Path 1 Flashcards
psammoma bodies, chromophobic, lots of ER & Golgi.
PRLoma
mixed cell somato/lactotroph adenoma or mammolactotroph, acidophilic macroadenoma
GHoma
basophilic/chromophobic MICROadenoma w/ pos immunoreactivity to POMC, ACTH, beta endorphins
corticotrophic adenoma aka Cushing dz or ACTH pit adenoma
what’s Nelson’s syndrome?
bil adrenalectomy -> inc CRH to inc ACTH & cortisol. hyperpig b/c inc MSH too (from POMC)
microadenoma in para/suprasellar; more inc of FSH than LH -> hormonally silent, just mass effect
gonadotrophic adenoma
macroadenoma along cell mem -> hyperthyroid & mass effect
thyrotropin adenoma
from GH, PRL, TSH -> respective effects. usually from gonadotrophs; not assoc w/ GH, ACTH, TSH. unencapsulated aggressive infiltrating neighboring tissue
plurihormonal adenomas. nonfxning adenoma. atypical pit adenoma
if pt can’t lactate, has amenorrhea or oligomenorrhea, breast involution/atrophy, wt loss after birth
sheehan
if pt has intracranial HTN, HA, hyperPRL, hypoGnRH/oligomenorrhea, hypopit
empty sella
genetic defects causing hypopit include:
GH defic, GHR defic, no pit-1 gene
craniopharyngioma
remnant of Rathke pouch along pit stalk; CTNNB1 -> WNT -> MYC, cyclin D1 & BRAF -> Ras -> MAPK -> MEK 1/2, ERK 1/2
adamantinomatous vs papillary craniopharyngioma
basophilic bottom layer, stellate reticulum interemed layer, wet/calcified keratin (ie. squamous cell ca) top layer; cystic spaces, brown/green fluid like motor oil, lipid/chol crystals vs none of that x/ it does have mature sq epith lining resembling oropharynx mucosa
clin pres & img of craniopharyngioma
inc ICP, HA, compressed optic chiasm -> vision defect, GH > FSH/LH > ACTH defic. CT for calcifications, MRI for location
Addison’s dz can cause vitiligo too b/c? labs?
autoimmune to melanocytes. hypoCl, normocytic anemia, dec cortisol/aldo/androgens (dec pubic/axillary hair)
causes of 1o acquired adrenal insuffic? what about 1o inherited adrenal insuffic?
hem, infxn, mets, infiltrative vs AR CAH, X-linked AHC (NROB1 -> DAX1), ALD
causes of 2/3o adrenal insuffic? img shows? is aldo affected?
hypopit d/o like pit adenoma or craniopharyngioma, megestrol acetate; steroid w/drawal. atrophied adrenals, thin ribbon cortex mostly of glomerulosa. no -> glomerulosa intact
aldo-secreting adrenocortical adenoma vs aldo-secreting adrenocortical carcinoma
well differentiated round yellow mass, pseudocapsule, lipid-rich, spironolactone bodies if txed w/ that? tx w/ uni adrenalectomy vs heterogenous b/c hem/nec, invade pseudocapsule, lipid poor, mets to liver & lung
genes for neuroblastomas. clin pres for neuroblastoma vs ganglioneuroma?
AD ALK on 2p23.3/.1, PHOX2B on 4p13; N-MYC. high catechol -> secretory diarrhea, opso/myoclonus syndrome, skull/bone mets, racoon eyes, vision impair vs mass effect
primary pigmented nodular adrenocortical dz
black/brown micronodules on atrophied surface; pos lipofuscin or neuromelanin, neg iron; w/ Carney complex (inactivating PRKAR1A & PDE11a) -> high cortisol/low ACTH
primary macronodular bil adrenal hyperplasia
AD somatic & germline mutation ARMC5; inc beta-adrenergic/glucagon/vasopressin/sero receptors, clear cyto/lipid rich or compact cyto/lipid poor
oviducts have what 2 simple columnar cells?
ciliated cells ctrlled by estrogen throughout the month; peg cells = secretory cells bulging over surface
interlobar vs intralobar mammary glands = made of? how does lactation work? what happens to mammary glands in PMP?
dense irreg copious adipose vs loose irreg fibroblasts. cyto has protein secreting cells -> lipid droplets in apical end -> epith cells = columnar to low cuboidal (after lipid secretion) -> alveoli extend -> myoepith cells surround ductal cells to move milk. epith atrophy, dec adipose but inc interlobar tissue
Tumor causes of Cushing dz vs ectopic ACTH vs ectopic CRH
ACTH pit tumor vs SCLC, panc ca, prostatic ca vs medullary thyroid ca, pheo
genetics of central vs nephro DI. cause of gest DI?
AD AVP vs X linked AVPR2 & AD/R AQP2. inc vasopressinase
