Histopath Blackboard Flashcards
MACROSCROPIC DERM TERMS
Traumatic lesion breaking the epidermis and causing a raw linear area (i.e. deep scratch); often self-induced.
Thickened and rough skin characterized by prominent skin markings (as lichen on a tree trunk); usually the result of repeated rubbing.
Circumscribed lesion, 5mm or smaller in diameter, characterized by flatness and distinguished by coloration (patch is greater than 5mm)
Separation of nail plate from nail bed
Elevated dome-shaped or flat-topped lesion 5mm or less across (nodule is greater than 5mm)
Elevated flat-topped lesion, usually greater than 5mm across (may be caused by coalescent papules)
Discrete, pus-filled, raised lesion.
Dry, horny, platelike excrescence; usually the result of imperfect cornification
Fluid-filled raised lesion 5mm or less across (bulla is greater than 5mm. Blister is the common term for either.)
Itchy, transient, elevated lesion with variable blanching and erythema formed as the result of dermal oedema.
Excoriation
Traumatic lesion breaking the epidermis and causing a raw linear area (i.e. deep scratch); often self-induced.
Lichenification
Thickened and rough skin characterized by prominent skin markings (as lichen on a tree trunk); usually the result of repeated rubbing.
Macule
Circumscribed lesion, 5mm or smaller in diameter, characterized by flatness and distinguished by coloration (patch is greater than 5mm)
Onycholysis
Separation of nail plate from nail bed
Papule
Elevated dome-shaped or flat-topped lesion 5mm or less across (nodule is greater than 5mm)
Plaque
Elevated flat-topped lesion, usually greater than 5mm across (may be caused by coalescent papules)
Pustule
Discrete, pus-filled, raised lesion.
Scale
Dry, horny, platelike excrescence; usually the result of imperfect cornification
Vesicle
Fluid-filled raised lesion 5mm or less across (bulla is greater than 5mm. Blister is the common term for either.)
Wheal
Itchy, transient, elevated lesion with variable blanching and erythema formed as the result of dermal oedema.
MICROSCOPIC DERM TERMS Acantholysis Dyskeratosis Acanthosis Ulceration Erosion Hydropic swelling Spongiosis Exocytosis Hypergranulosis Hyperkeratosis Vacouloisation Lentiginous Parakeratosis Pappilomatous
Loss of intracellular adhesion between keratinocytes
Diffuse epidermal hyperplasia
Abnormal, premature keratinization within cells below the stratum granulosum
Discontinuity of the skin showing incomplete loss of the epidermis
Infiltration of the epidermis by inflammatory cells
Intracellular oedema of keratinocytes, often seen in viral infections.
Hyperplasia of the stratum granulosum, often due to intense rubbing
Thickening of the stratum corneum, often associated with a qualitative abnormality of the keratin
A linear pattern of melanocyte proliferation within the epidermal basal cell layer
Surface elevation caused by hyperplasia and enlargement of contiguous dermal papillae
Keratinization with retained nuclei in the stratum corneum.
Intracellular oedema of the epidermis
Discontinuity of the skin showing complete loss of the epidermis revealing dermis or subcutis
Formation of vacuoles within or adjacent to cells; often refer to basal cell-basement zone area.
Acantholysis
Loss of intracellular adhesion between keratinocytes
Acanthosis
Diffuse epidermal hyperplasia
Dyskeratosis
Abnormal, premature keratinization within cells below the stratum granulosum
Erosion
Discontinuity of the skin showing incomplete loss of the epidermis
Exocytosis
Infiltration of the epidermis by inflammatory cells
Hydropic swelling (ballooning) Intracellular oedema of keratinocytes, often seen in viral infections.
Hypergranulosis
Hyperplasia of the stratum granulosum, often due to intense rubbing
Hyperkeratosis
Thickening of the stratum corneum, often associated with a qualitative abnormality of the keratin
Lentiginous
A linear pattern of melanocyte proliferation within the epidermal basal cell layer
Papillomatosis
Surface elevation caused by hyperplasia and enlargement of contiguous dermal papillae
Parakeratosis
Keratinization with retained nuclei in the stratum corneum. On mucous membranes, parakeratosis is normal.
Spongiosis
Intracellular oedema of the epidermis
Ulceration
Discontinuity of the skin showing complete loss of the epidermis revealing dermis or subcutis
Vacuolization
Formation of vacuoles within or adjacent to cells; often refer to basal cell-basement zone area.
Psoriasis vulgaris Lichen planus Seborrhoeic keratosis TB Sarcoid Sebaceous cyst Basal cell carcinoma Bowens disease Pagetoid Pemphigus Pemphigoid Spongiotic Erythema multiforme
- AB against desmosomes
- oedema between the keratinocytes, may result in discoid eczema or contact dermatitis.
- macules and papules covered with silvery scales, pinpoint bleeding
- Eruption of purple flat topped papules with mother of pearl sheen
- A vasculictic reaction associated with herpes viral infection.
- Caseating granulomatous reaction pattern
- Cauliflower like nature with a tendency to catch on clothing.
- Circular, smooth surface, central punctum, doesn’t transilluminate.
- Typically occurs in the elderly in sun-exposed sites. Ulcerating tumour with a classic pearly rolled edge.
- Keratinised Squamous cell carcinoma in situ.
- Child with a mole. Histologically, there are highly characteristic nests of spindle-shaped cells with heavy pigmentation.
- The term used to describe the spread of Melanocytes upwards through the epidermis
PemphiguS = Superficial Separation => Intraepidermal Acantholysis => Flaccid bullae that rupture easily => Infection=> death if not treated.
- AB against desmosomes (Desmoglein 1 & 3), circular immunoflurescence -> oral lesions.
PemphigoiD= Dermoepidermal junction (basement membrane) => Tense bullae that don’t rupture easily => Heal without scarring
Ab against hemidesmosomes (Bullous pemphigoid antigen 2/type 17 collagen/dystonin) , linear immunofluoresence, subepidermal
- Spongiotic is oedema between the keratinocytes, may result in discoid eczema or contact dermatitis. Eosinophilic infiltrate
- Psoriasis vulgaris
The normal transit time for the keratinocyte to mature is 56 days, whereas in psoriasis this occurs in only 7 days which results in a loss of some of the normal characteristics of the epithelium.
Form a layer of parakeratosis due to lack of granular layer.
Neutrophilic infiltrate. - Lichenoid/lichen planus.
Eruption of purple flat topped papules with mother of pearl sheen
Lymphocytes attacking the basement membrane leading to basal vacuation. - Erythema multiforme
A vasculictic reaction associated with herpes viral infection.
Other vasculitic dermatoses include
SLE, pityriasis rosea (Salmon pink scaly eruptions/herald patch) - TB is caseating granuloma, whereas sarcoid is non-caseating granulom
- Seborrhoeic keratosis - Benign
Cauliflower like nature with a tendency to catch on clothing. Proliferation of basal layer. keratin whorls. - sebaceous cyst - Misnomer, should be called an epidermal cyst.
Circular, smooth surface, central punctum, doesn’t transilluminate.
Can become infected and ruptured. - Basal cell carcinoma
Typically occurs in the elderly in sun-exposed sites.
Ulcerating tumour with a classic pearly rolled edge. Also known as a rodent ulcer.
take a 2mm margin around the tumour when resecting - Bowens disease
Keratinised Squamous cell carcinoma in situ.
SCCs often look like scaly red patches, open sores, elevated growths with a central depression, or warts; they may crust or bleed - Pigmented spindle cell naevus of Reed appears in children and young adults as a well-defined heavily pigmented lesion with a rather characteristic dermatoscopic star-shaped morphology.
Benign junctional naevus/ common mole. benign.
Junctional naevi are within the epidermis. for New junctional navei in the elderly would have to consider melanoma. - Pagetoid. The term used to describe the spread of Melanocytes upwards through the epidermis known as Pagetoid. Can be seen in melanoma.
BRAF for melanoma, >50% of melanomas are associated with BRAF mutations.
Acute mastitis Duct ectasia Fat necrosis Phyllodes tumour In situ lobular neoplasia Flat epithelial atypia Usual epithelial hyperplasia LCIS DCIS invasive ductal Invasive lobular
- A white, greenish or black nipple discharge from one or both nipples. Tenderness in the nipple or surrounding breast tissue. Redness and a breast lump
- Painful red breast in a lactating mother
- Hard lump following breast trauma
- firm, painless lump in the breast. growing quickly, over a few weeks or months. Age 50.
- 40yo with no constitutional symptoms, presents with tender breast lump near the nipple and serous nipple discharge.
- of the proliferative breast diseases, which has the highest risk of malignancy.
- Loss of e-cadherin TS gene. Presence of signet-ring cells
- invasive monomorphic cells with India file pattern
- Duct ectasia.
Abnormally dilated ducts with nipple discharge - Acute mastitis
Acute inflammation in the breast. Often seen in lactating women due to cracked skin and stasis of milk. Staphylococci the usual organism. Drainage & antibiotics usually curative. - Fat Necrosis
An inflammatory reaction to damaged adipose tissue. Giant cell formed from a few histiocytes coming together. They are destroying the fat cells - Phyllodes tumour A group of potentially aggressive fibroepithelial neoplasms of the breast. Present as enlarging masses in women aged over 50. Vast majority behave in a benign fashion but a small proportion can behave more aggressively. Artichoke like. more common in women who have benign breast lumps called fibroadenomas.
- Intraductal papilloma
A benign papillary tumour arising within the duct system of the breast.
Arise within small terminal ductules (peripheral papillomas) or larger lactiferous ducts (central papillomas).
Common.
Seen mostly in women aged 40-60.
Central papillomas present with nipple discharge. - In situ lobular neoplasia > Flat epithelial atypia > Usual epithelial hyperplasia
- LCIS The lack of E-cadherin results in a rounded shape without attachment to adjacent cells. The cells cannot form cribriform spaces or papillae, such as are seen in DCIS
BRAC1/2, CERB-B2 for breast cancer. Herceptin targets the CERB mutation.
8.Invasive lobular cancer. But Most common is invasive ductal carcinoma of no special type - It often has pronounced desmoplasia. Lobular carcinomas do not form a large mass and are poorly circumscribed. They are bilateral about 20% of the time. They make up only 5 to 10% of breast cancers.
NHS Breast Screening Programme
The aim of screening is to pick up DCIS or early invasive carcinomas.
Women aged 47-73 are invited for screening every three years
Radial scar. A benign sclerosing lesion characterised by a central zone of scarring surrounded by a radiating zone of proliferating glandular tissue. Stellate masses on mammography. Not a firm mass..
fibrocystic disease is breast lumpiness that may show calcification on mammogram but lumps vary with hormonal cycle.
Medullary carcinoma is often bulky, with pushing margins. It lacks the desmoplasia typical of ductal carcinomas. It has lymphoid stroma with little fibrosis surrounding sheets of large vesicular cells It accounts for only about 1% of breast cancers.
Colloid carcinomas produce abundant mucin. They are often well circumscribed.
An 18 year old female is brought in to A&E from a rave in the early hours of the morning. On initial examination she is agitated with a heart rate of 120 bpm. She is very sweaty and has wide dilated pupils.
These patients can also become feverish with renal failure and rhabdomyolysis.
A man was put into custody after driving under the influence of drugs. On arrest he was reported as acting extremely aggressive and paranoid. He also claimed his heart was racing. One hour later he was found dead. There was suspicion of police brutality.
James Pond comes to A&E claiming he’s been poisoned. Minutes later he dies. His skin was brick red and there was a faint odour of almonds.
A man was found collapsed on the floor of his room and his breathing was found to be severely depressed. A urine test was found to be positive for 6-MAM.
25 year old male is admitted with hyperventilation. He is sweating and appears nauseous. He says that he has ringing in his ears. Blood gases show that he has mixed acid-base disturbance
A depressed 30 year old woman was brought into A&E after being found by a friend. On examination she appears very drowsy with sinus tachycardia and wide dilated pupils. She has marked reflexes and extensor plantar responses. ECG shows a wide QRS interval
A 45 year old farm worker is admitted complaining primarily of nausea and vomiting. On further questioning it is revealed that he also has a headache, hypersalivation and he is finding it hard to breathe. On examination the patient appears sweaty and has flaccid paresis of his limb muscles
- Ecstasy
- Cocaine
- Cyanide
- Heroine
- salicylate can cause tinnitus and mixed acid-base disturbance. Stimulates Hyperventillation which causes respiratory alkalosis, but also metabolic acidosis due to salicylic acid.
- TCA.
Because she was depressed, now has hyperreflexia, widened QRS and tachycardia.
Both TCA od’s and ecstasy od’s can cause wide dilated pupils.
Ecstasy is more likely to lead to agitation and TCA drowsiness. Also Ecstasy can induce SIADH/cause hyponatraemia. - Organophosphates
Immunoassay can be used to test for all classes of drugs of abuse (DOA)?
A blood sample is required for use with gas chromatography mass spectroscopy
Colorimetric can be used to test for paracetamol in overdose
Liquid chomotrography can be used to test for benzodiazepines and various antipsychotic drugs
Thin layer chomotrography can be used to analyse samples of stool, liver and also urine?
