St All Images

Question 1

Answer 1

Parathyroid adenoma

• lack of fat

Question 2

Answer 2

Papillary thyroid carcinoma

Question 3

Answer 3

Normal adrenocortotroph population

• small nodular nests of ACTH+ cells

Question 4

chromogranin

Answer 4

Pheochromocytoma

• +: Chromogranin A

Question 5

Answer 5

Palpation thyroiditis

• histiocytes and lymphocytes

Question 6

Answer 6

Adrenocortical hyperplasia

• vacuolated fasciculata

Question 7

Answer 7

Medullary carcinoma

• nests of rounded mildly pleomorphic cells surrounded by amyloid

Question 8

Answer 8

Normal thryoid

• cuboidal epihtelial cells with reich vacular network

Question 9

Answer 9

Hashimoto’s thyroiditis

Question 10

Answer 10

Acidophil stem cell adenoma, paranuclear vacuolisation (giant mitochondria)

Question 11

Answer 11

Langerhans cell histiocytosis

Question 12

Answer 12

Adrenocortical hemangioma

Question 13

Answer 13

Fetal adrenal with primitive sympathetic cells forming neuroblastic nodules

Question 14

Answer 14

Pituitary apoplexy

Question 15

Answer 15

Adrenal gland with metastatic bronchogenic adenocarcinoma, FNA

Question 16

Answer 16

Ultimobranchial body rest in thryoid

• Gives rise to C cells

Question 17

Answer 17

Normal parathyroid, Oil Red O

• 80% are nonsecretory phase and contain intracytoplasmic fat

Question 18

Answer 18

Lingual thyroid

• dense fibrous tissue

Question 19

Answer 19

Granulomatous hypophysitis of pituitary

Question 20

Answer 20

Craniopharyngioma with biphasic growth (adamantinoma-like and stratified squamous)

Question 21

Answer 21

Craniopharyngioma

Question 22

Answer 22

Hemochromatosis, PPB

Question 23

Answer 23

Adrenocortical carcinoma

• marked nuclear pleomorphism
• intranuclear pseudoinclusions

Question 24

Answer 24

Follicular adenoma

• no capsular or vascular invasion
• microfollicular pattern, thinly encapsulated

Question 25

Answer 25

Microinvasive adenoma

Question 26

Answer 26

Post-FNA infarction of thyroid

Question 27

Answer 27

Hypothalamic neuronal hamartoma

Question 28

Answer 28

C cell nodular proliferation

• MEN2A
• +: calcitonin

Question 29

Answer 29

Pigmented (black) adrenocortical adenoma

• associated with Cushing syndrome
• compact cells with lipochrome pigment

Question 30

Answer 30

Ganglioneuroma

Question 31

Answer 31

Primary hyperaldosteronism

• Hyperplasia of zona glomerulosa

Question 32

Answer 32

Metastatic PTC in LN

• +: CK, thyroglobulin

Question 33

Answer 33

Adrenocortical adenoma with stromal fibrosis

• associated with Cushing syndrome

Question 34

Answer 34

Adrenal cyst, endothelial type (+ Factor VIII)

• other types: epithelial, parasitic, endothelial and psuedocysts

Question 35

Answer 35

Newborn adrenal of Beckwith-Wiedemann syndrome with widespread cytomegaly

Question 36

Answer 36

Craniopharyngioma with gliosis

Question 37

Answer 37

Medullary carcinoma

• +: calcitonin, CEA

Question 38

Answer 38

Parathyroid tissue in thyroid capsule

Question 39

Answer 39

Adrenal myelolipoma

• hematopoeitic tissue scattered among fat

Question 40

Answer 40

Rathe cleft cyst

Question 41

Answer 41

Prolactinoma with amyloid deposition and spherical bodies

Question 42

Answer 42

Normal parathyroid

Question 43

Answer 43

Pheochromocytoma, S100+ sustentacular cells

Question 44

Answer 44

Parathryoid carcinoma

• invasion of other structures
• vascular invasion
• mitoses
• nuclear pleomorphism present
• intranuclear pseudoinclusions

Question 45

Answer 45

Pituitary adenoma

Question 46

Answer 46

Parathyroid carcinoma

• Difficult to make dx on histo but mitoses helpful
• Gross and clinical showing invasion of other structures best indicator

Question 47

Answer 47

Mixed GH and PRL cell adenoma

Question 48

Answer 48

Newborn adrenal with focal cytomegaly of fetal cortex

Question 49

Answer 49

Diffuse hyperplasia of adrenal medulla

• anisonucleosis of cells expected

Question 50

Answer 50

Adrenocortical adenoma, myelolipomatous change

• Associated with Cushing syndrome

Question 51

Answer 51

Primary pigmented nodular adrenocortical disease - microadenomatous hyperplasia:

• Nodules of large, granular eosinophilic cells with enlargec hyperchromatic nuclei with prominent nucleoli
• filled with lipochrome
• associated with Carney complex (PRKAR1A)

Question 52

Answer 52

Follicular carcinoma

• BM bx showing thyroid follicles
• capsular invasion by primary
• vascular invasion in primary specimen

Question 53

Answer 53

Pheochromocytoma

Question 54

Answer 54

Hurthle cell nodule with extensive necrosis

Question 55

Answer 55

Insular carcinoma

• poorly differentiated
• showing some neuroendocrine growth pattern

Question 56

Answer 56

Basophil invasion

Question 57

Answer 57

Radiation change, nodular goiter

Question 58

Answer 58

Adrenocortical carcinoma

• areas of necrosis

Question 59

calretinin and CK

Answer 59

Adenomatoid tumour

• glands and tubules
• +: calretinin and CK

Question 60

Answer 60

DLBCL in pt with Hashimoto’s thyroiditis

Question 61

Answer 61

Parathyroid adenoma, Oil Red O

• total absence of fat

Question 62

Answer 62

Atrophic adrenal gland:

• fibrotic capsule and cortical layer is atrophic but medulla unaffected.

DDx adrenal hypofuntion:

• _atrophic:_autoimmune (lymphocytes and plasma cells, abs sto P450 enzyme), Type I polyglandular autoimmune sydrnome (APECED, AR), Type II polyglandular autoimmune syndrome (AD), previous Waterhouse-Friderichsen (fibrosis), exogenous corticosteroid, Cushing syndrome
• necrotic: CMV
• replacement: TB (caseous), fungus (caseous), Amyloidosis, tumour, Waterhouse-Friderichsen (blood), anticoagulatn tx (blood)

Question 63

Answer 63

Spindle cell oncocytoma

Question 64

Answer 64

Metastatic carcinoma to sellar bone and dura

Question 65

Answer 65

PTC, solid variant

Question 66

Answer 66

Gangliocytoma of pituitary

Question 67

Answer 67

Metastatic pulmonary adenocarcinoma