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Histopathology Flashcards

1
Q

Histopathologist Report

A
  • Patient Details
  • (Working) Diagnosis
  • Gross description of specimen
  • Microscopic description of specimen
  • Final working diagnosis
  • Signature
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2
Q

Congo Red?

A

Amyloid stains red
- Amyloidosis
- CAA
- Alzheimers

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3
Q

Masson’s Trichrome

A

Collagen stains blue

Helps visualize fibrosis

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4
Q

Luxol fast blue

A

Stains myelin

Dx of Demyelinating disorders (MS, PML,
Neuromyelitis Optica, ADEM)

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5
Q

Grocott Silver Stain?

A

Fungi
Pneumocytis jirovecii

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6
Q

Ziehl Neelsen (Acid fast)?

A

TB
(also stained by
Auramine stain)

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7
Q

India Ink

A

Cryptococcus

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8
Q

Coagulative (most solid organs) necrosis?

A

Gross: Triangle-shaped “wedge infarct”

Micro: Loss of nuclei (anucleated cells), Eosinophilic (red)

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9
Q

Liquefactive (Abscess/Brain infarction) necrosis?

A

Gross: Liquid, creamy (pus) consistency to lesion

Micro: Increased space, accumulation of debris,
Accumulation of neutrophils, macrophages

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10
Q

Fat necrosis (Pancreas/Breast)?

A

Gross: White deposits (Lipids precipitate out Ca2+)

Micro: Necrotic, anuclear adipocytes

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11
Q

Fibrinoid Necrosis (Vasculitis)

A

Histological Triad of vasculitis:
- Inflammatory infiltrate
- Thrombotic vascular occlusion
- Fibrinoid necrosis -> Deposition of fibrin in vessel walls

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12
Q

Caseous Necrosis (TB)?

A

Gross: Cheese-like lesion
Micro: Caseating Granuloma (see later slides)

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13
Q

Apoptosis

A
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14
Q

Acute Inflammation

A
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15
Q

chronic inflammation:

Granulomas

A
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16
Q

Cellular features of dysplasia

A
  • Hyperchromasia
  • Increased Nuclear :Cytoplasmic ratio
  • Mitotic features
  • Cellular pleomorphism
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17
Q

Tissue features of malignancy

A
  • Invasion through basement membrane
  • Distortion of tissue architecture
  • Invasion into surrounding tissues
  • Metastasis
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18
Q

TTF-1 IHC - indicates?

A

Lung cancer

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19
Q

CK7/CK20 IHC - indicates?

A

COLORECTAL cancer

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20
Q

cytokeratin IHC - indicates?

A

Tumours of epithelial origin

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21
Q

Synaptophysin IHC - indicates?

A

Neuroendocrine tumour

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22
Q

chromogranin IHC - indicates?

A

Neuroendocrine tumour

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23
Q

CD99 IHC - indicates?

A

Ewings sarcoma

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24
Q

TdT IHC - indicates?

A

Blast cells -> ALL/AML

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25
Ki-67 IHC - indicates?
Proliferation index - cancer
26
Pneumonia - histology?
- Actue inflammatory cells and RBC filling alveolar spaces uniformly - Congested capillaries in the alveolar septa
27
Pneumonia - lung
28
Bronchiectasis - pathology?
- Neutrophillic exudate in bronchi - Widened bronchi into periphery
29
Abscess Walled-off pus-filled cavity
30
TB Micro: Caseating Granuloma * Caseous necrosis in centre * Macrophages/Giant cells around centre * Lymphocytes in periphery
31
Pan-acinar Emphysema A1AT deficiency
32
Asthma - histology?
- Thickened basement membrane - Smooth muscle hypertrophy - Mucous plugging - Goblet cell hyperplasia - Eosinophilia
33
Adenocarcinoma?
* Back-to-back glands * Mucin rich
34
Squamous Cell Carcinoma
SCC * Keratin pearls * Intercellular bridges
35
Small cell carcinoma
(Synaptophysin +ve)
36
Adenocarcinoma - lung
37
Squamous Cell Carcinoma - lung
38
Large Cell Carcinoma - lung
39
Oesophagus: (Pre-)malignant process?
40
Eosinophilic oesophagitis * Eosinophilic micro-abscesses in proximal oesophagus
41
Eosinophil
42
Signet ring cells - Stomach cancer
43
Trophozoites in lumen - Giardiasis
44
Whipples disease - Periodic Acid Schiff +ve macrophages (deep pink)
45
Appendicitis - Fibrosis/ haemorrhage - Widespread inflammatory infiltrate - Erosion/ destruction of mucosa
46
Ulcerative Colitis - histology?
Continuous inflammation Microscopic Appearance * Partial thickness change * Crypt abscesses, Goblet cell depletion
47
Crohn's Disease histology?
Skip lesions Microscopic appearance * Full thicknessinflammation * Granulomas/Inflammatory cell infiltrate
48
UC
49
Chrons
50
Pseudomembranous Colitis Erosion of mucosal surface “Volcano sign” = Pseudomembrane (inflammatory cells + fibrin)
51
Colorectal Cancer
52
Liver – Acute inflammation
53
Liver – Cirrhosis Bridging fibrosis Regenerative nodules
54
Primary Biliary Cholangitis
55
Primary Sclerosing Cholangitis Onion skin fibrosis
56
Autoimmune Hepatitis
57
Stains Iron Haemochromatosis?
Perls Prussian Blue
58
A1AT deficiency - stain?
Periodic Acid Schiff
59
Stains Copper Wilson’s Disease
Rhodamine Stain
60
“Ground glass” hepatocytes -> HBsAg
61
MI infarct at 7 days - Angiogenesis - Fibrosis - Fibroblasts - Macrophages
62
Acute infarct @48h Necrosis of myocardium * Loss of nuclei * Hypereosinophilic Acute inflammatory infiltrate
63
MI Contraction bands (associated with reperfusion)
64
MI - “Wavy” fibres
65
Hypertrophic Obstructive Cardiomyopathy (HOCM) Disorganised fibres
66
HSV Inclusion Bodies Encephalitis
67
Herpes encephalitis - Bilateral temporal lobe involvement
68
Alzheimers Atrophic Gyri, widened sulci (relative sparing of occipital lobe)
69
Alzheimers Amyloid (plaques/angiopathy)
70
Alzheimers Hirano bodies
71
Phosphorylated tau -> Neurofibrillary tangles NOT specific for AD!
72
Alzheimer’s Disease Granulovacuolar Degeneration (Lysosomes)
73
Alzheimer’s Disease Granulovacuolar Degeneration (Lysosomes)
74
Neuritic Placques ALZHEIMERS
75
Frontotemporal Dementia Atrophy of frontal and temporal lobes
76
Pick Bodies (composed of tau) H&E ON LEFT IHC for tau ON RIGHT Frontotemporal Dementia
77
Loss of neurons/pigmentation in the substantia nigra of the midbrain Parkinson’s
78
Lewy Body Dementia Pigmented neuron of Substantia nigra NEXT TO Lewy Body
79
IHC: Alpha-synuclein Lewy Body Dementia
80
Huntington’s Disease Loss of the striatum (esp. caudate and putamen) -> Enlargement of ventricles
81
Huntington’s Disease
82
Psammoma body * Serous ovarian cystadenocarcinoma * Papillary Thyroid Cancer
83
GBM Giant cells
84
Oligodendoglioma - Fried egg appearance - 1p19q co-deletion
85
Biphasic Antoni A/B pattern Associated with Neurofibromatosis Type II (bilateral Schwannomas)
86
Pilocystic astrocytoma Associated with Neurofibromatosis Type I
87
Homer Wright Rosettes - neurobalstoma - Medulloblastoma - Pineoblastoma
88
Flexner-Wintersteiner rosette - Retinoblastoma - Medulloepithelioma
89
Perivascular pseudo rosette - Epidemyoma - Central neurocytoma - Glioblastoma
90
Lobular Carcinoma in situ No Lump, Often Bilateral Loose, blue cells
91
Ductal Carcinoma in situ Lump, Unilateral
92
Ductal carcinoma Lump, Unilateral Classical Adenocarcinoma features
93
Lobar carcinoma No lump, often bilateral Loss of E-Cadherin Tumour cells intersperse within tissue
94
Medullary Breast Cancer
95
Renal tumour Nephroblastoma/Wilm’s Tumour Triphasic Tumour Large hyperchromatic nuclei = Anablastic nephroblastoma (bad)
96
Adrenal tumour Neuroblastoma (Synaptophysin +ve, MYC amplification)
97
Renal Clear Cell Carcionma - kidney
98
Transitional Cell Carcinoma - bladder
99
Adenocarcinoma prostate 1. Nuclear enlargement of cuboidal cells 2. Loss of basal cells 3. Classical cellular features of malignancy (N:C ratio, hyperchromasia) 4. Classical tissue features of adenocarcinoma: Back-to-back glands
100
Testicular cancer Subtypes associated with key tumour markers
– Seminomas: Secrete PALP – Embryonal: Secrete beta-hCG – Yolk Sac Tumour: Secrete AFP – Choriocarcinoma: Secete beta-hCG – Sex cell tumours: ■ Testosterone (Child: Premature puberty) ■ Oestrogen (Child: Delayed puberty, Adult: Gynaecomastia, ED)

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