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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
Q

Ki-67 IHC - indicates?

A

Proliferation index - cancer

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26
Q

Pneumonia - histology?

A
  • Actue inflammatory cells and RBC filling alveolar spaces uniformly
  • Congested capillaries in the alveolar septa
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27
Q
A

Pneumonia - lung

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28
Q

Bronchiectasis - pathology?

A
  • Neutrophillic exudate in bronchi
  • Widened bronchi into periphery
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29
Q
A

Abscess
Walled-off pus-filled cavity

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30
Q
A

TB
Micro: Caseating Granuloma
* Caseous necrosis in centre
* Macrophages/Giant cells around centre
* Lymphocytes in periphery

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31
Q
A

Pan-acinar Emphysema
A1AT deficiency

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32
Q

Asthma - histology?

A
  • Thickened basement membrane
  • Smooth muscle hypertrophy
  • Mucous plugging
  • Goblet cell hyperplasia
  • Eosinophilia
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33
Q

Adenocarcinoma?

A
  • Back-to-back glands
  • Mucin rich
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34
Q

Squamous Cell Carcinoma

A

SCC
* Keratin pearls
* Intercellular bridges

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35
Q

Small cell carcinoma

A

(Synaptophysin +ve)

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36
Q
A

Adenocarcinoma - lung

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37
Q
A

Squamous Cell Carcinoma - lung

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38
Q
A

Large Cell Carcinoma - lung

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39
Q

Oesophagus: (Pre-)malignant process?

A
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40
Q
A

Eosinophilic oesophagitis

  • Eosinophilic micro-abscesses in proximal oesophagus
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41
Q
A

Eosinophil

42
Q
A

Signet ring cells - Stomach cancer

43
Q
A

Trophozoites in lumen - Giardiasis

44
Q
A

Whipples disease - Periodic Acid Schiff +ve
macrophages (deep pink)

45
Q
A

Appendicitis
- Fibrosis/ haemorrhage
- Widespread inflammatory infiltrate
- Erosion/ destruction of mucosa

46
Q

Ulcerative Colitis - histology?

A

Continuous inflammation

Microscopic Appearance
* Partial thickness change
* Crypt abscesses, Goblet cell depletion

47
Q

Crohn’s Disease histology?

A

Skip lesions

Microscopic appearance
* Full thicknessinflammation
* Granulomas/Inflammatory cell infiltrate

49
Q
50
Q
A

Pseudomembranous Colitis

Erosion of
mucosal surface

“Volcano sign”
= Pseudomembrane
(inflammatory cells +
fibrin)

51
Q
A

Colorectal Cancer

52
Q
A

Liver – Acute inflammation

53
Q
A

Liver – Cirrhosis

Bridging
fibrosis

Regenerative
nodules

54
Q
A

Primary Biliary Cholangitis

55
Q
A

Primary Sclerosing Cholangitis
Onion skin fibrosis

56
Q
A

Autoimmune Hepatitis

57
Q

Stains Iron
Haemochromatosis?

A

Perls Prussian Blue

58
Q

A1AT deficiency - stain?

A

Periodic Acid Schiff

59
Q

Stains Copper
Wilson’s Disease

A

Rhodamine Stain

60
Q
A

“Ground glass” hepatocytes -> HBsAg

61
Q
A

MI infarct at 7 days
- Angiogenesis
- Fibrosis
- Fibroblasts
- Macrophages

62
Q
A

Acute infarct @48h

Necrosis of myocardium
* Loss of nuclei
* Hypereosinophilic

Acute inflammatory infiltrate

63
Q
A

MI

Contraction bands
(associated with reperfusion)

64
Q
A

MI - “Wavy” fibres

65
Q
A

Hypertrophic Obstructive Cardiomyopathy (HOCM)

Disorganised fibres

66
Q
A

HSV Inclusion Bodies
Encephalitis

67
Q
A

Herpes encephalitis
- Bilateral temporal
lobe involvement

68
Q
A

Alzheimers

Atrophic Gyri, widened sulci
(relative sparing of occipital lobe)

69
Q
A

Alzheimers
Amyloid (plaques/angiopathy)

70
Q
A

Alzheimers
Hirano bodies

71
Q
A

Phosphorylated tau
-> Neurofibrillary tangles NOT specific for AD!

72
Q
A

Alzheimer’s Disease
Granulovacuolar Degeneration (Lysosomes)

73
Q
A

Alzheimer’s Disease
Granulovacuolar Degeneration (Lysosomes)

74
Q
A

Neuritic Placques
ALZHEIMERS

75
Q
A

Frontotemporal Dementia
Atrophy of frontal and temporal lobes

76
Q
A

Pick Bodies (composed of tau)
H&E ON LEFT IHC for tau ON RIGHT

Frontotemporal Dementia

77
Q
A

Loss of neurons/pigmentation in the
substantia nigra of the midbrain

Parkinson’s

78
Q
A

Lewy Body Dementia

Pigmented neuron of
Substantia nigra NEXT TO Lewy Body

79
Q
A

IHC: Alpha-synuclein
Lewy Body Dementia

80
Q
A

Huntington’s Disease
Loss of the striatum (esp. caudate and putamen)

-> Enlargement of ventricles

81
Q
A

Huntington’s Disease

82
Q
A

Psammoma body
* Serous ovarian cystadenocarcinoma
* Papillary Thyroid Cancer

83
Q
A

GBM

Giant cells

84
Q
A

Oligodendoglioma
- Fried egg appearance
- 1p19q co-deletion

85
Q
A

Biphasic Antoni A/B pattern
Associated with Neurofibromatosis Type II (bilateral Schwannomas)

86
Q
A

Pilocystic astrocytoma

Associated with Neurofibromatosis Type I

87
Q
A

Homer Wright Rosettes
- neurobalstoma
- Medulloblastoma
- Pineoblastoma

88
Q
A

Flexner-Wintersteiner rosette
- Retinoblastoma
- Medulloepithelioma

89
Q
A

Perivascular pseudo rosette
- Epidemyoma
- Central neurocytoma
- Glioblastoma

90
Q
A

Lobular Carcinoma in situ
No Lump, Often Bilateral
Loose, blue cells

91
Q
A

Ductal Carcinoma in situ
Lump, Unilateral

92
Q
A

Ductal carcinoma
Lump, Unilateral
Classical Adenocarcinoma features

93
Q
A

Lobar carcinoma
No lump, often bilateral

Loss of E-Cadherin
Tumour cells intersperse within tissue

94
Q
A

Medullary Breast Cancer

95
Q
A

Renal tumour

Nephroblastoma/Wilm’s Tumour

Triphasic Tumour

Large hyperchromatic nuclei
= Anablastic nephroblastoma (bad)

96
Q
A

Adrenal tumour

Neuroblastoma (Synaptophysin +ve, MYC amplification)

97
Q
A

Renal Clear Cell Carcionma - kidney

98
Q
A

Transitional Cell Carcinoma - bladder

99
Q
A

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
Q

Testicular cancer Subtypes associated with key tumour markers

A

– 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)

Rapid review (7 decks)

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