histology images - julia Flashcards
1
Q
A
- granulomas in lung due to TB
- glassic giant cells
- ringed by lymphocytes
- sometimes focalized necrosis
- epitheliod histeocytes (activated macrophages that look like epithelial cells)
2
Q
A
- erythrobastosis fetalis
- liver
- contains lots of erythroblasts cause body is trying to make as many RBCs as possible so using every organ it can
2
Q
A
- small vessel vasculitis in lung
- type III hypersensitivity response
- usually due to drug response/reaction
- called microangitis or microvasculitis
2
Q
A
- joint of RA patient
- low magnification (middle) shows synovial hypertrophy with formation of villi
- higher magnification (right) shows subsynovial tissue containing dense lymphoid aggregate
2
Q
A
- healthy bone marrow
- not lots of cells, little fat
2
Q
A
- liver stained with congo red and viewed under polarized light in patient with amyloidosis
- amyloid is the bright yellow/green areas
2
Q
A
- metastasizing sarcoma in lymphatic vessels in lung
- not metastesized yet because not out of lymphatic vessel and established in lung tissue
- shouldn’t be cells in lymphatics
- cells in lymphatics are abnormally structured, darkly stained, pleomorphic
- center of slide is normal alveolar structure of lung
2
Q
A
- pancreatic adenoma
- occurs 6-12 months into development of cancer
- still benign cause confined to basement membrane
- cells smaller, densely packed in comparison to normal cells
- normal cells on the edge
- enlargement of previous hyperplastic nodule
3
Q
A
- colon of patient with amyloidosis
- congo red stain
- the amyloid plaque is the bright area in teh middle (which looks yellow to me but should be granny smith apple green)
- overall, congo red stains the tissue red, but if you look at it under polarized light, the dye will act as a lens if it’s attached to amyloid and will therefore reflect in the green spectrum
4
Q
A
- adenocarcinoma of lymph node
- not normal archetecture - very complex
- nuclei darkly stained
- hyperchromasia
4
Q
A
- cervix with lesion
- darkly stained, crowded nuclei all the way through the top
- no layers
- increase in mitotic figures
- atypical cells involved through the full thickness of epithelium but doesn’t invade through the basement membar so not invasive
5
Q
A
- heart with amyloidosis
- cardiac myocyte on left
- asterisk indicates amyloid fibril deposition in space between myocytes
*
6
Q
A
- acute cellular rejection in kidney
- type IV hypersensitivity reaction
- lymphocytes in renal parenchyma
- dard spots in tubules = lymphocytes infiltrating
6
Q
A
- gut (probably colon)
- can see calonic crypts and smooth muscle (muscularis mucosae)
- in middle, though, there’s a paler pink area - this is deposition of amyloid in patient with amyloidosis
- in GI tract, usually develops in and around submucosal vessles first
- therefore need adequate amounts of submucosal tissue to rule out amyloidosis using biopsy
7
Q
A
- lung of asthmatic patient
- smooth muscle hypertrophy - cells surrounded by white circles
- thickend basement membrane - should only be a thin red line
- lots of peribronchiolar inflammation
- ring aroung bronchial = chronic inflammation (includes lymphocytes, macrophages, plasma cells, mast cells, eosinophils
7
Q
A
- pancreas in type I diabetes
7
Q
A
- uterus
- leiomyoma
- tumor cells very uniform
- On left compressed myometrium
- Large mass on the right (everything after white area) is tumor
- On higher power they’d look similar
- Very well demarkated, circumscribed
- Well differentiated because so uniform and can identify it as smooth muscle
- Can tell its benign because so well differentiated, among other things
- Also look for increase in mytotic figures – if 4 mytoses per field likely malignant (don’t need to know this)
9
Q
A
- kaposi’s sarcoma lesion in AIDS patient
- dermis has dense cellular infiltrate, narrow slit-like vascular spaces
- disorganized, haphazard, dense
9
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A
- normal larynx
- normal maturation
- more crowded in basal layer
- basement membrane (darker layer) intact
9
Q
A
- gastric adenocarcinoma (ulcerated)
- bottom left is normal
- above that have an irregular boarder that’s not circumscribed
- overgrowth of glandular structure and complex archetecture implies invasive
10
Q
A
- glomeruli filled with amyloid in patient with amyloidosis
- bit more subtle
- can see aggregates in mysangium though
- agregates are the smooth light pink areas
10
Q
A
- pulmonary hamartoma
- mass of normal lung elements that are fully differentiated but not where they should be and not functional
- popcorn calcification
11
Q
A
- invasive pannus in patient with RA
- I’m assuming that this is in a joint…
11
Q
A
- ulceration tumor at illiocecal junction
- top has normal mucosa, normal polarity
- bottom has lost polaritiy
- glandular structure in submucosa - shouldn’t be there - invasive
12
Q
A
- liver stained with congo red in patient with amyloidosis
- the amyloid is stained dark red here
- this is under normal light (not polarized, where the amyloid would be green)
- should be able to tell that this is liver
- amyloid depostied around blood vessel walls, in sinusoids
13
Q
A
- graft atherosclerosis
- chronic graft rejection secondary to extensive damage to endotehlium and artery wall
14
Q
A
- GI biopsy in patient with amyloidosis
- all he said about it was that it was “distorted as the devil”
15
Q
A
- rhabdomyosarcoma in skeletal muscle
- bottom of image has normal skeletal muscle
- top has sarcoma
- cells don’t look like skeletal muscle anymore - overgrown, darkly stained, nuclear size much bigger, not normal archetecture of tissue
16
Q
A
- heart from patient with amyloidosis
- balnd cellular pinkish stuff = amyloid deposits
- can tell it’s not collagen because there’s not a lot of fibroblasts (but should use congo red stain to be sure)
17
Q
A
- granuloma in lymph nodes
- due to type IV hypersensitivity reaction
- giant cells
- sarcoidosis
18
Q
A
- interstitial pneumonitis (inflammation of lung) in RA
19
Q
A
- pancreas
- adenocarcinoma invading duodenal muscularis
- glandular archetecture on right, but doesn’t have normal archetecture
- invading into muscular layer - should only be in mucosal layer
20
Q
A
- rheumatic fever vegitations on mitral valve
- chordae tendinae get sticky, shorten, fuse together
- eventually get deformation of the valve
- vegitations form on the flow surface of the valve
21
Q
A
- chronic graft rejection in kidney
- scarred parenchyma
- occluded vessel
- wouldn’t know it’s kidney
- focal damage to vessel wall
- lumen so compromised by repeated and longstanding damage there’s no lumen left
22
Q
A
- low grade squamous cell carcinoma
23
Q
A
- osteosarcoma in bone
- hyperchromatic cells
- mytotic figure in center implies increased mitosis
- pleomorphic
25
Q
A
- lung
- CMV infection in AIDS patient
- characteristic intranuclear inclusion
- might see in advanced AIDS
27
Q
A
- inflammatory phase of vasculitis
- type III hypersensitivity
- muscullar blood vessel
- internal elastic lamina is the dark pink squiggly line
- thrombus formation in lumen
- on left side of blood vessel, smooth muscle layer gone
- in small/medium arteries called polyarteritis nerdosa
28
Q
A
- liver failure due to amyloidosis
- heavy amyloid infiltration (pale pink amorphous material)
- don’t need to be able to tell that this was liver - it’s too distorted at this point
- not much blood getting in, and sinusoids totally filled with amyloid
29
Q
A
- stepwise progression of colon dysplasia to adenocarcinoma
- dysplasia on left
- in middle is benign adenoma
- on right is malignat tumor mass invading muscle
- have normal epi on left
30
Q
A
- necrotic phase of vasculitis
- type III hypersensitivity reaction
- can see a few smooth muscle cells in the bottom right corner of the vessel
- lots of neutrophils and nuclear debris present beyond what would be the endothelium
- thrombosis in vessel lumen
- this thrombosis will lead to ischemia, blood vessel wall destruction will lead to hemorrhage
- in small/medium arteries called polyarteritis nerdosa
30
Q
A
- biopsy of small intestine from patient with amyloidosis
- can see extensive infiltration by amyloid = homogenous pink hyaline substance
31
Q
A
- bone marrow after chemo
- lots of empty space cause cells have been killed
32
Q
best diagnosis of this abnormal growth?
A
dysplasia
34
Q
A
- SLE in the skin
- top image = liquefactive degeneration of the basal layer of the epidermis and edema at the dermoepidermal junction
- bottom image is an immunoflorscent stain for IgG - can see IgG deposits along dermoepidermal junction
35
Q
A
- mostly normal pancreatic tissue
- the area in the middle though (slightly lighter) is a focal hyperplasia
- occurs at 1-2 months stage into development of cancer
- mass of abnormal cells with large nuclei, chromatin
36
Q
A
- ultrastructure of amyloid in heart
- amyloid characterized by non-branching fibrils that are 7 to 10 nm wide
- no matter where deposited or what type of fibers are being made, will get fibrilar strands of processed protein
- forms very insoluble, dense masses between cells
37
Q
A
- normal lymph node
38
Q
A
- heart with rheumatic fever
- aschoff giant cell in top left = small with only 5-6 nuclei, not lots of cytoplasm
- anitschkow monocyte in bottom middle = chromatin looks like caterpillar
39
Q
A
- pancreas in type I diabetes
40
Q
A
- aschoff body in heart due to rheumatic fever
- where the inflammation in the muscle is
- note no bacteria
42
Q
A
- tricuspid valve in systemic lupus erythematosis
- darker areas are vegetations
- these consist of sterile fibrin-platelet aggregates
- no inflammation in these vegetations!
43
Q
A
- kidney with post-streptococcal glomerulonephritis
- lots of neutrophils
- basement membrane tends to look a little thicker (he said not to worry about it if you don’t see it though)
43
Q
A
- vasculitis in RA
45
Q
A
- myocarditis in SLE
46
Q
A
- bronchus
- dysplasia
- no secreting cells
- darkly stained cells have taken over the entire epidermis
- no layers anymore
- don’t appear to be proper cilia anymore
47
Q
what abnormality accounts for the abnormal cell? (star shaped thing in middle)
A
extra centrosomes
48
Q
A
- necrotic phase of vasculitis
- type III hypersensitivity
- hard to even know this was a blood vessel - totally necrotic
- in small/medium arteries called polyarteritis nerdosa
49
Q
A
- squamous cell carcinoma of larynx
- maligant, invasive
- islands of squamous epithelium invading into submucosa (areas surrounded by dark blue line at bottom of picture)
- this is relatively well differentated for a tumor, but has an invasive growth pattern
51
Q
A
- brain in AIDS patient with toxoplasmosis
- can see intracellular and extracellular tachyziotes of toxoplasma gondii
52
Q
A
- kidney with post-streptococcal glomerulonephritis
- the dark areas that are sort of in a diagonal line running from the bottom left to top right are aggregates of complexes (involving IgG) present just beyond the basement membrane
- these will attract neutrophils
53
Q
A
- cardiac biopsy in patient with amyloidosis
- the pale pinkish material that seems more homogenous than the rest of the tissue is deposition of amyloid
- the darker pink is cardiac myocytes
55
Q
A
- borderline papillary cycstic neoplasm of the ovary
- both cycstic neoplasm and a papillary neoplasm
- the islands of projections make it papillary
- borderline so has malignant potential but don’t see definitive invasion
56
Q
A
- normal glomerulus
- note thin-walled capillaries
58
Q
A
- lung with goodpasture’s
- have hemorrhage in alveoli
- can still see defined alveoli
60
Q
A
- acute cellular rejection
- blood vessel
- type IV hypersensitivity response
- damage to walls
- endothelium almost totally destroyed
- occlusion of lumen - filled with recipient T cells and macrophages
62
Q
A
- granuloma in lung due to TB
- classic giant cells
- epithelioid histocytes (activated macrophages resembling epithelial cells)
- this is a typical TB granuloma
62
Q
A
- neoplasm of skeletal muscle
- has cells with both myoid differentiation and anaplastic cells
- can tell that the ones with the green arrow are probably skeletal muscle
- but most of the rest is anaplastic - can’t tell what type of cells they are
- would use immunomarkers to confirm diagnosis
- from a mesenchymal tumor
63
Q
A
- kidney with goodpasture’s disease
- linear basement membrane staining with immunoflorescence due to IgG binding in glomerulus
- tubules have a different kind of basement membrane (different type of type IV collegen) so doesn’t stain
65
Q
A
- high grade carcinoma
- hard to tell it was squamous
- have necrosis at bottom (the dark pink surrounded by white)
- abnormal mitosis in middle
- pleoporphism = large purple cell in top left
66
Q
A
- immunoflorescent stain of post-streptococcal glomerulonephritis
- granular “lumpy-bumpy” basement membrane staining due to IgG-antigen deposits
- non-linear localization of glomeruli
- aggregated antibody
68
Q
A
- lung with goodpasture’s
- immunoflorescent stain for IgG
- binds to type IV collagen in alveolar wall basement membranes
69
Q
A
- multiple hyperplastic nodules in pancreas
- occurs 4-6 months into development of cancer
70
Q
A
- invasive ductal carcinoma in breast tissue
- has ductal structure, but haphazardly
71
Q
A
- subcuteaneous rheumatoid nodule in RA patient
- area of necrosis surrounded by palisade of macrophages and scattered chronic inflammatory cells
73
Q
A
- acute graft rejection (type IV hypersensitivity response)
- in parenchyma
- stained for surface antigens of T cells
- this type of reaction is almost exclusively t cells
74
Q
which feature best characterizes the dysplastic epithelium? (actinic keratosis)
A
loss of polarity
75
Q
A
- joint in RA patient
- synovitis (inflammation of synovial membrane)
76
Q
A
- hepatic amyloidosis
- sinusoids distended
- hepatocytes pushed out of the way
- moderate amyloid infiltration
77
Q
A
- cerebral amyloid angiopathy
- reddish material around blood vessels is amyloid deposits
- probably a congo red stain
78
Q
A
- acinar cell carcinoma in pancreas
- occurs after 1-2 years
- irregular nuclei
- clumped chromatin
- mitosis and some atypical mitosis (usually don’t see any mitosis in the pancreas)
80
Q
most likely diagnosis?
A
melanoma
82
Q
A
- tonsil with benign squamous papilloma
- Circumscribed lesion = benign neoplasia
- Bottom is what normal squamous cell epithelium should look like
- Section from top is from tumor – papillary archetecture
- Dark blue line at bottom is basement membrane – can see that it’s intact so no invasion into surrounding tissue
- Well differnetiated, no invasion, so features of benign
83
Q
A
- normal tonsil
84
Q
A
- lung with pneumocystis carinii infection in AIDS patient
- giemsa stain
- this type of infection won’t occur until T lymphocyte count gets below 200
85
Q
A
- normal pseudostratified cells in bronchus
- dividing stem cells
- mixture of cell populations
- cilia
86
Q
A
- colonic adenocarcinoma invading muscularis layer
- look at arrangement of nuclei - don’t have polarity
- very complex and crowded and highly nuclear cells
- hyperchromasia
- pleomorphism
87
Q
A
- antibody-mediated blood vessel damage
- type IV hypersensitivity (graft rejection)
- blood vessel has been killed
- endothelial cells basically all dead
- wall damaged
- example of donor blood vessel killed by host antibodies
88
Q
A
- fish-mouth deformation of aortic valve due to rhemuatic fever
- edges of valve should be three leaflets
- here they’ve fused together and there’s only a narrow appeture
89
Q
A
- congo red stain of CNS parenchyma
- patient with amyloidosis
- vessels are a little bit thickened
- not imaged with polarized light, so the amyloid appears dark red rather than green
90
Q
A
- cervix with dysplasia
- on the left, neraly normal cervix
- on left CIN 1
- on right CIN 3 - can see the atypical cells higher up in the layer
91
Q
what cytologic feature best defines this lesion as malignant?
A
pleomorphism
92
Q
A
- bone marrow in patient with multiple myeloma
- note the abundance of plasma cells - identifiable by their clock-face nuclei and perinuclear hoff
93
Q
A
- kidney with post-streptococcal glomerulonephritis
- note neutrophils in glomerular tufts
- lots of neutrophils
- basement membrane a bit thicker than it should be
94
Q
A
- example of amyloid stained by congo red and examined under polarized light
96
Q
A
- glomeruli filled with amyloid in patient with amyloidosis
- can see that the regular glomerular elements are totally pushed aside in some of these glomeruli
97
Q
this cancer has not yet acquired which malignant capacity?
A
angiogenesis
98
Q
best diagnosis?
A
well differentiated SCC
99
Q
A
- lymph node in patient with AIDS
- mycobacterium avium-intracellulare infection
- lots of acid-fast bacilli (cord-like accumulations) within histiocytes
100
Q
populations of cells give evidence of?
A
clonal progression
101
Q
nucleus indicated by arrow illustrates which malignant cytologic feature?
A
hyperchromasia
102
Q
A
- normal cervix
- can see normal maturation
- basal layer is more crowded
- all nuclei are similar
