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
Architecture? Diagnosis?
Alveolar pattern; paraganglioma
Architecture? Diagnosis?
Basaloid pattern; BCC
Architecture? Diagnosis?
Cribriform; adenoid cystic carcinoma
Architecture? Diagnosis?
Epithelioid; breast carcinoma
Architecture? Diagnosis?
Fascicular; leiomyoma
Architecture? Diagnosis?
Herringbone; fibrosarcoma
Architecture? Diagnosis?
Hobnailed; angiosarcoma
Architecture? Diagnosis?
Microcystic; acinic cell carcinoma
Architecture? Diagnosis?
Micropapillary; serous ovarian carcinoma
Architecture? Diagnosis?
Papillary; papillary carcinoma of breast
Architecture? Diagnosis?
Reticular; yolk sac tumor
Architecture? Diagnosis?
Rosette; ependymoma
Architecture? Diagnosis?
Staghorn vessels; hemangiopericytoma
Architecture? Diagnosis?
Storiform; dermatofibrosarcoma protuberans
Architecture? Diagnosis?
Tissue culture cells; nodular fasciitis
Architecture? Diagnosis?
Trabecular; oncocytoma
What is this?
Coagulative necrosis
(ischemic bowel)
What is this?
Caseating necrosis
(TB granuloma)
What is this?
Fibrinoid necrosis
(pulmonary vessel)
What is this?
Fat necrosis
(breast)
What is this?
Gangrenous necrosis
(toe wound)
Describe the distinctive morphologic feature here.
Amphophilic cytoplasm
(pheochromocytoma)
Describe the distinctive morphologic feature here
Foamy macrophages
(papillary RCC)
Describe the distinctive morphologic feature here
Keratinization
(squamous cell carcinoma)
Describe the distinctive morphologic feature here.
Plasmacytoid cells
(plasmacytoma)
Describe the distinctive morphologic feature here
Signet ring cells
(breast carcinoma)
Describe the distinctive morphologic feature here
Nuclear molding
(small cell carcinoma)
Describe the distinctive morphologic feature here.
Neuroendocrine nuclei
(carcinoid tumor)
Describe the distinctive morphologic feature here.
Cherry-red nucleoli
(melanoma)
Describe the distinctive morphologic feature here.
Myxoid stroma
(myxoid myxofibrosarcoma)
Describe the distinctive morphologic feature here.
Desmoplastic stroma
(colon cancer)
Describe the distinctive morphologic feature here.
Hyaline deposits
(schwannoma)
Describe the distinctive morphologic feature here.
Hemosiderin
(nasal polyp)
