Path Flashcards
What does von kossa stain and what dz
Calcium
Band k
Alcian blue stains what? What dz?
Mucopolysaccaride
Schnabels cav optic atrophy
Ziehl neelaen stains what?
Acid fast organisms
Collidal iron stains what? Used for what dz?
Mucopolysacc
Macular k dystropjy
What are desmin, myoglobin ihc stains used for?
Rhabdo
Whats the s-100 stain used for?
Neurofibroma and melanoma
What are hmb-45 and melan -a stains used for?
Nevius
Melanoma
What does acanthosis mean?
Thickening
Muir torre is ass w seb cell ca and also what other eyelid lesion?
Keratoacanthoma
Whats the defining feature histologically of verruca?
Pointy w LOTS of KERATIN
Whats bacillary angiomatosis?
Eschar 2/2 bartonella
Whats inverted follicular keratosis?
Sebhorric keratosis that become irritated
Whats the most common type of bcc?
Nodular
What type of bcc is most likely to recur?
Morpheaform
Whats gorlin goltz syndrome?
Pple w genetic predisposition to bcc
Get it young
May have tumors in place of wisdom teeth
What type of stain for seb cell ca and what type of spread?
Oil red o
Pagetoid
Whats the histology of an ephilis (freckle)?
Melanocytes producing more pigment
Whats the histology of a nevus
MORE number of melanocytes that stack up on each other and go into dermis
Whats the histology of lentigo?
More melanocytes but in their normal location at bottom of epidermis spreads linearly.
(Nevus- melanocytes stack up on each other and grow into dermis)
Where do melanocytes arise?
Neural crest
Where is a junctional nevus located?
At jxn between dermis and epidermis
Where is compound nevus locted and how does it appear clinically?
Epidermis and dermis and appears raised
Whats lentigo maligna melanoma?
Lentigo in jxn area that becomes a melanoma.
Usually middle aged pple sun exposed skin
Lesion may wax and wane
Whats the most common type of skin melanoma?
Superficial spreading
Who gets superficial spreading melanoma (most common type) and how does it appear
Younger pt can grow on any surface
Pagerois spread
Limbal dermoid associated w what syndrome?
Goldenhaar
Peters is ass w mom doing what during pregnancy
Etoh or warfarin
Whats labrador dystrophy of the k?
Actinic sub damage to k appears as yellowish deposits in stroma
Whats the term when the k stroma is inflammed?
Interstitial keratitis Causes: Hsv Tb Syphillis Cogans syndrome
In schnabels what is contained in the empty spaces?
Hyaluronic acid
histologically, in fuchs, what happens to the k endo?
the posterior part becomes thickened with banded collagen
whats subluxation of the lens?
displacement of the lens- in its plane
whats luxation of the lens
displacemen of the lens out of its plane
in what direction does the lens weill-marchesani luxate? and inheritence pattern
forward/back 2/2 microspherophakia
likely AD
lens findings in alports and inher pattern
anterior lenticonus
x-linked dominant
Lowes syndrome pseudonym and inheritence pattern
oculocerebral-renal syndrome
x linked recessive
main eye issue in lowe syndrome
glaucoma (50%)
what causes morgagnian globules/cataract?
broken down cortex
histolocalli what causes psc?
“bladder cells”- ie epi cells that abnormally migrate posteriorly and swell
whats the histology of a rubella cataract?
persistance of fetal nucleus in the center
what causes PCO?
leftover epi cells proliferate at the edge of the capsular bag. When they group they are called elschning pearls
what type of bug is p acnes
gram + fillamentous
how does the lens nourish itself?
anaerobic pathway- in high BG shift to HMP shunt
what % of sporadic aniridia will have willms tumor?
1/3
whats gillespie syndrome and whats the inher?
aniridia w MR and cerebellar ataxia
AR
Most common location of iris coloboma?
inf- nasal
in trisomy 13 (patau) the baby will have iris and ciliary body coloboma- what is found in the place of the cb?
cartiledge
how do you treat iris melanoma?
excise only- it does not metastsize
remember the ddx of iris nodules
brushfield spots (downs)
lisch nodules (nf1)
JXG
bussaca/koppe/berlin (sarcoid)
3 area of adhesion of uvea to globe
SS
Vortex veins
ONH
Meduloepithelioma of cb- benign or malig, what abnormal tissue may you see on path?
benign
calcium
in end stage glaucoma the vessels by the nerve get pushed where?
nasally
whats the path of melanomalytic glaucoma?
macrophages eating melanoma cells clogging tm
whats the gene in pseudoex?
LOXL1
Phacolytic glaucoma- intact capsule or violated?
intact
phacoanaphylactic glaucoma- intact bag or violated?
violated
name 3 types of membranes that can grown over the angle
1) nvg
2) ice
3) epi downgrowth
whats the mechanism of iris distortion in ice syndrome?
abnorm K endo grows down–> membrane covers iris/angle–>pinches iris–>distorts iris–>grows into crypts–> distorts iris stroma
ice- unilateral or bilateral?
unilateral
which part of the CB makes aqueous?
non-pig epithelium
whats the histology of steroid induced glaucoma?
GAG deposition in the TM
whats the hostology of haabs striae?
horizontal breaks in descemets seen in congenital glaucoma
what is asteroid made of?
calcium apetite spheres in vitreous
how many layers in retina and name them
9 nfl gang cell in plex in nuc outer plex outer nuc PR RPE Bruchs
Whats the watershed zone for perfusion of the retina
the inner nuclear layer
whats the “mulberry” lesion in the retina and what dz?
astrocytic hamartoma- tuberous sclerosis
whats the generic name of jetrea?
ocriplasmin
how much ON sample do you want to take in RB?
10mm
whats would you see in an eye developing sympathetic ophthalmia?
diffuse granulomatous panuveitis with exudative detachments
has RB OU- chance offspring will have RB?
45%
has unilateral RB- chance offspring will be effected?
7%
no hx of RB- chance offspring will have RB?
<1%
If spread to CNS prognosis is
6 mo to live
trilateral RB?
RB OU with pinealblastoma
if optic nerve extention is suspected- whats the next step in w/u?
LP
when do you enucleate in RB?
If the tumor is >50% of globe
if an RB is small (<50%) how do you treat?
high dose systemic chemo to decr tumor burden (with serial EUAs to make sure the tumor is decreasing), then local treatment with laser or cryo
how do you clinically dx RB?
Bscan and exam - will show calcifications
why might RB present with hypopyon?
if tumor cells float into AC
When would you do plaque radiotherapy in RB?
salvage therapy if other therapies have failed
how long after dx with bilateral RB might a child be dx with osteosarcoma or other secondary tumors like pinealoma, malignant melanoma?
9 yrs later
Whats pseudoexfoliative material made of?
Basement menbrane material
What % of pple dx w choroidal melanoma have metastatic dz at that time?
2%
pam w atypia progresses to melanoma what % of the time
50%
whats a meduloepithelioma derived from?
primitive medullary epithelium (primitive retina)
whats a fuchs adenoma?
CB tumor that is white and encapsulated. stains PAS positive
Should you consider a retinocytoma to be equivalent to a RB?
Yes. even though its more differentiaed, its considered like a RB
What did the COMS study show for large melanomas?
no benefit in survival in doing radiation prior to enuclation in large choroidal melanomas
what chromosome is NF1 found on?
17
what did coms show for medium sized melanomas?
no difference in rates of mets in pts getting enucleation vs plaque
how do melanomas tend to spread?
through the sclera
what is the systemic workup for melanoma?
physical exam
LFTs
CXR
What color are lisch nodules?
tan
what color are iris mamliation?
same color as iris
whats the inheritance of NF1?
AD
ocular melanoma: this location has best prognosis and this location has the worst
iris best (just excise) CB (worst)
whats the special stain for merkel cell ca?
chromogranin
what does mucor look like under the scope
hyphae branch at 90 degree angles
what does aspergillus look like under the scope?
hypae branch in finger-like projections
Most common location of iris melanoma
inferio-temporal iris
which type of leukemia mets to the orbit most?
ALL (bimodal distribution)
whats the other name of a meduloepithelioma, what part of the ciliary body is it a tumor of, and how is it treated?
diktioma
tumor of non-pigmented ciliary epithelium
enuc vs observation
can occur in ONH or retina
does alphagan cause pupillary constriction?
yes, bc of weak alpha 2 effect
what acute inflammation of the meibomian glands called?
internal hordeolum
whats an external hodeolum?
acute inflammation of zeiss glands (around eyelashes)
loss of what substance in the lens can lead to cataract formation?
glutathione
what does candida look like
what does fusarium look like
candida is a yeast and looks like a bud
fusarium is long filamentous fungi
what type of immune rxn is scleritis?
type 3
what causes dorsal midbrain syndrome in a kid?
pinealoma
where does conj melanoma met to?
where does uveal melanoma met to?
conj- lymph nodes
uvea- liver
what type of collagen in the lens capsule?
type 4
whats the most common eye dz associated with nevus of ota? (hint its not uveal melanoma)
glaucoma
whats the inheritance of marfans?
AD (tall dominant person)
bcc is most likely to met to orbit if its in which location?
medial canthus
name 2 stains for calcium
alizarin red
von kossa
what type of radiation is used for choroidal melanoma
Iodine-125
what causes bietti dystrophy?
defect in lipid metabolism
what does the term “tapetoretinal” mean?
retinal dystrophy effecting the PR and RPE
gelatinous k dystrophy whats the inher?
AR- its an amyloid thing
how do you treat capillary hemangioma?
topical timolol and oral propranolol
what fixative do you use it sending specimen for electron microscopy?
gluteraldehyde
a whole eyeball is going for formalin fixation, how do you prepare it?
suspend whole eyeball in formalin for 12 hours before cutting into it
fungal infection causes what type of local immune rxn
necrotizing granuloma
iris coloboma is considered “typical” if it is located where? what is it ass w?
infero-nasal “nasal= “normal= typical”
can be associated with colobomas in other parts of the eye
when is an iris coloboma atypical?
if its anywhere besides inf-nasal
Men2b what tumors do they get?
Medullary ca of the thyroid
Pheochromocytoma
whats a reducing substance in the lens that protects against cataract?
glutathione
whats the volume of the vitreous?
4mL
whats the special path finding in ON glioma?
Rosenthal fibers (degenerating eosinophilic filaments)
whats the special path finding in ON meningioma?
psammoma bodies (swirly round red thing made of calcium)
what characterizes hemangiopericytoma on path?
stag-horn vascular channels
what do antoni a cells look like?
nuclear palisading (nuclii all lined up in a row)
what does breast cancer look like?
“indian file” round blue nuclii all lined up in rows
what do you see on path with rhabdo?
cross-striations
what does ON glioma look like?
super dense!!! no spaces no cytoplasm (and don’t forget red Rosenthal fibers)
where do you see psammoma bodies?
ON meningioma
what do spindle A cell (melanoma) look like?
cigar shaped w chromatin stripe
what do spindle B look like?
cigar shaped w distinct dot nucleolus
what are melanoma epitheliod cells?
look cells that “look at you”
metastatic adenocarcinoma to the choroid will stain with what?
PAS
What do endophytic and exophytic mean when it comes to RB?
endophytic- from inner retina
exophytic- from outer retina
Flexner wintersteiner and homer-wright whats the difference?
Flexner - has a clear lumen
horner- just has pink tangles in the middle
what does coats disese look like on path?
exudates and lipid filled retina
what do you see in a medulloepithelioma?
cysts and hyaline
where does meduloepithelioma arise?
any tissue derived from neuroectoderm (retina, on, cb epi, iris epi)
what color does GMS look like in the cornea?
green
where is iron deposited in Fleischer ring?
in epithelium- looks blue on iron stain
non-sulfated keratin sulfate in which dz?
macular dystrophy
in posterior polymorphous, what does the K endo look like?
epi!
what does a plexiform neurofibroma look like?
“bag of worms”- round things full of mucin
