Block 10 - Haematology

Question 1

Haematology pathologies?

Answer 1

Question 2

What is bottle 482?

Answer 2

**482 Spleen: Infarction
**
Infarction of many internal organs leads to a “pale” infarct with a wedge-shaped gross appearance (conical in 3 dimensions) from occlusion of a branching blood supply. Here are splenic infarcts in a patient with infective endocarditis. Portions of the vegetations have embolized to the spleen. These infarcts are typical of ischemic infarcts: they are based on the capsule, pale, and wedge-shaped. The remaining splenic parenchyma appears dark red.

Question 3

2255 Spleen: Aneurysm of splenic artery; secondary to amyloidosis

Answer 3

2255 Spleen: Aneurysm of splenic artery; secondary to amyloidosis

Question 4

What is bottle 452?

Answer 4

452 Spleen: Abscess

Question 5

1921 Spleen: Miliary tuberculosis.

Answer 5

**1921 Spleen: Miliary tuberculosis.
**
This spleen shows a miliary pattern of granulomatous inflammation, with numerous small tan granulomas. This suggests a poor immune response. This patient had AIDS. The infection turned out to be Mycobacterium avium-intracellulare (MAI), also known as Mycobacterium avium-complex (MAC). This organism is unlikely to produce infection in immunocompetent patients.

Question 6

What is bottle 493?

Answer 6

**493 Spleen: Gaucher’s disease.
**
This is a cut section of spleen from this case. Again note the fine granular appearance to the tissue.

Question 7

What is bottle 501?

Answer 7

501 Spleen: Hodgkin’s disease

Question 8

2002 Para-aortic lymph nodes: small cell lymphocytic lymphoma

Answer 8

2002 Para-aortic lymph nodes: small cell lymphocytic lymphoma
****Definition / general
** Indolent mature B cell lymphoma
* Clonal proliferation of B cells with characteristic phenotype
** Essential features
*** Indolent mature B cell lymphoma
* Most common adult leukemia in the Western world
* Characteristic immunophenotype with CD19, CD5, CD20, CD23, CD200 positivity
* 2 types with distinct biological behavior based on mutation status of rearranged IGH gene

Question 9

490 Spleen: histiocytic lymphoma

Answer 9

**490 Spleen: histiocytic lymphoma
**A rare, very aggressive (fast-growing) type of non-Hodgkin lymphoma (cancer that begins in the cells of the immune system). It is marked by large abnormal lymphoid cells that do not look like T cells or B cells.

Question 10

what is bottle 2042?

Answer 10

2042 Calvarium - Multiple myeloma

Question 11

2083 Thymus: Spindle celled thymoma

Answer 11

**2083 Thymus: Spindle celled thymoma
**
Malignant epithelial tumor of the thymic gland
Gross description
* Lobulated
* Gray-tan
* Often encapsulated
* Possibly with cystic changes
* Sampling of perithymic lymph nodes important for staging

Question 12

What is bottle 496 Spleen?

Answer 12

496 Spleen: Metastatic adenocarcinoma

Question 13

373 Lymph node: Kaposi’s sarcoma

Answer 13

373 Lymph node: Kaposi’s sarcoma

Question 14

What is bottle 726?

Answer 14

**726 Lymph nodes: Sarcoidosis
**
Coronal section through the lungs, trachea and hila in a patient with sarcoidosis, demonstrating extensive right paratracheal and hilar nodal enlargement (giving rise to the lambda sign).

Sarcoidosis is a systemic disease of unknown etiology that is characterized by non-necrotizing granulomas in multiple organs and tissues. It is seen worldwide, although it is more common in the Scandinavian countries. In the US, the incidence is 10-15 times higher in blacks as compared to whites.

The most commonly affected organs and tissues include lung, lymph nodes, eyes, skin, and liver. Most cases present with bilateral hilar lymphadenopathy and/or lung involvement. Hilar lymph nodes and paratracheal lymph nodes are enlarged in 75% and 90% of cases respectively. One-third of patients have peripheral lymphadenopathy. The involved lymph nodes are yellow-white, rubbery, firm, non-matted and do not ulcerate.

Question 15

What is bottle 460?

Answer 15

460 Traumatic rupture of the spleen