Histopath: histopathology of systemic disease Flashcards
list opportunistic infections associated with HIV
pneumocystitis jiroveci
CMV - oesophagitis
candida
TB
cryptococcus - meningitis
toxoplasma gondii - encephalitis and mass lesions
herpes simplex
tumours associated with HIV
- Kaposi’s sarcoma
- Lymphoma (B cell, EBV)
- SCC
pathology of mycobacteria
- caseating granulomas
- acid fast bacilli
list extra-pulmonary features of mycobacterial infection
CNS - meningitis, tuberculoma
eye - conjunctivitis
adrenal - addisons
lymph node - swelling
GI - ascites
BM - anaemia
skin - lupus vulgaria
pathology of IgG4 related disease
- inflammation dominated by IgG4 antibody producing plasma cells
- fibrosis, obliteration of veins
- plasma cell (these have dark nucleus) rich infiltrate
effects of IgG4 related disease
- salivary and lacrimal glands - mikulicz syndrome
- thyroid - riedel thyroiditis
- peritoneum - retroperitoneal fibrosis
- liver - biliary obstruction
- pancreas - AI pancreatitis
- mass lesions - inflammatory pseudotumour
effects of alcohol on different systems
- liver - steatosis, steatohepatotis, cirrhosis, liver cell cancer
- GI tract - acute gastritis, oesophageal varices
- NS - peripheral neuropathy, Wernicke-Korsakoff syndrome
- CV - dilated cardiomyopathy, hypertension, atheroma
- pancreas - acute pancreatitis, chronic
- FAS
- cancer - oral, pharynx, oesophagus, liver, breast
types of amyloid
- AA - from serum amyloid A eg crohns, rheumatoid arthritis
- AL - derived from light chains - MM, B cell lymphoma
staining in amyloidosis
congo red
apple green birefringence under polarised light
clinical features of amyloidosis
- proteinuria, renal failure
- restrictive cardiomyopathy
- autonomic neuropathy
- Carpal tunnel syndrome
- macroglossia
- bleeding on injury
NB once amyloid deposits on organ, it is like plastic in that it cannot be removed, then damages local structures
Is sarcoid granuloma caseating or not?
- NON-CASEATING (TB = CASEATING)
- So no soft, necrotic caseating core (as seen in mycobacterium like TB)
CXR for TB
- cavitations (due to caseating granuloma deposits)
- especially at apices of lung
NB caseating described as like cottage cheese (this is the necrotic core)
Presentation of sarcoidosis (+ what is main site)
- Lung (characteristic site)- scattered granulomas, heal with fibrosis (scarring)
- Lymph nodes: usually hilar and mediastinal
- Spleen – enlarged
- Liver – enlarged
- Heart
- Joints – arthritis
- Bone marrow
- Skin: nodules, plaques or macules à erythema nodosum, skin lesions
- Eyes: iritis, choroid retinitis, lacrimal glands
- CNS
- Salivary glands
