Histopathology 1&2

Question 1

What does a histopathology report provide?

Answer 1

Diagnostic information
Prognostic information
Information regarding management
Feedback to imaging or tests
Benefits / adverse effects of treatment
Incidental findings

Question 2

What needs to go on a request?

Answer 2

Full demographic details on request form
Full demographic details on specimen container
Relevant clinical history
Relevant available results
Question
Contact details

Question 3

Give some examples of special stains

Answer 3

Diastase periodic acid Schiff 
EVG
Masson fontana
Perl's
Von Kossa
Ziehl Neelse
Giemsa

Question 4

What can DPAS stain detect?

Answer 4

Mucin

Question 5

What can EVG detect?

Answer 5

Elastins

Fibrosis

Question 6

What can Masson fontana stain detect?

Answer 6

Melanin

Question 7

What can Perl’s stain detect?

Answer 7

Iron

Question 8

What can von kossa stain detect?

Answer 8

Calcium phosphate

Question 9

what can ziehl neelsen stain detect?

Answer 9

AFB

Question 10

What can giemsa stain detect?

Answer 10

Mast cells

HP

Question 11

What are some sampling errors that can occur?

Answer 11

Wrong site

Small volumes of tissue

Question 12

What are the cytology signs of neoplasia?

Answer 12

Nucleoli
Atypical mitoses
Hyperchomasia

Question 13

What is immunohistochemistry used for?

Answer 13

Identifies specific proteins in tissue using monoclonal antibodies
Important and useful in developing a differential diagnosis
Gives prognostic information and informs treatment

Question 14

What are the 6 types of tissue?

Answer 14

Epithelium
Connective tissue
Muscle
Neural tissue
Germ-line cells
Blood

Question 15

What are examples of tissue epithelium?

Answer 15

Squamous or glandular
Endothelium
Mesothelium
Synovium
Meninges

Question 16

What are examples of connective tissue?

Answer 16

Fat
Fibrous tissue
Bone
Vasculature
Cartilage
ECM

Question 17

What are the examples of muscle tissue?

Answer 17

Skeletal
Smooth
Cardiac

Question 18

What are examples of neural tissue?

Answer 18

Neurons
Astrocytes
Oligodendrocytes
Microglia
Melanocytes

Question 19

What are examples of blood tissues?

Answer 19

Erythrocytes
Leucocytes
Thrombocytes / platelets

Question 20

What are intermediate filaments?

Answer 20

Proteins that give cells their internal structures

Question 21

What cancers are CK7 and CK20 positive?

Answer 21

Upper GI (adenocarcinoma)
Pancreatic (ductal)
Urothelial

Question 22

What cancers are CK7 positive and CK20 negative?

Answer 22

Breast
Ovarian
Pulmonary 
Endometrial
Thyroid

Question 23

What cancers are CK7 negative and CK20 positive?

Answer 23

Colorectal

Merkel cell

Question 24

What cancers are CK7 negative and CK20 negative?

Answer 24

Prostatic
Hepatocellular
Renal cell
Adrenal cortical

Question 25

What biomarkers are prognostic for breast?

Answer 25

BRCAI

Her-2/neu (worse prognosis)

Question 26

What biomarkers are prognostic for ovary?

Answer 26

BRCAI

Question 27

What biomarkers are prognostic for colon?

Answer 27

High frequency MSI

Question 28

What biomarkers are prognostic for NSCLC

Answer 28

K-ras

EGFR

Question 29

What are the medical benefits of autopsies?

Answer 29

Final diagnosis
Cause of death
Correlation of clinical course to pathologic changes

Question 30

What are the benefits of autopsies for the family of deceased?

Answer 30

Certainty about what happened
Relieve irrational guilt
Assistance with grieving process
Hereditary diseases
Infectious diseases
Insurance compensation

Question 31

What are the benefits of autopsies for public health?

Answer 31

Accurate epidemiological statistics

Surveillance of communicable diseases

Question 32

What are the benefits of autopsies for medical education?

Answer 32

Provision of teaching
Practical experience of anatomy and pathology
Integration and correlation of theoretical and practical clinical knowledge

Question 33

What are the benefits of autopsies for medical research?

Answer 33

New diseases
Detect changing patterns of well-known entities
Evaluate drug toxicity / unwanted effects and efficacy of new treatments
Provision of tissue samples

Question 34

What are the types of modern autopsies?

Answer 34

Conventional / post-morten examination
Forensic autopsy
Minimally invasive autopsy (by imaging) 
 - CT full body scan
 - CT coronary angiography
 - endoscopic sampling / limited dissection / full autopsy

Question 35

When is a medical certificate of cause of death issued?

Answer 35

By the doctor who has treated or seen the deceased in 14 days before death and knows the cause.

Or

Coroner reviews case, is satisfied death was due to natural causes and instructs a doctor/GP to issue certificate

Question 36

What are the mandatory reasons to refer to the coroner?

Answer 36

• All deaths of children and young people under 18, even if due to natural causes
• Deaths within 24 hours of admission to hospital
• Deaths that may be linked to medical treatment, surgery or anaesthetic procedure
• Deaths that may be linked to an accident, however long ago it happened
• Deaths that may be linked to drugs or medications, whether prescribed or illicit
• If there is a possibility that the person took their own life
• If there are any suspicious circumstances or history of violence
• Deaths that may be linked to the person’s occupation, for example if they have been exposed to asbestos
• All deaths of people who are in custody or detained under the Mental Health Act, even if due to natural causes

Question 37

What do post-mortems ascertain?

Answer 37

Identity of deceased
Time of death
Place of death
Cause of death
Is an inquest required?

Question 38

Where can a collateral history be gathered from for a post-mortem?

Answer 38

Coroner’s officers, police, next of kin, neighbours
Medication
Correspondence at home
GP and other agencies
Previous admissions and pathology database