Amyloidoses & Rheumatology Flashcards
The wall of an artery stained with Congo red is shown under (A) ordinary light and (B) polarized light. Collagen has a silvery appearance. What is the red-green birefringence showing?
AL amyloid
Amyloid deposits in tissue
Which 2 letters represent the amyloid fibrils in the glomerulus?
A and S (for spicules)
What are the pink colored deposits?
AA amyloid in a glomerulus
Cerebrovascular amyloid seen with Congo red and polarized light, in what disease?
Alzheimer’s
Amyloid along the sinuses of what organ?
Liver
AL amyloid in the blood vessels of what organ?
Heart / myocardium
Dermal fibrosis / dense collagen accumulation beneath the epidermis and absence of dermal appendages are characteristic of what disease?
Scleroderma
Intimal thickening of the renal interlobular artery in what disease?
Scleroderma
Intense inflammatory cell infiltrate in the arterial wall and surrounding connective tissue is associated with fibrinoid necrosis and disruption of the vessel wall in what disease?
Polyarteritis nodosa
A. Chronic inflammation throughout the wall of a large artery and a lumen severely narrowed by intimal thickening. B. A high-power view shows giant cells adjacent to the fragmented internal elastic lamina (arrows). What disease is indicated?
Temporal / giant cell arteritis
Vasculitis of a pulmonary artery with chronic inflammatory cells and Langerhans giant cells (arrows) in the wall, together with thickening of the intima (asterisks). What disease?
Wegener’s granulomatosis / Granulomatosis with polyangiitis
A medium-sized artery with fibinoid necrosis and surrounding eosinophilic infiltrate indicates what disease?
Churg-Strauss / Eosinophilic granulomatosis with polyangiitis
A. Conspicuous coronary artery aneurysms in the heart of a child. B. A microscopic section of a coronary artery from the same patient shows two large defects (arrows) in the internal elastic lamina, with two small aneurysms filled with thrombus. What disease was present?
Kawasaki disease
Section of the upper extremity shows an organized arterial thrombus that has occluded the lumen. Some inflammatory cells are evident in the adventitial fat. In this instance, the vein (arrow) and the adjacent nerve (arrowhead) show foci of chronic inflammation. What disease?
Buerger disease
Necrosis of the fingertips in what disease?
Buerger disease
Name the four lettered zones of this articular hyaline cartilage section.
Tangential zone (T), transitional zone (Tr), radial zone (R) and calcified C zone (C)
Which 2 zones of this articular cartilage under polarized light have the highest concentration of collagen fibers (yellow)?
Tangential and radial zones
Fibrocartilaginous plug extending from the bone marrow to joint surface in what disease?
Osteoarthritis
Focal absence of the articular cartilage, thickening of subchondral bone (left), and a subchondral bone cyst indicate what disease?
Osteoarthritis
Hyperplastic synovium from a patient with what disease shows numerous finger-like projections, with focal pale areas of fibrin deposition? The brownish color of the syn- ovium reflects hemosiderin accumulation derived from old hemorrhage.
Rheumatoid arthritis
A microscopic view reveals prominent lymphoid follicles (Allison- Ghormley bodies; arrows), synovial hyperplasia and hypertrophy, villous folds and thickening of the synovial membrane by fibrosis and inflammation. What disease is shown?
Rheumatoid arthritis
A higher-power view of the inflamed synovium demonstrates hyperplasia and hypertrophy of the lining cells. Numerous giant cells are on and below the surface. The stroma is chronically inflamed. What disease?
Rheumatoid arthritis
Rheumatoid arthritis
A. Subcutaneous mass on a digit. B. Microscopic view shows a central area of necrosis surrounded by palisaded macrophages and a chronic inflammatory infiltrate. What disease is this nodule related to?
Rheumatoid arthritis nodule
The vertebral bodies are square and have lost most of their trabecular bone, owing to osteoporosis from disuse. Bone bridges fuse one vertebral body to the next across the intervertebral disks. Por- tions of the intervertebral disk are replaced by bone marrow. Bony bridges also fuse the posterior elements
Ankylosing spondylitis
What disease is shown?
Gout
Histologic section in bright field demonstrates brownish monosodium urate crystals within the bone. What disease?
Gout
High-power micrograph in polarized light with a quartz compensator plate demonstrates negative birefringence of what crystals (those having their long axes parallel to the slow compensator axis are yellow)?
Urate crystals (gout)
A section through the tophus (if usual aqueous processing is used) demonstrates a foreign body reaction around a pink, amorphous lesion from which the urate crystals have been dissolved during processing. What disease?
Gout
A radiograph of the first metatarsophalangeal joint shows a lytic lesion that destroys the joint space. There is an adjacent soft tissue tophus, as well as surrounding edema. What disease?
Gout
A. Gross specimen demonstrates chalky-white calcific material. B. Microscopically, the deposits are deep purple with discernible rhomboid-shaped crystals. What disease?
CPPD (calcium pyrophosphate dihydrate) deposition disease
Nodules of benign hyaline cartilage forming in the synovium cause what disease?
Synovial chondromatosis
