H. MoleHyaditiform mole Swollen villi Edematous avascular stroma Multinucleated syncytiotrophoblastsCase:Pregnant lady with very highHCG levels, large for dategestation, passage of grape-like clusters
DysgerminomaID points:polygonal uniform lookingseminoma cells, lymphocyticinfiltrateFibrous septaCase: Young male with hard unilateral testicular mass, localized to the testes.
CryptorchidismCryptorchidism Interstitial fibrosis Thickened tubular basement membraneCase:Young male with emptyscrotal sac
FibrocysticDiseaseApocrine change in cellslining ducts.Dilation of ducts, normallining of ducts.Case:Asymptomatic woman withU/L palpable breast mass.
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
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.
Kidney necrosisAttenuation of epithelial cellsPresence of casts in lumina oftubules and collecting ducts.Interstitial edema.Case:Patient with ARF, druginduced or shock-induced, DIC
ChronicPyelonephritisHyaline like deposit inglomeruli.Abudant chronicinflammatory cells.Case:Patient with recurrent kidneyinfections, UTI, renalscarring, chronic renalfailure, TIN.
MembranousGNGlomeruli are large.Proliferation of mesangialcells.Glomerular capillaries showtram track apperance.Case:Nephrotic Syndrome S/S
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.
GlomerolunephritisMembranousglomerulonephritis Thickening of basement membrane NeutrophilsCase:30-50 yr old male withnephrotic syndrome
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.
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
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
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
Prostate CAProstate CA- single layer of cuboidal cells lining ducts, back to back arrangement of glandsCase:Old man with backpain, mets, urinaryfrequency, hesitancy, poorstream
Contents• Nasal Polyp• Nasopharyngeal CA• Laryngitis• Tonsillitis• Pneumonia• Granulomatous inflammation• Bronchoalveolar CA• Small Cell CA• Sq. Cell CA
Nasal PolypNasal polyp Pseudostratified columnar epithelium Eosinophils and fibroblasts Case: Patient of allergy, with U/L nasal obstruction
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
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
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
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
PleomorphicadenomaPleomorphic adenoma Cartilage Neoplastic acinus Connective tissue & adipose cells Apparently encapsulatedCase:Patient with swelling overangle of jaw.
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 achalasia, withweight loss, dysphagia tosolids, cough and formationof tracheo-esophealfistulae, hemoptysis
GastritisChronic gastritis Plasma cells with lymphocytes Atrophy of epithelial liningCase:Patient with retrosternalburning, NSAIDuse, hyperparathyroidism, steroid use
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
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
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
Crohn’s DiseaseCrohn’s disease Granulomatous inflammation Transmural damage Linear ulcersCase:Male, melena, fistulaformation, mouth ulcers, caninvolve any part ofGIT, mostly ileum
CholestasisAccumulation of bile pigmentin liver parenchymaDilated bile canaliculiFoamy appearance (featherydegeneration)Apoptotic bodies visible.Case:Jaundice, pruritis, elevatedALP, bilirubin
Fatty LiverSmall droplets of fat inhepatocytes.Perivenular andperisinusoidal fibrosispresent.Case:Obese patient with longstanding diabetes, metabolicsyndrome, alcoholic, hyperlipidemia
ChronicHepatitisChronic hepatitis- collagen fibers, fibrous tissue inflammatory cells in portal tracts Steatosis Liver architecture preservedCase:K/C Hep B orC, alcoholic, takinghepatotoxic drugs
CirrhosisCirrhosis Bridging fibrous septa Nodules Total disruption of liver architectureCase:Long standing liverdisease, alcoholic, encephalopathy, asterixis, spiderangioma, ascites
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.
Contents• Osteochondroma• Osteosarcoma• Sq. Cell CA Skin
OsteochondromaOsteochondroma Hyaline cartilage Fibrous perichondriumCase:Patient with sudden onset ofpain in knee due to nerveimpingement
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.
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)
MegaloblasticanemiaMegaloblastic anemia Hypersegmented nuclei in neutrophils Immature RBCs and WBCsCase:Adult woman, with C/Operipheral neuropathy,fatigue, psychiatricdisturbances, vegetarian orpost-op gastrectomy
Burkitt’sLymphoma•Intermediate sizedlymphocytes with round tooval nucleus•Macrophages with clearcytoplasm (starry skyappearance)Case:African child withmass/swelling in the jaw orretroperitoneum
Hodgkin’sLymphomaRS cells in a reactiveinflammatory backgroundconsisting oflymphocytes, eosinophils andgranulocytes.Case:Patient with multiple swellingin neck and axillary regionassociated withmalaisa, night sweats, lowgrade fever
NHL LymphomaLymphocytesCase:Patient with malaise, lowgradefever, lymphadenopathy, hepatosplenomegaly, incontiguous involvement oflymphnodes.