Histopathology Flashcards
Caseating necrosis
TB
What type of epithelium has intercellular bridges?
Squamous
What type of epithelium has keratin?
Squamous
Stain used for amyloid
Congo Red (stains amyloid bright red)
Amyloid under polarised light looks like…
Apple green birefringence
Villous atrophy and crypt hyerplasia
Coeliac
Antibodies in Coeliac
Anti-EMA and anti-TTG (endomysial and tissue transglutaminase)
Skin complication of coeliac
Dermatitis herpetiformis (“blistering rash on elbow/knees”)
Pancreatic calcifications
Chronic pancreatitis (diagnostic)
What cancer type is “mucin-secreting glands set in desmoplastic stroma”
Adenocarcinoma
Rosette Cells
Neuroendocrine tumours
Rokitansky-Aschoff sinus
Chronic Cholecystitis
• Diverticula in gall bladder (due to obstruction)
o Gallbladder pumps harder to get rid of obstruction
o –> Increases pressure inside gallbladder
o –> Rokitansky-Aschoff sinus:
Liver with lots of nodules
Cirrhosis (nodules = regenerating hepatocytes)
Liver biopsy shows nodular hepatocyte with collagen cuff around it
Cirrhosis
Spotty necrosis and interface hepatitis
Acute hepatitis (Spotty necrosis = foci of inflammation and apoptosis-> happens in all acute hepatitis) (Interface hepatitis = can’t see where hepatocytes end and portal tract begins = T cell destruction of hepatocytes)
Ballooning of hepatocytes
Alcoholic hepatitis (most important feature – shows that they are apoptosing)
Bowel disease where don’t pass meconium in first 24 hrs
Hirschsprung’s Disease
Pericellular fibrosis around hepatocytes
Alcoholic hepatitis
Liver disease causing itchy skin
Primary Biliary Cholangitis (bile acids escape to circulation)
Test for Primary Biliary Cholangitis
Anti-mitochondrial antibodies
Gut disease occurring in “watershed zones” (splenic flexure and rectosigmoid)
Ischaemic Colitis (watershed zones are far from gut’s blood supply)
ERCP: “beaded appearance”
Primary Sclerosis Cholangitis
Chocolate brown liver
Haemachromatosis
What stain used for iron in Haemachromatosis?
Prussian Blue (brown iron stained blue)
What stain used in Wilson’s Disease?
Rhodamine stain
Eye sign in Wilson’s Disease
Kayser-Fleischer rings (brown ring around edge of iris)
Very steroid responsive liver disease
Autoimmune hepatitis
Hirschsprung’s Disease associated with which congenital disease?
Down Syndrome
Mallory-Denk Bodies
Alcoholic hepatitis (hepatocyte damage)
Liver disease with increased gamma globulin
Primary Sclerosis Cholangitis
IBD: Whole GI tract affected (mouth to anus)
Crohn’s
IBD: Only large bowel affected = moves upwards from anus
Ulcerative Colitis
IBD: Inflammation confined to mucosa (not though wall)
Ulcerative Colitis
IBD: Cobblestone mucosa
Crohn’s
IBD: Crypt abscess
Ulcerative Colitis
IBD: Transmural inflammation
Crohn’s
Lip and mouth complications of Crohn’s
Cheilitis = inflammation of lips (look dry and cracked) Stomatitis = mouth ulcers
Extra-intestinal complication of Ulcerative Colitis
Primary Sclerosing Cholangitis
Skin complication of Crohn’s
Erythema multiforme/nodosum
Dangerous bowel complication of Ulcerative Colitis
Toxic megacolon
Ulcerative Colitis increases risk of which cancer?
Bowel Adenocarcinoma
Mouth ulcers in which GI condition?
Crohn’s
Familial Adenomatous Polyposis involves mutation in which gene?
APC tumour suppressor gene (chromosome 5q21)
Colorectal cancer in very young person. What disease do they have?
Hereditary Non-Polyposis Colorectal Cancer (HNPCC)
- poorly differentiated and mucinous carcinomas
- often carcinomas proximal to splenic flexure
Brain biopsy shows piloid “hairy” cell with Rosenthal fibres
Pilocytic Astrocytoma
Heterogeneous and enhancing brain tumour
Glioblastoma Multiforme
Brain tumour with long history of neuro signs/seizures
Oligodendrogliomas
Co-deletion is specific for which brain tumour?
Oligodendrogliomas (co-deletion of 1p/19q)
Cystic cerebellar lesions
Pilocytic Astrocytoma
Whorl pattern (spirals) on brain biopsy
Meningioma
Brain cells look like fried eggs (round cells with clear cytoplasm)
Oligodendrogliomas
Small blue round cell brain tumour, with Homer-Wright Rosettes
Medulloblastoma
Brain tumour in patient who had lobectomy 5 years ago
Brain mets (lobectomy = previous cancer)
Medulloblastoma expresses this neuronal marker
Synaptophysin
Can’t see gyrae on brain MRI
Cerebral Oedema (can’t see gyrae because tightly compressed)
T2-weighted brain MRI shows “target sign”
Cavernous Angioma
Head injury with runny nose and ears
Skull fracture (esp hairline fracture = extend into base of skull)
Beta-amyloid plaques in Hippocampus
Alzheimer’s Disease
What protein accumulates in Parkinson’s?
Alpa-synuclein (forms Lewy Bodies)
Balloon Neurones
Pick’s Disease
Cortical atrophy on brain MRI (Widening of sulcae, shrinkage of gyrae)
Alzheimer’s Disease (lose brain tissue)
Frontotemporal atrophy on brain MRI
Pick’s Disease
Amyloid lines cerebral vessel walls
Alzheimer’s Disease
Tau protein
Alzheimer’s Disease
Pick Bodies in hippocampus
Pick’s Disease
What genetic condition increases risk of kidney cancer?
Von Hippel Lindau
Cancer with frond-like growths (like a leaf)
Non-Invasive Papillary Urothelial Carcinoma
Testicular cancer which can differentiate into other cancer types (e.g. lung)
Post-Pubertal Teratoma
Schiller-Duval Body
Yolk Sac Tumour (testicular cancer in <3yrs)
Testicular cancer presenting with precocious puberty
Leydig Cell Tumour (releases hormones)
Skin disease which is Nikolsky’s Sign Positive
Pemphigus Vulgaris (slight rubbing detaches upper epidermis from lower epidermis)
Skin bubbles which do not easily rupture
Bullous Pemphigoid
Skin disease with hyperkeratosis
Contact Dermatitis (epidermis thicker after scratching)
Silvery plaques on extensor surfaces
Plaque Psoriasis
Skin disease with white lines in mouth
Lichen Planus
Horn cysts
Seborrhoeic Keratosis (entrapped keratin- surrounded by proliferating epidermis)
Skin bubbles which easily rupture
Pemphigus Vulgaris
Skin lesion with smooth surface, non-mobile, central punctum
Sebaceous Cyst
Skin lesion with rolled pearly white border, central ulceration
Basal Cell Carcinoma
Crusty, non-healing ulcer with everted edge on sun-exposed areas
Squamous Cell Carcinoma
Weird horns growing on skin
Bowen’s Disease = Early Form of SCC
Rodent Ulcer
Basal Cell Carcinoma
Stain for melanin
Fontana stain
Herald Patch
Pityriasis Rosea (salmon-pink, scaly –> rash on trunk)
Skin cancer which does NOT metastasise
Basal Cell Carcinoma
Skin viral infection which causes target lesions
Pityriasis Rosea = HHV6/7 (get URTI before rash)
Low-risk HPV types
HPV 6 and 11
High-risk HPV types
HPV 16 and 18
Bone disease with mottled rarefaction (bone thinner) and lifting of periosteum
Osteomyelitis
Bone biopsy contains multinucleated Langerhans-type Giant cells
TB Bone Disease
Joint disease with osteophytes
Osteoarthritis
Joint disease with spares the distal interphalangeal joint
Rheumatoid Arthritis
Grimley-Sokoloff cells in biopsy
Rheumatoid Arthritis (multinucleated giant cells specific for RA)
Bone X-Ray shows “onion-skinning” of periosteum
Ewing’s Sarcoma
Bone disease with Codman Triangle on X-Ray
Osteosarcoma - see in kids
Bone X-Ray is lytic with fluffy calcification
Chondrosarcoma
Joint disease with subcondral sclerosis and subcondral cyst
Osteoarthritis
Bone disease with sheets of small round blue cells on biopsy
Ewing’s Sarcoma
Lung disease with Curschmann’s Spiral
Asthma
Lung infection which does not have consolidation on CXR, but shows patchy changes. Terminal event which kills off old person.
Bronchopneumonia
Central lung tumour
Squamous Cell Carcinoma
Lung cancer containing “large cells”
Large Cell Carcinoma
Oat-shaped lung cells on biopsy
Small Cell Lung Cancer
Cancer which causes pleural thickening
Mesothelioma
Peripheral lung tumour
Adenocarcinoma
Ovarian cancer type which is strongly associated with endometriosis
Clear Cell Carcinoma