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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
Q

Chronic Bronchitis Complications

A

Repeat infections
Chronic Hypoxia
Cor Pulmonale
Lung Cancer

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26
Q

Bronchiecstasis

A

Permanent abnormal dilatation of bronchi

Infection, obstruction, ciliary dyskinesia, inflammation, systemic disease

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27
Q

Bronchiecstasis Complications

A

Infections
Haemoptysis
Cor Pulmonale
Amyloidosis

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28
Q

Cystic Fibrosis

A

1 in 2500
Autosomal Recessive
Cystic Fibrosis Transmembrane Conductance Regulator

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29
Q

Pulmonary Oedema

A

LHF, Alveolar Injury, Neurogenic, High Altitude

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30
Q

Pulmonary Oedema Histology

A

Acute: Watery lungs, intra-alveolar fluid on histology

Chronic: Iron laden macrophages (Heart failure cells) , fibrosis

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31
Q

Diffuse Alveolar Damage

A

Fluffy White infiltrates = white out cxr

Lungs expanded, firm, plum colours, airless, heavy

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32
Q

Adult Diffuse alveolar damage

A

Acute respiratory distress syndrome

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33
Q

Neonatal Diffuse Alveolar Damage

A

Hyaline Membrane Disease of the Newborn

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34
Q

Prognosis of DAD

A

40% death
Infections
Fibrous Scarring

35
Q

Bronchopneumonia

A

Elderly

Low virulence organisms ie. staph haem strep, pneumococcus

Patchy bronchial and peribronchial distribution, lowe lobes
Acute inflammation surrounding airways and within alveoli

36
Q

Lobar Pneumonia

A

Infrequent since ABx

High virulence organisms -> 95% S. pneumoniae

Widespread fibrinosuppurative consolidation

37
Q

Lobar Pneumonia Histology

A

Congestion -> Hyperaemia, Intra-alveolar fluid

Red hepatisation -> Hyperaemia, Intra-alveolar neutrophils

Grey Hepatisation -> Intra-alveolar connective tissue

Resolution -> Normal architecture

38
Q

Complications of infective lung disease

A 
Abscess
Pleuritis
Empyema 
Scarring 
Septicaemia
39
Q

Emphysema

A

Permanent loss of alveolar parenchyma distal to terminal bronchiole

40
Q

Causes of Emphysema

A

Smoking
Alpha-1-antitrypsin Deficiency
IVDU, cadmium exposure, Marfan’s

41
Q

Emphysema COmplications

A

Bullae
Resp Failure
Cor Pulmonale

42
Q

Granulomatous Lung Disease

A

Collection of histiocytes/macrophages/multinucleate giant cells

Can be necrotising or non necrotising

TB, Sarcoidosis, foreign bodym occupational lung disease

43
Q

Fibrosing `Lung disease

A

Idiopathic pulmonary fibrosis (Cryptogenic fibrosing alveolitis)

Extrinsic allergic alveolitis (farmer’s lung)

Industrial Lung Disease (pneumoconiosis)

44
Q

Idiopathic Pulmonary Fibrosis

A

Cryptogenic Fibrosing Alveolitis

Chronic SOB, Cough

CT and Biopsy

Progressive, 50% dead within 3 yrs

45
Q

Macrohistology of Idiopathic Pulmonary Fibrosis

A

Basal and peripheral fibrosis and cyst formation

46
Q

Microhistology of Idiopathic Pulmonary Fibrosis

A

Interstitial Fibrosis at varying stages

47
Q

Small PE

A

Haemorrhagic Infarct
Repeated
Pleuritic Chest oain, acute SOB, progressive SOB

48
Q

Large PE

A

Saddle emboli can occlude the main pulmonary trunk

Sudden death, acute RHF/CVS Shock

49
Q

Precapillary causes of pulmonary hypertension

A

Vasoconstrictive (hypoxia)

Embolic (thromboembolic)

50
Q

Capillary causes of pulmonary hypertension

A

Widespread pulmonary fibrosis

51
Q

Postcapillary causes of pulmonary hypertension

A

Veno-occlusive disease

Left sided heart disease

52
Q

Classification of lung tumours

A

Benign ie chondroma

Malignant, 90% epithelial

squamous = adeno > large cell = small cell

53
Q

What in smoke causes lung cancer?

A

Tumour initiators ie polycyclic aromatic hydrocarbons

Tumour Promoters ie. N Nitrosamines

Complete carcinogens ie. nickel, arsenic

54
Q

Squamous Cell Carcinoma

A

35% lung cancers
Smoking
Central from bronchial epithelium

Local spread, late metastasis

55
Q

Invasive Adenocarcinoma

A

27% Lung Cancers
Smoking, female, far-east
Peripheral

Metastases common early

56
Q

Development of Adenocarcinoma

A

Atypical adenomatous hyperplasia

->

Non-mucinous adenocarcinoma in situ

->

Mixed pattern invasive adenocarcinoma

57
Q

Invasive Adenocarcinoma Histology

A

Glandular Differentiation
Papillae Formation
Mucin

58
Q

Large Cell Carcinoma

A

10% Lung Cancers
Poorly differentiated, large cells

no histological evidence of glandular/squamous differentiation, some evidence on electron microscopy

Poor prognosis

59
Q

Small Cell Carcinoma

A 
20% 
Smoking 
Central near bronchi 
80% advanced
Chemosensitive but awful prognosis + associated with paraneoplastic syndromes
60
Q

Small Cell Carcinoma Histology

A

Small, poorly differentiated

p53 and RB1 mutations

61
Q

Bevacizumab and SCC

A

Fatal haemorrhage, don’t use

62
Q

Adenocarcinoma with Ros1/ALK translocation

A

Crizotinib

63
Q

What inhibits immune response in SCC/Adenocarcinoma?

A

PDL1

64
Q

Breast lump aspirate coding

A 
C1 - adequate 
C2- Benign 
C3 - Atypia, probably benign 
C4 - Suspicious of Malignancy 
C5 - Malignancy
65
Q

Duct Ectasia

A

Inflammation/Dilatation of large breast ducts

Nipple discharge, pain, retraction

Cytology shows proteinaceous material and inflammatory cells only

66
Q

Acute Mastitis

A 
Acute Inflammation 
Lactating women 
Staphylococci 
Painful red breast 
Drainage, ABx
67
Q

Fat Necrosis

A

Inflammation due to damage adipose tissue
Trauma, surgery, radiotherapy

Breast mass

68
Q

Fibrocystic breast disease

A

Exaggerated normal breast tissue change in response to hormonal influence

Common

Lumpiness

No Cancer risk

69
Q

Fibroadenoma

A

Benign fibroepithelial neoplasm of breast
Circumscribed mobile breast lump
Shelling out = curative

70
Q

Phyllode’s Tumour

A

Potentially aggressive fibroepithelial breast cancers

Benign usually >50

71
Q

Intraductal papilloma

A

Benign papillary tumour arising within the ductal system of the breast

peripheral = small terminal ductules

central = larger lactiferous ducts

72
Q

Intraductal Papilloma

A

F 40-60

central present with nipple discharge

Peripheral silent if small

Excision

73
Q

Breast Radial Scar

A

Benign sclerosing lesion

Central scarring surrounded by radiating zone of proliferating glandular tissue

Complex if >1cm

74
Q

Proliferative Breast Diseases

A

Increased risk for subsequent breast carcinoma

Typically microscopic with no symptoms

75
Q

Usual epithelial hyperplasia

A

Not a direct precursor to breast carcinoma, but increased risk

76
Q

Atypical ductal carcinoma

A

Aka flat epithelial atypia
earliest morphological precursor to low grade ductal carcinoma in situ

4x relative risk

77
Q

In situ lobular dysplasa

A

Risk factor for invasive breast carcinoma

7-12 x relative risk

78
Q

Ductal Carcinoma in situ

A

Neoplastic intraductal epithelial proliferation in the breast

Inherent progression to carcinoma

Microcalcification on mammography

10% symptoms

Excision

79
Q

Invasive breast carcinomas

A

Malignant epithelial tumours

RF = BRCA mutation, increased exposure to progesterone, COCP, BMI, alcohol

80
Q

Basal Cell Breast Carcinoma

A

BRCA
Breast cytokeratins CK5/6/14
Central necrosis, sheets of atypical cells and lymphocytic infiltrate

81
Q

Invasive breast tumour grading

A
  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
Q

Breast cancer prognosis

A

Axillary lymph nodes = key

Size, type, grade

83
Q

Male breast disease

A

Gynaecomastia

0.2% breast cancers

Meded Path Lectures (15 decks)

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