Successfully reported this slideshow.
EMR
Contents•   MNG•   Hashimoto’s Thyroiditis•   Graves Disease•   Papillary CA Thyroid•   Medullary CA Thyroid•   Mucinous C...
MultinodularGoiterMultinodular goiter-     colloid present in     follicles,     tall columnar cells lining     follicles,...
Hashimoto’sThyroiditisExtensive infiltration ofparenchyma by inflammatorycells (lymphocytes andplasma cells)Atrophic thyro...
Graves’ Disease1.   Moth eaten appearance     of colloid2.   Crowding and     hypertrophy of tall     columnar cellsCase:W...
Papillary CAthyroidPapillary CA thyroid-      Orphan Annie nuclei,     psammoma bodiesCase:H/O radiation tohead/neck, mets...
Medullary CAThyroidPolygonal cells formingnests, follicles andtrabeculae.A cellular amyloid depositsderived from alteredca...
MucinousCystadenomaOvaryMucinous cystadenoma ovary    Mucin secreting cysts    Mucinous pleomorphic cellsCase:U/L pelvic m...
SerouscystadenomaovarySerous cystadenoma ovary     Pleomorphic atypical     cells     Nests of tumor cells     Psammoma bo...
Dermoid Cyst  ID points:  1.Dermal appendages  2. Stratified squamous epithelium  Case:  Young girl, with pelvic  pain, ra...
Simple CysticHyperplasiaID points:1. Dilated endometrial    glands2. Increased gland to stroma    ratioCase:Woman with exc...
AtypicalEndometrialHyperplasiaID points:1. Distorted endometrial    glands2. Crowding of glands3. Loss of cellular polarit...
EndometrialPolypEndometrial polyp     Endometrium     resembling basalis wih     small muscular arteries     Cystically di...
AdenomyosisID points:1. Endometrial glands in    myometrium2. Reactive hypertrophy of    myometriumCase:Young female with ...
LeimyomaLeimyoma     Whorls of smooth     muscle fibers     Spindle cellsCase:Woman withmenorrhagia, increasedfrequency, m...
Squamous CellCA CervixSquamous cell CA cervix       Keratin pearls       Full thickness epithelium       involved       Ne...
LeimyosarcomaLeimyosarcoma    Cigar shaped cells    Increased mitotic figures    Necrosis    Hyperchromatic nucleiCase:Men...
H. MoleHyaditiform mole      Swollen villi      Edematous avascular      stroma      Multinucleated      syncytiotrophobla...
Retained productsof conceptionRetained products ofconception    Fetal RBCs    Chorionic villiCase:Incomplete abortion
DysgerminomaID points:polygonal uniform lookingseminoma cells, lymphocyticinfiltrateFibrous septaCase:    Young male with ...
CryptorchidismCryptorchidism    Interstitial fibrosis    Thickened tubular    basement membraneCase:Young male with emptys...
FibrocysticDiseaseApocrine change in cellslining ducts.Dilation of ducts, normallining of ducts.Case:Asymptomatic woman wi...
FibroadenomaFibroadenoma breast-      increased stroma,     star-shaped     intracanalicular ducts     Ducts lined by norm...
Invasive DuctalCA breastInfiltrating ducts.Ducts lined by single layer ofcells.Pleomorphic nuclei.Stroma shows densedesmop...
Invasive CAbreastBreast CA-      Increased N/C ratio,      pleomorphic,      undifferentiated cellsCase:Old woman, with me...
KUB
Contents•   Kidney Necrosis•   Chronic pyelonephritis•   Membranous GN•   Crescenteric GN•   Glomerulonephritis•   Renal C...
Kidney necrosisAttenuation of epithelial cellsPresence of casts in lumina oftubules and collecting ducts.Interstitial edem...
ChronicPyelonephritisHyaline like deposit inglomeruli.Abudant chronicinflammatory cells.Case:Patient with recurrent kidney...
MembranousGNGlomeruli are large.Proliferation of mesangialcells.Glomerular capillaries showtram track apperance.Case:Nephr...
Crescenteric GNDeposition of protein likematerial in Bowman’s space.Proliferation of cells inparietal layer of Bowman’scap...
GlomerolunephritisMembranousglomerulonephritis    Thickening of basement    membrane    NeutrophilsCase:30-50 yr old male ...
Focal SegmentalGlomerulosclerosis Some glomeruli/part of glomeruli show sclerosis. Matrix proliferation. Protein depostion...
Renal Cell CARenal cell carcinoma    Vacuolated or lipid-    laden appearance of    cells (clear cells)    Scant stroma   ...
Transitional CellCA BladderTransitional cell carcinoma    Transitional cells are    arranged in 8-10 layers    Form papill...
Benign ProstaticHyperplasiaBenign prostatatichyperplasia-    increased fibrous stroma,    double layers of cells lining   ...
Prostate CAProstate CA-     single layer of cuboidal     cells lining ducts,     back to back     arrangement of glandsCas...
RES
Contents•   Nasal Polyp•   Nasopharyngeal CA•   Laryngitis•   Tonsillitis•   Pneumonia•   Granulomatous inflammation•   Br...
Nasal PolypNasal polyp    Pseudostratified    columnar epithelium    Eosinophils and    fibroblasts    Case:    Patient of...
NasopharyngealCANasopharyngeal CA    Large epithelial cells    with indistinct borders    Cells with prominent    eosinoph...
LaryngitisNeutrophilsCongestionHyperemiaStratified squamousepitheliumCase:High fever, hoarseness ofvoice
TonsillitisLymphnode lined bystratified squamousepithelium.Proliferation of germinalcenters, infiltration ofreactive lymph...
PneumoniaAlveolar architecture intact.Distended alveolar spacesVascular congestionLeukocytic infiltrateCase:Patient withco...
GranulomatousInflammationEpitheloid cellsRim of fibroblastsMultinucleated giant cellsNecrotic centerCase:TB? (caseous necr...
Alveolar Cell CALungAlveolar carcinoma    Atypical columnar    epithelial cells    Hobnailing of nuclei    Lining the alve...
Small Cell CALungSmall cell carcinoma of lung/Oat cell CA     Undifferentiated     neoplasm of primitive     appearing cel...
Squamous CellCa LungSquamous cell carcinoma oflung      Well-differentiated      squamous carcinoma of      the lung, show...
GIT
Contents•   Pleomorphic Adenoma (Parotid)•   Barret’s esophagus•   Sq. Cell CA esophagus•   Gastritis•   H. Pylori (Chroni...
PleomorphicadenomaPleomorphic adenoma    Cartilage    Neoplastic acinus    Connective tissue &    adipose cells    Apparen...
Barret’sEsophagusSquamous to columnar(intestinal) metaplasiaGoblet cellsChronic inflammatory cells.Case:Long standing GERD
Squamous CAesophagusSquamous cell CA esophagus    Keratin pearls    Stratified squamous epitheliumCase:Patient of achalasi...
GastritisChronic gastritis     Plasma cells with     lymphocytes     Atrophy of epithelial     liningCase:Patient with ret...
H. PyloriSpiral rod shaped organismseen in superficial cells ofstomach mucosaIntestinal metaplasiaChronic inflammatory cel...
CA Stomach(Diffuse)Signet ring cells permeatingmucosa of stomach wallLarge mucin lobesCase:Long standing peptic ulcerdisea...
Celiac DiseaseCeliac disease     Absence of microvilli     Intraepithelial     lymphocytes     Inflammatory infiltrate    ...
Crohn’s DiseaseCrohn’s disease    Granulomatous inflammation    Transmural damage    Linear ulcersCase:Male, melena, fistu...
UlcerativeColitisUlcerative colitis     Mucosal ulceration     Inflammatory cells     Crypt abscesses     Epithelial metap...
AdenomatousPolypAdenomatous polyp    Epithelial proliferative    dysplasia    Stalk covered by normal    epithelium    Neo...
Colorectal CAColorectal CA(adenocarcinoma of colon)      Signet ring cells invading      bowel wall      Intracellular muc...
Carcinoid TumorCarcinoid tumor     Solid nest of     monotonous appearing     cells with small uniform     nuclei     Cell...
AcuteappendicitisAcute appendicitis    Star-shaped lumen    Superficial ulceration    Neutrophils and pus    cells    Cong...
ChroniccholecystitisChronic cholecystitis-     subserosal fibrosis,      lymphoplasmacytic     infiltrateCase:Female, fort...
CholestasisAccumulation of bile pigmentin liver parenchymaDilated bile canaliculiFoamy appearance (featherydegeneration)Ap...
Fatty LiverSmall droplets of fat inhepatocytes.Perivenular andperisinusoidal fibrosispresent.Case:Obese patient with longs...
ChronicHepatitisChronic hepatitis-    collagen fibers, fibrous    tissue     inflammatory cells in    portal tracts    Ste...
CirrhosisCirrhosis     Bridging fibrous septa     Nodules     Total disruption of liver     architectureCase:Long standing...
HepatocellularCAHepatocellular CA    Dilated sinusoidal space    Malignant hepatocytes    Case:    Patient of chronic live...
Bones, SoftTissue & Skin
Contents•   Osteochondroma•   Osteosarcoma•   Sq. Cell CA Skin
OsteochondromaOsteochondroma    Hyaline cartilage    Fibrous perichondriumCase:Patient with sudden onset ofpain in knee du...
OsteosarcomaCoarse lace like pattern ofneoplastic bone laid bymalignant cells.Large hyperchromatic nucleiof neoplastic cel...
Sq. Cell CA SkinLobules of squamous cellswith glassy cytoplasmundergoing keratinization.(keratin pearls)Case:Man with ever...
CVS
AtherosclerosisLipid coreFibrous cap of atheromatousplaqueThickening of tunica mediaCase:Patient of HTN, IHD withchest pain
HEM
Contents•   Iron deficiency Anemia•   Thalessemia•   Megaloblastic anemia•   Burkitt’s Lymphoma•   Hodgkin’s Lymphoma•   NHL
Iron DeficiencyAnemiaIron deficiency anemia    Microcytic, hypochromic RBCs    Target cells distort into pencil cellsCase:...
ThalessemiaThalessemia    Basophilic stippling    Nucleated RBCs    Microcytic, hypochromic    RBCsCase:Child- failure tot...
MegaloblasticanemiaMegaloblastic anemia    Hypersegmented nuclei in neutrophils    Immature RBCs and WBCsCase:Adult woman,...
Burkitt’sLymphoma•Intermediate sizedlymphocytes with round tooval nucleus•Macrophages with clearcytoplasm (starry skyappea...
Hodgkin’sLymphomaRS cells in a reactiveinflammatory backgroundconsisting oflymphocytes, eosinophils andgranulocytes.Case:P...
NHL LymphomaLymphocytesCase:Patient with malaise, lowgradefever, lymphadenopathy, hepatosplenomegaly, incontiguous involve...
Pathology Revision for IPE;  Shifa College of Medicine
Pathology Revision for IPE;  Shifa College of Medicine
Pathology Revision for IPE;  Shifa College of Medicine
Pathology Revision for IPE;  Shifa College of Medicine
Pathology Revision for IPE;  Shifa College of Medicine
Pathology Revision for IPE;  Shifa College of Medicine
Pathology Revision for IPE;  Shifa College of Medicine
Pathology Revision for IPE;  Shifa College of Medicine
Pathology Revision for IPE;  Shifa College of Medicine
Pathology Revision for IPE;  Shifa College of Medicine
Upcoming SlideShare
Loading in …5
×

Pathology Revision for IPE; Shifa College of Medicine

550 views

Published on

Published in: Education, Health & Medicine
  • Be the first to comment

Pathology Revision for IPE; Shifa College of Medicine

  1. 1. EMR
  2. 2. Contents• MNG• Hashimoto’s Thyroiditis• Graves Disease• Papillary CA Thyroid• Medullary CA Thyroid• Mucinous Cystadenoma• Serous Cystadenoma• Dermoid Cyst• Simple cystic endometrial hyperplasia• Atypical endometrial hyperplasia• Endometrial polyp• Adenomyosis• Leimyoma• Leimyosarcoma• H. mole• Retained products of conception• Dysgerminoma• Cryptorchidism• Fibrocystic Disease• Fibroadenoma• Invasive Ductal CA Breast
  3. 3. MultinodularGoiterMultinodular goiter- colloid present in follicles, tall columnar cells lining follicles, follicular hyperplasia Degenerating changes- necrosis, hemorrhage, fi brosisCase:Diffuse neck swelling, iodinedeficient diet, mostlyfemales, resident of hillyareas, pressure symptoms-dysphagia, dyspnea
  4. 4. Hashimoto’sThyroiditisExtensive infiltration ofparenchyma by inflammatorycells (lymphocytes andplasma cells)Atrophic thyroid folliclesNormal low cuboidalepithelium replaced byeosinophilic hurthle cells.Case:Woman withhypothyroidism, thyroidperoxidase antibodiespositive.
  5. 5. Graves’ Disease1. Moth eaten appearance of colloid2. Crowding and hypertrophy of tall columnar cellsCase:Woman withexophthalmos, hyperthyroidism symptoms, TSIs positive
  6. 6. Papillary CAthyroidPapillary CA thyroid- Orphan Annie nuclei, psammoma bodiesCase:H/O radiation tohead/neck, mets to cervicallymphnodes
  7. 7. Medullary CAThyroidPolygonal cells formingnests, follicles andtrabeculae.A cellular amyloid depositsderived from alteredcalcitonin molecules secretedby neoplastic cells.Case:Male, with familial MENSyndrome, mets present.
  8. 8. MucinousCystadenomaOvaryMucinous cystadenoma ovary Mucin secreting cysts Mucinous pleomorphic cellsCase:U/L pelvic massAbdominal painPseudomyxoma peritoneiiGross specimen, increasedmucin production
  9. 9. SerouscystadenomaovarySerous cystadenoma ovary Pleomorphic atypical cells Nests of tumor cells Psammoma bodies Tall columnar cellsCase:B/L ovarian massesGross: smooth glisteningsurface, septa
  10. 10. Dermoid Cyst ID points: 1.Dermal appendages 2. Stratified squamous epithelium Case: Young girl, with pelvic pain, radiological evidence of calcification in pelvic mass
  11. 11. Simple CysticHyperplasiaID points:1. Dilated endometrial glands2. Increased gland to stroma ratioCase:Woman with excessive estrogen: PCOD, obesity etc
  12. 12. AtypicalEndometrialHyperplasiaID points:1. Distorted endometrial glands2. Crowding of glands3. Loss of cellular polarityCase:Woman < 40-50 yrs, obese, HRT, post- menopausal, vaginal bleeding
  13. 13. EndometrialPolypEndometrial polyp Endometrium resembling basalis wih small muscular arteries Cystically dilated endometrial glands (finger like projections)Case:Woman with intermittentvaginal spotting
  14. 14. AdenomyosisID points:1. Endometrial glands in myometrium2. Reactive hypertrophy of myometriumCase:Young female with enlarged uterus, dysmenorrhea, m enorrhagia
  15. 15. LeimyomaLeimyoma Whorls of smooth muscle fibers Spindle cellsCase:Woman withmenorrhagia, increasedfrequency, multipara
  16. 16. Squamous CellCA CervixSquamous cell CA cervix Keratin pearls Full thickness epithelium involved Neoplastic fragments in stromaCase:Young woman, multiplesexual partners, repeatedHPV infections, young age atfirst intercourse, abnormalPap smear report
  17. 17. LeimyosarcomaLeimyosarcoma Cigar shaped cells Increased mitotic figures Necrosis Hyperchromatic nucleiCase:Menorrhagia, mets, pelvicadhesions leading tosymptoms
  18. 18. H. MoleHyaditiform mole Swollen villi Edematous avascular stroma Multinucleated syncytiotrophoblastsCase:Pregnant lady with very highHCG levels, large for dategestation, passage of grape-like clusters
  19. 19. Retained productsof conceptionRetained products ofconception Fetal RBCs Chorionic villiCase:Incomplete abortion
  20. 20. DysgerminomaID points:polygonal uniform lookingseminoma cells, lymphocyticinfiltrateFibrous septaCase: Young male with hard unilateral testicular mass, localized to the testes.
  21. 21. CryptorchidismCryptorchidism Interstitial fibrosis Thickened tubular basement membraneCase:Young male with emptyscrotal sac
  22. 22. FibrocysticDiseaseApocrine change in cellslining ducts.Dilation of ducts, normallining of ducts.Case:Asymptomatic woman withU/L palpable breast mass.
  23. 23. FibroadenomaFibroadenoma breast- increased stroma, star-shaped intracanalicular ducts Ducts lined by normal cellsCase:Young female, inreproductive agegroup, cyclical breast pain orincrease in mass size, freelymobile mass, increases in sizeduring pregnancy/menstrualcycle
  24. 24. Invasive DuctalCA breastInfiltrating ducts.Ducts lined by single layer ofcells.Pleomorphic nuclei.Stroma shows densedesmoplasia.Case:Woman with palpable breastmass, nippledischarge, peau’d orangeappearance of breast, axillarylymphnodes +, mets present.
  25. 25. Invasive CAbreastBreast CA- Increased N/C ratio, pleomorphic, undifferentiated cellsCase:Old woman, with mets,axillary nodes palpable,nipple retraction
  26. 26. KUB
  27. 27. Contents• Kidney Necrosis• Chronic pyelonephritis• Membranous GN• Crescenteric GN• Glomerulonephritis• Renal Cell CA• Transitional Cell CA Bladder• BPH• Prostate CA
  28. 28. Kidney necrosisAttenuation of epithelial cellsPresence of casts in lumina oftubules and collecting ducts.Interstitial edema.Case:Patient with ARF, druginduced or shock-induced, DIC
  29. 29. ChronicPyelonephritisHyaline like deposit inglomeruli.Abudant chronicinflammatory cells.Case:Patient with recurrent kidneyinfections, UTI, renalscarring, chronic renalfailure, TIN.
  30. 30. MembranousGNGlomeruli are large.Proliferation of mesangialcells.Glomerular capillaries showtram track apperance.Case:Nephrotic Syndrome S/S
  31. 31. Crescenteric GNDeposition of protein likematerial in Bowman’s space.Proliferation of cells inparietal layer of Bowman’scapsule.Case:Patient presenting withARF, withGoodpasture’s, Wegener;s, SLE etc.
  32. 32. GlomerolunephritisMembranousglomerulonephritis Thickening of basement membrane NeutrophilsCase:30-50 yr old male withnephrotic syndrome
  33. 33. Focal SegmentalGlomerulosclerosis Some glomeruli/part of glomeruli show sclerosis. Matrix proliferation. Protein depostion. Some glomeruli totally sclerosed. Case: Nephrotic Syndrome S/S: Hyperlipidemia, lipiduria, proteinurea > 3.5 g/day, children/adults. Not responsive to steroids.
  34. 34. Renal Cell CARenal cell carcinoma Vacuolated or lipid- laden appearance of cells (clear cells) Scant stroma Clear, granular cytoplasm Bizarre nuclei with giant cells.Case:Painless hematuria, flankpain, palpable mass
  35. 35. Transitional CellCA BladderTransitional cell carcinoma Transitional cells are arranged in 8-10 layers Form papillae, having fibrovascular coreCase:Old man with painlesshematuria, working innaphthylene/rubber industry
  36. 36. Benign ProstaticHyperplasiaBenign prostatatichyperplasia- increased fibrous stroma, double layers of cells lining ducts, corpora amylasiaCase:Old man with increasedhesitancy, frequency, poorstream and smoothlyenlarged prostate on DRE
  37. 37. Prostate CAProstate CA- single layer of cuboidal cells lining ducts, back to back arrangement of glandsCase:Old man with backpain, mets, urinaryfrequency, hesitancy, poorstream
  38. 38. RES
  39. 39. Contents• Nasal Polyp• Nasopharyngeal CA• Laryngitis• Tonsillitis• Pneumonia• Granulomatous inflammation• Bronchoalveolar CA• Small Cell CA• Sq. Cell CA
  40. 40. Nasal PolypNasal polyp Pseudostratified columnar epithelium Eosinophils and fibroblasts Case: Patient of allergy, with U/L nasal obstruction
  41. 41. NasopharyngealCANasopharyngeal CA Large epithelial cells with indistinct borders Cells with prominent eosinophilic nucleoli Lymphocytes surrounding syncytial cells.Case:Chinese man with nasalobstruction, cranial nervepalsies, enlarged cervicalnodes
  42. 42. LaryngitisNeutrophilsCongestionHyperemiaStratified squamousepitheliumCase:High fever, hoarseness ofvoice
  43. 43. TonsillitisLymphnode lined bystratified squamousepithelium.Proliferation of germinalcenters, infiltration ofreactive lymphocytes.Case:Child with sorethroat, cervicallymphadenopathy, high gradefever, odynophagia
  44. 44. PneumoniaAlveolar architecture intact.Distended alveolar spacesVascular congestionLeukocytic infiltrateCase:Patient withcough, sputum, high gradefever, chest pain, crackles
  45. 45. GranulomatousInflammationEpitheloid cellsRim of fibroblastsMultinucleated giant cellsNecrotic centerCase:TB? (caseous necrosis)Sarcoidosis? Cat-ScratchDisease?
  46. 46. Alveolar Cell CALungAlveolar carcinoma Atypical columnar epithelial cells Hobnailing of nuclei Lining the alveoli projecting towards the lumen, intervening stroma is not infilterated by the tumor.Case:Non-smoker, usuallyfemale, central mass
  47. 47. Small Cell CALungSmall cell carcinoma of lung/Oat cell CA Undifferentiated neoplasm of primitive appearing cells Cells are flat shaped, with scant cytoplasm Their size is approximately double to that of a lymphocyte.Case:Paraneoplasticsyndrome, ACTH, Growthhormone, ADH high relatedsymptoms
  48. 48. Squamous CellCa LungSquamous cell carcinoma oflung Well-differentiated squamous carcinoma of the lung, shows keratin pearl formation. Cells show atypia and loss of intercellular junctions.Case:Smoker, male, central mass inchest, late mets toliver, bone, adrenals
  49. 49. GIT
  50. 50. Contents• Pleomorphic Adenoma (Parotid)• Barret’s esophagus• Sq. Cell CA esophagus• Gastritis• H. Pylori (Chronic gastritis)• Stomach CA (diffuse)• Celiac Disease• Crohn’s Disease• Ulcerative Colitis• Adenomatous Polyp• Colorectal CA• Carcinoid Tumor• Acute appendicitis• Chronic cholecystitis• Cholestatis• Fatty liver• Chronic hepatitis• Cirrhosis• Hepatocellular CA
  51. 51. PleomorphicadenomaPleomorphic adenoma Cartilage Neoplastic acinus Connective tissue & adipose cells Apparently encapsulatedCase:Patient with swelling overangle of jaw.
  52. 52. Barret’sEsophagusSquamous to columnar(intestinal) metaplasiaGoblet cellsChronic inflammatory cells.Case:Long standing GERD
  53. 53. Squamous CAesophagusSquamous cell CA esophagus Keratin pearls Stratified squamous epitheliumCase:Patient of achalasia, withweight loss, dysphagia tosolids, cough and formationof tracheo-esophealfistulae, hemoptysis
  54. 54. GastritisChronic gastritis Plasma cells with lymphocytes Atrophy of epithelial liningCase:Patient with retrosternalburning, NSAIDuse, hyperparathyroidism, steroid use
  55. 55. H. PyloriSpiral rod shaped organismseen in superficial cells ofstomach mucosaIntestinal metaplasiaChronic inflammatory cellsCase:Patient not responding to PPIregimen, fecal antigenpostive, urease breath testpositive, feco-oraltransmission
  56. 56. CA Stomach(Diffuse)Signet ring cells permeatingmucosa of stomach wallLarge mucin lobesCase:Long standing peptic ulcerdisease, weightloss, anemia, supraclavicularlymphnode (virchow’snode), signs ofobstruction, hematemesis, melena
  57. 57. Celiac DiseaseCeliac disease Absence of microvilli Intraepithelial lymphocytes Inflammatory infiltrate Flattening of villi Vascular degeneration of epithelium Crypt hyperplasiaCase:Child with chronic diarrhea,weight loss and intoleranceto wheat, rye, barleyproducts
  58. 58. Crohn’s DiseaseCrohn’s disease Granulomatous inflammation Transmural damage Linear ulcersCase:Male, melena, fistulaformation, mouth ulcers, caninvolve any part ofGIT, mostly ileum
  59. 59. UlcerativeColitisUlcerative colitis Mucosal ulceration Inflammatory cells Crypt abscesses Epithelial metaplasia Diffuse inflammatory process limited to mucosa and superficial submucosa.Case:Acutely sickpatient, melena, megacolon, joint pains, gallbladderproblems, commonly involvescolon, increased chances ofmalignancy
  60. 60. AdenomatousPolypAdenomatous polyp Epithelial proliferative dysplasia Stalk covered by normal epithelium Neoplastic epithelium forming branching glandsCase:Pt with melena, familyhistory of colorectalproblems, undergoingcolonoscopy. May presentwith symptoms ofhypokalemia andhypoalbuminemia.
  61. 61. Colorectal CAColorectal CA(adenocarcinoma of colon) Signet ring cells invading bowel wall Intracellular mucin Neoplastic glands in muscularisCase:Old man withanemia, obstruction, melena, altered bowel habits
  62. 62. Carcinoid TumorCarcinoid tumor Solid nest of monotonous appearing cells with small uniform nuclei Cells with pink cytoplasm and round- oval stippled nucleus Infrequent mitosesCase:Flushing, diarrhea, bronchospasm, mucoid stool
  63. 63. AcuteappendicitisAcute appendicitis Star-shaped lumen Superficial ulceration Neutrophils and pus cells Congested blood vessels Hypertrophied musclesCase:Patient with tenderness inRIF.
  64. 64. ChroniccholecystitisChronic cholecystitis- subserosal fibrosis, lymphoplasmacytic infiltrateCase:Female, forties, fat, flatulence, bloating, fatty mealintolerance
  65. 65. CholestasisAccumulation of bile pigmentin liver parenchymaDilated bile canaliculiFoamy appearance (featherydegeneration)Apoptotic bodies visible.Case:Jaundice, pruritis, elevatedALP, bilirubin
  66. 66. Fatty LiverSmall droplets of fat inhepatocytes.Perivenular andperisinusoidal fibrosispresent.Case:Obese patient with longstanding diabetes, metabolicsyndrome, alcoholic, hyperlipidemia
  67. 67. ChronicHepatitisChronic hepatitis- collagen fibers, fibrous tissue inflammatory cells in portal tracts Steatosis Liver architecture preservedCase:K/C Hep B orC, alcoholic, takinghepatotoxic drugs
  68. 68. CirrhosisCirrhosis Bridging fibrous septa Nodules Total disruption of liver architectureCase:Long standing liverdisease, alcoholic, encephalopathy, asterixis, spiderangioma, ascites
  69. 69. HepatocellularCAHepatocellular CA Dilated sinusoidal space Malignant hepatocytes Case: Patient of chronic liver disease with signs of decompensation and worsening ascites, melena, hemate sis, bloody ascites etc.
  70. 70. Bones, SoftTissue & Skin
  71. 71. Contents• Osteochondroma• Osteosarcoma• Sq. Cell CA Skin
  72. 72. OsteochondromaOsteochondroma Hyaline cartilage Fibrous perichondriumCase:Patient with sudden onset ofpain in knee due to nerveimpingement
  73. 73. OsteosarcomaCoarse lace like pattern ofneoplastic bone laid bymalignant cells.Large hyperchromatic nucleiof neoplastic cells.Case:Young boy with painful knee,lung mets, Xray findings ofCodman’s triangle, sun burstappearance.
  74. 74. Sq. Cell CA SkinLobules of squamous cellswith glassy cytoplasmundergoing keratinization.(keratin pearls)Case:Man with everted ulcer onlip, face, arm (sun exposedarea) or everted ulcerdeveloping in long standingscars (burns etc)
  75. 75. CVS
  76. 76. AtherosclerosisLipid coreFibrous cap of atheromatousplaqueThickening of tunica mediaCase:Patient of HTN, IHD withchest pain
  77. 77. HEM
  78. 78. Contents• Iron deficiency Anemia• Thalessemia• Megaloblastic anemia• Burkitt’s Lymphoma• Hodgkin’s Lymphoma• NHL
  79. 79. Iron DeficiencyAnemiaIron deficiency anemia Microcytic, hypochromic RBCs Target cells distort into pencil cellsCase:Pregnant female, child withworm infestation, womanwith fibroids
  80. 80. ThalessemiaThalessemia Basophilic stippling Nucleated RBCs Microcytic, hypochromic RBCsCase:Child- failure tothrive, multiple transfusionhistory, hepatosplenomegaly, chipmunk facies, skullshowing hair on endappearance onxray, consanguineousmarriage
  81. 81. MegaloblasticanemiaMegaloblastic anemia Hypersegmented nuclei in neutrophils Immature RBCs and WBCsCase:Adult woman, with C/Operipheral neuropathy,fatigue, psychiatricdisturbances, vegetarian orpost-op gastrectomy
  82. 82. Burkitt’sLymphoma•Intermediate sizedlymphocytes with round tooval nucleus•Macrophages with clearcytoplasm (starry skyappearance)Case:African child withmass/swelling in the jaw orretroperitoneum
  83. 83. Hodgkin’sLymphomaRS cells in a reactiveinflammatory backgroundconsisting oflymphocytes, eosinophils andgranulocytes.Case:Patient with multiple swellingin neck and axillary regionassociated withmalaisa, night sweats, lowgrade fever
  84. 84. NHL LymphomaLymphocytesCase:Patient with malaise, lowgradefever, lymphadenopathy, hepatosplenomegaly, incontiguous involvement oflymphnodes.

×