Histo buzzwords Flashcards
Mastitis
High neutrophils
Breast abscess
Aspirate + culture
Incision + drainage + IV abx (flucloxacillin)
Duct ectasia
Greeny brown discharge
Duct dilatation w/ proteinaceous materials inside ducts + macrophages
Fat necrosis
Damaged fat lobules w/ empty fat spaces
Fibroadenoma
Most COMMON cause of mobile lump in young women
Firm mobile + painless
Stromal proliferation
Phyloides tumour
‘leaf like’ fronds (projections) / ‘artichoke’ appearance
‘malignant fibroadenoma’ - but actually pre-malignant (just more malignant than fibroadenoma)
Fibrocystic disease
Fibrocyst = fluid filled
Size varies w/ periods
Intraductal papilloma
red discharge (bloody)
Dilated duct w/ papillary mass
Radial scar
Mimics breast cancer (but is not cancer) - centrofibrous stellate area
Gynaecomastia
‘Finger-like’ projections
Breast cancers - meaning of cytopathology:
1. 4
2. 5a
3. 5b
- 4 - suspicious of malignancy
- 5a - carcinoma in situ
- 5b - invasive carcinoma
Invasive ductal carcinoma (renamed to no special type -..-)
Most COMMON breast cancer
Large pleomorphic cells
(any breast cancer that can’t be categorised falls into this category - i.e. no specific features)
Invasive lobular
Indian file (single file)
E-cadherin loss
Invasive tubular
Elongated tubules
Invasive mucinous
Empty spaces w/ mucin
Ductal carcinoma in situ
Microcalcifications + necrosis
Lobular carcinoma in situ
NO microcalcifications OR necrosis
Nottingham grading system (used to grade breast cancer) is composed of:
- tubule formation
- nuclear pleomorphisms
- mitotic activity
Prognosis is dependent on…
BONUS: Mx
- Axillary lymph node status
- Oestrogen + progesterone receptor positive = good prognosis
- HER positive = poor prognosis
BONUS: MX -
ER +ve = Tamoxifen (CI: fluoxetine, post-menopausal)
Instead give anastrazole for post-menopausal
HER +ve = Herceptin (AKA trastuzumab)
Basal cell carcinoma of the breast
Triple negative for all receptors (oestrogen, progesterone, HER)
Lymphocytic infiltrate
Test for: basal cytokeratins
Gynae:
1. complication of PID?
2. Endometriosis - where/what are chocolate cysts
3. Fibroids - what type of muscle cell?
4. What type of epithelium is involved in VIN?
5. What proteins do HPV 16 + 18 affect?
- Fitz-Hugh-Curtis
- Endometriomas, typically found on ovaries
- Bundles of smooth muscle cell
- Squamous epithelium (squamous carcinoma AKA primary vulval carcinoma = MOST COMMON type of vulval carcinoma)
- 16 encodes for E6 (inactivates p53); 18 encodes for E7 (inactivated retinoblastoma)
Follicular cyst (ovarian)
regress after several menstrual cycles
only found in pre-menopausal women
Dermoid cyst
(or mature / cystic teratoma)
Hair
Rokitansky protruberance (meaning hair + teeth)
Teeth
Dysgerminoma
AKA female seminoma
MOST common ovarian malignancy in young women + responsive to radiotherapy
NOTE: seminomas treated w/ surgery
Serous ovarian cancer
psamomma bodies
most COMMON benign epithelial tumour
Mucinous ovarian tumour
pseudomyxoma peritonei
Endometroid ovarian tumour
Mimics endometriosis w/ chocolate cysts
Large increase in Ca125
SBA: deep dyspareunia + raised Ca125
Fibroma
Meigs syndrome = fibroma + ascites + pleural effusion
Sertoli / leydig tumour
virilisation + hirsutism (+ defeminisation w/ breast atrophy)
Krukenberg tumour (ovarian)
from gastric mets
signet ring cells
SLE
anti-smith = most sensitive
anti-dsdNA
anti-histone = drug-induced lupus
Libman sack endocarditis - associated w/ SLE
Limited systemic sclerosis
anti-centromere antibodies
CREST syndrome
Diffuse systemic sclerosis
anti-Scl 70
Polymyositis
anti-Jo-1
proximal muscle weakness
high creatine kinase
EMG +ve (p
olymyositis = p
ositive)
Dermatomyositis
anti-Jo-1
EMG -ve
Gottron’s papules
Takayasu
pulseless (but alive)
Temporal arteritis
GGS
- g
iant cells, g
ranulomatous transmural inflammation,s
kip lesions
Like Crohn’s but in temporal arteritis
polyarteritis nodosa
associated w/ Hep B
rosary bead appearance
Kawasaki disease
fever for >5 days, strawberry tongue, coronary aneurysm (do ECHO!)
thromboangitis obliterans (Buerger’s disease)
HEAVY smokers
Tibial + radial arterial inflammation
corkscrew appearance of vessels
Small vasculitides:
1. granulomatous w/ polyangiitis
2. eosinophilic granulomatous w/ polyangiitis
3. Microscopic polyangiitis
4. HSP
affects renals
fibrous dysplasia
McCune Albright syndrome = cafe au lait spots + fibrous dysplasia + precocious puberty
‘chinese letters’
soap bubble osteolysis
fibrous dysplasia in femoral head = ‘shepherd’s crook’
osteoma
histology = normal
associated w/ Gardner’s (FAP + osteomas)
osteoid osteoma
usually presents in proximal femur
histology = normal
X-ray finding = radiolucent nidus w/ sclerotic rim (looks like a bullseye)
SBA: dull pain made better w/ aspirin
osteochondroma
most common benign tumour
bony protuberance w/ cartilage cap (AKA mushroom)
giant cell tumour
giant cells + soap bubble appearance (similar to fibrodysplasia)
enchondroma
popcorn / cotton wool appearance
Malignant bone tumours
- Osteosarcoma = sunburst appearance
- Ewing’s = onion skin
- Chondrosarcoma = ‘fluffy’ calcifications
Rheumatoid arthritis
spares DIP
HLA DR4
multinucleate giant cells (AKA grimley sokoloff)
Osteoarthritis
LOSS; thickeness of bone plate
Osteomyelitis
10 days after onset = involucrum (new bone fromation)
Later = sequestrum detachment
Ankylosing spondylitis
HLA B27
CXR = apical fibrosis
sacroiliitis
psoriatic arthritis
HLA B27
pencil in a cup deformity
Paget’s disease
increased risk of osteosarcoma
isolated high ALP
Osteolysis in early disease; mixed lytic / sclerotic lesions later
Ricket’s / osteomalacia
vitamin D deficiency –> reduced bone mineralisation
kids = bowed legs
osteomalacia = looser zones (pseudofractures)
hyperparathyroidism
osteitis fibrosa cystica = v. thin bones
(+ brown tumours)