Pathology practical 2

Question 1

What is the specimen?
Gross pathology 3
Diagnosis 2

Answer 1

Distal part of ureters, bladders, and prostate

bladder mucosae shows sandy patches
Bladder is hypertrophied, dilated
small polyps on bladder lumen

Bilharzial cystitis

Question 2

What is the specimen?
Gross pathology 2
Diagnosis

Answer 2

part of sigmoid colon

mucosa has large number of variable sized polyps
Polyps are grayish sessile and pedunculated

Bilharzial polyps of colon

Question 3

What is the specimen?
Gross pathology 3
Diagnosis

Answer 3

Half of foot

shows multiple irregular abscess cavities showing necrotic contents and showing black granular fungus
inflammatory and necrotic process on soft and boney tissue
some abscesses on skin

Madura foot

Question 4

What is the specimen?
Gross pathology
Diagnosis

Answer 4

both kidney, ureters, bladders and prostate

Bladder mucosa shows sandy patches and fissured transverse ulcer.
left ureter is thickened, marked dilated and yellow patches.
Left pelvis are dilated and mucosa shows sandy patches.

Bilharzial cystitis with sandy patches and fissured ulcer
Bilharzial ureteritis with sandy patches
Left hydroureter and hydronephrosis

Question 5

What is the specimen?
Gross pathology 2
Diagnosis

Answer 5

Left foot

skin is thickened and nodular
Nodules are variable sized and grayish ulcerations are seen

Nodular leprosy

Question 6

What is the specimen?
Gross pathology
Diagnosis

Answer 6

Pancreas, mesentery, mesenteric and para-aortic lymph nodes

Lymph nodes are enlarged and matted
cut section is yellow and caseous
Nodes are surrounded by greyish fibrous tissue

Tabes mesenterica
Tuberculosis of para-aortic lymph nodes

Question 7

What is the specimen?
Gross pathology
Diagnosis

Answer 7

segment of SI

Mucosa has many transverse ulcers
ulcers have undermined edges and yellowish caseous floor

Secondary intestinal tuberculosis

Question 8

What is the specimen?
Gross pathology
Diagnosis 3

Answer 8

ileum with mesentery

intestine is twisted leading to moist gengtrene on wall
Mesentery shows hyperaemic patches
Merckel’s diverticulum 3cm

Merckel’s diverticulum
Intestinal volvulus with gangrene
Septic peritonitis

Question 9

What is the specimen?
Gross pathology
Diagnosis

Answer 9

unopened heart

Visceral pericardium is dull, opaque and grayish due to fibrin deposition

Fibrinous pericarditis

Question 10

What is the specimen?
Gross pathology
Diagnosis

Answer 10

sectioned lung

Lung section showing yellow metastatic nodules (usually big)

Lung metastases

Question 11

What is the specimen?
Gross pathology
Diagnosis

Answer 11

Opened caecum and appendix

Mucosa of the caecum shows large irregular ulcer
Edges of the ulcer are raised, everted and floor is yellowish-gray and necrotic

Ulcerative carcinoma of the caecum

Question 12

What is the specimen?
Gross pathology
Diagnosis

Answer 12

Part of skull

Outer part has projecting globular mass that is non capsulated and ivory white in appearance, The mass is very hard and the groove seen at the bottom is an attempt of sawing the tumor

Ivory osteoma of skull

Question 13

What is the specimen?
Gross pathology
Diagnosis

Answer 13

An aortic segment with two common iliac arteries

Intima of aorta and common iliac arteries has multiple yellow irregular atherosclerotic patches
some lesions are ulcerated and there are small brownish thrombi

Atherosclerosis of abdominal aorta and common iliac arteries associated with ulceration and thrombosis

Question 14

What is the specimen?
Gross pathology
Diagnosis

Answer 14

Part of large cystic ovarian mass

Outer surface is smooth while inner surface has dermoid ridge projecting in cyst and shows different tissue like hair and teeth

Dermoid cyst of ovary

Question 15

What is the specimen?
Gross pathology
Diagnosis

Answer 15

Open uterus

Oval polyp arising from endometrium
Polyp is well defined grayish and has tiny cysts on surface

Endometrial polyp

Question 16

What is the specimen?
Gross pathology
Diagnosis

Answer 16

one half of an appendix

it is markedly swollen
Mucosal lining is necrotic and dull brown
Wall is perforated near the tip with yellowish exudates deposited on the outer surface.

Acute suppurative appendicitis
Septic peritonitis

Question 17

What is the specimen?
Gross pathology
Diagnosis

Answer 17

Section of the spleen

Spleen is enlarged.
Blue fibrosiderotic nodules (blue because of potassium ferrocyanide and hydrochloric acid)

Congestive splenomegaly due to portal hypertension

Question 18

What is the specimen?
Gross pathology
Diagnosis

Answer 18

Past of the skull cap

Skull shows multiple variable-sized irregular defects
Bone adjacent to these defects shows worm eaten appearance

Syphilitic osteitis of the skull

Question 19

What is the specimen?
Gross pathology
Diagnosis

Answer 19

Sectioned lung

The cut surface of the lung shows numerous scattered small caseous foci
Enlarged lymph node
Pleural fibrosis and adhesion

Miliary tuberculosis of the lung
Pleural fibrosis and adhesions

Question 20

What is the specimen?
Gross pathology
Diagnosis

Answer 20

Two slices of liver

enlarged liver
The cut surface shows multiple irregular small abscess cavities
Their lining is irregular yellowish and shreddy necrotic
Very tiny cavities are due to post mortem autolysis

Pyaemic abscesses of the liver

Question 21

What is the specimen?
Gross pathology
Diagnosis

Answer 21

IVC and common iliac veins

Lumen of vessels is occluded by dark red thrombi

Thrombosis of the IVC and the common iliac veins

Question 22

What is the specimen?
Gross pathology
Diagnosis

Answer 22

Sectioned lung

Has apical cavity with yellow caseous lining
Smooth fibroused wall
Small caseous foci
Transverse ridge

Natural is inflammatory

Chronic fibro caseous pulmonary TB

Question 23

What is the specimen?
Gross pathology
Diagnosis

Answer 23

Bisected spleen

Spleen is enlarged
Cut shows many recent infracts which are wedged-shaped
Bases are bulging covered with opaque fibrin deposits
Infracts are brownish with pale periphery

Multiple recent splenic infracts
Perisplenitits

Question 24

What is the specimen?
Gross pathology
Diagnosis

Answer 24

A section of the shaft of femur

Medullary canal shows a non capsulated infiltrating tumor mass
femur shows marked destruction in pathological fracture

Metastatic tumor of the femur associated with pathological fracture (fracture without trauma)

Question 25

What is the specimen? Gross pathology Diagnosis

Answer 25

A slice of enlarged liver Dark areas (congestion) yellow areas (fatty changed) surface shows nutmeg appearance Caused by RS heart failure Chronic venous congestion of the liver

Question 26

What is the specimen? Gross pathology Diagnosis

Answer 26

Left foot Foot is black, shrunken and mummified An irregular groove The anterior tibial artery is yellow thickened due to atherosclerosis and an occluding thrombosis Dry gangrene of the left foot Atherosclerosis and thrombosis of anterior tibial artery

Question 27

What is the specimen? Gross pathology Diagnosis

Answer 27

Open stomach Stomach appears rigid and contracted Gastric wall is diffused thickened and infiltrated by a grayish tumor growth Mucosal folds are obliterated Diffuse infiltrative carcinoma of stomach

Question 28

What is the specimen? Gross pathology Diagnosis

Answer 28

Right upper limb Distal of the arm forearm are dark brown with skin maceration Circular groove is sight of tourniquet No line of separation was identified Moist gangrene of the right upper arm

Question 29

What is the specimen? Gross pathology Diagnosis

Answer 29

Section in the arm Lower part of humerus is destroyed and replaced by large mass Mass is non capsulated fleshy, grayish brown. Cut section areas of necrosis and hemorrhage. Skin has keloids Osteosarcoma of the humerus Multiple keloids (scars)

Question 30

What is the specimen? Gross pathology Diagnosis

Answer 30

Section in the lung Lower lobe is grayish and swollen and sharp border Pleura is dull and opaque reticulated fibrin deposition Upper and middle lobes are collapsed with scattered black spots caused by acute non-suppurative inflammation Lobular pneumonia and fibrinous pleurisy

Question 31

What is the specimen? Gross pathology Diagnosis

Answer 31

Bisected kidney outer surface has depressions representing base of infracts they are whitish gray Infractions are pyramidal in shape with dark margin Healed renal infarcts

Question 32

What is the specimen? Gross pathology Diagnosis

Answer 32

Half of a cystic ovarian mass oval unilocular cyst outer surface is smooth and greyish inner surface has many papillae Papillary serous cystadenoma of ovary

Question 33

What is the specimen? Gross pathology Diagnosis

Answer 33

Small intestine Dilated due to intestinal obstruction Tumor is well defined and grayish Intact mucosa Fibroma

Question 34

What is the specimen? Gross pathology Diagnosis

Answer 34

Section in lung Large cavity with Smooth lining with THICK fibrous wall Collapse lung Pleura fibrosis and adhesion Chronic Lung Abscess

Question 35

What is the specimen? Gross pathology Diagnosis

Answer 35

section in Liver Size reduced Borders Sharp has regenerated nodules grayish white 1cm and surrounded by fibrosis Liver cirrhosis

Question 36

What is the specimen? Gross pathology Diagnosis

Answer 36

Breast mass mammary hyperplasia with breast fat and the mass is capsulated well defined greyish mass

Question 37

What is the specimen? Gross pathology Diagnosis

Answer 37

Lipoma Capsulated mass, lobulated yellow

Question 38

What is the specimen? Gross pathology Diagnosis

Answer 38

Sectioned Multiple abscesses yellow shreddy linning Some abscess has blackish line Pleural fibrosis and adhesion Acute superlative inflammation Acute lung abscess and gangrene Pleural fibrosis and adhesions

Question 39

What is the specimen? Gross pathology Diagnosis

Question 40

What is the specimen? Gross pathology Diagnosis

Answer 40

Breast Fibrous capsule with well defined greyish mass not pre cancerous so begnin Peri canalicular Fibroadenoma

Question 41

What is the specimen? Gross pathology Diagnosis

Answer 41

Testicular mass Smooth outer surface Lobules with hair tuffs Mature cystic teratoma

Question 42

What is the specimen? Gross pathology Diagnosis

Answer 42

Scalp Raised everted edge, malignant ulcer and necrotic floor Ulcerative carcinoma

Question 43

What is the specimen? Gross pathology Diagnosis

Answer 43

Mastectomy specimen breast Nipple is retracted (due to fibrosis) Depressed skin due to fibrosis (orange appearance) Irregular invasive ill-defined grayish white mass Invasive duct carcinoma

Question 44

What is the specimen? Gross pathology Diagnosis

Answer 44

Liver section Lobulated surface healed gummata surrounded by fibrosis Hepar Lobatum

Question 45

What is the specimen? Gross pathology Diagnosis

Answer 45

Hand Raised everted edges, necrotic floor, hemorrhage Malignant ulcer Ulcerative carcinoma

Question 46

What is the specimen? Gross pathology Diagnosis

Answer 46

Section in liver Reduced size Sharp borders Thick grayish fibrosed portal tracts Irregular surface Bilharzial periportal Fibrosis

Question 47

Section in? Arrow points to? Diagnosis

Answer 47

Liver tissue Subserosal CT showing edema and congested capillaries with fibrin network Fibrinous peritonitis

Question 48

Section in? Arrow points to? Diagnosis

Answer 48

Small intestine Subserosal CT showing edema and congested capillaries with fibrin network Fibrinous peritontis

Question 49

Section in? Arrow points to? Diagnosis

Answer 49

Appendix Mucosa, submucosa and musculosa show edema congested capillaries Acute suppurative appendicitis

Question 50

Section in? Arrow points to? Diagnosis

Answer 50

Lung Alveolar space contain network of fibrin entangling many RBCS. They also show edema and congestion of capillaries Lobar Pneumonia

Question 51

Section in? Arrow points to? Diagnosis

Answer 51

Myocardium Area of scar tissue which has some fibroblasts, dilated capillaries. Adjacent muscle fibers are red and atrophic Healed Myocardial infarct

Question 52

Section in? Arrow points to? Diagnosis

Answer 52

Non capsulated benign tumor Branched core of CT covered by a thick hyperplastic stratified squamous epithelium Squamous cell papilloma

Question 53

Section in? Arrow points to? Diagnosis

Answer 53

Benign tumor in intestine Proliferated acini variable in size and shape line with columnar cell Adenoma

Question 54

Section in? Arrow points to? Diagnosis

Answer 54

Benign tumor in breast Proliferated ducts round in cut section. Ducts are separated by delicate fibrous tissue containing blood vessels Pericanalicular fibroadenoma

Question 55

Section in? Arrow points to? Diagnosis

Answer 55

Benign tumor of breast Proliferated ducts compressed and invaginated surrounded by CT stroma. Intracanalicular fibroadenoma

Question 56

Section in? Arrow points to? Diagnosis

Answer 56

Benign tumor Fibrous capsule surrounds the tumor and sends fibro vascular septa dividing the tumor into lobules Lipoma

Question 57

Section in? Arrow points to? Diagnosis

Answer 57

Uterine cervix Cell shows loss of orientation, large hyperchromatic nuclei. Squamous cell carcinoma INSITU

Question 58

Section in? Arrow points to? Diagnosis

Answer 58

Skin Tumor masses periphery show a layer of cell nests. They are polyhedral in shape Squamous cell carcinoma

Question 59

Section in? Arrow points to? Diagnosis

Answer 59

Breast Malignant tumor formed of infiltrating sheets of malignant epithelial cells separated by dense fibrous stroma Infiltrating duct carcinoma

Question 60

Section in? Arrow points to? Diagnosis

Answer 60

Colonic wall A malignant tumor formed of irregular acini infiltrating the submucosa and muscle layer, Adenocarcinoma

Question 61

Section in? Arrow points to? Diagnosis

Answer 61

Enlarged lymph node partial replacement of the nodal tissue by malignant tumor deposits Metastatic carcinoma

Question 62

Section in? Arrow points to? Diagnosis

Answer 62

Malignant tumor Proliferated spindle cells arranged in herring bone pattern Fibrosarcoma

Question 63

Section in? Arrow points to? Diagnosis

Answer 63

Lung tissue Alveolar spaces contain transudate. Alveolar walls are thickened due to interstitial edema and congested capillaries Chronic venous congestion

Question 64

Section in? Arrow points to? Diagnosis

Answer 64

Liver tissue Central veins and sinusoids are dilated and congested. Liver cells in the center of the lobules show complete necrosis Chronic venous congestion

Question 65

Section in? Arrow points to? Diagnosis

Answer 65

Transverse section in a blood vessel The thrombus in between the lines of Zhan is formed by a network fibrin entangling the red and white blood cells Recent thrombus

Question 66

Section in? Arrow points to? Diagnosis

Answer 66

Section in spleen Infraction appears as structureless pink area. In between the two zones, there is a zone of congestion (it is sandwiched) Infarction in spleen

Question 67

Section in? Arrow points to? Diagnosis

Answer 67

Lung tissue Infract showing atrophic alveolar walls appearing as thin fibrous septa and alveolar spaces containing many intact RBCS. Rest of lung shows chronic venous congestion Infraction of Lung

Question 68

Section in? Arrow points to? Diagnosis

Answer 68

Lymph node Multiple tubercles are seen surrounded by caseation with langhan's giant cells Caseating tuberculosis

Question 69

Section in? Arrow points to? Diagnosis

Answer 69

Lung Small tubercles scattered in the interstitial lung tissue usually near small blood vessels. Miliary tuberculosis

Question 70

Section in? Arrow points to? Diagnosis

Answer 70

Skin Each abscess consist of blue fungal colonies surrounded by neutrophils and macrophages Madura foot

Question 71

Section in? Arrow points to? Diagnosis

Answer 71

Colon Many bilharzial ova in the submucosa that has yellowish shell. The ova are surrounded by bilharzial reaction. Bilharziasis

Question 72

Section in? Arrow points to? Diagnosis

Answer 72

Polyp in colon central core of vascular CT showing fresh, degenerated and calcified ova surrounded by bilharzial reaction Bilharzial polyp of colon

Question 73

Section in? Arrow points to? Diagnosis

Answer 73

Section from the urinary bladder wall Bilharzial ova are deposited mainly in the submucosa and less in other layers. Ova are surrounded by bilharzial reaction Bilharziasis in urinary bladder

Question 74

Section in? Arrow points to? Diagnosis

Answer 74

Section in liver Portal tracts show wide fibrous expansion while liver lobules are normal Bilharzial periportal fibrosis