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Lester Grossing Manual > TTD > Flashcards

TTD Flashcards

1
Q

when to submit complete appendix

A

grossly normal and mucin accumulation

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2
Q

provides cytologic detail and decalcifies bone, for marrow biopsy

A

Zenker’s fixative

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3
Q

why use fresh tissue for flow cytometry

A

S-phase determination, no nuclei fragmentation

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4
Q

fixative for uric acid crystals

A

ethanol (dissolve in for,alin)

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5
Q

volume of fixative

A

15-20x volume of specimen

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6
Q

retention times for gross specimen

A

14 days after final report

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7
Q

retention times for paraffin blocks and slides, reports

A

10 years

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8
Q

retention time for cytology slides

A

5 years

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9
Q

short suture

A

superior margin

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10
Q

long suture

A

lateral margin

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11
Q

volar surface of hand

A

palm

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12
Q

volar surface of hand

A

sole

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13
Q

divides into medial and lateral parts

A

sagittal plane

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14
Q

divides into anterior and posterior

A

coronal

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15
Q

divides into superior and inferior

A

transverse

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16
Q

organs that require inflation

A

bladder, colon for diverticular disease

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17
Q

where to fix lymph nodes

A

Bouin’s fixative

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18
Q

type of margin taken parallel to plane of resection

A

en face

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19
Q

disadvantage of en face margin

A

distance from lesion cannot be taken, cautery artifact may be present

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20
Q

advantage of en face margin

A

10-100 times greater surface area, entire structure can be evaluated

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21
Q

type of margin taken perpendicular to plane of resection

A

perpendicular

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22
Q

advantage of perpendicular margin

A

exact distance is taken, good when small tissue is negative margin

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23
Q

disadvantage of perpendicular margin

A

very little tissue is sampled

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24
Q

mordants for ink

A

Bouin’s, dilute acetic acid, methanol

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25
Q

tumor sizes measured to nearest?

A

millimeter (no round off)

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26
Q

Tumors that are weighed

A

parathyroid adenomas, adrenal tumors, sarcomas

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27
Q

desmoplastic response

A

fibrosis so tumors are harder

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28
Q

describe necrotic areas

A

soft and friable

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29
Q

renal cell carcinoma (clear cell type)

A

golden yellow and hemorrhagic

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30
Q

normal adrneal or adrenal cortical lesions

A

orange yellow

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31
Q

xanthogranulomatous inflammation

A

yellow

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32
Q

cirrhosis

A

orange yellow

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33
Q

steroid producing tumors

A

often pale or bright yellow

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34
Q

chloroma or any purulent exudate

A

green

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35
Q

prior hemorrhage with oxidation of blood

A

green (in synovial tissue in hemochromatosis)

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36
Q

ochronosis

A

pale yellow (black or brown)

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37
Q

melanosis coli

A

black mucosa

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38
Q

anthracotic pigment

A

black

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39
Q

gout or chondrocalcinosis

A

chalky white

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40
Q

pheochromocytoma (dusky color)

A

white to tan

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41
Q

changes pheochromocytoma color to black, brown or purple

A

chromaffin reaction

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42
Q

well-circumscribed or pushing borders

A

fibroadenoma, mixed tumor, hamartoma

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43
Q

irregular or spiculated tumors

A

invasive carcinomas, surgical scars

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44
Q

jagged or notched borders

A

cutaneous melanoma

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45
Q

serpiginous borders

A

mucosal shape of colon carcinoma

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46
Q

smoothly lobulated

A

lipoma

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47
Q

bosselated (round protuberances)

A

bone in degenerative joint disease

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48
Q

verrucous

A

cutaneous condyloma

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49
Q

papillary

A

bladder tumors, papillary renal cell carcinoma

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50
Q

villous slender projections

A

villous adenoma of the colon

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51
Q

eburnated like ivory

A

Exposed polished bone surface after loss of cartilage in degenerative joint disease

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52
Q

velvety

A

normal gallbladder mucosa

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53
Q

pedunculated (with a stalk)

A

some colon polyps, achrocordon

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54
Q

Sessile (broad-based)

A

Some colon polyps

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55
Q

Macule (flat lesion)

A

Lentigo, café-au-lait spot

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56
Q

Papule (raised lesion)

A

Mole

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57
Q

Friable (soft and falling apart or crumbly)

A

Papillary renal cell carcinoma, necrotic tumors

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58
Q

Excrescence (an irregular outgrowth)

A

Carcinoma invading through skin

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59
Q

Fimbriated (fringe-like)

A

The normal end of the fallopian tube

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60
Q

Exophytic (projecting out from a surface)=

A

A papilloma in a duct

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61
Q

Endophytic (projecting within a space)

A

inverted papilloma

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62
Q

Scabrous (covered with small projections and rough to the touch)

A

Pleural plaque

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63
Q

Papyraceous (like parchment or paper)

A

Fetus papyraceous – a fetus found within the placental membranes of a twin

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64
Q

Currant jelly

A

postmortem blood clot

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65
Q

chicken fat

A

postmortem blood clot

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66
Q

Sugar-coated spleen

A

Perisplenitis

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67
Q

Unripe pear or waterchestnut

A

Gritty consistency of breast cancer

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68
Q

Grape vesicle

A

The villi of a hydatidiform mole

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69
Q

sago spleen

A

Miliary nodules of amyloidosis

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70
Q

Strawberry gallbladder

A

Cholesterolosis

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71
Q

Nutmeg liver

A

chronic congestion

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72
Q

Apple-core lesion

A

An obstructing colonic adenocarcinoma (as seen on x-ray)

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73
Q

Rice bodies

A

Loose bodies in a joint

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74
Q

Lardaceous spleen

A

Amyloidosis

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75
Q

Fish-mouth stenosis

A

Rheumatic heart valve

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76
Q

Vegetation

A

Thrombus on a heart valve

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77
Q

Caseous necrosis

A

Cheese-like material (especially in tuberculous granulomas)

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78
Q

Cannot be identified - what to say

A

grossly consistent with…

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79
Q

fat necrosis

A

yellow, chalky

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80
Q

dissolved with formalin

A

lipids, carbohydrates

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81
Q

may be degraded with picric acid

A

DNA and RNA

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82
Q

adequate fixation time in formalin

A

6-8 hours

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83
Q

effect of temperature on fixation

A

increased, but also increases rate of autolysis

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84
Q

penetration efficiency of fixative

A

0.1 cm per hour

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85
Q

time of removal of tissue from the body to time specimen is in fixative

A

ischemic time

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86
Q

time specimen is in fixative

A

fixation time

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87
Q

formalin is

A

10% phosphate buffered formaldehyde

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88
Q

why buffer formaldehyde

A

otherwise degrades rapidly and does not preserve nucleic acids well

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89
Q

formalin

A

40% formaldehyde in water

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90
Q

10% formalin equals

A

4% formaldehyde

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91
Q

what fixative for lacunar cells of nodular sclerosing variant of Hodgkin’s

A

formalin

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92
Q

how to maintain antigenicity in formalin

A

don’t overfix, add zinc

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93
Q

rate of formalin fixation

A

0.4 cm/24 hours

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94
Q

dissolves uric acid crystals

A

formalin

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95
Q

calcification in breast dissolve in which fixative

A

formalin, if over 24 hours

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96
Q

fine bubbling of nuclei due to chromatin coalescence

A

formalin

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97
Q

major acute toxic effects of formalin

A

eye, upper respiratory tract, dermal

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98
Q

most people can smell formaldehyde at

A

0.1-1.0 ppm

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99
Q

for molecular studies

A

70% ethanol

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100
Q

composition of Bouin’s solution

A

picric acid, formaldehdye, and acetic acid

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101
Q

results in sharp H&E staining

A

Bouin’s

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102
Q

can facilitate finding small lymph nodes

A

Bouin’s

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103
Q

Lymph nodes are white and fat is yellow

A

Bouin’s

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104
Q

prolonged fixation can be sued to decalcify tissue

A

Bouin’s

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105
Q

Tissues should not be fixed over 18 hours (will be brittle)

A

Bouin’s

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106
Q

How to avoid overfixation in Bouin’s

A

Transfer to ethanol

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107
Q

Why should large specimens not be fixed in bouin’s

A

entire thing will be yellow

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108
Q

causes degradation of DNA and RNA

A

picric acid

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109
Q

lyses red cells, disslves iron and small calcium deposits

A

bouin’s

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110
Q

An explosive if dry and must be kept moist

A

picric acid

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111
Q

color of bouin’s

A

yellow

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112
Q

color of b-plus

A

clear

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113
Q

composition of b-plus

A

buffered formalin with 0.5% zinc chloride

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114
Q

used for lymph node fixation, spleens, other issues if lymphoproliferative disorder is suspected

A

b-plus

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115
Q

mercury containing fixative

A

B-5

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116
Q

rapid fixation with excellent cytologic detail

A

b-plus

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117
Q

Excellent antigen preservation for lymphoid markers

A

b-plus

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118
Q

color of zenker’s acetic fixative

A

orange

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119
Q

composition of zenker’s acetic fixative

A

potassium dichromate, mercuric chloride, acetic acid

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120
Q

length of time for decalcification and cytologic preservation with zenker’s

A

8-12 hours

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121
Q

may be used for bone marrow biopsies

A

Zenker’s fixative

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122
Q

length of time for soft tissue tumors with muscle differentiation with zenker’s

A

4 hours

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123
Q

may be preferred for bloody specimens, with RBC lysed

A

zenker’s

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124
Q

penetrates poorly

A

zenker’s

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125
Q

what happens to tissue in zenker’s >24 hours

A

may be brittle

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126
Q

how to prevent tissues being brittle when in zenker’s

A

transfer to formalin

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127
Q

how to remove mercury precipitates

A

water bath (bone marrows > 1 hour, soft tissue >4 hours)

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128
Q

level of antigen preservation for IHC with Zenker’s

A

low

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129
Q

interferes with chloroacetate esterase activity

A

zenker’s

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130
Q

composition of glutaraldehyde

A

Glutaraldehyde, cacodylate buffer

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131
Q

fixative for electron microscopy

A

glutaraldehyde

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132
Q

treatment with tissues for glutaraldehdye

A

minced slowly, fixed rapidly, requires refrigeration

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133
Q

can result in false positive PAS stains

A

glutaraldehyde

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134
Q

alcohol fixative composition

A

ethanol and methanol

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135
Q

mechanism of action of alcohol fixatives

A

rapidly displace water and denature protein

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136
Q

use for synovial specimens if gout is suspected

A

alcohol

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137
Q

fixatives for smears, touch preps, frozen sections

A

methanol

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138
Q

fixative that dissolves lipids

A

alcohol

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139
Q

example of alcohol-based fixative that doesn’t shrink and harden tissue

A

methacarn

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140
Q

fixatives that fix and decalcify tissues

A

bouin’s and zenker’s

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141
Q

amount of time to decalcify small specimens

A

1-2 hours

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142
Q

time for femoral heads decalcification

A

1-2 days

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143
Q

effect of prolonged decalcification on nuclear antigens

A

may not be preserved: ER, PR, p53, Ki-67, blood H group

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144
Q

where to embed undecalcified sections

A

plastic

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145
Q

neurotoxin, short-term exposure can cause headaches, dizzines, fatigue

A

xylene

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146
Q

where to release bullets and criminal evidence

A

police, with chain of custody

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147
Q

purpose of pathology reports

A

diagnostic and prognostic information, for research trials and QA, databases and epidemiology, to guide treatment

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148
Q

error in report - what to do

A

unsign, correct, resign - but retain original for documentation purposes

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149
Q

measurement of standard cassettes

A

3 x 2.5 x 0.4

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150
Q

thickness of sections

A

0.3 cm

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151
Q

standard microscope slides

A

7.5 x 2.5

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152
Q

why dehydrate tissues

A

embedding media cannot penetrate tissues with water

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153
Q

agent for clearing

A

xylene

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154
Q

why xylene is clearing agent

A

miscible with alcohol and embedding medium, has a high refractive index

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155
Q

infiltration

A

with paraffin

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156
Q

steps in tissue processing

A

dehydration, clearing, infiltration

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157
Q

section slice

A

4 microns

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158
Q

deeper sections

A

20 microns apart

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159
Q

how to submit small punch biopsies

A

intact and bisected

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160
Q

skin shave biopsy

A

intact and sectioned and perpendicular

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161
Q

small intestine biopsies

A

put on a mesh

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162
Q

types of slides for IHC

A

commercial plus charged slides

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163
Q

more adhesive slides

A

double plus slides

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164
Q

how to arrange needle biopsies

A

in parallel rows perpendicular to slide axis

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165
Q

specimens best intact and sectioned before embedding

A

temporal arteries, vas deferens, small skin punch biopsies <0.4 cm, skin punch with vesicular lesions, skin shave

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166
Q

tissues embedded one side up

A

small specimens in large tissues, en face margins

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167
Q

how many levels of tissue to obtain

A

2-3 levels, first superficial and halfway through

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168
Q

slides to order for liver masses

A

3 h&e plus some unstained

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169
Q

immunoperoxidase studies for ABO compatibility

A

identification of tissue, but decalcification may mess up with H antigens, also only for big tissues

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170
Q

HLA typing using PCR

A

for small tissues

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171
Q

polymorphic satellite markers

A

definite match between patient and specimen

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172
Q

extra stain for stomach

A

alcian yellow

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173
Q

extra stains for liver

A

iron, retic, tri

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174
Q

stains for kidney

A

jones silver, pas, afog

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175
Q

extra slides for melanoma

A

intervening 5 slides

176
Q

spacing for breast slides

A

equally spaced hundreds of microns

177
Q

extra stain for bone marrow

A

giemsa

178
Q

acceptable threshold for significant disagreement is

A

2%

179
Q

retrognosis

A

trying to determine the size of the tissue in the past

180
Q

seroconversion after needlestick from HbeAg+

A

30%

181
Q

seroconversion after needlestick from HbeAg-

A

<6%

182
Q

postexposure prophylaxis for HBV

A

hyperimmuneglobulin + vaccine within a week

183
Q

risk for HC transmission after needlestick

A

75%

184
Q

exposure mucous membrane and skin exposure HIV

A

10% of cases

185
Q

seroconversion to HIV after needlestick

A

0.30%

186
Q

seroconversion to HIV after mucocutaneous

A

0.10%

187
Q

TB survives formalin, t/f

A

TRUE

188
Q

postexposure treatment HIV decreases risk of seroconversion by

A

81%

189
Q

Symptoms of Creutzfeld Jakob

A

rapidly progressive dementia, myoclonus, nonspecific neurologic findings

190
Q

way to inactivate CJD

A

formalin 24 hours, 95% formic acid 1 hour, formalin 24 hours

191
Q

viruses transmitted by cadavers

A

smallpox, hemorrhagic fever viruses

192
Q

diffuse rash, deep-seated vesicles/pustules, same stafe, hemorrhage into GI tract

A

smallpox variola major

193
Q

eosinophilic intracytoplasmic viral inclusions in smallpox

A

Guarnieri bodies

194
Q

no person-to-person spread for anthrax t/f

A

TRUE

195
Q

eschar with hge, hemorrhagic enteritis, meningitis, mediastinitis

A

anthrax

196
Q

how to see anthrax after antibiotics

A

silver stains and IHC

197
Q

encapsulated Gram-positive bacilli with flattened ends in short chains

A

anthrax

198
Q

plague

A

Yersinia pestis

199
Q

acute lymphadenitis with surrounding edema

A

bubonic plague

200
Q

symmetrical, descending pattern of weakness and paralysis with microthrombosis

A

clostridium botulinum

201
Q

skin ulcer, oculoglandular, pharyngeal, typhoidal

A

francisella tularensis, tularemia

202
Q

hemorrhagic fever viruses include

A

filoviruses, ebola, marburg, arenaviruses

203
Q

how long to fix small specimens infectious

A

4-6 hours

204
Q

larger specimens fixative for infection

A

72 hours

205
Q

decontaminate with

A

bleach

206
Q

kind of gloves to prevent puncture injuries

A

metal mesh and kevlar cloth type gloves

207
Q

radioactive agents patients

A

sentinel nodes, octreotide lesions

208
Q

halflife of 99mtechnetium

A

6 hours

209
Q

allowed disposal of radioactives

A

10 half lives - 60 hours after surgery

210
Q

failure to examine grossly results in discrepancies in what % of cases

A

5%

211
Q

most common claim filed against pathologists in surgical pathology

A

misdiagnosis of melanoma

212
Q

found on transbronchial biopsies, vs small cell carcinoma

A

crushed blue cells

213
Q

to diagnose signet ring carcinoma

A

mucin stains

214
Q

on smears, plasma cells can closely resemble cells of an

A

adenoma

215
Q

extranodal locations of lymphoma

A

skin, nasal cavity, mediastinum, stomach

216
Q

most common missed diagnoses in rib specimens

A

multiple myeloma, CLL

217
Q

soft tisse lesion that can have atypical cells and look alarming, rapidly growing mass, young adult

A

nodular fasciitis

218
Q

papillary endothelial hyperplasia aka

A

Masson lesion

219
Q

papillary endothelial hyperplasia aka Masson lesion vs

A

angiosarcoma

220
Q

has papillary appearance, golden yellow cytoplasmic pigment, PSA-negative, monster cell

A

seminal vesicle

221
Q

cells can be bland and mistaken for histiocytes, occur decades after original diagnosis, unusual sites (e.g. eyelid)

A

metastatic renal cell carcinoma

222
Q

difficult diagnosis in breast specimens

A

sclerosing adenosis vs invasive carcinoma

223
Q

stains for sclerosing adenosis that will show myoepithelial cells

A

SMA-actin, P63

224
Q

source of light at the base of the microscope, adjusted by moving circular ring around it

A

field diaphragm

225
Q

located below stage, can be moved up and down and centered with 2 screws

A

substage condenser

226
Q

located in substage condenser, adjusted by using a rotating ring in front of condenser

A

aperture iris diaphragm

227
Q

needs to be changed to optimize contrast in objectives

A

aperture diaphragm

228
Q

how to change light intensity

A

transformer

229
Q

ways to increase contrast

A

(1) closing the aperture diaphragm below 60% (2) lowering substage condenser

230
Q

why increase contrast

A

look for refractile material

231
Q

drawbacks of increasing contrast

A

resolution and sharpness are reduced

232
Q

how to adjust for Kohler illumination

A

(1) open aperture and field diaphgragm completely, at 20x (2) close field diaphragm almost completely (3) raise condenser until edges of diaphragm are sharply focused, condenser usually at highest position, (4) use centering screws on substage condenser to center image of the field diaphragm (5) slowly open the field diaphragm until it disappears from view (6) remove eyepiece objective and look into tube (7) open and close aperture diaphragm until only 66-77% of back lens is illuminated to prevent glare

233
Q

optimal image formation

A

(1) adjust eyepiece for width to form a single image, (2) close each eye individually to focus eyepiece, (3) adjust illumination

234
Q

why oil immersion lenses provide higher resolution

A

refractive index of oil is higher than air, lights rays bent to a greater degree, more light

235
Q

use of oil immersion mag

A

(1) hemepath and (2) small organisms like TB, microsporidia

236
Q

how to scan slide for oil immersion

A

4x beside oil, also apply ink to area of interest

237
Q

remove oil from slide

A

xylene

238
Q

objects that have a refractive index different than normal tissue

A

refractile objects

239
Q

look brighter and shinier than tissues

A

refractile objects

240
Q

doubly refractile

A

refractile and polarizable

241
Q

how to see refractile objects

A

increase contrast

242
Q

light oriented in one specific plane

A

polarized light

243
Q

how is polarized light produced

A

use 2 crossed polarizing filters

244
Q

most tissues do not change quality of light

A

isotropic

245
Q

tissues change direction and speed of light

A

polarizable, birefringent, anisotropic

246
Q

appears bright in comparison to dark tissue

A

polarizable, birefringent, anisotropic

247
Q

can reflect light at 2 different wavelengths

A

dichroic birefringence

248
Q

polarizable that have regular repeating structures

A

crystalline, amyloid or collagen, polyethylene

249
Q

when can no light pass through polarizer

A

if polarizer and analyer are at 90 degrees to each other, then polarizer rotates, allows light, appears bright

250
Q

the polarizing disk below the condenser

A

polarizer

251
Q

polarizing disk above the specimen (top of slide or above objectives)

A

analyzer

252
Q

determination of positive and negative birefringence

A

requires using a compensating first order red filter under polarized light

253
Q

determine uric acid crystals from CPPD crystals

A

positive and negative birefringence, do on crystals in solution and not on fixed tissue

254
Q

refractile but not polarizable

A

hemosiderin

255
Q

polarizable but not or poorly refractile

A

amyloid

256
Q

polarizable and refractile

A

suture material

257
Q

apple green under polarization

A

amyloid

258
Q

accuracy of measuring estimation from known field diameters

A

1-2 mm

259
Q

accuracy of direct measurement on the slide

A

1-2 mm

260
Q

accuracy of vernier scale on movable stage

A

0.1 mm

261
Q

accuracy of ocular reticle

A

0.01 mm (10 um)

262
Q

factors that affect size of microscope field

A

(1) brand, (2) eyepiece and objective magnification, (3) distance between eyepiece and objective, (4) additonal heads (lengthen) and built-in polarizing lenses

263
Q

ways to measure microscope field

A

(1) mark 2 edges of field on glass slide, measure with rule (2) use Vernier scale, edge of coverslip is a good landmark that can be moved across (3) stage micrometer for direct measurement of HPF

264
Q

typical size of microscope fields

A

0.05-1 cm

265
Q

formula for measuring size of higher fields

A

constant = eyepiece mag x obj mag x field diameter

266
Q

formula for area of HPF once field is known

A

area PHF = 3.1415 x radius^2

267
Q

lobe of a neutrophil nucleus

A

2 um

268
Q

nucleus of a small lymphocyte

A

5-6 um

269
Q

red blood cell

A

7 um

270
Q

histiocyte nucleus

A

10 um

271
Q

how to measure small breast carcinomas

A

direct measurement on slides

272
Q

scale located on the stage and divided into millimetres

A

rule scale

273
Q

scale fixed in position, divided into 10 divisions, each measuring 0.9 mm

A

vernier scale

274
Q

how to measure on vernier scale

A

(1) look at the number of mm on rule scale before 0 on vernier, (2) decimal place is where there is alignment between rule and vernier scale (3) measure with object at edge of field of view, then move to other edge, and get the difference

275
Q

eyepiece and objective magnifications are irrelevant to measurement

A

vernier scale

276
Q

with 2 sets of scales corresponding to X and Y axes

A

vernier scale

277
Q

more reproducible than other techniques

A

vernier scale

278
Q

where to find amyloid material

A

bone marrow (multiple myeloma), medullary carcinoma of thyroid, periarticular tissue in dialysis patients

279
Q

acellular homogenous pink, sometimes with giant cells, congo red +, orange/red without polarization and apple green with polarization

A

amyloid

280
Q

studies to identify specific types of amyloid

A

immunoperoxidase studies

281
Q

multiple myeloma IPO for amyloid

A

lambda, kappa chains

282
Q

medullary carcinoma of the thyroid IPO amyloid

A

calcitonin

283
Q

dialysis related amyloidosis

A

b2 microglobulin

284
Q

amyloid p/r status

A

yes, yes/no

285
Q

bile p/r status

A

no, no

286
Q

helpful for recognition of HCC

A

bile

287
Q

is bile pas-positive

A

yes

288
Q

bone and collagen p/r status

A

yes, no

289
Q

polarization of normal bone shows

A

regular osteoid seams (not seen in woven bone)

290
Q

types of collagen polarizable and not polarizable

A

type 1, yes, type 3 (reticulin), no

291
Q

bone and collagen overstained with congo red?

A

also apple green with polarization (background must not show staining)

292
Q

stains to identify collagen

A

trichrome and reticulin

293
Q

lymphoma associated with polarizable collagen

A

nodular sclerosing Hodgkin disease

294
Q

calcium oxalate p/r status

A

yes, yes

295
Q

where to find ca oxalate

A

apocrine cysts of the breast, benign thyroid follicles, giant cells in sarcoidosis

296
Q

flat rhomboid (or needle shaped) colorless or pale yellow crystals

A

ca oxalate

297
Q

can be source of mammographic calcifications

A

ca oxalate

298
Q

present in congential hyperoxaluria

A

ca oxalate

299
Q

calcium phosphate p/r status

A

no, no

300
Q

where to find ca phosphate

A

benign and malignant breast lesions, chronic inflammation or necrosis, collagen deposition (heart valves), pulmonary blue bodies

301
Q

purple granular material that are calcium stain +

A

ca phosphate

302
Q

most common source of mammographic calcifications

A

ca phosphate

303
Q

ca pyrophosphate p/r status

A

yes, yes

304
Q

where to find ca pyrophosphate

A

large joints, periarticular tissues

305
Q

bule to purple short rhomboid crystals (may be needle-shaped)

A

ca pyrophosphate

306
Q

crystals water soluble and require anaqueous processing

A

ca pyrophosphate

307
Q

charcot-leyden crystals p/r status

A

no, yes

308
Q

where to find charcot-leyden crystals

A

eosinophils (chronic sinusitis, parasitic nifections, asthma)

309
Q

bright red needle like crystals

A

charcot-leyden crystals

310
Q

corpora amylacea p/r status

A

no, no

311
Q

where to find corpora amylacea

A

prostate, brain, lung

312
Q

extracellular laminated light pink spherical structures

A

corpora amylacea (incidence increases with age)

313
Q

gamna-gandy nodules p/r status

A

no, yes/no

314
Q

where to find gamna-gandy nodules

A

spleen, lymph nodes, thymus gland, thyroid, cardiac myxomas

315
Q

granulomas consisting of hemosiderin, calcium, foreign body giant cells, and ovoid or bamboo-shaped structures

A

gamna-gandy nodules

316
Q

siderotic granulomas found in sites of previous hemorrhage

A

gamna-gandy nodules

317
Q

can mimic fungal mycella or parasite eggs

A

gamna-gandy nodules

318
Q

hamazaki-wesenberg bodies p/r status

A

no, yes

319
Q

where to find hamazaki-wesenberg bodies

A

areas of prior hemorrhage, lymph nodes sinusoids

320
Q

small round to ovoid brown bodies that may appear budding

A

hamazaki-wesenberg bodies

321
Q

can mimic pigmented fungal forms or bacteria

A

hamazaki-wesenberg bodies

322
Q

hemosiderin p/r status

A

no, yes

323
Q

where to find hemosiderin

A

any area of hemorrhage, liver in hemochromatosis and hemosiderosis

324
Q

coarse granular brown intra- and extracellular granules, iron stain +

A

hemosiderin

325
Q

a complex of iron and ferritin

A

hemosiderin

326
Q

useful in distinguishing prior from intraoperative bleeding

A

hemosiderin

327
Q

liesegang rings p/r status

A

no, no

328
Q

where to find liesegang rings

A

any area of old hemorrhage

329
Q

round extracellular concentric laminated or fibrillated concretions of precipitated proteins

A

liesegang rings

330
Q

may be mistaken for giant kidney worm or fungal organisms

A

liesegang rings

331
Q

cornstarch p/r status

A

yes, no

332
Q

where to find cornstarch

A

surgical sites

333
Q

3-20 micron spheres, maltese cross appearance after polarization, PAS, MSS+

A

cornstarch

334
Q

lubricate surgical gloves

A

cornstarch

335
Q

can incite a granulomatous response

A

cornstarch

336
Q

formalin pigment p/r status

A

no, yes

337
Q

most commonly seen in bloody tissues, brown or black finely granular extracellular deposits

A

formalin pigment

338
Q

due to a reaction between formic acid and heme

A

formalin pigment

339
Q

how to avoid formalin pigment

A

use buffered formalin

340
Q

can be mistaken for malaria pigment

A

formalin pigment

341
Q

gelfoam p/r status

A

no/yes, no/yes

342
Q

where gelfoam is found

A

vascular spaces of hemangiomas or other vascular lesions, mark breast biopsy sites

343
Q

irregular fenestrated bluish or clear material

A

gelfoam

344
Q

stains to help identify gelfoam

A

elastic stains

345
Q

gold p/r status

A

yes, no

346
Q

where to find gold

A

skin, lymph nodes, organs of patients treated with gold for RA

347
Q

small intracellular black particles in histiocytes

A

gold

348
Q

can mimic mammography calcifications if present in intrammary LNs

A

gold

349
Q

graft material gore-tex or dacron p/r status

A

yes, yes

350
Q

look like numerous uniform round filaments with small black granules

A

graft goretex dacron

351
Q

india ink p/r status

A

no, no

352
Q

where india ink found

A

site of biopsied colonic polyps

353
Q

seen as black granular pigment in stroma or within histiocytes

A

india ink

354
Q

may be useful to document site of previously biopsied polyp that’s been removed

A

india ink

355
Q

melanosis coli p/r status

A

no, no

356
Q

where to find melanosis coli

A

lamina propria of colon

357
Q

fine brown to black granules in macrophages, PAS+, silver stain +

A

melanosis coli

358
Q

associated with anthracende derived bowel cathartics, can cause grossly pigmented colonic mucosa

A

melanosis coli

359
Q

mercuric chloride p/r status

A

yes/no, no

360
Q

why mercuric chloride in tissues

A

if fixatives with mercury

361
Q

appear as dark brown granular extracellular deposits throughout tissue

A

mercuric chloride

362
Q

metal p/r status

A

no, no

363
Q

where to find metal

A

tissue around prosthetic joints

364
Q

appear as small black irregular angulated or needle shaped fragments, intra or extracellular

A

metal

365
Q

minocycline p/r status

A

no, no

366
Q

where to find minocycline

A

thyroid, atheromatous plaques, substantia nigra

367
Q

describe minocycline

A

black granular pigment

368
Q

myospherulosis p/r status

A

no, no

369
Q

where to find myospherulosis

A

nasal cavity and paranasal sinuses

370
Q

sac like structures with outer lipid surrounding endobodies (RBCs)

A

myospherulosis

371
Q

due to packing with petroleum-based ointment

A

myospherulosis

372
Q

can be mistaken for protothecosis or fungi

A

myospherulosis

373
Q

polyethylene p/r status

A

yes ,yes

374
Q

where to find polyethylene

A

tissue around prosthetic joints

375
Q

appear as large fragments, filaments, shards, or small intracellular fragments, often with a giant cell reaction, oil red O +

A

polyethylene

376
Q

polymethyl-methacrylate (bone cement) p/r status

A

no, no

377
Q

where to find polymethylmethacrylate bone cement

A

tissue around prosthetic joints

378
Q

appear as round to oval holes surrounded by a giant cell reaction

A

polymethylmethacrylate (bone cement)

379
Q

dissolves in xylene and may have barium sulfate

A

polymethylmethacrylate (bone cement)

380
Q

silicone p/r status

A

no, yes

381
Q

where to find silicone

A

in tissue around implants, rarely in draining lymph nodes

382
Q

may be removed during processing and appear as empty holes with residual refractile material around the edge

A

silicone

383
Q

if intracellular, may appear like multiple vacuoles in histiocytes, can be mistaken for lipoblasts

A

silicone

384
Q

similar appearance to silicone

A

other organic oils

385
Q

sodium polystyrene sulfonate (kayexalate) p/r status

A

no, yes

386
Q

where to find sodium polystyrene sulfonate (kayexalate)

A

GI tract

387
Q

appear as irregular eosinophilic crystals present in the lumen or within ulcers, PAS+ and AFB+

A

sodium polystyrene sulfonate (kayexalate)

388
Q

may cause necrosis of bowel wall

A

sodium polystyrene sulfonate (kayexalate)

389
Q

surgical gut suture p/r status

A

yes, no

390
Q

where to find surgical gut suture

A

prior biopsy sites (often breast)

391
Q

appear as ovoid deeply eosinophilic monofilament often surrounded by a chronic inflammatory response and giant cells

A

surgical gut

392
Q

may be mistaken for metaplastic bone

A

surgical gut

393
Q

nuclei may be spindle shaped due to sterilization by cautery, with jagged edges during resorption

A

surgical gut

394
Q

composition of photo

A

specimen to fill frame

395
Q

magnification of photos

A

take low and high

396
Q

other sutures p/r status

A

yes, yes

397
Q

may be monofilament or polyfilament, often colorless

A

sutures

398
Q

may be surrounded by chronic inflammation

A

absorbable sutures

399
Q

talc p/r status

A

yes, yes

400
Q

where to find talc

A

pleura after talc pleurodesis, granulomas in IVDAs

401
Q

appear as irregular clear to yellow crystalline material

A

talc

402
Q

thorotrast p/r status

A

no, no

403
Q

where to find thorotrast

A

liver, spleen

404
Q

coarse light brown or gray granules in histiocytes or stroma, similar to hemosiderin

A

thorotrast

405
Q

radiocontrast associated with cirrhosis, HCC, bile duct ca and angiosarcoma of spleen

A

thorotrast

406
Q

half-life of thorotrast

A

400 years

407
Q

anthracotic pigment p/r status

A

no, no

408
Q

appearance of anthracosis

A

black granular deposits in macrophaes, lymph nodes of respiratory tract

409
Q

asbestos fibers p/r status

A

no/yes, no

410
Q

thin fibers encrusted with beaded protein and iron (ferruginous bodies)

A

asbestos fibers

411
Q

asbestos looks similar to

A

aluminum silicate, fiberglass, lung elastin (need spectroscopy)

412
Q

how to quantify and identify asbestos

A

energy dispersive x-ray analysis

413
Q

insects files and ticks p/r status

A

yes, yes

414
Q

silica p/r status

A

yes, no

415
Q

minute polarizable material in histiocytes and fibrotic nodules (lung)

A

silica

416
Q

plant material p/r status

A

yes, yes

417
Q

part of plant identified by polarization

A

cell wall

418
Q

can be useful to document colonic rupture

A

plant material

419
Q

most precise measurements

A

ocular reticle

420
Q

has either a line scale or grid on the surface of a disc, used with a focusing objective, distance must be calibrated

A

reticle (graticule)

421
Q

a glass slide with very accurate scale of known size etched

A

stage micrometer

422
Q

typical divisions of stage micrometer

A

1 mm divided into 100 divisions, 1 division = 10 um

423
Q

calibrating a reticle

A

(1) place into eyepiece (2) view stage micrometer, measure distance between lines on reticle (3) do for all objectives, (4) keep record, include diameter of each microscopic field

424
Q

measuring with a reticle

A

(1) place reticle on an eyepiece, (2) place calibration line over object or distance, (3) determine number of units on calibration line

425
Q

why wipe xylene away

A

damage adhesive for objective

426
Q

how many days to dry microscope slides

A

6-7 days

427
Q

when mounting media is completely dry

A

1-2 months

428
Q

keep slides from sticking together

A

adhesive footplate opposite the label

429
Q

when reading slides not dry

A

can use a bit of xylene under coverslip and then re-apply coverslip

430
Q

where to write notes

A

footplates

431
Q

where to immerse for 15-30 minutes to restore specimen color

A

80% ethanol

432
Q

better if inflated fixed

A

lung, bladder, colon for diverticulosis

433
Q

best photo under saline (delicate tissues) or transillumination through saline, light box

A

lungs (severe emphysema), papillary structures

434
Q

need to hold something in photo

A

use hemostat

435
Q

label for photo

A

surg path number and ruler, not diagonal, ruler closer to specimen than label

Lester Grossing Manual (1 decks)

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