Histopathology 1&2 Flashcards
What does a histopathology report provide?
Diagnostic information Prognostic information Information regarding management Feedback to imaging or tests Benefits / adverse effects of treatment Incidental findings
What needs to go on a request?
Full demographic details on request form Full demographic details on specimen container Relevant clinical history Relevant available results Question Contact details
Give some examples of special stains
Diastase periodic acid Schiff EVG Masson fontana Perl's Von Kossa Ziehl Neelse Giemsa
What can DPAS stain detect?
Mucin
What can EVG detect?
Elastins
Fibrosis
What can Masson fontana stain detect?
Melanin
What can Perl’s stain detect?
Iron
What can von kossa stain detect?
Calcium phosphate
what can ziehl neelsen stain detect?
AFB
What can giemsa stain detect?
Mast cells
HP
What are some sampling errors that can occur?
Wrong site
Small volumes of tissue
What are the cytology signs of neoplasia?
Nucleoli
Atypical mitoses
Hyperchomasia
What is immunohistochemistry used for?
Identifies specific proteins in tissue using monoclonal antibodies
Important and useful in developing a differential diagnosis
Gives prognostic information and informs treatment
What are the 6 types of tissue?
Epithelium Connective tissue Muscle Neural tissue Germ-line cells Blood
What are examples of tissue epithelium?
Squamous or glandular Endothelium Mesothelium Synovium Meninges
What are examples of connective tissue?
Fat Fibrous tissue Bone Vasculature Cartilage ECM
What are the examples of muscle tissue?
Skeletal
Smooth
Cardiac
What are examples of neural tissue?
Neurons Astrocytes Oligodendrocytes Microglia Melanocytes
What are examples of blood tissues?
Erythrocytes
Leucocytes
Thrombocytes / platelets
What are intermediate filaments?
Proteins that give cells their internal structures
What cancers are CK7 and CK20 positive?
Upper GI (adenocarcinoma)
Pancreatic (ductal)
Urothelial
What cancers are CK7 positive and CK20 negative?
Breast Ovarian Pulmonary Endometrial Thyroid
What cancers are CK7 negative and CK20 positive?
Colorectal
Merkel cell
What cancers are CK7 negative and CK20 negative?
Prostatic
Hepatocellular
Renal cell
Adrenal cortical
What biomarkers are prognostic for breast?
BRCAI
Her-2/neu (worse prognosis)
What biomarkers are prognostic for ovary?
BRCAI
What biomarkers are prognostic for colon?
High frequency MSI
What biomarkers are prognostic for NSCLC
K-ras
EGFR
What are the medical benefits of autopsies?
Final diagnosis
Cause of death
Correlation of clinical course to pathologic changes
What are the benefits of autopsies for the family of deceased?
Certainty about what happened Relieve irrational guilt Assistance with grieving process Hereditary diseases Infectious diseases Insurance compensation
What are the benefits of autopsies for public health?
Accurate epidemiological statistics
Surveillance of communicable diseases
What are the benefits of autopsies for medical education?
Provision of teaching
Practical experience of anatomy and pathology
Integration and correlation of theoretical and practical clinical knowledge
What are the benefits of autopsies for medical research?
New diseases
Detect changing patterns of well-known entities
Evaluate drug toxicity / unwanted effects and efficacy of new treatments
Provision of tissue samples
What are the types of modern autopsies?
Conventional / post-morten examination Forensic autopsy Minimally invasive autopsy (by imaging) - CT full body scan - CT coronary angiography - endoscopic sampling / limited dissection / full autopsy
When is a medical certificate of cause of death issued?
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
What are the mandatory reasons to refer to the coroner?
- 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
What do post-mortems ascertain?
Identity of deceased Time of death Place of death Cause of death Is an inquest required?
Where can a collateral history be gathered from for a post-mortem?
Coroner’s officers, police, next of kin, neighbours
Medication
Correspondence at home
GP and other agencies
Previous admissions and pathology database
