overload
  • Mostly MAC (mycobacterium avium ); typically diagnose with acid-fast stain
26
Q

What is seen here?

A
  • There are NO villi in colon!
  • Crypts here look like test tubes in a rack and they reach the muscularis mucosa
  • Submucosa layer also seen here?
27
Q

Where is ischemic colitis commonly found first?

A

Splenic flexure

  • Less vasculature here
28
Q

Is the rectum intra or retroperitoneal?

A

Retroperitoneal (says she)

29
Q

What is seen here?

A

Normal colonic histology

  • Equally spaced crypts
  • Separated by vessels
30
Q

What is seen here?

A

Pseudomembranous colitis

  • “Volcano eruption” of neutrophils and dead cells
  • Increased chronic inflammatory cells in lamina propria
31
Q

Important: compare Crohn’s disease and Ulcerative colitis in terms of:

  • Location (layers and along length)
  • Features
A

Crohn’s disease

  • Skip lesions
  • Most common location = terminal ileum
  • Transmural inflammation, ulcerations, fissures

Ulcerative colitis:

  • Does not reach muscularis mucosa
  • Always have rectum involvement!
  • Continuous involvement as it moves proximally
  • Psuedopolyp, ulcer
32
Q

What is seen here?

A

Crohn’s disease

  • Increased chronic inflammatory cells in lamina propria; crypts no longer equally spaced
  • Granuloma
33
Q

What is seen here?

A

Diverticulum/diverticulosis (diverticulitis if inflamed)

  • Mucosa pushed down; can go down through muscularis propria and serosa if severe
  • From mucosal side, you see holes
34
Q

What is seen here?

A

Polyp

  • Can see normal layers of intestinal wall
35
Q

What is seen here?

A

Polyp: tubular adenoma

  • Base of the polyp is on the bottom right
  • Normal colonic mucosa (pedunculated tubular adenoma) on the bottom right; the rest of the crypts are darker
36
Q

What is seen here?

A

Villous adenoma

  • If less than 25% has villous architecture, you still call it tubular
  • If more than 75% has villous architecture, it’s “villous”, but anything in between (25-75%) is “tubulovillous)
37
Q

What is seen here?

A

Adenocarcinoma of colon

38
Q

What is seen here?

A

Colon adenocarcinoma

  • Glands with necrotic material inside
  • Multinucleate cells
  • Many mitotic figures
39
Q

What is seen here?

A

Chronic cholecystitis (gallstones in gallbladder)

  • Fibrotic (inside appears like outside; abnormal)
  • Stones press on mucosa -> atrophy
40
Q

What is seen here?

A

Adenocarcinoma involving gallbladder

  • Typically seen in older women
  • Just the thickened wall piece with whitish color (pretty localized)
41
Q

What is seen here?

A

Normal appendix

  • Many lymphoid aggregates and follicles (fewer as you age)
42
Q

What is seen here?

A

Acute appendicitis

  • Focal ulceration of mucosa
  • Collection of neutrophils
  • To diagnose, must have neutrophils in muscularis propria
43
Q

What is seen here?

A

Acute appendicitis

  • Neutrophils in muscularis propria (necessary to diagnose acute appendicitis)
44
Q

What is seen here?

A

Serosa/mesothelial cells (benign to reactive transition)

  • Mesothelial cells are flat at rest
  • Become round and columnar when irritated
45
Q

What is seen here?

A

Acute serositis, marked

  • Layers of neutrophils
  • Reactive mesothelial cells (if chronic, can proliferate and become columnar, but this reactivity happens first)