morph Flashcards
Toxic granulations: coarse, dark, abnormal azurophilic (primary) neutrophilic granules
sepsis/severe inflamm –> leukocytosis
Dohle bodies: patches of dilated ER seen as sky-blue cytoplasmic puddles
sepsis/severe inflamm –> leukocytosis
LNs:
- Large germinal centers with numerous mitotic figures.
- Nodes are swollen, gray-red and engorged
- Endothelial cell hyperplasia (lining the sinus).
Acute Nonspecific Lymphadenitis
centeroblasts
Chronic Nonspecific Lymphadenitis: follicular hyperplasia (dark)
cernteocytes
Chronic Nonspecific Lymphadenitis: follicular hyperplasia (light)
Tingible-body MF
Chronic Nonspecific Lymphadenitis: follicular hyperplasia
o Contain the nuclear debris of B cells
immunobalsts
Chronic Nonspecific Lymphadenitis: paracortical hyperplasia
-Activated T cells 3-4 times the size of resting lymphocytes
marrow hypercelular w lymphobalsts
ALL (acute lymphoblastic leukemia)
-condensed chromatin, less prominent nucleoli, cyto w/o granules
LN archetectural effacement
- C/SLL (chronics,small lymphocytic leukemia)
- follicular lymphoma
LN Proliferation centers Larger lymphocytes gathered in loose aggregates that contain mitotically active cells*
C/SLL (chronics,small lymphocytic leukemia)
Smudge cells
C/SLL (chronics,small lymphocytic leukemia)
-Small round lymphocytes in the peripheral blood with scant cytoplasm, disrupted when making the smear.
high mititc index; apop; starry sky pattern d/t phagocytosis of nuclear remnants by mf
Burkitt lymphoma
centrocytes
follicular lymphoma
centroblasts
follicular lymphoma
paratrabecular lymphoid aggregates
follicular lymphoma
Rouleaux formation
multiple myeloma (plasma cell myeloma) =plasma cell: increased M protein causes RBCs to stick together linearly in blood smears, indicative, but not specific.
Flame cells
multiple myeloma (plasma cell myeloma) =plasma cell: intracellular accumulation of degraded protein with fiery red cytoplasm
Mott cells
multiple myeloma (plasma cell myeloma) =plasma cell: multiple grapelike cytoplasmic droplets
Russel inclusions
-multiple myeloma (plasma cell myeloma)
-lymphoplasmacytic lymphoma
= plasma cell: PAS+ cytoplasmic globules
Dutcher inclusinos
-multiple myeloma (plasma cell myeloma)
-lymphoplasmacytic lymphoma:
=plasma cell: PAS+ nuclear globules
Heavily infiltrated splenic red pulp = obliteration of white pulp w a beefy red gross appearance.
hairy cell leukemia
effaced LNs; mix of variably sized malig T-cells w eos and mfs and neoangiogenesis
Peripheral T-cell Lymphoma, Unspecified
- hallmark cells: anaplastic cells with horseshoe nuclei and voluminous cytoplasm
- tumor cells surround venules, infiltrating lymphoid sinuses
Anaplastic Large Cell Lymphoma
multi-lobated nuclei (‘cloverleaf’ or ‘flower’ cells)
Adult T-cell Leukemia/Lymphoma
Epidermis and upper dermis are infiltrated by neoplastic T cells with a cerebriform appearance.
Mycosis Fungoides
gneneralized exfoliative erythroderma
Sezary Syndrome
leukemia of cells with characteristic cerebriform nuclei
Sezary Syndrome
Large lymphocytes with abundant blue cytoplasm and azurophilic granules.
Large Granular Lymphocytic Leukemia
destructive nasopharyngeal mass
Extranodal NK/T-cell Lymphoma
invades small vessels –> ischemic necrosis
Extranodal NK/T-cell Lymphoma
Large azurophilic granules in tumor cell cytoplasm.
Extranodal NK/T-cell Lymphoma
Large, aneuploid B cells with multiple nuclei or a single nucleus with multiple lobes and inclusion-like nucleolus and Clearing around the nucleoli
AND single round or oblong nucleus with large inclusion like-nucleolus
mononuclear variant of RS cell
Large, aneuploid B cells with multiple nuclei or a single nucleus with multiple lobes and inclusion-like nucleolus and Clearing around the nucleoli
AND delicate, folded or multilobate nuclei and Abundant pale cytoplasm that retracts during tissue processing = nucleus in an empty hole
lacunar variant of RS cell
cell shrinking and becomoing pynknotic
dying (mummicifation) of RS cell
Large, aneuploid B cells with multiple nuclei or a single nucleus with multiple lobes and inclusion-like nucleolus and Clearing around the nucleoli
AND multilobed nucei: “popcorm cells”
lymphohistiocytic variant of RS cell
lacunar variant RS cells
Hodgkin Lymphoma: Nodular Sclerosis Subtype
- collagen bands that divide LNs into circumscribed nodules.
- Often involves cervical, supraclavicular and mediastinal LNs
Hodgkin Lymphoma: Nodular Sclerosis Subtype
mononuclear variant RS cells
Hodgkin Lymphoma: Mixed cellularity Subtype
lymphohistiocytic variant of RS cell
- Hodgkin Lymphoma: Lymphocyte Depletion Subtype
- Hodgkin Lymphoma: Lymphocyte Predominance Subtype
aeur rods
- AML, NOS M2, M3
- AML w genetic abrrs
Ring sideroblasts
Myelodysplastic syndromes (MDS) (erythroid effect) =Erythroblasts with iron laden mitochondria visible as perinuclear granules
Neutrophils with Decreased secondary granules, toxic granulations or Dohle bodies
Myelodysplastic syndromes (MDS) (Granulocyte Lineage Effects)
Pseudo-pelger-huet cells
Myelodysplastic syndromes (MDS) (Granulocyte Lineage Effects) =Neutrophils with only 2 nuclear lobes
Cells with single nuclear lobes or multiple separate nuclei (‘pawn ball’)
Myelodysplastic syndromes (MDS) (Megakaryocytic Lineage Effects)
hypercellular marrow: basophilia, eosinophila
Chronic Myelogenous Leukemia (CML)
hypercellular marrow w residual fat
Polycythemia Vera (PCV or PV)
obliterate fibrosis of marrow
spent phase of Polycythemia Vera (PCV or PV)
cloudlike clusters of megakaryocytes
late Primary Myelofibrosis (PM)
osteosclerosis
late Primary Myelofibrosis (PM)
Dacryocytes
Primary Myelofibrosis (PM) -Tear drop shaped cells damaged during release from the fibrotic marrow.
o Abundant, vacuolated cytoplasm
o Vesicular nuclei with linear grooves or folds
o *Birbeck granules:
Langerhans Cell Histiocytosis
=pantalaminar tubules w dilated terminal end (‘tennis racket’ appearance) *contain langerin.
proliferation of Langerhans cells in medullary cavity of bone typically in the calvarium, ribs, femur.
Unifocal Unisystem Langerhans Cell Histiocytosis (eosinophilic granuloma)
nodules and cysts in middle/upper lobes
Pulmonary Langerhans Cell Histiocytosis
o Enlarged and soft spleen.
o Acute congestion of the red pulp => encroach on and efface lymphoid follicles.
o Infiltrates of nfs, plasma cells, +/- eos
Nonspecific Acute Splenitis
spleen: o Cut surface is gray-red to deep red. o Firm. o Thick, fibrous capsule. o Red pulp: congested then fibrotic. o Becomes fibrous and cellular if long-standing and mineral/pigment deposition too
congestive splenomegaly
spleen:Bland: pale, wedge shaped, subcapsular, fibrous capsule
splenic infarct
spleen: suppurative necrosis that leads to depressed scars.
splenic infarct: septic
Hassall corpuscles (whorled) with keratinized cores. (squamous cells)
thymic epithelial cells
B germinal centers in thymus
thymic (follicular) hyperplasia
thymic cells: : elongated/spindle shaped; swirling, bland oval nuclei w inconspicuous nucleoli
medullary type epithelial cells: noninvasive thymoma
thymic cells:
Cells are usually cortical with abundant cytoplasm and round, vesicular nuclei.
o Numerous reactive lympohoid cells
o Capsular invasive
cortical type cells: Invasive (malignant) Thymoma: (but cytologically benign)