histopathology COPY COPY Flashcards
pain relived by sitting forward, raised amylase. Inflammatory condition resulting in injury of the acinar cells to the pancreas
Pancreatitis
rare, mainly childhood, presents with abdo pain, emesis, jaundice
Pancreatoblastoma.
Cyst with the epithelial layer
cystadenoma
diarrhoea A 39 year old Nepalese man presents with severe watery diarrhoea.He is found to have hypokalaemia and, surprisingly, a metabolic acidosis. A RUQ mass is detected by contrast-enhanced spiral CT scanning. Stool bicarb is high and urine anion gap is negative.
vipoma
associatted with necrolytic migrating erythema
Glucaoma
recurrent ulceration, hematemesis, diarrhoea, multiple gastro duodenal ulcers, diarrhoea, non-responsive to omeprazole
zollinger ellison syndrome
Dilatation of the large breast ducts, menopause, tender lump around the areola +/- Thick, white nipple a green nipple discharge. secretions. Mimics mammographic appearance of cancer
Duct ectasia.
Mostly in smokers and not associated with lactation. Histologically, keratinizing squamous epithelium extends deep into nipple duct orifices.
Periductal mastitis
red breast, lactating, cracked skin - continue expressing + antibiotics
Mastitis
Very common. Group of changes caused by exaggerated normal response to hormones
Fibrocystic:
Local areas of epithelial proliferation in large mammary ducts, Hyperplastic lesions rather than malignant or premalignant. May present with blood stained discharge.
Duct papilloma
Proliferation of fibroepithelium and stromal tissue’ can arise with pre-existing fibroadenoma.
>50, potentially aggressive
○ Artichoke like tumor.
Phyllodes tumour
Incidence increased dramatically since development of mammography. Appear as areas of CALCIFICATIONS. 10% present with clinical symptoms. Much increased risk of progressing to invasive breast Ca. Cancer staged into low grade, intermediate, high grade
Ductal Carcinoma in Situ
loss of E-cadherin:
Invasive lobular
ALWAYS incidental finding on biopsy as no calcification 20-40% bilateral
LCIS
Most common type of invasive cancer:
DCIS
Woman with known breast cancer has a red and rough nipple:
Paget’s disease
Woman with breast lump, FNA shows C5 grading.
Invasive breast carcinoma
old, rectal bleeding, fever, LIF
Diverticulitis
left sided abdominal pain relived by defecation
diverticular disease
left sided abdominal pain relived by defecation plus fever
Diverticulitis
obstruction, constipation, vomiting
Sigmoid volvulus
patients after lung transplant are more likely to get adenocarcinoma of colon
CF
Pernicious anaemia, H pylori associated
Maltoma
Cancer due to Coeliac disease HLA B8 associated 10% would get primary lymphoma a of the gut if not properly treated
Enteropathy Associated T-cell Lymphoma
associated with pernicious anemia and gastric ulcer
Chronic gastritis
single episode of melana, erosion through the gastric wall and infiltrate
Acute Gastritis
well differentiated, progression from athropic gastritis to chronic, eldery male, same as Berret but in oesophagus
intestinal gastric cancer
Young women, associated with poor prognosis and lints plastic a and signet ring cells
diffuse gastric cancer
male with change in bowel habit, weight loss, bleeding PR
adenocarcinoma of the colon
hyperplastic polyps associated mutation
AFP
Seen at 50-60s years old, caused by shedding of the epithelium Polyps not associated with increased cancer risk
Hyperplastic
type of polyps associated with mucocutenous hyper pigmentation, freckles around the mouth. Focal malformation of mucosa and lamina proporoiat
Hamartomas Polyp
What mutation is associated with hamartomous polyps
AD - LKB1
Fe def, anaemia, weight loss
Right sided tumor
> 100 polyps seen, name the condition, and the mutaiton
70% Autosomal Dominant mutation in APC gene (Anaphase promoting Complex).
Change in bowel habit, crampy LLQ pain
Left sided bowel tumor
Bilateral pigmentation of the retina, bleeding per rectum, teenager, family history of colorectal cancer:
FAP
Associated with bilateral pigmentation on the retina, osteomas and dental carries:
Gardener Syndrome
Carcinoma in the right colon (Fe, anemia, weight loss), few polyps, fast progression to malignancy, AD mutations in mismatch repair genes
Hereditary non-polyposis colorectal cancer (Lynch syndrome)
What on surveillance would be an indication for colectomy in UC?
Dysplastic polyps
What would you see on histology in Crohn’s?
Non-Cesaiting Granulomas, Cobblestone
Intermittent diarrhea, pain and fever
diverticulitis
ring enhancing lesion HIV person
HIV Tuberculoma but I would say toxoplasmosis or brain abscess.
CSF shows. Oligoclonal Bands of IgG on, Electrophoresis.
Multiple Sclerosis
elderly person with insidious onset of neuro problems, ‘collapse at home’
Subdural
hit on side of head and lucid interval, car traffic accident
Middle meningeal/extradural bleed
Psychiatry symptoms first with young age of onset. Depression then CNS symptoms in young person.
young omnivore who had psychiatric symptoms then motor symptoms
Chorea-ataxia follow it x. Variant CJD
Neurosign’s first and presents later. Rapid progressive dementia with myoclonus.
Sporadic CJD
Optic nerve tumour excised and now lump on hand.
Neurofibromatosis type 1
1:5000 condition, mutation on Ch 17 which encodes neurofibrin. Associated with phaochromocytomas
Neurofibroblasotma
Epileptic with patch on back and lumps in brain
Tuberous sclerosis
adenoma sebaceum (angiofibromas):
Tuberous sclerosis
Capillary loops surrounded by epithelial cells, anywhere in the CNS, presenting between 2nd and 5th decade. Associated with headaches, seizures, focal neurological signs, rapid loss of consciousness.
AV Malformation
Presents from birth, anywhere in the CNS, usually 50+ of age. Well-defined malformation pf closely packed abnormal vessels with no parenchyma – vascular spaces that can leak, look like rasbery
Cavernous angioma
raised ICP symptoms for a while then became obtunded.
Herniation
Mass under dura mater compressing frontal lobe (usually). Check notes from David, also NF2.
Commonest brain tumour:
Meningioma
Highly vascular tumors and have a tendency to infiltrate. They have extensive areas of necrosis and hypoxia. As a rule, high-grade gliomas almost always grow back even after complete surgical excision, so are commonly called recurrent cancer of the brain
Gliomas
Patient with HIV, raised ICP, new onset epilepsy.
Cryptococcus: most common fungal infection of CNS.
Headache, fever, malaise, nausea/vomiting, seizures, focal neurological deficit.
Tuberculoma
Someone on dialysis with bone pain –
Renal osteodystrophy
Thin trabeculae, normal osteoid
Osteoporosis
The cell associated with howships lacunae, stimulated by IL-6 in myloma
Osteoclast
wide seams of osteoid and increased volume of osteoid
osteomalacia
where would you see fibrous osteodystrophy, Brown’s Tumor:
In primary hyperparathyroidism, renal osteodystophy
Unmerlised bone (osteoid) can be seen in
osteomalcia
Massive osteoclast are seen in which condition?
(Paget’s)