Pathology I Practical Review

1. Review

2.  RS① Lobar pneumonia, grey hepatization
 RS② ---- Bronchopneumonia
 US① acute diffuse proliferative
glomerulonephritis
 US③ Chronic Pyelonephritis
 DS② Chronic Gastric Ulceration
 DS⑥ Gastric adenocarcinoma
 DS⑧ subacute fulminant hepatitis
 DS ④ portal cirrhosis
 DS⑤ hepatocellular carcinoma
GS① Hydatidiform Mole
GS④ Invasive Mole
GS② Choriocarcinoma of uterus
NP⑧ thyroid adenoma
ES② Graves disease
MS① ----Osteosarcoma
NS① ---Acute purulent meningitis

3. IMAGE OF PRACTICAL SECTION
RS① Lobar pneumonia, grey hepatization
Fibrinous exudate
 The alveoli are
consolidated.
 The lesion is
diffuse.

4. IMAGE OF PRACTICAL SECTION
RS①Lobar pneumonia, grey hepatization
Fibrin
neutrophils
Capillary
ischemia of
alveolar wall

5. IMAGE OF PRACTICAL SECTION
RS①Lobar pneumonia, grey hepatization
neutrophils
Fibrinous network

6. RS①Lobar pneumonia
Fibrinous exudate in some aveoli has been disolved and absorbed

7. Low magnification
 Patchy distribution of the foci
 A bronchiole filled with
inflammatory cells in the center
of the focus
 Detached epithelial cells
IMAGE OF PRACTICAL SECTION
RS② ---- Bronchopneumonia

8. High magnification
 Large amount of
necrotic neutrophils
fill the bronchiole
lumen and adjacent
alveolar spaces.
 The capillaries of
alveolar walls are
congestive.
RS② ---- Bronchopneumonia

9. US① acute diffuse proliferative
glomerulonephritis
The most characteristic change
occurs in glomeruli
 Diffuse - nearly all glomeruli are
affected
 Enlarged glomeruli with increased
cellularity
 Proliferation and swelling of
endothelial and mesangial cells
 Infiltration of inflammatory cells

10. Other changes in renal tubules
and interstitium
 Protein casts or red cells casts
in the renal tubules
 Mesenchymal renal hyperemia
and exudative lesions
 Infiltration of some neutrophils
US① acute diffuse proliferative
glomerulonephritis

11.  The lesions were characterized by
inflammatory infiltration in the
renal interstitium.
 The cells infiltration is mainly
consisted of lymphocytes which
may aggregate and form
lymphocytic follicules.
US③ Chronic Pyelonephritis

12.  Glomerulosclerosis may be
seen in some areas
 "Colloid casts" are present in
the dilated tubules
US③ Chronic Pyelonephritis

13. US③ Chronic Pyelonephritis
 Some features of acute
episode are shown
 Formation of the abscesses
 WBC casts

14. DS② Chronic Gastric Ulceration
Microscopically,at low power, a ulcer can be seen.

15. DS② Chronic Gastric Ulceration
necrosis
granulation tissue
inflammatory exudate
Goblet cells
Thickened
vessel
proliferating
nerve fibers
Scar layer
Smooth musle
At medium power,
inflammatory infiltration
layer, necrotic layer,
granulation tissue ,scar
tissue on base of ulcer can
be seen.
Proliferating nerve fibers
and thickened vessels can
be also seen.

16. DS⑥ Gastric adenocarcinoma
 Irregular gland formation
 The malignancy invades the muscle wall
 Mucus secreted by the tumor cells fills
the lumen
 Cellular and nuclear pleomorphism with
abnormal spindle

17. DS⑧ subacute fulminant hepatitis
 Destruction of classic liver nodules
 Disorderly nodular regeneration of
hepatocytes with numerous fibrosis
 Bile duct proliferation and cholestasis
 Infiltrate of mononuclear inflammatory
cells

18. DS ④ portal cirrhosis
 Regenerating liver nodules in varying
sizes separated by fibrous tissue bands
 Hepatocytes in the nodules are arranged
turbulently, with absent or deviated
central vein
 Bile duct proliferation and lymphocyte
infiltration in the fibrous septa
 Fatty change and bile pigment can be
seen sometimes

19. DS⑤ hepatocellular carcinoma
 The tumor cells are arranged in nests with
relatively clear borders
 Dilated sinusoids
 Cellular and nuclear pleomorphism
 Infiltrate of lymphocyte in surrounding
stroma
 Non-neoplastic, preserved hepatocytic
cords are compressed

20. GS① Hydatidiform Mole
 The chorionic villi show hydropic
swelling----the central substance of
the villi is a loose, myxomatous,
edematous stroma.
 The vessels of villi decrease or
disappear
 proliferation of the chorionic
epithelium including
syncytiotrophoblast cells and
cytotrophoblast cells in different
degree

21. GS④ Invasive Mole
 Microscopic view
 Retained hydropic villi
penetrate the uterine wall
deeply.
 The epithelium of the villi
is marked by hyperplastic
and atypical changes,
with proliferation of both
syncytiotrophoblast cells
and cytotrophoblast cells

22. GS② Choriocarcinoma of uterus
 The tumor is composed
of obviously atypical
hyperplasia of
cytotrophoblasts and
syncytiotrophoblasts,
arranged in nests and
cords.
 The tumor invades the
uterine wall.
syncytiotrophoblasts
cytotrophoblasts
myometrium
myometrium
syncytiotrophoblasts

23. GS② Choriocarcinoma of uterus
 Choriocarcinoma shows clear
cytotrophoblastic cells with
central nuclei and light stained
cytoplasm and
syncytiotrophoblastic cells with
multiple dark nuclei embedded in
eosinophilic cytoplasm.
 There are no stroma and vessels
in the tumor. Chorionic villi are
not formed, accompanying with
masses of hemorrhage
syncytiotrophoblasts
cytotrophoblasts

24. NP⑧ thyroid adenoma
 At low magnification, the tumor is
demarcated from the surrounding normal
thyroid parenchyma by well-formed
capsule.
 The constituent cells are arranged in
uniform follicles that contain colloid.
 Regressive changes are usually present
in the tumor.
Areas of hemorrhage

25. ES② Graves disease
The follicle of thyroid are varial in size
with many small hyperplastic follicles
that the follicular epithelial cells are tall
and columnar with nuclei at the basis.
The colloid within follicular lumen is
pale with the scalloped appearance of
the edges.
Lymphocytes formed lymphoid
follicles.

26. MS① ----Osteosarcoma
 Island of osteoid
(pink-staining) and
calcified osteoid
(dark-staining)
 Anaplastic tumor
cells
 Giant cells
osteoid
calcified
osteoid

27. MS① ----Osteosarcoma
 Malignant cells---spindle
shaped and uniform or
quite pleomorphic, with
bizarre, hyperchromatic
nuclei and frequent
mitotic figures.

28. NS① ---Acute purulent meningitis
 The vessels in the
subarachnoid space are
intensely congested.
 Meninges contain an amount
of neutrophils and fibrin in
the subarachnoid space
 Infection of the underlying
brain parenchyma is rare.