morph Flashcards by Bri deer

pink (amorphous) hyaline thickening with assoc bv luminal narrowing; plasma proteins leak actoss endo mem

Hyaline arteriolosclerosis

-can be caused by diab mictoangiography

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Vessels show concentric laminated layers (onion skin) thickening and narrow lumen

hyperplastic arteriolosclerosis

-onion skin = sm cells w thickened reduplicated BMs

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necrotizing arteriolitis and fibrinoid deposits in vessel wall

hyperplastic arteriolosclerosis if have malig HTN

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fatty streak composed of foam cells

ath

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Aths with destruction and thinning of the aortic media w bland, laminated, poorly organized mural thrombus

AAA

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periarotic fibrosis and exuberant transmural lymphoplasmacytic infiltrate

inflamm AAA

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tissue fibrosis affecting many tissues; aortitis and periaortitis

IgG4 AAA

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Cystic medial degeneration w/o inflammation

aortic dissection

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granulomatous inflamm w elastic lamina fragmentation

giant cell (temporal) arteritis

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patchy and focal involveet: biopsy may be -

giant cell (temporal) arteritis

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multinucleated giant cells

giant cell (temporal) arteritis

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Healed areas: Intimal fibrosis (thickening) with medial scarring and luminal narrowing

giant cell (temporal) arteritis

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Eventually: collagenous scarring with admixed chronic inflammatory cells in all 3 layers of the vessel wall

Takayasu Arteritis (pulseless disease)

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non-grnaulomatous Segmental transmural fibrinoid necrotizing inflammation of renal and visceral aas (NOT pulmonary)

Polyarteritis Nodosa (PAN)
-inflamm can weaken wall --> aneurysm/rupture/thrombosis

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fibrinoid necrosis w neutrophilic/eosinophilic/monophilic infiltrates

Polyarteritis Nodosa (PAN)

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Lesions usu only affect part of the vessel circumference with a predilection for branch points.

Polyarteritis Nodosa (PAN)

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all lesions at same stage

Microscopic Polyangiitis (leukocytoclastic vasculitis/ hypersensitivity vasculitis)

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non-grnaulomatous Segmental transmural fibrinoid necrotizing inflammation of renal and visceral aas

Microscopic Polyangiitis (leukocytoclastic vasculitis/ hypersensitivity vasculitis)

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Fragmented (apoptotic) neutrophilic nuclei within and around vessel walls

Microscopic Polyangiitis (leukocytoclastic vasculitis/ hypersensitivity vasculitis)\
= (leukocytoclastic vasculitis).

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granulomas and eos

Churg-strauss Syndrome (allergic granulomatosis and angiitis)

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Non-specific TH17 cell involvement leads to recruitment of neutrophils.

Behcet Disease

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giant cells w WBC infiltrate

Granulomatosis with Polyangiitis (Wegener Granulomatosis)

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Granulomas may coalesce to form nodules that cavitate

Granulomatosis with Polyangiitis (Wegener Granulomatosis)

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Upper resp tract: sinonasal and pharyngeal inflamm w granulomas and vasculitis

Granulomatosis with Polyangiitis (Wegener Granulomatosis)

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Lower resp tract: multiple necrotizing granulomas, which may coalesce and cavitate

Granulomatosis with Polyangiitis (Wegener Granulomatosis)

Segmental, thrombosing, acute (neutrophils) and chronic inflammation (org and recanilization) Tibial and radial aa.'s

Thromboangiitis Obliterans (Buerger Disease)

Giant cell formation and secondary involvement of adjacent nerve and vein and they may all eventually have a common fibrous sheathe.

Thromboangiitis Obliterans (Buerger Disease)

contraction band necrosis or microscopic foci of granulation tissue and/or scar

Myocardial Vessel Vasospasm

neutrophils and monocytes in dilated lymphatics

lymphangitis

discrete red lesion in the skin or mucous membrane

Telangiectasia

Light pink-deep purple flat lesion on head or neck composed of dilated bvs

Nevus Flammeus

thin walled caps w scant stroma in the skin, SQ tissue, mucus mems (oral cavity and lips)

capillary hemangioma or pyogenic granuloma after trauma

cavernous blood-filled vascular space separated by CT stroma with indistinct/infiltrative borders

Cavernous Hemangioma

exudate (not RBC)filled, slightly elevated, blebs of small lymphatic channels lined with EC in head, neck, axillary SQ tissues

Simple (capillary) Lymphangioma

really lg unencapsulatd tumors in neck or axilla of children

Cavernous Lymphangioma (cystic hygromas

tumors from modified SMCs w big round nuclei

Glomus Tumor (glomangioma)

Skin lesion with localized red papules and nodules or round, subq mass

Bacillary Angiomatosis

Capillary proliferation with epithelioid ECs

Bacillary Angiomatosis

Lesions contain stromal neutrophils, nuclear dust and causal bacteria

Bacillary Angiomatosis

Pinkpurple patches of the LE with dilated, irregular EC lined spaces + lymphocytes, plasma cells & MΦ

classic KS

o Dermal accuulations of Dilated, jagged vasc channels lined w spindle cells and perivascular aggregates

classic KS

Difficult to recognize veins + plump, cuboidal neoplastic cells (~ epithelium

Epithelioid Hemangioendothelioma

Small, well-demarcated red nodules --> large, fleshy, grey-white soft tissue masses (mostly in skin, st, breast, liver); central area of necrosis and hem

angiosarcoma

epicardial fat

aging <3

basophilic degen

aging <3

lipofuscioum increase

aging <3

sigmoid septum

aging <3 | =LV cavity reduced --> bulging of vent septum into LV outflow tract

lambl escrescences

aging <3 | = buckling of mitral leaflets into LA during systole => atrial dilation

stiff aorta --> spikes in p transmitted to organs = HTN damage

aging <3

hemosiderin

L sided HF "<3 failure cells" indicative of pulm edema

nutmeg liver

R sided HF

increased fibrous tissue in liver

R sided HF | =cardiac sclerosis/cirrhosis

boot shaped heart

tetraolgy of fallot | -from RVH

lg aorta, small pulmonary a

tetraolgy of fallot

RVH with LV atrophy

transposition of great a's

<3: dark mottling

4-24 hr after MI

<3: PMNs

12h-3d after MI

<3: yellow-tan1-

1-10d after MI

<3: necrosis

4h-3d after MI

<3: red-gray

10-14d after MI

<3: phagocytosis and granulation tissue

7-10d after MI

<3: grey-white scar

2-8 wk after MI

<3: incraesed collagen

2-8 wk after MI

<3: colagenous scarring complete

+ 2mos after MI

contration bands

reprofused <3 tissue --Due to the huge amount of Ca that is brought by the plasma with the cell having no way to keep it out that leads to severe contraction.

irregular, stony hard nodules in the fibrous annulus

mitral annular calcification

affected leaflets are enlarged, redundant, thick, rubbery

mitral valve prolapse

Tendinous Cords are long, thin, stretched, or even snapped off.

mitral valve prolapse

Focally marked thickening of the spongiosa layer with myxomatous changes

mitral valve prolapse | (increased proteoglycan deposition).

aschoff bodies

inflamm lesions of rheumatic fever - not granulomas - Swollen eos collagen + T cells + Plump Mfs - called Antishkow Cells

Mfs have lots of cytoplasm that are sometimes binucleate

inflamm lesions of rheumatic fever

caterpillar cells

inflamm lesions of rheumatic fever | -chromatin condense to central slender wavy ribbon like structures

Infalmm and fibrinoud nectosis of endocardium and L-sided valves, w verrucae

rheumatic fever or RHD

Mitral Leaflet Thickening

RHD

mitral Commissural Fusion and Shortening

RHD

Thickening and Fusion of Chordae Tendinae of mitral valve

RHD

“fish-mouth” or “button-hole stenosis

RHD | fibrous bridging across the valvular commissures

migratory arthritis

rheumatic fever | - one lg joint becomes painful and swollen for days then subsides spont, w no residual disability

erythema marginatum

rheumatic fever

subQ nodules

rheumatic fever

Spastic Movements

rheumatic fever | =Sydenham chorea

rapidly progressing necrotizing and destructive lesions on <3 valves or mural endocardium

acute infective endocarditis

Vegetations are friable (they break = emboli), bulky, potentially destructive containing fibrin, inflammatory cells, and the bacteria.

infective endocarditis

small deposits of fibrin, platelets and blood components on the leaflets of the valves which are sterile and contain no organisms

Nonbacterial Thrombotic Endocarditis (NBTE)

Single or multiple granular, pink, small lesions on either or both side of the valve, the endocardium, or chords assoc w fibrinoid necrosis

Libman Sacks Endocarditis (LSE) (Endocarditis of Systemic Lupus Erythematosus)

Glistening white intimal plaque-like thickenings of the endocardial surfaces of the cardiac chambers and valve leaflets. -Lesions are composed of SMC and collagen fibers in an MPS matrix

carcinoid heart dis

spical ballooning of LV w abn wall motion and contractile dysf

dilated cardiomyopathy

stunned myocardium - show multifocal contraction band necrosis

dilated cardiomyopathy

globular <3

dilated cardiomyopathy | -dilation all 4 chambers

functional regurg

dilated cardiomyopathy | -valves not affected by dilation affects them

nml size ventricles, enlarged atria w patchy diffuse interstitial fibrosis

restrictive cardiomyopathy

eos in heart and multiple organs

loeffler endomyocarditis

fibrosis of LV myocardium w aortic valve obs and other <3 anomalies

endocardial fibroelastosis

serious endocardial thickening and huge hypertrophy

hypertrophic cardiomyopathy

Disproportionate septal and wall thickening

hypertrophic cardiomyopathy | - (most prominent in subaortic region) (bulging into lumen) w/o vent dilation= “Banana Lumen”

myofiber disarray

hypertrophic cardiomyopathy

RV wall is very thin from loss of myocytes with fatty infiltrates and fibrosis.

Arrhythmogenic RV cardiomyopathy (ARVC)

patchy and diffuse areas of necrosis next to lymphpocytes

myocarditis

heart may be flabby and mottled by either pale foci or minute hem lesions.

myocarditis

multinucleated giant cells mixed with other WBCs, and extensive necrosis

giant cell myocarditis

Interstitial perivascular infiltrates composed of lymphocytes, Mfs and eosinophils

hypersensativity myocarditis

epicardium: has lymphocytes in epipericardial fat

Serous pericarditis

have neoplastic cells

Serous pericarditis from tumors

The surface is dry with fine granular roughening

Fibrinous pericarditis

epicardium: thick yellow fluid d/t erythrocytes, inflamm cells, and fibrin

Serofibrious pericarditis

Serosal surfaces are reddened, granular, and coated with exudate.

purulent/supparative pericarditis

fibrin + blood in pericardium

hemorrhagic pericarditis

pericardial sac is obliterated, replaced with a fibrous shell which can be calcified or not

constrictive pericarditis

singular lesion on fossa ovalis

myxoma

much MPS ground substance

myxoma

Sea-anemone like lesions

papillary fibroelastoma

hair-like projections that are covered in endothelium with a core of myxoid CT w lots of MPS and elastic fibers

papillary fibroelastoma

grey-white myocardial masses found in multiples on ventricles: can look like spider cells

rhabdomyoma