Pathology Flashcards
Seborrheic Dermatitis
Erythematous-yellow, greasy base, with extensive scaling and crusting dandruff, follicular lipping,
Psoriasis
Salmon-plaques-silvery white scales (Koebner Phenomenon), test tubes in a rack appearance, auspitz signs, Munro microabscess
Lichen Planus
Pruritic,purple,polygonal,planar papules and plaques, itchy,violaceous, flat-topped papules (wickham striae), interface dermatitis, sawtoothing, civatte or colloid bodies and lichen planopilaris.
Granulomatous Uveitis (uvea)
Sarcoidosis (complication), mutton-fat keratin precipitates ant segment, candle wax dripping post segment.
Impetigo
Mauled and pustules - honey-colored crusts, imp contangiosa-GABHS; PSGN complication; imp bullosa, staph aureus. Sub corneal pustule beneath stratum corneum
Hypertensive retinopathy
Arteriolosclerosis, copper wiring, silver wiring, cotton-wool spots, focal choroidal infarcts (elschnig pearls), DM retinopathy
Central retinal artery occlusion
Hollenhorst plaques, cherry red spots in macula
Age-related macular degeneration
Irreversible blindness; “drusen” yellow deposits in macula; choroidal neovascularization
Retinitis pigmentosa
Asst w/ “Refsum disease”
apoptosis of rods and cones
Waxy pallor of the optic disk
Early night blindness
Retinoblastoma
Most common 1 intra-ocular malignancy in children
Most common presentation is leukocoria
“Flexner-Wintersteiner Rosettes
Papilledema
Optic nerve swelling inc ICP
Blurred disk borders on fundoscopy
Fibroadenoma
Breast
Most common Popcorn calcification
Phylloides tumor
Breast
Bulky tumor from tumor cells
Leaf-like extensions
Intraductal papilloma
Breast
Most common “bloody nipple discharge” <50
Develop in lactiferous ducts or sinuses
Lobular CIS
Breast
Dyscohesive cells w/ oval or round nuclei and small nucleoli
Lack-protein adherin
Invasive ducktail carcinoma
Breast
Most common type of Breast Ca (70%) Grating sound (like cutting a water chestnut)
Invasive lobular carcinoma
Breast
Most common cause of bilateral breast cancer
Signet ring cells in Indian file pattern
Medullary carcinoma
Breast
Fleshy mass with syncytium sheets of large cells with vesicular, pleomorphic nuclei, and prominent nucleoli
Mucinous carcinoma
Breast
Soft/rubbery mass
“Pale gray-blue gelatin”
Inflammatory breast cancer
P'eau de orange Worst prognosis High degree and aneuploidy Tumor emboli Persistent e-cadherin nuclei
Uteropelvic Junction Obstruction
Kidney
Most common cause of hydronephrosis in infants and children
Left ureter
Bilateral in infants/unilateral in adults
Methysergide (ergot derivative)
Anti migraine drug to cause peritoneal fibrosis
Acute cystitis
Kidney
Triad: dysuria, suprapubic pain, frequency (q15-20mins)
Suppurative neutrophilic infiltration
Hyperemic bladder with exudation
Acute bacterial cystitis
Kidney
Most common bacteria: PEEK
Proteus, E. coli, Enterobacter, Klebsiella
Interstitial cystitis (hunner ulcer)
Inflammation and fibrosis
Glomerulations
Mast cells
Malacoplakia
E. coli; soft, yellow mucosal plaques
Large foamy macrophages (machaelis-gutmann bodies)
Urothelial CA in situ
Pagetoid spread
Mucosal thickening w/o intra luminal mass
Reiter syndrome
Conjunctivitis, urethritis, arthritis
Testicular torsion
Twisting of the spermatic cord
“Bell-clapper deformity”
Hemorrhagic testicular infarction
Yolk sac tumor
Testis
Lace-like cell network
Homogenous,yellow-white,mutinous appearance
“Schiller duval bodies”
A-feto protein, A1-anti trypsin
Teratoma
Hester-skeeter collection
Malignant transformation
Painless enlargement of the testis
Para-aortic>mediastinal>supraclavicular
Leydig cell tumor
Crystalloids of Reinke
Sertoli cell tumor
Crystalloids charcot-bottcher
Testicula lymphoma
Most common form of testicular neoplasms in men over 60 years of age.
Acute bacterial prostatitis
E. coli; (-), intraprostatic of urine,lymphohematogenous routes
Fever,chills,dysuria
DRE: prostate exquisitely tender and boggy
Chronic bacterial cystitis
Low back pain, dysuria, perineal and suprapubic discomfort
Recurrent UTI’s caused by the same organism
Benign prostatic hyperplasia
Peri urethral transition zone
Median lobe hyper trophy
Modular hyperplasia- hallmark finding
– due to actions of dihydrotestosterone(hyperplasia of stromatolites cells
Prostate adenocarcinoma
Most common form of cancer in men
Tied w/colorectal cancer
Acinar variant (70%cases)
Posterior peripheral zone
Pelvic inflammatory disease
Female genital
Turbo-ovarian abscesses, pyosalphinx
Comp: follicular salphigitis & hydrosalphynx leading to infertility/ectopic pregnancy
“Violin-string adhesions in fitz Hugh-Curtis syndrome
Bacteremia
Bartholin cyst
Vulva
Perineal pain, local discomfort
Marsupial inaction
Lichen sclerosis
Vulva
Aka chronic atrophic vulvitis
4 cardinal: thinning with rete pegs, hydrophilic degen of basal cells, collage nous fibrous tissue and lymphocytic
Vaginal dryness,stiffening and constriction.
Lichen simplex chronicus
Vulva
Aka: sq. hyperplasia, hyperplastic dystrophy
Epith. thickening, exp stratum granulosum,hyperkeratosis
Leukoplakia
Keratinizing SCCA, vulva
Vulva
Nest and tongues of malignant squamous cells with prominent “keratin pearls”
Not asst with HPV
Papillary hidradenoma
Vulva
Circumscribed nodule-labia majora
Identical to Intraductal papilloma a of the breast
Condyloma acuminata
Vulva
HPV 6 & 11
Koilocytic atypia
Not precancerous lesions
Septate vagina
Failure fusion of Müllerian ducts
Uterus didelphys
In utero exposure to DES
Vaginal adenosis
Red, granular areas contrasting with normal mucosa
Columnar mutinous epith
May progress to clear celladenocarcinoma of the vagina
Gartner duct cyst
Vagina
Derived from wolfian (mesonephric) duct
Submucosal fluid filled cyst
Embryonal rhabdomyosarcoma
Aka: sarcoma botryoides
Grape-like clusters
Cervical cancer
HPVs infect immature cells at sq columnar junction
Koilocytic atypia
E6 and E7 proteins-involve in RD inactivation
Endometriosis
Chocolate cyst (red-blue, yellow-brown) Infertility most common presentation
Adenomyosis
Endometrial tax within the uterine wall
Irregular nests of endometrial stroma
Menometrorrhagia (irreg and heavy menses)
Endometrial hyperplasia
Asst with prolonged estrogen stimulation of the endometrium
Invariably leads to endometrial adenocarcinoma
Endometrial carcinoma
Most common invasive CA in female genital
Peak 55-65 y/o
With signs of stromal invasion.
Myoma uteri
Most common benign tumor in women
“Whirled pattern of smooth muscle bundles”
Degeneration-red or corneus, hyaline,myxomatos, calcific, cystic, catty
PCOS
Aka: stein-leventhal syndrome, numerous cystic follicles or follicle cyst.
Thickened,fibrotic superficial cortex w/ innumerable follicle cysts (follicular hyperthecoses)
Serous tumors, ovaries
Psamomma bodies
Using Sassone and Lerner criteria
Mutinous tumors, ovary
Multiloculated tumors filled with sticky, gelatinous fluid rich in glycoproteins
Pseudomyxoma peritonei
Rupture of mucinous tumors
Brenner tumor, ovary
Sharply demarcated nests of epithelial cells (walthard cells rests)
Mature teratoma
Aka: dermoid cyst
Most common ovarian GCT
Cyst containing hair & cheesy sebaceous materials
Malignant transformation
Monodermal or specialized tearatomas
Strums ovarii-hyperthyroidism
Ovarian Carcinoid-produces serotonin & carcinoid synd.
Stromal carcinoid-combination of struma ovarii and ovarian carcinoid
Dysgerminoma
Ovarian counterpart of Seminoma
Unilateral 80-90%, polyhedral cells w scant fibrous stroma
Malignant but only 1/3 are aggressive
Yolk sac tumor
Rich in A-fetoprotein & A1 antitrypsin
Glomerulus-like structure (Schiller-duval bodies)
Granulosa cell tumor
Elaborate large amount of estrogen
Glan-like structure (“call-exner bodies”)
Tumor marker:inhibin
Meig syndrome
Fibrous and thecomas
Ovarian tumor
Hydrothorax
Ascites
Androblastoma
Musculinization
Sertoli cells or leydig cells interspersed with stroma
Krukenberg tumor
Bilateral metastasis
Mucin producing, signet ring cancer cells
Gastric in origin
Ectopic pregnancy
Ampulla-most common site
Prior pelvic inflammatory disease-most common predisposing factor
Morp: hematosalphynx
Placenta previa
Placental implants very near to the cervical os
Partial, marginal, total, low-lying
Painless vaginal bleeding during the 3rd trimester
Placental abruption
Premature separation due too retroperitoneal clot
RF: Hypertension, smoking cocaine addiction
Painful vaginal bleeding during 3rd trimester
Placenta accreta
Partials or complete absence of fibrinoid layer (Nitabach layer)
Attached-accreta
Invades-increta
Penetrates-percreta
Placental infections
Comp: PROM Grp B pathogens most common pathogen TORCHES Morp: greenish opaque and membranes, dense band like exudate a on amniotic surface Comp:neonatal sepsis and meningitis
Pre eclampsia
Hypertension
Edema
Proteinuria
Usually begins at 32nd weeks AOG
Eclampsia
Pre eclampsia with convulsions
Hydatidiform mole
GTD
Grape-like structures
Circumferential trophoblast proliferation
Extra villus islands
Tumor marker: b-HCG
Invasive mole
GTD
Morp: invasion of the myometrium by hydrophic chorionic villi
Hematogenous
Choriocarcinoma
GTD
Mixed proliferationsof syncytiotrophoblast and cytotrophoblast
Invasion of underlying myometrium
Most commonly metastasize to lung and vagina
Placental site trophoblast tumor
GTD
Intermediate trophoblast
Malignant trophoblastic cells diffusely infiltrating the myometrium
Guillain-Barre Syndrome
Campy jejuni infxn
Ascending motor paralysis
Aminocytologic dissociation
Spinal Muscular Dystrophy
Aka: infantile motor neuron disease
Ant. Horn cell destruction
SMN1
Panfascicular
Myotonic dystrophy
CTG trinucleotide repeats
Morp: Subsarcolemmal band of cytoplasm (ring fiber)
Sarcoplasmic mass
Mitochondrial myopathies
Proximalk muscle weakness
MELAS syndrome (mitochondrial enceph, lactic acidosis, stroke-like episodes), Ragged red fibers-irreg fibers w/ subsarcolemmal
Parking lot inclusions
Dermatomyositis
Heliotrope rash
Gottron lesions
Osteogenesis imperfecta
Brittle bone disease
Type 1 collagen def
Most common inherited
Blue sclerae
Osteopetrosis
Aka: marble bone disease, Albers Schöenberg dse.
Impaired function of osteoclasts
Absence of medullary canal
“Erlenmeyer flask deformity”
Osteoporosis
Post menauposal-thin, perforated trabecular plates w/ loss interconnections
Senile-thin cortex, widened haversian systems
Paget’s disease
Aka: osteitis deformans
Mosaic pattern-jigsaw puzzle appearance
Leontiasis ossea, platybasia
“Chakstick-typen fracture”
Hyperparathyroidism
Osteitis fibrosa cystica or Von recklinghausen disease of bone.
Dissecting osteitis
Brown tumor
Osteonecrosis
Avascular necrosis
“Legg-Calvé-Perthes disease” in children
Creeping substition
Pyogenic osteomyelitis
Staph aureus most common cause
Salmonella patients with sickle cell diasease
Osteomyelitis
Subperiosteal abscesses with draining sinus
Sequestrum, involucrum, Brodie abscess
Osteoid osteoma
Nidus formation, hemorrhagic gritty tan tissue
Osteosarcoma
Most common malignant bone tumor
Most common location-metaphysis of long bone
Lace-like pattern, Colman triangles and sunburst appearance
Chondroblastoma
Chicken wire pattern
2nd most common malignant bone tumor
Anaplastic chondrocytes
Fibrous dysplasia
Polyostotic fibrous dysplasia with cafe au lait spots and endocrinopathies (mc-cune Albright syndrome)-precocious puberty
Ewing sarcoma
Mutation in EWS gene on chrom#22
Homer-right rosettes
Onin-skin appearance
Giant cell tumor
Aka: osteoclastoma
Mutations in RANK/RANKL signaling pathway
Degenerative osteoarthritis
Mushroom-shaped outgrowths (osteophytes)
DIP: heberden nodes
PIP: Bouchard nodes
Joint mice, eburnated
Rheumatoid arthritis
Panus formation
Rheumatoid nodules
Ankylosing spondylitis
Asst with HLA-B27
bamboo spine deformity
Reiter syndrome
Aka: reactive arthritis, shige,salmo,yersi,campy,chlamy
Triad: uveitis, urethritis,arthritis
Balanitis circinata, keratoderma blenorrhagica
Psoriatic arthritis
Sausage-shaped DIP
Pencil in cup deformity
Gout
Acute gouty arthritis-crystallization of urates
Chronic gouty arthritis-tophi
(-)bifringent, (+)podagra
Transtentorial herniation
CNIII compression
Kernohan’s notch
Duret hemorrhages
Epidural hematoma
Arterial bleed (bone and dura), frax of temporotemporal bone (ptyrion)
Middle menigeal artery
CT scan: lenticular shaped lesion
Lucid interval
Subdural hematoma
Venous bleeding (dura and arachnoid)
Bridging veins
CT scan: crescent shape lesions
Delayed, fluctuating levels of consciousness, Subdural memb.
