Cardio/Heme Flashcards
Normal Bone Marrow
Aplastic anemia
Hypochromic, microcytic anemia
“Hair-on-end” new bone formation; beta-thalassemia major
Macrocytic, megaloblastic anemia (vitamin B12 or folate deficiency)
megaloblastic anemia (see hypersegmented neutrophil)
Sickle cell anemia (see sickled RBCs)
glucose 6 phosphate-dehydrogenase deficiency (see Heinz bodies and bite cells)
Hereditary spherocytosis
Pseudo-Pelger-Huet neutrophil (hyposegmented neutrophil; myelodysplastic syndrome)
Nucleated RBCs with myelocytes (myelodysplastic syndromes)
Ringed sideroblasts (myelodysplastic syndromes)
Bi-lobed Pelger-Huet cells with a blast (myelodysplastic syndromes)
Multiple myeloma, bone marrow aspirate (mostly mature-appearing plasma cells with eccentrically placed nuclei; prominent Golgi zones)
Mott Cell (intracellular accumulation of Ig in multiple myeloma bone marrow aspirate)
Flame cell (multiple myeloma, see fiery red cytoplasm)
Dutcher Bodies (nuclear globules, multiple myeloma)
Antibody monoclonal proliferation in multiple myeloma
Lytic bone lesions, multiple myeloma
Rouleaux formation, multiple myeloma
Auer rods, acute myelogenous leukemia (AML)
Abnormal hypercellular bone marrow in acute myeloid leukemia (AML)
promyelocytes in bone marrow and peripheral blood, acute promyelocytic leukemia (APL, and AML subtype)
Gingival hyperplasia, monocytic leukemia (AML subtype)
Leukemia cutis, monocytic leukemia (AML subtype)
Acute lymphoblastic leukemia (ALL) peripheral blood evaluation (multiple “blasts” are shown)
Acute lymphoblastic leukemia (ALL) bone marrow (packed with leukemic cells)
Chronic myeloid leukemia (CML) peripheral smear (numerous granulocytes at varying degrees of maturation)
Chronic myeloid leukemia (CML) peripheral smear (cells in varying degrees of maturation)
Chronic lymphocytic leukemia (CLL) peripheral smear (increased lymphocytes)
Hairy cell leukemia (chronic leukemia)
Hairy cell leukemia, TRAP stain (TRAP+)
Smudge cell, small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) (NHL)
Mantle cell lymphoma (abnormal architecture without the mantle zone)
t(11;14) translocation => cyclin D overexpression
Mantle cell lymphoma (cyclin D stain); NHL
t(11;14) => cyclin D overexpression
Follicular lymphoma NHL (resembles normal germinal center B cells and mimics follicular architecture of normal lymphoid tissues)
t(14;18) => Bcl-2 overexpression
Follicular lymphoma NHL
t(14;18) => Bcl-2 overexpression
Marginal cell (MALT) lymphoma
associated with infections (H. pylori)
Marginal cell (MALT) lymphoma
Lymphoepithelial lesion, marginal cell (MALT) lymphoma
Marginal cell (MALT) lymphoma
Burkitt lymphoma NHL (starry sky appearance)
t(8;14) => MYC/IGH
t(8;22) => MYC/lambda
t(2;8) => MYC/kappa
Burkitt lymphoma NHL (Ki-67 stain)
t(8;14) => MYC/IGH
t(8;22) => MYC/lambda
t(2;8) => MYC/kappa
Burkitt lymphoma NHL sporadic form (ileocecal mass)
t(8;14) => MYC/IGH
t(8;22) => MYC/lambda
t(2;8) => MYC/kappa
Burkitt lymphoma NHL (starry sky)
Burkitt lymphoma NHL, endemic form
t(8;14) => MYC/IGH
t(8;22) => MYC/lambda
t(2;8) => MYC/kappa
Diffuse large B cell lymphoma NHL
t(3;6)
Mycosis fungoides NHL (oncology equivalent of a burn)
Anaplastic large cell lymphoma NHL
t(2;5)
Anaplastic large cell lymphoma NHL (CD30+, ALK+)
t(2;5)
Classical Reed-Sternberg cell (HL)
Reed-Sternberg cell, multinucleated variant (HL)
Reed-Sternberg cell, mononuclear variant (HL, mixed cellularity type)
Reed-Sternberg cell, lacunar variant (HL, nodular sclerosis type)
Hyaline arteriolosclerosis
Hyperplastic arteriolosclerosis
Monckeberg medial sclerosis (calcification of media in muscular artery; no effect on lumen; not clinically significant)
Fatty streak (foam cells, T cells, small amounts of extracellular lipid)
Plaque rupture - exposes thrombogenic substances and can induce thrombus formation
Plaque rupture with thrombus formation
Consequence of complicated atherosclerotic lesion: cholesterol embolus in kidney vessel
Ruptured abdominal aortic aneurysm
Aortic dissection, blood splays apart the media to form a channel
Aortic dissection
2-4 hours post-MI: triphenyltetrazolium chloride-stained section
Pale area indicates lack of LDH due to leakage from dead cells; white scar indicates old infarct
[microscopically, you might see wavy fibers at borders]
12 hours post-MI
Microscopic: wavy fibers, pyknosis, hypereosinophilia, hemorrhage
Gross: mottling
24 hours post-MI
Microscopic: pyknosis, hypereosinophilia, few neutrophils
[Gross: mottling]
1-3 days post-MI
Microscopic: neutrophilic infiltrate, loss of striations and nuclei of myocytes
[Gross: mottling with yellow-tan infarct center]
3-7 days post-MI
[Microscopic: phagocytosis at borders, disintegration of myofibers and dying neutrophils]
Gross: hyperemic border, central yellow-tan softening
7-10 days post-MI
Microscopic: phagocytosis and early granulation tissue formation
[Gross: depressed red-tan margin, soft yellow-tan center]
10-14 days post-MI
Microscopic: trichrome stain shows early collagen deposition; well-established granulation tissue, neovascularization and collagen
[Gross: depressed red-gray infarct borders]
2-8 weeks post-MI
Microscopic: collagen deposition, less cellular
Gross: gray-white scar
2-8 weeks post-MI
Microscopic: collagen deposition, less cellular
Gross: gray-white scar
Reperfusion injury: myocytes with prominent hypereosinophilic cross-striations spanning myofibers (because of hypercontracted sarcomeres)
Infective endocarditis
Infective endocarditis
Nonbacterial thrombotic endocarditis (NBTE)
Aortic valve with calcific aortic stenosis
Calcific aortic stenosis
Bicuspid aortic valve
Mitral valve prolapse
Mitral valve prolapse
Mitral valve prolapse
Mitral annular calcification
Mitral stenosis
Dilated cardiomyopathy
Dilated cardiomyopathy
Hypertrophic cardiomyopathy
Restrictive cardiomyopathy (heart showing thickened walls; tissue shows a pale “waxy” appearance and consistency - characteristic of amyloidosis
Cardiac amyloidosis
Atrial septal defect, secundum type (defect located at and resulting from a deficient or fenestrated oval fossa); L-to-R shunt
Ventral septal defect, membranous type; L-to-R shunt
Patent ductus arteriosus
Tetralogy of Fallot (narrow pulmonary valve, thickening of right ventricular wall, overriding aorta, ventricular septal defect)
Transposition of the great vessels
Hemopericardium
Acute pericarditis (“shaggy” surface)
Suppurative pericarditis
Caseous pericarditis
Myxoma
Myxoma
Lipoma
Angiosarcoma
