SAQ Flashcards
What do you need in gross description?
Organ: a … specimen + particular site
A: solitary lesion / multiple
Border: irregular, infiltrative
Cut-surface & Colour: homogenous / heterogenous
Dimension / size: exact size or with reference to neighbouring structures
Extension: layers of hollow organs / neighbouring structures
⇒ diagnosis
Marked nuclear atypia
- ↑ N/C ratio
- enlarged, pleomorphic, hyperchromatic nuclei
- prominent nucleoli
- frequent mitosis
ADC microscopic descrition
proliferation of tumour cells with glandular differentation
in a background a desmoplastic stroma +/- lymphovascular invasion
cells arranged in infiltrative, irregular, angular, complex glands
cells with marked nuclear atypia (…) with intracellular mucin
SCC description
proliferation of tumour cells with squamous differentiation
in a background desmoplastic stroma +/- lymphovascular invasion
cells arranaged in infiltraive sheets and nests of keratin pearls
polygonal cells with marked nuclear atypia (…) with intracellular bridges and keratinisation
HCC description
proliferation of tumour cells with hepatocytic differentation
in a desmoplastic stroma +/- lymphovascular invasion
tumour cells arranged in thickened trabeculae
cells with marked nuclear atypia (…)
What do you look for as a clinician in pathology report?
Procedure related:
- resection margin clearance
Grading:
- tumour grade
- histological subtype
Staging:
-
Tsize of tumour, depth of invastion, status of lymphovascular permeation -
Nstage of nodal metastasis
Treatment indications:
- hormonal receptor / molecular status
- status of background
Ordinance for coroner report
Coroners Ordinance Cap 504
Metaplasia
reversible replacement of one differentiated cell type by another differentiated cell type
Dysplasia
reversible disordered growth and maturation of cells
Hamartoma
disorganised overgrowth of tissue indigenous to that site
Thrombus vs Embolus
blood clot forms locally inside a vessel
mass that floats freely in blood & travels along the bloodstream
What is target therapy?
a type of cancer treatment with drugs that specifically target on driver mutation for carcinogenesis / tumour growth, to precisely identify and attack cancer cells while minimally damage normal cells
Gross description of vessels with atherosclerosis
- fatty streaks (as flat yellow spots)
- multiple variable-sized raised atherosclerotic plaques
- confluent 匯合 in the aortic bifurcation
- more pronounced at locations of turbulence (i.e. opening of blood vessels into aorta / bifurcation)
- large plaques are complicated by ulceration with superimposed thrombus
- +/- aneurysmal dilatation at …
Microscopic appearance of atherosclerosis
Complicated atheroma
- Atheromatous plaque: fibrous cap + necrotic core
- Cells: SMCs, foam cells
- ECM: collagen, elastic fibers, proteoglycans
- Lipids
- Acute plaque changes
- Rupture, fissuring, ulceration or erosion of plaque
- Mural thrombus formation
- Haemorrhage into plaque
- Athero-embolism (ruptured plaque discharges debris into blood → microemboli)
- Aneurysm
Pathological definition of acute myocardial infarct
irreversible coagulative necrosis of the myocardium from ischaemia / reduction in coronary blood supply
