A-Z Review

By Alan Simmons,2014-06-26 19:29
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A-Z Review ...

    A-Z Review

    Thursday, September 28, 2006

    2:36 AM


    o Can be acute, subacute, or chronic

    o Permanent destruction of parenchyma

    o Microscopic: polys surrounded by rim of fibrin. Fibrin goes to fibrosis


    o Benign tumors

    o Highly polarized nuclei, hugging along basement membrane

    o Glands we


    o Present with constipation

    o Napkin ring lesion- typically happens on the left hand side. Goes all the

     way around

    o Blood in stool

    o Invades glands, goes into muscle wall; BM less apparent; multiple

     layers of epithelium

    o Low grade= in situ

    o High grade- through the wall and gone to liver

    o Grading- cytopatholic diagnosis

    o Staging- based on tumor and how far it has spread

     ?Alcoholic hyalin

    o Neurofibiliary tangles in brain

    o Alcoholism in liver

    o Consists of pre-keratin- ropy coily stuff

    o Alcoholic hep may form- invasion of polys because hepatocytes are

     becoming necrotic

    o Acute alcholictitis?- This is an "-its" not related to infection

    o EM- shows intermediate filaments (intracellular)

    o EM- extracellular- tells you its amyloidosis


    o Cherry apple green appearance

    o Prussia blue- iron

    o Oil red o- fatty deposition

    o Firbils (EM)-


    o Coal workers lung

    o This pigment can go to lymph nodes of lung

    o Areas of fibrosis

    o SOB

    o Alveolar sac wall- macros have black pigment

    o Differentiate pigments in macrophages- iron, lipofucsin, hemosiderin

     (iron taken up by lysosomes)


    o Councilmen's body is a kind of apoptosis cell

    o Liver- seen in Hep B and C

    o Nuclei has been periphrialized (sp?)

     ?Asbestos body

    o Seen in BAL

    o See long asbestos fibers, cross striations, they have iron

    Page 1 of 11

    o Increase in CA of lung

    o Someone who served in the navy in WWII

    o Parietal pleura- benign

    o Mesothelioma- tumor not B9

     ?You will see this in cross section- won picture of the year for

     this pic

     ?You can see mesothelioma enveloping the lung

     ?Asteroid body

    o Inclusion of cells seen in sarcoidosis

    o Represent ingested collagen

    o Seen in berylosis


    o Mucin plug in bronchus

    o Increase thickness of BM- KEY!!!

    o Muscular hypertrophy

    o Increase eosinophils

    o You can drive a truck down the BM!!


    o Most common category of brain tumor

    o Low grade- astrocytoma

    o High grade- gliablastoma multiformi (sp?)

    o Not crossing the midline

    o Some necrosis

    o Pt can live a year or so


    o Decreased of specialized cytoplasm

    o Shown a brain

     ?Autoimmune diseases

    o Hasimoto's- pink cytoplasm of cells (see some colloid);

     ?See lymphos attack

     ?Hurthle Cells- pink cytoplasm; isolated enlarged cells; they are

     under immune attack

     ?Basal cell CA

    o Face and eye lids

    o Pearly white or pink picture

    o Smooth surface

    o Malignant, but do not metastasis

    o Cells look like basal cells

    o There are 250 types of cancers…holy shit!

    o Basal cell vs. transitional cell= no header to tell apart


    o Thymine deficiency

     ?Blastoma (suffix)

    o Peripheral are B9

    o Central are malignant

    o Hepatoblastoma, neuroblastoma (adrenal), nephro- B9

    o Rb- malignancy of eyeball

    o Blastoma- can look malignant; osteoblastoma, or chondrablastoma of

     bone is B9 NO MATTER WHAT

     ?Bronchogenic CA

    o Squamous cell CA- central

    o Small cell CA- central

    o AdenoCA- peripheral

    Page 2 of 11

    o Large cell CA-

    o If you see cancer in lymphnodes- its metastatic

     ?Burkitts lymphoma

    o Know your translocations!


    o Weight loss with malignancy

    o TNFa, Cataspin (sp?)

    o Patient with gastric cancer, metastasis to lymph node- LOOK AT PIC

     ?Café au lait spot

    o Neurofibromatosis- can have nodules in the iris (Lisch nodules)

    o Over 6 sots with are 1.5cm in diameter= diagnostic

     ?CO poisoning

    o Always pops up!

    o Cherry red blood

    o Carboxy hemoglobin vs. normal Hb


    o Associated with colon cancer

    o Used clinically to monitor response to therapy

    o Cell surface antigen

    o Colon cancer


    o Tumor seen in lung

    o Can be seen in appendix

    o Wheezing

    o Diarrhea

    o Increase bowel sounds

    o Fibrosis within the heart


     ?The individual is flushing

    o Cells look like fried eggs

    o Nuclei have salt and pepper appearance

     ?CA in situ/dysplasia

    o Cancer in above BM

    o Cervical epi- if malignant cells extend to surface, call it CA in situ

    o Partial thickness, call it dysplasia

    o Disorganization of cell, enlarged nuclei, decreased intercellular


     ?Caseous necrosis

    o Associated with TB

    o Major cause of Addisons disease- TB?

    o Picture: bilateral adrenal involvement with caseous necrosis

    o Caseous necrosis: you can see langhans giant cells, marcos,


    o Hamartoma- tumor like mass seen commonly in lung

     ?See fibrous tissue, cartilage

    o Chroistoa- tissue in wrong location

     ?16 yof who had terminal ileum with gastric mucosa causing

     peptic ulcer

     ?You will see it in Meckel's diverticulum (in illeum)***** KNOW


    o Two things needed to Dx:



    Page 3 of 11

    o Comes in few flavors

     ?Micronodular- nutritional

     ?Macronodular- hepatitis

    o Gross: you can see nodules and fibrosis


    o Ends of fingers are expanded

    o See convexity to the nail

    o Associated with bronchogenic CA

    o You can see it with pulmonary abscess


    o Look for cocci first when you are given a slide of lung

     ?Cor pulmonale

    o Right heart failure due to lung disease

    o Saddle embolus- goes across into both of the lungs

    o Associated with nutmeg liver

    o Nutmegs remind you of Christmas punch

    o You can see centriloublar congestion- RBCs are within the sinusoids

    o If RBCs are not in sinusoids= cenriloular necrosis


    o Overproduciton of cortisol

    o Moon face

    o Plethora of congested blood vessels in face

    o Buffalo hump

    o Abdomnial stria

    o Elevated levels of cortisol are damaging to capillaries


    o Mast cells (EM)

    o Know mast cells before and after release!!!!!!!!!!!!!!!!!!!!


    o Type II- amyloidosis (AIAPP)

    o Type I- fibrosis of the islets

    o Gangrene- not good


    o Fluid in extracellular location

    o Bronchus with edema fluid- bee sting; can see air bubbles

    o Micro: homogenous pink fluid in sac (edema); dark pink material in

     alveolar sac (pumonary alveolar proteinosis)

    o KNOW!!!!


    o PE are often missed

    o Pylonephritis- also missed

    o Look at the PICTURE…fix it in your damn mind= acute embolus and


    o Infarct

     ?Micro: you can see coagu necrosis and hemorrhage (lung)

     ?Environmental pathology

    o Electrocuted

    o Pt that died in fire

     ?Smoke below vocal cords= died of smoke inhalation

    o Patient with needle tracks


    o 1.012 is the break off point

    o Ascites- low albumin (transudate)

    Page 4 of 11

    o Acute appendicitis- exudate

     ?Pt over 65 don’t show pain…hmmm interesting

     ?Fat necrosis

    o Soapification-

    o Injury to exocrine cells; amalyses, lipases

    o Typically- acute pancreatitis, there is a minimal poly response

    o Back pain

     ?Fatty change

    o Small fat droplets

    o Macrovessicular fatty change- associated with pregnancy, alcohoic

     liver disease, kashawikor

    o Staining with Oil Red O- stain for fat

     ?Fat embolism

    o Broken bone secondary to an accident

    o Fat embolism goes to brain and cause hemorrhage to white matter

     (peticheal)*** KNOW


    o Alcoholic hylian

    o Amyloid

    o AZ disease

     ?Fibrinoid necrosis

    o Arteries

    o Accumulation of plasma protein with in blood vessels

    o Arthus reaction- you can see it


    o Capsulated B9 breast tumor


    o Tripolar mitosis

    o Associated with fibroblasts


    o Pt with diabetic ulcer secondary to small vessel arterialsclerosis

    o Wet- bacterial super infection

    o Dry- no bacterial component to inflammation

    o Frostbite- gangrene involves all toes

     ?Gaucher disease

    o Metabolic disease

    o Crinckled cell (macors) appearing cytoplasm

    o Elongated lysosome

    o Typically seen in spleen, Bone marrow, liver

     ?Giant cells

    o you should know this

    o Astroid bodies- in sarcodosis

     ?Glioblastoma multiforme

    o Hemrohhage

    o Pt. over 50 with seizure has a brain tumor until proven otherwise!


    o Nodular glomerulscleoris- with diabetes

    o Gnephritis- post strepcoccal; lumps and bumps in glomerular


     ?Goodpasture's syndrome

    o Looking at glomerulus with immnoflourance

    o Linear stain on immunoflo

    o Hemorrahgic lung

    Page 5 of 11

     ?Granulation tissue

    o Reparative mechanism

    o Scab

     ?You will see multiple small blood vessels underneath

     ?Dilated capillaries

     ?Graves disease

    o Hyperthyroidism

    o Micro: hyperplasia, enfolding of epithelium


    o Collection of macros

    o Early: collection of macros

    o Final point: fibrotic and calcified

    o Sarcoidosis- asteroid body



    o Collection of blood in abnormal location

    o Subarachnoid- ruptured berry aneurysms

    o Subdural


    o Old blood accumulating in cells

    o Iron accumulating for other reasons

    o Brownish material in cytoplasm

    o Do an Iron stain- persuian blue


    o Micro: necrosis, lots of empty areas around hepatocyte, non-cohesive,

    evidence of necorsis and hemmorahge, macrophages filled with

     hemosideron, concileman body


    o Malignant tumor

    o 90% will present as single lesion

    o Occur in liver that has cirrhosis

    o Cancer in a cirrhoitic liver- it is a primary tumor not a metastasis

    o Hepatacellualr CA: look for bile plugs

    o These are monocolonal- you don’t see Kuffer cells

    o Person recording the video is on some mad ass drugs!

    o A regenerating tumor will carry both kuffer and hepatocytes

    o A hepatoma (cancer) will only carry one cancer type (monoclonal)

     ?Hyaline droplets

    o Seen in kidney

    o If you increase the amount of protein, you will see protein deposition

     in kidney

    o Dark pink round objects represents a lysosome that has taken in



    o Larynx

    o Pt. with contact dermatitis from her perfume…she seems way too



    o Myocardial hypertorphy

    o Prostate- both

    o Pt. had a renal artery stenosis on right side causing atrophy; the other

     kidney had compensatory hypertrophy

    o Prostate-

    Page 6 of 11

     ?Immunodeficiency diseases

    o Pnemocisitcs carini- fluid in alvolar sac looks bubbly

    o Sliver stain- you can see the bug; they are the same size of RBCs


    o Coagulation necrosis

    o Hyperemic area around it

    o Early phase: myocytes are swelling

    o Nuclei undergo karrolysis and you it becomes very eosinophilic

    o Days later: drop out of myoctyes and acute poly infiltrate

    o Look at infarct in lung


    o Rh incompatibility

    o Elevated bilirubin

    o Staining is in the basal ganglion- it doesn’t have the blood brain


    o Hydrops fetalis


     ?Infant is edematous secondary to liver dysfunction and




    o HPV infection type 16 and 18

    o Perinuclar vaculation

    o Raisinoid nuclei


    o Kwashiokor- look at hair

    o Marasmus- monkey face child


    o 9:22- Burkitts


    o Autophagocytosis; lysosomal system degrades membranes within cells

    o Brown atrophy

    o EM: LOOK AT IT! Picture shown is of adrenal (increase SER)

     ?Liquefactive necrosis

    o Requires presence of hydrolytic enzymes; means that water must be

     present for enzymes to work

    o Epithelium of bowel- rich in water

    o Ameobiasis

    o You will probably see it in the brain!

     ?Low/high amplitude swelling

    o Low- reversible

     ?Fluid going from matrix to cristea

    o High- irreversible

     ?Meckel's diverticulum

    o Gastric mucous within the diverticulum

     ?Megaloblastic anemia

    o Folic or B12 deficiency

    o Look for demyelination of posterior column in B12 deficiency


    o Riboflavin deficiency

    o Can be seen in alcoholics and copper deficiency


    Page 7 of 11


    o Pus along vessels


    o Respiratory epithelium undergoing squamous metaplasia

    o Squamous metaplasia of urinary bladder

    o Egyptian with hematuria, think squamous metaplasia


    o Liver: nodules have central necrosis and appear umbilicated, think CA

     of breast or colon

    o Heart: think CA of breast, lungs, or melanoma (this SOB can go


     ?Metastatic/dystrophic Calcification

    o Meta- hypercalciema- non injured sites (stomach, alveolar sac; pH of

     extracellular fluid is low)

    o Dystrophic- injured sites (heart valves)


    o Cancer of terminally differentiated plasma cells

    o Eccentric round nuclei

    o Perinuclear huff (SER in cell)


    o Heart

    o Kidney- acute tubular necrosis- look to see if there are mitotic figures

     in epithelium= good sign of regeneration


    o Renal cell CA- KNOW!!!!!!!!!!!!

    o Osteogenic sarcoma

    o Loss of q14 on Chromosome 13- Rb


    o Wilms tumor


    o In adrenal gland

    o Huge hemorrhage tumor

    o Micro: primitive appearing neural type cells

     ?Skiped a bunch

     ?Nutmeg liver

    o Central lobular congestion

     ?Oncofetal antigens

    o CEA

    o Alphafeto protein- heptatoma


    o B9


    o Vitamin D deficiency

    o Proliferation of cartilage

    o Widening of wrist in young children

    o Increase cartilage of costocondral junction


    o Inflammation within bone

    o KNOW!!


    o Decalcification of bone

    o Eat your TUMS

     ?Paraneoplastic syndromes

    Page 8 of 11

    o Know them all


    o Niacin deficiency

    o D.D.D

    o Casal Necklace- typical patter for pellagra for dermatitis


    o Pemphigoid- autoantiboides against desmosomes


    o Hylain droplets


    o Bile plug

     ?Will have greenish to orangish staining to them


    o Silocosis- nodules on pleura surface

    o Use polarized light to see silica

    o Silica taken up by macrophages

    o Talc- heroin


    o Bronchopnemonia

    o Lobar pneumonia

     ?Polarized light

     ?Potts disease

    o TB of the spine


    o Premature aging


    o Karyolysis- EM: chromatin and nuclear protein around the rim

    o Pyknois- EM: denatured nuclear material

     ?Rachitic Rosary

    o Costocondral junction- over proliferation of cartilage due to Vit D


     ?Renal CA

    o Micro: cells filled with glycogen


    o Control of cell cycle

    o Most common cause of malignancy in eye would be a melanoma

     ?Reye's Syndrome

    o Aspirin and pts with viral disease

    o Fatty change in liver

    o Pediatric case LOOK AT THE RULER

     ?RA/osteoarthritis gout

    o RA- formation of pannus; material added to surface of joint

     ?Micro: see pannus migrating over cartilage and causing

     proteolytic digestion

    o Osteoarthirs- things being subtracted from joint; degradation of

     cartilage; exposure of underlying bone

     ?Riboflavin deficiency

    o Chelosis

     ?Also caused by B6

    o Magenta tongue!


    o Granuloma within the spleen

    o Astreoid body

    Page 9 of 11


    o Hypertrophic- keloid

     ?African American, Mediterranean person


    o Pirate

    o Capillary hemorrhage

    o Parafollicular hemorrhages

    o Hemorrhage into bone marrow

    o My aunt has 20 orange trees…


    o Seen before

     ?Small cell CA of lung

    o Paraneoplastic syndrome: ACTH, ADH production; Cushing and

     hyponatremia respectively

    o Nuclear molding- cells are hugging each other

    o Responds well to chemotherapy

    o EM: neurosecretoy granules (also seen in carcinoids) KNOW!!


    o P450 system; hyperplasia; Phenobarbital (pt can convert pro-

     carcinogen to carcinoge)

     ?Soft tissue tumors

     ?Squamous cell Ca

    o Hypercalcimea as a paraneoplatic syndrome

    o Keratin pearls

     ?Strap cells

    o Rhabdomyocytes! Rhabdomyosarcoma; Know !!!!!!!

     ?System lupus


    o Hair, teeth, cookies, french fries, scorpion from Kontiki

     ?Tay Sachs

    o Myelo lysosomes?

     ?Thiamine deficiency

    o Wet beri beri



    o Inflammation in leg veins

    o Picture of Leg- dilated varices (superficial)

     ?Transitional cell CA

    o Can also get in head and neck region

    o CA of renal pelvis, urethra, bladder


    o Broken bone

    o Fat embolism



    o Defect goes through epithelium down to connective tissue


    o Esophagus

     ?Pt with cirrhosis

     ?There is a X-ray that you should look at!


    Page 10 of 11

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