Histology Flashcards
This patient has proteinuria, haematuria, and hypertension.
What is the diagnosis?
What would be found on light microscopy?
The image shows linear deposits of Ig along the GBM suggestive of anti-GBM disease.
Glomerular crescents composed of proliferating parietal cells with monocytic and macrophagic infiltration would be seen on LM.
This patient has nephrotic syndrome.
What is the histology suggestive of?
What would be seen on EM?
There is uniform, diffuse thickening of the glomerular capillary wall WITHOUT an increase in cellularity (cf membranoproliferative) , this is consistent with membranous glomerulopathy.
EM shows classical dense deposits manifest as “spikes” seen when silver stain is used.
What are the causes of this histological appearance?
The slide is suggestive of membranous glomerulonephropathy.
85% of MGN is idiopathic.
The remainder occur secondary to:
Diabetes, Solid tumours, SLE
Drugs
Infections
This image is suggestive of what?
What is the pathophysiology of the albuminuria associated with this disease?
The effacement of the podocyte foot processes is characteristic of minimal change disease, the most common cause of nephrotic syndrome is children.
Podocyte foot process fusion causes loss of the anionic charge which leads to selective loss of albumin.
In the context of nephrotic syndrome, what is the image below most suggestive of?
What is the likely cause?
What is the pathongomonic lesion shown?
Nodular glomerulosclerosis.
Diabetic nephropathy is the most common cause of NS.
The Kimmelsteil-Wilson nodule (pink hyaline material) is generated by damaged matrix from chronic glycosylation.
What is the image below suggestive of in the context of nephrotic syndrome?
What are the causes of this nephropathy?
Focal segmental glomerulosclerosis can develop secondary to HIV infection, heroin abuse, and severe obesity.
It is a less common cause of nephrotic syndrome in adults and children.
What are the cells on the slides called?
What does the presence of these cells suggest?
Koilocytes (on the right).
Large nuclei, hyperchromasia, and perinuclear clearing are characteristic findings in Koilocytes.
They are present in HPV infection, so confer risk for anal, oral, or cervical cancer.
What is the breast lesion demonstrated in this slide?
What are the classical histological features?
Fibroadenomas are characterised by a benign-appearing cellular or myxoid stroma that encircles epithelium-lined glandular and cystic spaces.
This is a slide from a breast lesion in a 62 year old female.
What are the findings consistent with?
This is DCIS; there is malignant clonal cell proliferation contained by the surrounding basement membrane.
This slide was taken from a breast biopsy.
What is the type of tumour represented in the slide?
Medullary carcinoma of the breast.
Note the characteristic solid sheet of vesicular, pleomorphic mitotically active cells pushing, not invading, nearby normal tissue.
This slide was taken from a breast biopsy.
What is the lesions? Is it malignant?
The slide has features of sclerosing adenosis.
There is central acinar prolieration and compression of surrounding tissue with surrounding fibrotic tissue.
It is not malignant. It confers 1.5-2.0 x risk for Ca breast.
What fungus causes this appearance?
How is the diagnosis confirmed?
These small ovioid bodies within a macrophage are characteristic of Histoplasma infection.
Diagnosis is confirmed on culture with Sabourad agar, serolgy with complement fixation, and Histoplasma antigen in urine and blood.
What is the endemic location of the pathogen in the slide below?
Coccidioides immitis is endemic to desert areas of the United States and Mexico.
What is this stain?
How does it work?
This slide shows acid-fast bacilli; likely mycobacteria or nocardia.
The Ziehl-Neelson stain works by first applying an aniline dye (carbolfuschin). In AFB, the dye penetrates the cell wall and fixes to mycolic acid. The sample is then washed with HCl and EtOH, which dissolves the outer membrane of all the bacteria, but does not wash away the colour set into the mycolic acid. A counter-stain is then used, which is taken up by non-mycolic acid bacteria.
What does this slide demonstrate?
The Reid index is the ratio of the thickness of the mucous gland layer in the bronchial wall submucosa, to the thickness of the bronchial wall between the epithelium and bronchial cartilage.
Values over 40% correlate well with severity and duration of COPD.
This biopsy is from a 16 month old girl with diarrhoea.
What is the disease?
What are the characteristic findings?
Celiac’s disease.
The hallmark signs are villous atrophy and crypt hyperplasia.
The presence of Brunner’s glands confirms that this biopsy is from the duodenum.
This slide was taken from an ileocolic specimen in a young patient with restricted ileal disease.
Which cell type is repsonsible for the lesion?
Non-caseating granulomas are characteristic of Crohn’s disease.
TH-1 cells mediate the delayed hypersensitvity reaction and granuloma formation seen in Crohn’s. In contrast to UC, which has a TH-2 predominance.
This is a jejunal biopsy from a 5 month old with steatorrhoea.
What is the diagnosis?
What might be seen on peripheral blood film?
Alipoproteinaemia.
The foamy inclusions of the enterocytes are accumulations of lipid due to impaired formation of apolipoprotein-B containing lipoproteins.
Acanthocytes might be seen on peripheral blood smear, a result of impaired absorbtion of fat-slouble vitamins.
