Chapter 2 - Descriptive Terms in Anatomic Pathology Flashcards
Define five terms describing tumor interface with surrounding tissue.
Circumscribed: Well-delineated lesion
Encapsulated: Surrounded by a fibrous capsule
Infiltrative: Invading into the surrounding tissue
Lobular: Circumscribed or anatomic distribution
Pushing border: Expanding into and compressing surrounding tissue.
What mitotic feature is a convincing indicator of malignancy?
Atypical/Tripolar mitoses
Describe the architectural pattern:
Alveolar
Basaloid
Biphasic
Alveolar: Resembling alveoli or little cells, sacs, or nests
Basaloid: Resembling BCC (blue-nested with tightly packed nuclei and palisading)
Biphasic: Having components of two cell lineages
Describe the architectural pattern:
Cribriform
Discohesie
Epithelioid
Cribriform: Perforated, like a colander
Discohesive: Falling apart into single cells
Epithelioid: Composed of round to oval cells with abundant cytoplasm
Describe the architectural pattern:
Fascicular
Glandular
Glomeruloid
Fascicular: Bundles of elongated, spindly cells streaming in parallel arrays
Glandular: Forming polarized gland structures with lumens
Glomeruloid: A coiled tangle of vessels, capillaries, or glands
Describe the architectural pattern:
Herringbone
Hobnailed
Indian file
Herringbone: Resembling tweed fabric; bundles in zigzag array
Hobnailed: Epithelial or endothelial cells protruding into a lumen
Indian file: Cells infiltrating through tissue in single-file lines
Describe the architectural pattern:
Microcystic
Micropapillary
Nested
Microcystic: Scattered small cystic spaces that are not ducts or tubules
Micropapillary: Papillary shaped projections without fibrovascular cores
Nested: Same as alveolar
Describe the architectural pattern:
Pagetoid
Palisading
Pagetoid: Single malignant cells scattered in a benign epidermis (evident at low-power)
Palisading: Parallel arrays of nuclei resembling a fence
Describe the architectural pattern:
Polarized
Pseudopapillary
Polarized: Epithelial cells that have a uniform nuclear position, often surrounding a true lumen.
Pseudopapillary: A papillary pattern caused by cell die-off in between fibrovascular septa
Describe the architectural pattern:
Reticular
Rosettes
Reticular: Resembling a network or net-like array
Rosettes: A group of nonepithelial cells that are clustered around a lumen or fibrillary core
(pseudorosettes are around a vessel)
Describe the architectural pattern:
Spindled
Staghorn vessels
Spindled: Composed of elongated cells with fusiform nuclei
Staghorn vessels: Gaping, branching vessels with thin walls, scattered throughout a lesion
Describe the architectural pattern:
Storiform
Syncytial
Storiform: Spindled lesion with a cartwheel pattern, whorls of cells rather than parallel or right-angle bundles
Syncytial: Having cytoplasmic continuity between the constituent cells
Describe the architectural pattern:
Tissue culture pattern
Trabecular
Tissue culture patern: Loose aggregate of stellate cells with delicate tentacles of cytoplasm
Trabecular: In cord-like arrays separated by fibrous septae
Recall six forms of necrosis and their morphology
Coagulative: Mummified cells with preserved architecture
Caseating: Total loss of cellular structure and architecture
Fibrinoid necrosis: Vessel wall replacement by pink amorphous material
Fat necrosis: Disrupted fat cells with foamy macrophages and giant cells
Geographic necrosis: Large confluent patches of necrosis
Necrobiosis / Gangrenous necrosis: Granular and blue with fibrin deposition
Describe the cellular descriptor:
Amphophilic
Foamy macrophages
Granular
Amphophilic: A unique color, almost iridescent purple.
Foamy macrophages: Small dark eccentric nuclei with glittery granular lipid vacuoles
Granular: Containing granules or tiny vacuoles, more obvious without a condenser
Describe the cellular descriptor:
Hof
Keratinized
Mucinous
Hof: Perinuclear clear zone, corresponds to golgi apparatus
Keratinized: Very pink and dense appearance on H&E
Mucinous: Appears clear after processing, will stain mucicarmine or PAS/AB.
Describe the cellular descriptor:
Oncocytic
Plasmacytoid
Signet ring
Oncocytic: Large cells with granular eosinophilic cytoplasm (due to mitochondria)
Plasmacytoid: Round cells with abundant cytoplasm and an eccentric round nucleus
Signet ring: Ring-shaped, with a nucleus flattened by a cytoplasm stuffed with mucin
Describe the nuclear descriptor:
Clock-face
Molding
Neuroendocrine
Clock-face: Evenly distributed clumped chromatin, resembles a soccer ball
Molding: Pressing into and indenting each other due to near-absence of cytoplasm
Neuroendocrine: Finely speckled or salt & pepper chromatin. Bland cells.
Describe the nuclear descriptor:
Pleomorphic
Vesicular
Cherry-red nucleolus
Pleomorphic: Multiple sizes and shapes, irregularity
Vesicular: Full of vesicles/bubbles in the chromatin
Cherry-red nucleolus: Enlarged, solid nucleolus with a refractile reddish tinge. Implies malignancy.
Describe the membrane descriptor:
Ciliated
Intercellular bridges
Ciliated: Having cilia, but sometimes the terminal bar is enough
Intercellular bridges: Corresponds to desmosomes, the prickles or spines between squamous cells
Describe the stromal descriptor:
Myxoid
Desmoplastic
Ectatic
Myxoid: Resembling mucus; faint pink to bluish grey and paucicellular. Associated with soft tissue lesion and hyaluronate.
Desmoplastic: Causing edema and fibrosis, appears as a pale halo around an infiltrating gland.
Ectatic: Dilated, often filled with macrophages and debris
Describe the stromal descriptor:
Edematous
Fibrotic/sclerotic
Hyaline
Edematous: Cleared-out space due to waterlogging
Fibrotic/sclerotic: Pink and opaque on H&E with streaming in parallel fibers
Hyaline: Clear, transparent, homogenous. Glassy-pink
Describe the noncellular entity:
Amyloid
Anthracotic pigment
Calcium, psammoma bodies
Colloid
Amyloid: Glassy pink, stains salmon-pink with congo and fluoresces apple-green
Anthracotic pigment: Very black, dense fine granules
Calcium/psammoma: Purple and granular, with hard edges. Psammomma = concentrically laminated
Colloid: Could refer to mucin-producing neoplasm or thyroidal colloid (thin homogeneous pink)
Describe the noncellular entity:
Hemosiderin
Lipofuscin
Melanin
Tattoo pigment
Hemosiderin: Glittery golden-brown refractile appearance
Lipofuscin: Yellowish-brown and granular
Melanin: NOT refractile, may be brown to grey
Tattoo pigment: Similar to anthracotic pigment, may be multicolored
