Path Pics Flashcards
1
Q
Name cells that white arrows point to.
A
Type II pneumocyte
2
Q
Name cells at black arrows.
A
club cells or clara cells
3
Q
What type of cell is this?
What do the arrows point to?
A
type II pneumocyte
lamellar bodies
4
Q
Name the cell.
A
macrophage
5
Q
Name the cell.
A
alveolar macrophage
6
Q
Name the cell.
Why does this cell look this way?
A
alveolar macrophage: crack cocaine user
7
Q
A
resorption atelectasis:
tumor obstructing right bronchus, markedly reduced right lung volume and right mediastinal shift
8
Q
A
compression atelectasis:
left pneumothorax from chest wall trauma, left lung collapse and right mediastinal shift
9
Q
What is at the arrow in this liver?
What disease does it indicate?
What lung disease will this person have?
A
pink PAS positive hyaline globules
alpha 1 antitrypsin deficiency
panacinar emphysema
10
Q
What type of emphysema effects this part of the acinus?
A
centriacinar
11
Q
A
emphysema: hyperinflation
12
Q
A
hyperinflation of lungs: emphysema
13
Q
What is at the arrow?
What disease is this?
A
centriacinar emphysema: enlarged airspaces with tissue destruction at APEX
14
Q
What is at the arrows?
What disease is this?
A
central part of acinus has abnormally large airspace with club-shaped alveolar septa that appear to be free floating
centriacinar emphysema
15
Q
What type of emphysema effects this part of the acinus?
A
panacinar emphysema: whole acinus is affected
16
Q
A
destruction with airspace dilation is most severe in lower lobe
Panacinar emphysema
17
Q
A
relatively uniform dilation of all parts of acini
panacinar emphysema
18
Q
What type of emphysema effects this part of the acinus?
A
paraseptal emphysema: distal acini adjacent to interlobular septa and pleura affected
19
Q
A
paraseptal emphysema
bullae: markedly enlarged subpleural airspaces
20
Q
A
paraseptal emphysema: distal airspaces immediatley beneath the pleural space have marked dilation
21
Q
A
chronic bronchitis: submucosal gland hypertrophy
22
Q
A
chronic bronchitis: lymphocytes (arrow) surround the bronchial epithelium
23
Q
A
chronic bronchitis: goblet cells (arrows) increased
24
Q
A
mucous plug
asthma
25
asthma: thick BM with eosinophilic inflammation
26
Asthma: Charcot-Leyden (disintegrated eosinophils) and eosinophils
27
asthma: Curschmann spirals (mucous tight coils)
28
bronchiectasis: dilated airways exted almost to pleura
29
bronchiectasis: saccular dilation of airways with surrounding fibrosis
30
bronchiectasis: airway dilation accompanied by surrounding fibrosis and luminal pus
31
allergic rhinitis: type I hypersensitivity
arrow: Charcot-Leyden crystals
star: inflammation
32
nasal polyp with stromal edema and eosinophils
33
angiofibroma: large blood vessels and fibrous tissue
34
subpleural "net-like" reticulations (arrow)
idiopathic pulmonary fibrosis
35
patchy interstitial fibrosis (white arrow) that is most severe subpleurally with interveneing normal tissure
idiopathic pulmonary fibrosis
36
usual interstitial pneumonia (UIP): patchy interstitial fibrosis most severe subpleurally
indicitive of IPF or collagen vascular associated lung disease
37
usual interstitial pneumonia (UIP): localized areas of fibroblastic proliferation (arrows: fibroblast foci)
lymphocytes
38
usual interstitial pneumonia (UIP)
arrows: densely collagenized fibrosis
asterik: honeycomb cysts lined with metaplastic bronchiolar epithelium
39
usual interstitial pneumonia (UIP)
seen in IPF and collagen vascular disease associated lung disease
40
cryptogenic organizing pneumonia (COP)
intra-alveolar plugs of loose fibroconnective tissue (arrows)
41
organizing pneumonia following adult respiratory distress syndrome: alveolar duct plugged by loose fibroconnective tissue (arrows)
similar to COP: need clinical information to differentiate
42
simple coal workers pneumoconiosis
arrow: coal dust macule with dilated adjacent airspaces (localized emphysema)
43
complicated coal workers pneumoconiosis
BLACK LUNG
44
silicosis: dense collagenized nodule with surrounding lymphocytes
45
silicosis: birefringent silica particles under polarized light
46
asbestos
right: straight stiff: more pathogenic
left: curly flexible
47
pleural plaques (dense collagen): arise on parietal pleura and diaphragmatic domes
seen in asbestos inhalation
48
ASBESTOS bodies: iron coated asbestos
49
ASBESTOS bodies: iron coated on Prussian blue
50
asbestosis: diffuse interstitial fibrosis (looks like UIP) with asbestos bodies
51
Drug-induced pneumonitis: mild interstitial fibrosis with lymphocytes and type II pneumocyte hyperplasia (arrows)
52
sarcoidosis
gramuloma (arrow) alond bronchovascular bundles and interlobular septa
53
sarcoidosis
granuloma surrounding bronchiole
54
sarcoidosis: non-caseating granulomas with giant cells
55
asteroid bodies
sarcoidosis and other granulomatous diseases
56
Schaumann bodies (calcification)
sarcoidosis and other granulomatous diseases
57
hypersensitivity pneumonitis: lymphocytic interstitial inflammation and fibrosis is centered on bronchiole (arrow)
58
hypersensitivity pneumonitis
granuloma with giant cells surrouned by lymphocytes
59
hypersensitivity pneumonitis
plug of organizing pneumonia with lymphocytes
60
end stage hypersensitivity pneumonitis
HONEYCOMB LUNG: end stage of many interstitial fibrosisng lung diseases
61
desquamative interstitial pneumonia or respiratory bronchioloiti: filling of small airways with macrphages with yellow-brown pigment, widening of alveolar walls, mild fibrosis, type II cell hyperplasia
62
pulmonary langerhans cell histiocytosis
positive for: langerin, S-100, CD1a
63
pulmonary alveolar proteinosis: alveoli are filled with dense, amorphous, protein-lipid granular precipitate (alveolar walls are normal)
64
penumocystis jirovecii
Gomori methenamine silver stain
65
saddle pulmonary embolism: lodges at bifurcatio nof pulmonary arteries
sudden death due to acute cor pulmonale
66
arrows: pulmonary embolism
line: wedge shaped hemorrhagic infarct
67
pulmonary embolism with early infarction with alveolar hemorrhage (arrow) and coagulative necrosis of the alveolar septa (asterik)
68
resolving pulmonary infarct: after 48 hours
becomes paler red-brown (arrows) due to conversion of hemorrhage into hemosiderin by macrophages (will eventually scar)
69
non-thrombotic pulmonary embolism
foreign material (IV drug use)
70
pulmonary vascular thickening contricts lumen
pulmonary HTN
71
plexogenic lesion: network of capillary formations span lumen of pulmonary arteries
severe primary pulmonary HTN and congenital heart disease with L to R shunt
72
diffuse pulmonary hemorrhage: lungs are heavy and show diffuse dark red consolidation
goodpasture, idiopathic pulmonary hemosiderosis, lupus, wegener granulomatosis
73
necrotizing hemorrhagic interstitial pneumonitis due to autoimmune alveolar BM destruction: arrow necrosis of alveolar walls with intra-alveolar hemorrhage
goodpasture syndrome
74
pulmonary edema
75
long standing pulmonary edema with alveolar microhemorrhages and hemosiderin-laden macrophages (arrow= heart failure cells)
76
protein rich fluid and necrotic epithlial cells: hyaline membranes
Diffuse alveloar damage: acute stage
77
diffuse alveolar damage: organizing stage
hyaline membranes have been resorbed and replaced with plugs of intra-alveolar organizing fibroconnective tissue (arrow)
right: trichrome stain
78
bronchopneumonia: patchy pale areas of consolication in upper lobe
79
lobar pneumonia: lower lobe is consolidated
80
red hepatization: pneumonia
81
gray hepatization: pneumonia
82
S. pneumoniae
right: alveoli with neutrophils and proteinaceous exudate
left: gram positive lancet shaped diplocci in neutrophil rich exudate
83
pulmonary abscess: necrotizing pneumonia
84
pulmonary abscess: lots of neutrophils, alveolar destruction
85
atypical pneumonia: lymphocytic inflammation of the interstitium (red arrows) and pneumocyte hyperplasia (yellow arrows)
86
Ghon complex (black arrow) and caseous hilar nodes (red arrow)
primary TB
87
TB granulomas with central necrosis
88
granulomatous inflammation with central necrosis (caseation) rimmed by macrophages
TB
89
TB: red rods on acid fast stain
90
confluent areas of caseous necrosis and cavitation (arrow) on upper lobe (highest O2)
secondary TB
91
miliary TB: lymphohematogenous dissemination
multiple foci of granulomatous inflammation
92
granulomatous inflammation, necrotizing
histoplasmosis
93
histoplasmosis: macrophages with tiny yeast
94
blastomycosis
BROAD BASED BUD: snowman
95
right: H and E: lighlty basophilic budding yeast surrounded by a clear space (capsule)
left: stain that highlights capsule
Cryptococcus neoformans
96
thick walled non-budding SPHERULES filled with ENDOSPORES
Coccidiomycosis
97
CMV pneumonia
infected cell: enlarged with cytoplasmic and intranuclear viral inclusions (owl eyes)
98
pneumocystis pneumonia
right: central umbilications on SILVER STAIN
left: organism in granular alveloar exudate
99
aspergillosis
right: ACUTE ANGLE branching, SEPTATE HYPHAE
left: angioinvasion allows aspergillus to cause hemorrhagic destrction that crosses fissure
100
Murcormycosis
angioinvasive
BROAD WIDE ANGLE BRANCHING, NON-SEPTATE HYPHAE
101
bronchogenic cysts
102
pulmonaory sequestration
103
meconium aspiration syndrome
arrows: amniotic fluid/squamous debris and meconium (red)
104
infant
hyaline membrane disease: neonatal RDS
105
circumscribed coin lesion; peripheral solitary
hamartoma
106
grey-white glistening nodule
hamartoma
107
lobules of mature cartilage entrapped in benign respiratory epithelium
pulmonary hamartoma
108
peripheral spiculated mass
adneocarcinoma
109
peripheral tumor
adenocarcinoma
110
cancer
pneumonia like consolidation of entire lobe
adenocarcinoma
111
lung adenocarcinoma
mucin produing glands
112
lepidic pattern shows growth along alveloar septa (arrows)
lung adenocarcinoma
113
large centrally located mass
squamous cell lung carcinoma
114
large tumor that obliterates entire central portion of lung and shows cavitation
squamous cell lung carcinoma
115
keratin pearl
squamous cell lung carcinoma
116
large cells with prominent nucleoli
large cell lung carcinoma
117
central tumor (arrows) with infiltrative growth into surrounding lung
small cell lung carcinoma
118
small cells with scant cytoplasm and crush artifact (arrow), mitoses
small cell lung carcinoma
119
endobronchial circumscribed tumor
carcinoid tumor
120
nests of bland cells with granular chromatin
carcionoid tumor
121
dense core granules on EM are evidence of neuroendocrine differentiation
carcinoid tumor
122
pancoast tumor
123
metastatic lung cancer: cannonball appearance
124
circumscribed nodule of metastatic colon adenocarcinoma with normal surrounding parenchyma
125
diffusely thickened pleura with rind like encasement of lung
Malignant pleural meosthelioma
126
mesothelioma type?
epithelioid type of mesothelioma
tubules: arrow that mimic adenocarcinoma
127
CALRETININ: positive brown stain
mesothelioma
128
mesothelioma or adenocarcinoma?
long, slender microvilli
mesothelioma
129
mesothelioma or adenocarcinoma?
adenocarcinoma
stubby microvillous rootlets
130
nasopharyngeal carcinoma
poorly differentiated squamoous cell carcinoma in background of lymphocytes
131
laryngeal papilloma
132
laryngeal carcinoma
squamous cell carcinoma of vocal cord
