Histology Flashcards
What are neutrophils associated with?
acute inflammation
What a e nuceli like for neutrophils?
multi-lobed nuclei
What are lymphocytes associated with?
chronic inflammation (or could be lymphomas)
How much cytoplasm is in lymphocytes?
small cytoplasm
What do eosinophils look like?
red granules
What are eosinophils associated with?
- allergic reactions
- parasitic infections
- tumours e.g. Hodgkin’s disease
When could you have eosinophilic oesophagitis?
due to allergic reaction to food
What do mast cells contain?
Lots of granules
e.g. otacharia
What type of reaction are mast cells associated with?
type 1 hypersensitivity
What type of cells are macrophages?
phagocytic cells
What are macrophages associated with?
- late acute inflammation
2. chronic inflammation (including granulomas)
What are granulomas?
organised collection of activated macrophages
What is at the centre of granulomas?
giant cell (lots of nuclei)
What are granulomas associated with?
type 4 hypersensitivity reaction
What does the ziehl-neelson stain do?
reveals presence of acid fast bacteria
What are different types of tumours?
- Carcinomas
- Sarcomas
- Lymphoma
- Melanoma
What is a carcinoma?
malignant neoplasm of epithelial tissue
What is a sarcoma?
malignant tumour of connective tissue
What is a lymphoma?
malignant tumour of lymphoma (not benign)
What is a melanoma?
malignant tumour of melanocytes
What are types of carcinoma?
- squamous cell carcinoma
- adenocarcinoma
- transitional cell carcinoma
What production is squamous cell carcinoma associated with?
- keratin production
- produce intercellular bridges
- as they differentiate more they produce less keratin and less intercellular bridges
What do adenocarcinomas arise from?
glandular tissue
What production is adenocarcinomas associated with?
- mucin production
- form glands
How can you tell the type of tumour?
- pink stuff is keratin so it is squamous cell carcinoma
- forming a gland so it is a adenocarcinoma and mucin stain on it
What are sites of origin of squamous cancer?
- skin
- head and neck
- oesophagus
- anus
- cervix
- vagina
What stain is used in grandular eputhelium?
mucin stain (blue is mucin)
What are the sites of origin of adenocarcinomas?
- Lung
- Breast
- Stomach
- Colon
- Pancreas
What are the signs of a malignant melanoma?
- irregular
- nodular
- no sharp defined edges
- may bleed
What is the tumour histology in malignant melanoma?
brown pigment (malignant melanomas make melanin)
What stain can be used for melanin?
fontana
What are the two different types of stains?
- Histochemical
2. Immunohistochemical (antigens)
How do histochemical stains work?
- Based on the chemical reaction between the stain and a specific component of the tissue
- The product of this reaction has a specific colour or other property which can be identified
Why may you do a histochemical stain?
- high power microscopic view of liver
- cirrhotic patient
- nodules of liver cells, surrounded by fibrous tissue
- Lots of brown pigment - so do histochemical stain (an confirms iron rather than melanin for example
What stain is from haemochromatosis?
prussian blue iron stain positive
What stain may you do in glomerulus?
Thickened pink areas and do congo red stain to see cause and if positive confirms pink stuff is amyloid (can cause nephrotic syndrome)
What stain is done for amyloid?
congo red positive
How does amyloid show up with polarising?
apple green birefringence
How do immunohistochemical stains work?
- Based on using an antibody specific to an antigen in the tissue
- Need a detection system to make this binding visible
- Two antigen A and B
- Antibody binds to anti-antigen and marker system
How can you tell the type of tumour?
- Impossible to know, no keratin formation or gland formation or mucin or cellular bridges
- Stain tumour with epithelial marker: and brown is positive
What epithelial marker is used?
cytokeratin and brown is positive so would be carcinoma
What is a lymphoid marker?
CD45 (brown is positive)
What stains may you use to find out primary for liver metastasis?
Stain with CK7 and it is negative (brown parts are normal bile duct and liver)
What would CK20 + and CK7 - mean?
colorectal cancer
Can you use stains for infections and how?
- yes
- some cells have multiple nuclei and pale centres which is characteristic of herpes simplex but also want to check it is not chickenpox so do imunochemistry with antibody for the herpes simplex and brown so positive:
What is a teratoma?
type of germ cell tumour
What tissue can teratoma contain?
- any of the 3 layers of embryo:
1. ectoderm: skin
2. mesoderm: connective tissue
3. endoderm: gut
Do teratomas always have all 3 layers of embryo?
any of the 3 layers of embryo:
- ectoderm: skin
- mesoderm: connective tissue
- endoderm: gut
Where are teratomas found?
ovaries and testes (gonads)
What does squamous epithelium make?
keratin
What tumours can come from surface epithelium of ovary?
- Serous
- Mucinous
- Endometriod
- Clear cell
- Brenner
- Mixed epithelial
- Undifferentated
- Mixed mullerian
What tumours arise from sex cord/stroma of ovary?
- Granulosa/theca celll tumours
- Fibroma
- Androblastoma
- Gonadoblastoma
What tumours arise from germ cells?
- teratoma
- dysgerminoma
- yolk sac tumour
- choriocarcinoma
What are types of somatic testicular germ cell tumours?
teratoma (mature or immature)
What are types of embryonic testicular germ cell tumours?
embryonal carcinoma (EC)
What are types of extra-embryonic testicular germ cell tumours?
- Yolk sac tumour
2. Choriocarcinoma
What are types of non differentiation germinal state c testicular germ cell tumours?
- Seminoma (testis)
- Dysgerminoma (ovary)
- Germinoma (extragonadal)
What is worse mature or immature?
immature: more aggressive, more malignant
What is the difference between ovarian and testicular teratomas?
- More common in ovary than testis
- In ovary: almost always “benign” - mature
- In testis: almost always “malignant”
- Incidence of testicular tumours is rapidly increasing
What is a dermoid cyst?
mature cystic teratoma
When are dermoid cysts common?
women
Why do teratomas happen?
occur from germ cells which have been left behind during embryonic migration from the posterior dorsal ridges
What areas are teratomas found in?
- outside the gonads usually in the middle of the body:
1. pineal
2. base of skull
3. mediastinum
4. retroperitoneum
5. sacro-coccygeal area - midline
What are 3 different types of teratomas?
- immature
- mature
- monodermal
What are two different types of mature teratoma?
- mature solid teratoma
2. monodermal cystic teratoma (dermoid)
How are teratomas graded?
1-3
Where are neuro-endocrine tumours found?
- present every part of body
- more common in GI tract
What are the immunohistochemical markers for neuroendcrine cells?
- Chromogranin
- Synaptophysin
- CD56
What hormones are involved in neuroendcrine cells?
gastrin, seretonin, insulin etc
What is needed for neuroendocine tumour?
anywhere with glandular epithelium
What is a common sit for neuroendcorine tumours?
appendix
What is a immunohistochemical marker that stains proliferating cells?
Ki-67 and Higher Ki-67 the higher the rate of proliferating cells
What syndromes are assoicted with hypersecretion of hormones and which ones?
- Zollinger-Ellison: gastrin (increased acid production so lots of peptic ulcers)
- Carcinoid: serotonin
- Hypoglycaemia: insulin
What is the triad of SEZ?
- pancreatic or duodenal tumours
- peptic ulcers
- gastric hypersecrertion