Pathology 2 Flashcards
general biopsy advice?
more tissue the better
if its a large mass, you need a larger sample
when might fresh tissue be used as samples?
soft tissue lesions with specific genetic abnormalities (e.g leukaemias etc)
how are fresh tissue samples used?
Cytogenic Studies tissue placed in culture medium and cells grown fresh karyotyping FISH molecular genetic studies
function of karyotyping?
gives overview of chromosomal culture
not good for small lesions
functions of FISH?
good for known translocations
paints relevant small area of chromosomes to show where it is
give 3 examples of a benign lesion?
ganglion cyst giant cell tumour fibromatosis fibrous dysplasia (rare) fibrous cortical dysplasia (rare)
what is a ganglion cyst?
lump - usually peripheral and near joint capsule or tendon sheath(common around wrist)
what causes a ganglion cyst?
degenerative change within connective tissue
- not a true cyst as no epithelial lining
what does ganglion look like on histology?
space with myxoid material
secondary inflammatory changes
name 4 superficial fibromatoses
dupuytrens
knuckle pads
plantar
penile - peyronie’s
what causes fibromatoses?
fibrous overgrowth of dermal and subcutaneous tissue
fibromatoses histology?
spindle lesion in background of pink tissue
who are dupuytrens common in?
males>females
>60
alcohol
can be ideopathic
what are deep fibromatoses?
different disease mesenteric or pelvic e.g - desmoid tumours - assoc with Gardner's syndrome
what are giant cell tumours?
uncommon tumour of bone characterised by multinucleate giant cells
- benign?
what are the 3 types of giant cell tumour?
pigmented villonodular synovitis
giant cell tumour of tendon sheath - digits
giant cell tumour of bone
- both benign
what is pigmented villonodular synovitis?
benign tumour of synovium in joints
- type of giant cell tumour?
giant cell histology?
hemosiderin stained, multinucleate giant cells
foam cells
highly vascularised
how are giant cell tumours treated?
tendon = small nodules - easily excised PVNS = more destructive and diffuse n joint space - difficult to excise and can recur
what does a lipoma look like on histology?
resembles normal fat tissue
nuclei are small and at the edge
what are some types of lipoma?
fibro angio spindle cell pleomorphic atypical - more unusual cell form
atypical lipoma?
mature fat with scattered bigger cells with atypical nuclei (lipoblasts)
- atypical lipoma if superficial (unlikely to metastasise)
- if retroperitoneal space = lipoma like liposarcoma
what do angiolipoma look like?
often painful
vascular with fibrin trombi
usually multiple and peripheral
causes of tender lumps? (ANGEL)
Angiolipoma Neuroma (traumatic) Glomus tumour (nail beds) Eccrine spiradenoma skin adnexal) Cutaneous leiomyoma (erector pilae)
liposarcoma histology?
lots of lipoblasts
what is a leiomyoma?
tumour of smooth muscle
most common tumour in body (esp. uterus)
spindle cells in pink matrix
disorganised
come atypical cells
possible malignancy
what is IHC?
immunohistochemistry
looks for particular proteins
can be used to determine what tissue a tumour is derived from(e.g leiomyosarcoma = lots of actin etc)
rhabdomyomas?
benign tumours of skeletal muscle
very rare
can occur in heart in children
name 3 types of rhabdomyoma
embryonal rhabdomyosarcoma (children)
Alveolar (young adults)
Pleomorphic (older)
rhabdomyosarcoma histology?
rhabdomyoblasts
chondroma vs enchondroma?
chondroma = benign cartilage tumour (common) enchondroma = in digits (rare)
tumour arising in the axial skeleton in older person most likely to be?
chondrosarcoma
don’t really affect children
chondrosarcoma red flag?
tumour in axial skeleton
tumour with basically normal cells in periphery/axial?
peripheral = probably benign axial = probably malignant
benign bone lesion?
simple osteoma (often in cranial bones)
multiple benign bone lesions?
gardner’s syndrome
what is an osteoid osteoma?
bone tumour producing osteoid (mature bone)
sclerotic rim
where do osteosarcomas usually occur?
more common in paediatric group
in long bones
what indicates an osteosarcoma?
Codman’s triangle on radiology
any malignant tumour that produces osteoid = osteosarcoma until proven otherwise
where is an osteosarcoma likely to spread?
lung fields
- where vascular drainage goes
what is a Ewing’s sarcoma?
small, round blue cell tumour of unknown histogenesis
destructive, rapidly growing and highly malignant
often affects soft tissue/bones in children and adolescents
what is the most common type of cancer in adults?
carcinoma
features of sarcomatoid carcinomas?
have properties of both carcinoma and sarcoma
what is a pseudosarcoma?
benign condition that can mimic sarcoma
- e.g tissues undergoing repair as they appear atypical
reactive lesions?
smallish rapidly growing lesions which can be preceded by trauma
e.g nodular fasciitis, myositis ossificans
what is nodular fasciitis?
reactive lesion
chaotic appearance with large atypical cells and frequent normal mitoses
haemorrhage common
what is myositis ossificans?
reactive lesion
like nodular fasciitis which often occurs in large muscles
preceding trauma
