Test 1 Flashcards
Ureter
Highly convoluted mucosa Urothelium with multiple layers (3-6) Dense, vascularised lamina propria Muscularis Adventitia
Urethra
Urothelium Lamina propria Submucosa of fibroelastic tissue May see sub urethral glands Muscularis Adventitia
Bladder
Urothelium (5-6 layers)
Lamina propria made up of fibroelastic tissue
Thin vascularised submucosa
Very thick muscularis layer (detrusor muscle)
Adventitia
Vas Deferens
Pseudostratified columnar epithelium Small lumen surface Lamina propria rich in elastic fibres Very thick muscularis layer (longitudinal, circular, longitudinal) Adventitia
Testes
Dense CT capsule (tunica albigunea)
Extends into the testes as septa
Seminiferous tubules
Surrounding seminiferous tubules are Leydig cells
Mucosa of seminiferous tubules made up of Sertoli cells
Flat cells on outside of seminiferous tubules are Myoid cell (smooth muscle cells)
CT framework throughout
Seminal Vesicles
Tortuous glands Lined by pseudostratified columnar epithelium Thick CT capsule (tunica albuginea) Lamina propria made up of elastic fibres LP surrounded by smooth muscle
Penis
Urethra in middle
Outer tunica albuginea
Urethra surrounded by erectile tissue known as corpus spongiosum
Corpus spongiosum = dense fibroelastic tissue with smooth muscle dotted throughout
Urethral glands may be present
Cavernous sinuses seen
Benign Prostatic Hyperplasia
Proliferation of glands
Multilayered epithelium (usually only simple columnar)
Greatly thickened fibromuscular stroma
Corpora amylacia present (hyaline within glands)
Urethra CIS
Loss of normal urothelium Cells have irregular nuclei and nucleoli Ulceration of epithelial layer Lamina propria with inflammatory cells Epithelial cells exfoliating into lumen No invasion into submucosa (basement membrane still intact)
Prostate with Adenocarcinoma
Glandular architecture becomes tortuous and thickened
Cribriform arrangement
Invasion of tumour cells into the stroma
Prostate
Glands lined with simple columnar epithelium
Fibromuscular stroma surrounding glands
Surrounded by thin layer of CT
Ovary
Surface mesothelium of simple cuboidal epithelium
Dense CT tunica albuginea
Medulla made up of loose CT
Ovarian follicles seen
Ovarian Follicle
Oocyte surrounded by layer of epithelial cells
Zona pelucida surrounding oocyte (dense glycoprotein)
Many layers of granulosa cells sitting on theca interna
Theca interna seen just outside the basal layer and is thick CT
Theca externa delicate CT and mixed with smooth muscle cells
Fibroid Uterus
Mucosa normal
Blood vessels with very thick walls
Whirl like bundles of smooth muscle
Usually encapsulated with CT layer
Endometrial Curretage
Fragmented specimen
Haemorrhage
You’re looking for normal structure (endometrial glands, simple columnar epithelium etc.)
Uterus with Attached Placenta
Placenta:
- chorionic villi
- lacunae
- decidua is endometrial lining
- chorionic villi filled with vessels and capillaries
Cervix
Stratified squamous epithelium (3 layers: basal, intermediate and superficial
Basal cells on basement membrane
CT stroma underneath BM
On PAS shows positive staining of squamous cells as they contain glycogen
Endocervical glands also stain positive on PAS (cystic lakes may also be seen staining positive)
Fallopian Tube
Mucosa made up of complex folds
Ciliated columnar epithelium (not all ciliated)
Secretory peg cells seen within epithelium
CT framework that makes up the folds
Smooth muscle layer (circular and longitudinal) outside of mucosal folds
Uterus
Simple columnar epithelium
Stratum functionale contains endometrial glands (thickness depends on stage of menstrual cycle)
Stratum basale seperating functionale and myometrium
Myometrium very thick muscular layer
Uterus Adenocarcinoma
Loss of surface mucosa
Loss of normal architecture
Clusters of epithelial cells throughout
Evidence of haemorrhage
Tumour cells have eccentric nuclei due to mucin secreting vacuole
Mucin secreting vacuoles stain positive with the PAS stain
Trachea
Pseudostratified ciliated columnar epithelium Lamina propria made of CT Seromucinous glands seen Loose CT surrounding hyaline cartilage Goblet cells seen within epithelium CT fibroblasts within LP Adipose tissue before cartilage Perichondrium surrounds cartilage (delicate CT)
Emphysema
Pleural bulli (holes in submucosa)
Expanded alveolar spaces
Fibrotic thickening in alveoli walls
Lung Adenocarcinoma
Thickening of alveolar walls (much more thick)
Shows lepidic growth pattern
In alveolar spaces there are balls of tumour cells
Tumour cells growing along the lumen of alveoli
When staining with PAS, shows mucin targets and other small granules of residual glycogen
Lung Small Cell Carcinoma
Crowded mass of tumour cells
Poorly arranged, pleomorphic, hyperchromatic tumour cells with indistinct cytoplasm
Can see nuclear moulding forming rows
Normal Liver
Dense CT capsule known as Glisson’s capsule
Central vein surrounded by cords of hepatocytes
Spaces between hepatocytes are called sinusoids
See portal triad with accompanying bile ducts
CT septa separating lobules
With Masson’s Trichrome, shows CT septa in blue
With Gordon and Sweet’s, shows reticulin fibres holding together hepatocytes
With PAS, hepatocytes filled with glycogen
Cirrhotic Liver
Normal architecture of liver is lost
Degenerative hepatocytes
Marked fatty lipid infiltrate (infiltrates hepatocytes, nucleus displaced to periphery)
Normal loose CT septa replaced by more dense fibrotic CT
Mallory bodies seen with regenerative hepatocytes
With Masson’s trichrome, see CT septa has been replaced by thick fibrotic CT and also losses normal structure, regenerative cells stain deep red
With Gordon and Sweets, loss of reticulin fibres in the CT septa as well as hepatocytes that have been disrupted by lipid vacuole
Gall Bladder
Surface mucosa folded
Simple columnar epithelium
CT LP
Smooth muscle layer very close to mucosa
Large external adventitia with BV, lympatics, collagen CT
Can see Rokitansky Aschoff sinuses
Metastatic Colon Carcinoma of Liver
Tumour shows gland formation
Clearly separated from normal liver structure
Tumour cells have high NC ratio and prominent nucleoli
With PAS/AB, can see abundant lakes of acid mucin found inbetween tumour cells
Normal Breast
Terminal Ductal Lobular Units (have 2 layers of cells: cuboidal/myoepithelial cells)
Intralobular CT loose, interlobular CT dense
Adipose tissue throughout
Fibroblasts seen in stroma
Myoepithelial cells seen surrounding ducts (flat cells)
May also see nerve roots
May see PAS positive material within ducts (note that the epithelial cells have no PAS positive staining - important when identifying adenocarcinoma)
Fibroadenoma of Breast
Encapsulated by dense CT Complex extensions of ducts Tumour made up of dense CT Epithelium of ducts thicker (more than 2 layers) Increase in myoepithelial cells
Fibrocystic Breast
Dilated ducts (with cystic deposit)
Macrophages in ducts
Stroma dense CT
Complex gland formation
Gynaecomastia
Fibrous stroma
Some very simple mammory ducts
Enlarge ducts with thickening of epithelial layer
Increase in myoepithelial cells
With PAS, staining in luminal epithelium (acid mucins on surface of epithelium)
Ductal Cell Carcinoma in Situ (DCIS)
Some normal ducts
May see cystic lakes
Tumour encapsulated in normal ducts as BM is still intact
Tumour cells hyperchromatic and pleomorphic
Calcific material within ducts
Lobular Carcinoma
Lots of fibrosis
Inflammation seen
Solid in structure
Interlobular stroma invaded by tumour cells (only invade stroma)
Tumour cells form rows and many have vacuoles
With PAS, tumour cells with vacuoles stain positive for neutral mucins (look like target cells)
With Masson’s Trichrome, lots of collagen (blue) surrounding tumour cells (red)
