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Meded Path Lectures > Histopathology > Flashcards

Histopathology Flashcards

1
Q

Cirrhosis Definition

A

Whole Liv er
Fibrosis
Nodules of regenerating Hepatocytes
Distortion of liver vascular architecture (shunting)

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2
Q

Cirrhosis Classification

A

Nodular size (macro/micro)

Aetiology (alcohol, viral)

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3
Q

Cirrhosis Complications

A

Portal Hypertension
Hepatic Encepalopathy
Hepatocellular Carcinoma

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4
Q

Acute Hepatitis causes

A

Viruses

Drugs

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5
Q

Acute Hepatitis Histology

A

Spotty Necrosis

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6
Q

Chronic Hepatitis causes

A

Viral
Drugs
Autoimmune

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7
Q

Chronic Hepatitis Histology Staging

A

Severity of inflammation = grade

Severity of fibrosis = stage

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8
Q

Interface Hepatitis histology

A

Piecemeal Necrosis

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9
Q

Types of alcoholic liver disease

A

Fatty Liver
Alcoholic Hepatitis
Cirrhosis

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10
Q

Alcoholic Hepatitis Histology

A

Ballooning (+/- Mallory Denk Bodies)
Apoptosis
Pericellular Fibrosis
Zone 3

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11
Q

Non-Alcoholic Fatty Liver Disease

A

Histologically looks like Alcoholic fatty liver disease

Caused by insulin resistance

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12
Q

PBC

A

F>M
Anti-mitochondrial antibodies
Bile duct loss associated with chronic inflammation (with granulomas)

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13
Q

PSC

A

M>F

Periductal Bile duct fibrosis leading to loss

UC

Cholangiocarcinoma

Bile duct imaging

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14
Q

Haemochromatosis

A

Genetics -> Increased gut iron absorption

Chr 6 (HFe)

Parenchymal damage to organs (bronzed diabetes0

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15
Q

Haemosiderosis

A

Iron accumulation in macrophages

Blood transfusion

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16
Q

Wilson’s Disease

A

Copper accumulation due to failure of hepatocyte excretion into bile

Biopsy

Chr 13

Kayser-Fleischer rings
Hepatolenticular degeneration

Rhodanine Stain

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17
Q

Autoimmune Hepatitis

A

F>M
Active with plasma cells
Anti-smooth muscle actin antibodies
Steroid response

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18
Q

Alpha 1 antitrypsin deficiency

A

Intra-cytoplasmic inclusions due to misfolded protein

Hepatitis
Cirrhosis

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19
Q

Hepatic Granuloma Causes

A

PBC
Drugs

TB
Sarcoidosis

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20
Q

Benign Liver Tumours

A

Liver Cell adenoma
Bile duct adenoma
Haemangioma

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21
Q

Cholangiocarcinoma causes

A

PSC
Worm infections
Cirrhosis

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22
Q

Macroscopic histological asthma features

A

Mucous plug

Overinflated Lung

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23
Q

Microscopic Asthma Histology

A

Hyperaemia
Eosinophilic inflammation and goblet cell hyperplasia - mucous
Hypertrophic constricted muscle
Mucous plugging and inflammation

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24
Q

Chronic Bronchitis Histology

A

Dilatation of Airways
Hypertrophic Mucous Glands
Goblet Cell Hyperplasia

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25
Chronic Bronchitis Complications
Repeat infections Chronic Hypoxia Cor Pulmonale Lung Cancer
26
Bronchiecstasis
Permanent abnormal dilatation of bronchi Infection, obstruction, ciliary dyskinesia, inflammation, systemic disease
27
Bronchiecstasis Complications
Infections Haemoptysis Cor Pulmonale Amyloidosis
28
Cystic Fibrosis
1 in 2500 Autosomal Recessive Cystic Fibrosis Transmembrane Conductance Regulator
29
Pulmonary Oedema
LHF, Alveolar Injury, Neurogenic, High Altitude
30
Pulmonary Oedema Histology
Acute: Watery lungs, intra-alveolar fluid on histology Chronic: Iron laden macrophages (Heart failure cells) , fibrosis
31
Diffuse Alveolar Damage
Fluffy White infiltrates = white out cxr Lungs expanded, firm, plum colours, airless, heavy
32
Adult Diffuse alveolar damage
Acute respiratory distress syndrome
33
Neonatal Diffuse Alveolar Damage
Hyaline Membrane Disease of the Newborn
34
Prognosis of DAD
40% death Infections Fibrous Scarring
35
Bronchopneumonia
Elderly Low virulence organisms ie. staph haem strep, pneumococcus Patchy bronchial and peribronchial distribution, lowe lobes Acute inflammation surrounding airways and within alveoli
36
Lobar Pneumonia
Infrequent since ABx High virulence organisms -> 95% S. pneumoniae Widespread fibrinosuppurative consolidation
37
Lobar Pneumonia Histology
Congestion -> Hyperaemia, Intra-alveolar fluid Red hepatisation -> Hyperaemia, Intra-alveolar neutrophils Grey Hepatisation -> Intra-alveolar connective tissue Resolution -> Normal architecture
38
Complications of infective lung disease
``` Abscess Pleuritis Empyema Scarring Septicaemia ```
39
Emphysema
Permanent loss of alveolar parenchyma distal to terminal bronchiole
40
Causes of Emphysema
Smoking Alpha-1-antitrypsin Deficiency IVDU, cadmium exposure, Marfan's
41
Emphysema COmplications
Bullae Resp Failure Cor Pulmonale
42
Granulomatous Lung Disease
Collection of histiocytes/macrophages/multinucleate giant cells Can be necrotising or non necrotising TB, Sarcoidosis, foreign bodym occupational lung disease
43
Fibrosing `Lung disease
Idiopathic pulmonary fibrosis (Cryptogenic fibrosing alveolitis) Extrinsic allergic alveolitis (farmer's lung) Industrial Lung Disease (pneumoconiosis)
44
Idiopathic Pulmonary Fibrosis
Cryptogenic Fibrosing Alveolitis Chronic SOB, Cough CT and Biopsy Progressive, 50% dead within 3 yrs
45
Macrohistology of Idiopathic Pulmonary Fibrosis
Basal and peripheral fibrosis and cyst formation
46
Microhistology of Idiopathic Pulmonary Fibrosis
Interstitial Fibrosis at varying stages
47
Small PE
Haemorrhagic Infarct Repeated Pleuritic Chest oain, acute SOB, progressive SOB
48
Large PE
Saddle emboli can occlude the main pulmonary trunk Sudden death, acute RHF/CVS Shock
49
Precapillary causes of pulmonary hypertension
Vasoconstrictive (hypoxia) Embolic (thromboembolic)
50
Capillary causes of pulmonary hypertension
Widespread pulmonary fibrosis
51
Postcapillary causes of pulmonary hypertension
Veno-occlusive disease | Left sided heart disease
52
Classification of lung tumours
Benign ie chondroma Malignant, 90% epithelial squamous = adeno > large cell = small cell
53
What in smoke causes lung cancer?
Tumour initiators ie polycyclic aromatic hydrocarbons Tumour Promoters ie. N Nitrosamines Complete carcinogens ie. nickel, arsenic
54
Squamous Cell Carcinoma
35% lung cancers Smoking Central from bronchial epithelium Local spread, late metastasis
55
Invasive Adenocarcinoma
27% Lung Cancers Smoking, female, far-east Peripheral Metastases common early
56
Development of Adenocarcinoma
Atypical adenomatous hyperplasia -> Non-mucinous adenocarcinoma in situ -> Mixed pattern invasive adenocarcinoma
57
Invasive Adenocarcinoma Histology
Glandular Differentiation Papillae Formation Mucin
58
Large Cell Carcinoma
10% Lung Cancers Poorly differentiated, large cells no histological evidence of glandular/squamous differentiation, some evidence on electron microscopy Poor prognosis
59
Small Cell Carcinoma
``` 20% Smoking Central near bronchi 80% advanced Chemosensitive but awful prognosis + associated with paraneoplastic syndromes ```
60
Small Cell Carcinoma Histology
Small, poorly differentiated | p53 and RB1 mutations
61
Bevacizumab and SCC
Fatal haemorrhage, don't use
62
Adenocarcinoma with Ros1/ALK translocation
Crizotinib
63
What inhibits immune response in SCC/Adenocarcinoma?
PDL1
64
Breast lump aspirate coding
``` C1 - adequate C2- Benign C3 - Atypia, probably benign C4 - Suspicious of Malignancy C5 - Malignancy ```
65
Duct Ectasia
Inflammation/Dilatation of large breast ducts Nipple discharge, pain, retraction Cytology shows proteinaceous material and inflammatory cells only
66
Acute Mastitis
``` Acute Inflammation Lactating women Staphylococci Painful red breast Drainage, ABx ```
67
Fat Necrosis
Inflammation due to damage adipose tissue Trauma, surgery, radiotherapy Breast mass
68
Fibrocystic breast disease
Exaggerated normal breast tissue change in response to hormonal influence Common Lumpiness No Cancer risk
69
Fibroadenoma
Benign fibroepithelial neoplasm of breast Circumscribed mobile breast lump Shelling out = curative
70
Phyllode's Tumour
Potentially aggressive fibroepithelial breast cancers Benign usually >50
71
Intraductal papilloma
Benign papillary tumour arising within the ductal system of the breast peripheral = small terminal ductules central = larger lactiferous ducts
72
Intraductal Papilloma
F 40-60 central present with nipple discharge Peripheral silent if small Excision
73
Breast Radial Scar
Benign sclerosing lesion Central scarring surrounded by radiating zone of proliferating glandular tissue Complex if >1cm
74
Proliferative Breast Diseases
Increased risk for subsequent breast carcinoma Typically microscopic with no symptoms
75
Usual epithelial hyperplasia
Not a direct precursor to breast carcinoma, but increased risk
76
Atypical ductal carcinoma
Aka flat epithelial atypia earliest morphological precursor to low grade ductal carcinoma in situ 4x relative risk
77
In situ lobular dysplasa
Risk factor for invasive breast carcinoma 7-12 x relative risk
78
Ductal Carcinoma in situ
Neoplastic intraductal epithelial proliferation in the breast Inherent progression to carcinoma Microcalcification on mammography 10% symptoms Excision
79
Invasive breast carcinomas
Malignant epithelial tumours RF = BRCA mutation, increased exposure to progesterone, COCP, BMI, alcohol
80
Basal Cell Breast Carcinoma
BRCA Breast cytokeratins CK5/6/14 Central necrosis, sheets of atypical cells and lymphocytic infiltrate
81
Invasive breast tumour grading
1. Tubule Formation 2. Nuclear Polymorphism 3. Mitotic Activity Scored 1-3, added ``` 3-5 = 1 = well 5-7 = 2 = moderate 8-9 = 3 = poorly ``` ``` Her2 = high ER/PR = Low ```
82
Breast cancer prognosis
Axillary lymph nodes = key | Size, type, grade
83
Male breast disease
Gynaecomastia | 0.2% breast cancers

Meded Path Lectures (15 decks)

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