Pathology and Diagnosis in Medicine

Pathology Paper I: General Pathology, Hematopathology, Childhood Diseases

• Long answer question
  • A 28-year-old female presents with fatigue, a butterfly-shaped rash, and a history of obstetric complications.
  • Most probable diagnosis: Systemic Lupus Erythematosus (SLE).
  • Diagnosis criteria for SLE: Presence of at least 4 out of 11 criteria - Malar rash, discoid rash, photosensitivity, oral ulcers, arthritis, serositis, renal disorder, neurological disorder, hematological disorder, immunologic disorder, antinuclear antibody (ANA) positivity.
  • Pathological changes in the heart: Libman-Sack's endocarditis, pericarditis (inflammation of the lining of the heart), and myocarditis (inflammation of the heart muscle) are common.
  • Pathogenesis of SLE: Immune dysregulation with the production of autoantibodies against nuclear components like DNA, RNA, and histones. These antibodies can be detected in the serum, which is helpful in the diagnosis.

Pathogenesis of Septic Shock

• Septic shock is a life-threatening condition that occurs when the body's response to an infection leads to widespread inflammation and blood vessel dilation, resulting in decreased blood pressure and organ dysfunction.
• The release of inflammatory mediators, such as tumor necrosis factor alpha (TNF-alpha), interleukin-1 (IL-1), and interleukin-6 (IL-6), triggers a cascade of events that ultimately leads to the clinical manifestations of septic shock.
• Causes of septic shock: Bacterial infections are the most common cause, particularly from Gram-negative bacteria (e.g., E. coli, Pseudomonas aeruginosa), followed by Gram-positive bacteria (e.g., Streptococcus pneumoniae, Staphylococcus aureus), and fungal infections.

Pediatric Small Round Cell Tumors

• These are a group of malignant neoplasms that originate from primitive neuroectodermal cells and are characterized by their small, round cells with scant cytoplasm. They often present as solid masses.
• Examples: Neuroblastoma, Ewing sarcoma, rhabdomyosarcoma, medulloepithelioma, primitive neuroectodermal tumor (PNET).
• Neuroblastoma: A malignant tumor of the sympathetic nervous system, commonly found in the adrenal gland or along the sympathetic chain.

Amyloidosis

• A group of diseases characterized by the extracellular deposition of amyloid, a misfolded protein that can accumulate in various tissues and organs.
• Types: Amyloidosis is classified based on the type of amyloid protein deposited.
• Consequences: Amyloid deposits can lead to organ dysfunction and failure, including heart failure, kidney failure, and neuropathy.
• Causes: There are a variety of genetic, inflammatory, and infectious conditions associated with amyloidosis.

Klinefelter Syndrome

• A genetic condition affecting males caused by having an extra X chromosome (XXY).
• Symptoms: Testicular atrophy, infertility, tall stature, hypogonadism, and learning disabilities.
• Diagnosis: By karyotype analysis.

Pathogenesis of Primary Tuberculosis

• Mycobacterium tuberculosis, an acid-fast bacillus, infects the lungs and other tissues.
• Mechanism: The bacteria enter the body via inhalation, reaching the alveoli.
• Immune response: The host's immune system attempts to contain the infection through macrophage activity. However, M. tuberculosis can survive within macrophages.
• Caseation necrosis: Eventually, the infected area undergoes caseation necrosis, forming granulomas - characteristic lesions of tuberculosis, which are composed of macrophages, lymphocytes, and giant cells.

Microscopic Findings in Tubercular Lymphadenitis

• Granuloma: Caseating granulomas are formed, with central areas of necrosis surrounded by epithelioid cells, giant cells, and lymphocytes.
• Caseation necrosis: Granulomas typically exhibit areas of caseation necrosis, appearing as cheese-like material.
• Acid-fast stains: Acid-fast staining using Ziehl-Neelsen or Kinyoun's method can be used to identify the presence of Mycobacterium tuberculosis within the granuloma.

Long Answer Question: 8-year-old girl with fatigue, yellowish sclera, hepatosplenomegaly, 'crewcut' skull appearance

• Most probable diagnosis: Thalassemia major (also called Cooley's anemia).
• Pathogenesis: An inherited genetic disorder characterized by a deficiency in globin chain synthesis, leading to an imbalance in hemoglobin production with decreased oxygen-carrying capacity.
• Morphological features:
  • Bone marrow: Marked erythroid hyperplasia with increased numbers of immature red blood cells.
  • Spleen: Splenomegaly due to extramedullary hematopoiesis.
  • Skeletal changes: "Crewcut" skull appearance, frontal bossing, and expansion of the medullary cavities of long bones.
• Laboratory investigations:
  • Complete blood count: Anemia with low hemoglobin and hematocrit.
  • Peripheral blood smear: Hypochromic and microcytic red blood cells, target cells, and nucleated red blood cells.
  • Electrophoresis: Demonstrates absence or reduced amounts of normal hemoglobin.
  • DNA analysis: Confirms the type of gene mutation.

WHO Classification of Acute Myeloid Leukemia

• This is a classification system based on morphology, cytochemistry, immunophenotype, and genetics.
• The classification helps to distinguish different types of AML based on their unique characteristics.

Rh Incompatibility

• A condition that can occur during pregnancy when an Rh-negative mother is carrying an Rh-positive fetus.
• Pathogenesis: During labor or delivery, Rh-positive fetal blood cells can enter the maternal circulation, stimulating the production of anti‑Rh antibodies in the mother's blood. If the mother is pregnant with another Rh-positive fetus, these antibodies can cross the placenta and attack the fetal red blood cells, leading to hemolytic anemia.
• Consequences: Potential for fetal anemia, erythroblastosis fetalis, and hydrops fetalis.

Causes of Pancytopenia

• Pancytopenia is a condition characterized by a reduction in all three major blood cell types - erythrocytes (red blood cells), leukocytes (white blood cells), and platelets. It can be caused by a variety of conditions including: -Aplastic anemia (bone marrow failure). -Severe infections. -Nutritional deficiencies. -Autoimmune disorders. -Bone marrow infiltration by diseases like leukemia, lymphoma, or metastatic cancer. -Exposure toxins or medications.

Bone Marrow Findings in Aplastic Anemia

• Hypocellular bone marrow: The bone marrow is markedly hypocellular (reduced in cell numbers), with a decrease in all hematopoietic cell lines (red blood cells, white blood cells, and platelets).
• Fatty replacement: The hypocellular areas are often replaced by fat cells, which are typically pale and are seen under microscopy.
• Absence of hematopoietic precursors: There is a lack of hematopoietic precursors, which are the immature cells that are responsible for producing mature blood cells.

Megaloblastic Anemia

• A group of anemias characterized by the presence of large, immature red blood cells (megaloblasts) in the bone marrow and peripheral blood.
• Causes: Megaloblastic anemia is typically due to a deficiency in vitamin B12 (cobalamin) or folate.
• Pathogenesis: These vitamins are essential for DNA synthesis and cell division. Their deficiency leads to abnormal DNA synthesis and impaired cell division, resulting in the production of large, abnormal red blood cells.

Disseminated Intravascular Coagulation (DIC)

• A life-threatening condition characterized by widespread activation of the coagulation system, resulting in the formation of microthrombi (small clots) within the blood vessels.
• Causes: DIC is often triggered by severe illness or injury, sepsis, trauma, malignancy, or obstetric complications.
• Pathogenesis: It occurs when the body's natural clotting system becomes unregulated, leading to uncontrolled clotting and consumption of clotting factors.
• Consequences: The widespread formation of microthrombi can lead to organ damage and failure.

Diagnosis of Multiple Myeloma

• A type of blood cancer that affects plasma cells, which are specialized white blood cells that produce antibodies.
• Factors: Multiple myeloma is diagnosed based on a combination of clinical, laboratory, and radiographic findings.
• Key features: -Elevated levels of monoclonal protein in the blood and/or urine. -Presence of lytic bone lesions (bone lesions created by the cancer). -Myeloma cells in the bone marrow.

Blood Components and their Uses and Storage Conditions

• Red blood cells (RBCs): Used for anemia, blood loss, and surgical procedures. Stored at 1-6 °C for up to 42 days.
• Platelets: Used for bleeding disorders, thrombocytopenia, and chemotherapy-induced thrombocytopenia. Stored at room temperature for up to 5 days.
• Fresh Frozen Plasma (FFP): Used for clotting factor deficiencies, and as a source of albumin. Stored at -18°C or lower for up to 1 year.
• Cryoprecipitate: Used to treat von Willebrand disease and hemophilia A. Stored at -18°C or lower for up to 1 year.
• Granulocytes: Used for infections in patients with severe neutropenia. Stored at room temperature for up to 24 hours.

Chronic Myeloid Leukemia (CML)

• A type of blood cancer affecting the bone marrow that results in an overproduction of white blood cells, particularly granulocytes.
• Pathogenesis: CML is caused by a specific chromosomal abnormality known as the Philadelphia chromosome, which results from a translocation between chromosomes 9 and 22. The Philadelphia chromosome leads to the production of a fusion protein called BCR-ABL, which plays a key role in the development of CML.
• Peripheral smear and Bone marrow findings: -Peripheral smear: Increased numbers of neutrophils, eosinophils, basophils, and myelocytes. -Bone marrow: Markedly hypercellular, with a predominance of granulocytic precursors.

Pathology Paper II: Systemic Pathology

Long Answer Question: 18-year-old female with fever, decreased urination, cola-colored urine, and recent sore throat

• Most probable diagnosis: Acute glomerulonephritis (GN).
• Urine examination findings:
  • Proteinuria: Presence of protein in the urine.
  • Hematuria: Presence of red blood cells in the urine.
  • Casts: Protein casts (cylinders of protein) may be present in the urine.
• Pathological changes in the kidney:
  • Glomerular hypertrophy: Enlargement of the glomeruli, the filtering units of the kidney.
  • Mesangial proliferation: Increase in mesangial cells, which are specialized cells within the glomerulus.
  • Hypercellularity: Increased number of cells within the glomerulus.
  • Crescent formation: In severe cases, crescent formation may occur, which is the formation of a crescent-shaped structure within the glomerulus.
• Pathogenesis: Acute GN is often caused by an immune response to an infection, such as a streptococcal infection. The immune system mistakenly attacks the glomeruli, leading to inflammation and damage.

Osteogenic Bone Tumors

• Osteogenic bone tumors are cancers that arise from bone-forming cells (osteoblasts).
• Examples: Osteosarcoma, chondrosarcoma, Ewing sarcoma, and fibrosarcoma.
• Gross and microscopic morphology of Osteosarcoma:
  • Grossly: Osteosarcomas appear as a solid, destructive mass, often with areas of hemorrhage and necrosis.
  • Microscopically: Osteosarcomas are characterized by the production of malignant osteoid (bone-like tissue), which is often irregular and disorganized.

Hepatitis B Virus (HBV)

• Mode of transmission: HBV is transmitted primarily through contact with infected blood, body fluids, or maternal transmission.
• Microscopic features of chronic hepatitis:
  • Piecemeal necrosis: Irregular destruction of hepatocytes at the periphery of hepatic lobules.
  • Portal inflammation: Infiltration of the portal tracts by lymphocytes, plasma cells, and macrophages.
  • Fibrosis: Increased collagen deposition in the liver.

Atherosclerosis

• Aetiopathogenesis: Atherosclerosis is a chronic inflammatory disease involving the buildup of plaque within the arteries.
• Pathogenesis: The process begins with endothelial injury, leading to inflammation, LDL (low-density lipoprotein) accumulation, and oxidation. This attracts monocytes and macrophages, which engulf the oxidized LDL, forming foam cells.
• Complications: Atherosclerosis can lead to coronary heart disease (CHD), stroke, peripheral artery disease, and aortic aneurysm.

Men Syndrome

• Men (Multiple Endocrine Neoplasia) syndrome: A group of genetic disorders characterized by tumors in multiple endocrine glands.
• Types:
  • MEN 1: Parathyroid hyperplasia, pancreatic islet cell tumors, and pituitary tumors.
  • MEN 2A: Medullary thyroid cancer, pheochromocytoma, and parathyroid hyperplasia.
  • MEN 2B: Medullary thyroid cancer, pheochromocytoma, and mucosal neuromas.

Hydatidiform Mole

• Definition: A benign tumor of the uterus that arises from abnormal fertilization of an egg.
• Types:
  • Partial hydatidiform mole: A fetus with some abnormalities is present. The karyotype is usually 69 XXY (or 12+4+4=101+12+4+4=101).
  • Complete hydatidiform mole: No fetus is present. The karyotype is usually 46 XX (or 46 XX).
• Complications: Complete hydatidiform moles have a higher risk of developing into choriocarcinoma, a malignant tumor.

Krukenberg Tumor

• Definition: A type of metastatic tumor that spreads to the ovaries from a primary gastrointestinal tumor, usually gastric cancer.
• Gross appearance: The ovaries are usually enlarged and firm with a "signet ring" appearance due to the accumulation of mucus-filled cells.

Type 2 Diabetes Mellitus

• Pathogenesis: Type 2 diabetes mellitus is characterized by insulin resistance, a condition in which the body's cells do not respond properly to insulin. This can be caused by a combination of genetic and environmental factors, such as obesity, lack of physical activity, and family history.
• Complications: Type 2 diabetes mellitus can lead to a variety of serious complications, including heart disease, stroke, kidney failure, nerve damage, and blindness.

Choriocarcinoma

• Definition: A highly malignant tumor that arises from the trophoblastic cells that normally form the placenta.
• Causes: It often develops after a molar pregnancy, but can also occur after a normal pregnancy or miscarriage.
• Pathogenesis: Characterized by rapid growth and metastasis, often spreading to the lungs, brain, and liver.

Yolk Sac Tumor

• Definition: A type of germ cell tumor that originates from the yolk sac, a structure that provides nourishment to the developing embryo.
• Commonly seen in: Ovaries and testes.
• Histologically: It is characterized by the presence of Schiller-Duval bodies, which are glomerulus-like structures.

Teratoma

• Definition: A tumor composed of tissues derived from all three germ layers (ectoderm, mesoderm, and endoderm).
• Types:
  • Mature teratomas: Made up of mature tissues that are organized in a well-differentiated manner.
  • Immature teratomas: Contain immature tissues that may be poorly differentiated.

Malformations Associated with Predominantly Left-to-Right Shunts

• Atrial septal defect (ASD): A hole in the wall between the atria, allowing blood to flow from the left atrium to the right atrium.
• Ventricular septal defect (VSD): A hole in the wall between the ventricles, allowing blood to flow from the left ventricle to the right ventricle.
• Patent ductus arteriosus (PDA): A failure of the ductus arteriosus, a blood vessel connecting the aorta and pulmonary artery, to close after birth.

Well-Established Granulation Tissue with New Blood Vessels and Starting of Collagen Deposition occurs in Evolution of Myocardial Infarction at

• 3-7 days: During the healing phase of MI, granulation tissue begins to form. This is a type of tissue that typically develops in wounds and is characterized by the growth of new blood vessels (angiogenesis) and the production of collagen.

Genotype of -/- a /a with Two Normal Alpha Genes is seen in

• Alpha thalassemia trait: This genotype indicates that an individual is a silent carrier of alpha thalassemia and typically does not have any significant symptoms.

Clara Cells are Seen in

• Bronchiole: Clara cells are found in the bronchioles, small airways in the lungs, and are characterized by their dome-shaped apical surface and secretion of surfactant-like substances.

Lymphocytic Infiltration and Epithelial Injury Involving the Small Interlobular Bile Ducts with Presence of Poorly Formed Epithelioid Cell Granulomas is a Morphological Hallmark of

• Primary biliary cholangitis (PBC): This autoimmune disorder primarily targets the small bile ducts, leading to inflammation and destruction, which can eventually result in cholestasis (stagnation of bile).

Koilocytes are Most Commonly Seen in

• HSIL (High-grade Squamous Intraepithelial Lesion): Koilocytes are abnormal squamous epithelial cells that are commonly seen in cervical intraepithelial neoplasia (CIN) and are a hallmark of human papillomavirus (HPV) infection.

Pathology & Lab Medicine: 5th Semester Examination (Paper I - Pathology)

Long Answer Question: Describe Thrombosis

• Definition: Thrombosis is the formation of a blood clot (thrombus) within the blood vessel lumen, obstructing the flow of blood.
• Causes of primary and secondary hypercoagulable states:
  • Primary hypercoagulable states: Genetic disorders that predispose individuals to clotting such as Factor V Leiden mutation, Prothrombin gene mutation, and protein S deficiency.
  • Secondary hypercoagulable states: Acquired conditions that can increase the risk of clotting such as cancer, pregnancy, and trauma.
• Heparin-induced thrombocytopenia (HIT): A rare but serious complication that can occur in patients receiving heparin, a blood thinner. Antibodies develop against heparin, leading to platelet activation and clotting.
• Morphology of different types of thrombi:
  • Red thrombi: Consist mostly of red blood cells and are typically found in slow-flowing blood.
  • White thrombi: Consist mostly of platelets and fibrin and are usually found in rapidly flowing blood.
  • Mixed thrombi: Contain both red and white components.

Role of Complement in Inflammation

• Complement system: A part of the innate immune system that plays a crucial role in inflammation and host defense against infection.
• Mechanism: Upon activation, the complement system triggers a cascade of enzymatic reactions, leading to the generation of biologically active proteins that:
  • Promote inflammation: Complement activation facilitates the recruitment of inflammatory cells to the site of injury.
  • Enhance opsonization: Complement proteins coat microbes, making them more susceptible to phagocytosis.
  • Directly destroy pathogens: Some complement proteins can directly kill microbes.

Graft-Versus-Host Disease (GVHD)

• Definition: A serious complication that can occur after a bone marrow transplant when the donor's immune cells (graft) attack the recipient's tissues (host).
• Pathogenesis: The immune cells of the graft, particularly T lymphocytes, recognize the recipient's cells as foreign and mount an immune attack against them.
• Manifestations: GVHD can affect various tissues, including the skin, liver, gut, and lungs, causing rash, jaundice, diarrhea, and respiratory distress.

Viral Carcinogenesis

• Mechanism: Some viruses can integrate their genetic material into the host cell genome, disrupting cellular growth regulation and causing uncontrolled cell division.
• Examples:
  • Human papillomavirus (HPV): Infects the epithelial cells of the skin and mucous membranes, causing several cancers including cervical cancer.
  • Hepatitis B virus (HBV) and Hepatitis C virus (HCV): Chronic infection with these viruses can increase the risk of liver cancer.
  • Epstein-Barr virus (EBV): Associated with Burkitt's lymphoma, nasopharyngeal carcinoma, and Hodgkin's lymphoma.

Neuroblastoma

• Definition: A malignant tumor arising from immature nerve cells (neuroblasts) found in the sympathetic nervous system.
• Commonly found in: Adrenal glands, neck, and chest.
• Clinical presentation: Can present with a wide range of symptoms, including abdominal mass, fever, weight loss, and bone pain.

Types of Hypersensitivity Reactions

• Type I (Immediate) hypersensitivity: Antigen-specific IgE antibodies bind to mast cells and basophils. Upon re-exposure, the antigen triggers the release of histamine and other inflammatory mediators, leading to rapid allergic reactions such as anaphylaxis. Example: Allergic reactions to peanuts, pollen, or insect stings.
• Type II (Cytotoxic) hypersensitivity: Antibodies bind to antigens on cell surfaces, leading to cell destruction. Example: Hemolytic anemia, transfusion reactions, and autoimmune hemolytic anemia.
• Type III (Immune Complex) hypersensitivity: Antibodies bind to antigens, forming immune complexes that deposit in tissues, triggering inflammation. Example: Systemic lupus erythematosus (SLE), serum sickness, and post-streptococcal glomerulonephritis.
• Type IV (Delayed) hypersensitivity: T cell-mediated immune response that takes several days to develop. Example: Contact dermatitis, tuberculin reaction, and graft-versus-host disease.

Balanced Reciprocal & Robertsonian Translocation

• Balanced reciprocal translocation: A type of chromosomal rearrangement where two non-homologous chromosomes exchange segments.
• Robertsonian translocation: A special type of translocation where the entire long arms of two acrocentric chromosomes (chromosomes with the centromere near one end) fuse together. This is common in chromosome 13, 14, 15, 21, and 22.

Acute Phase Reactants

• Acute phase reactants: Plasma proteins whose levels increase rapidly in response to inflammation.
• Examples: C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fibrinogen, and amyloid A.
• Significance: These proteins are useful as markers of inflammation and can help in the diagnosis of inflammatory conditions, including infections, autoimmune diseases, and malignancies.

Clinical Manifestation of SLE

• SLE: A chronic autoimmune disease characterized by the production of autoantibodies against various components of the cells and tissues.
• Clinical manifestations:
  • Skin: Butterfly rash (malar rash).
  • Musculoskeletal: Arthritis, joint pain, and myalgia.
  • Renal: Glomerulonephritis.
  • Cardiovascular: Pericarditis, myocarditis.
  • Nervous system: Seizures, psychosis.
  • Hematologic: Anemia, leukopenia, thrombocytopenia.

p53 Mutation

• p53: A tumor suppressor gene that plays a crucial role in regulating cell cycle progression and preventing cancer development. Mutations in the p53 gene are found in a wide range of cancers.
• Consequences: Mutations inactivate the p53 protein, disrupting its ability to regulate cell growth and repair damaged DNA. This can lead to uncontrolled cell division and cancer development.

Pathology & Lab Medicine: 5th Semester Examination (Paper II - Pathology)

Long Answer Question: 4-year-old female in her first trimester of pregnancy with spontaneous bleeding, grape-like vesicles, and elevated serum ß-HCG

• Provisional diagnosis: Hydatidiform mole, a benign tumor of the uterus characterized by abnormal growth and development of the placenta.
• Cytogenetic abnormalities:
  • Partial hydatidiform mole: Usually 69 XXY (or 69 XXX).
  • Complete hydatidiform mole: Usually 46 XX (or 46 XY).
• Differentiating features:
  • Complete hydatidiform mole: Larger vesicles, no fetal parts, and a higher risk of developing choriocarcinoma.
  • Partial hydatidiform mole: Smaller vesicles, some fetal parts, and a lower risk of developing choriocarcinoma.

Medullary Carcinoma of Thyroid

• Definition: A type of thyroid cancer derived from parafollicular C cells.
• Light Microscopy: Tumors often exhibit a "solid" or "trabecular" pattern, with nests and sheets of cancerous cells.
• Immunofluorescence: Medullary thyroid carcinoma cells express calcitonin, which can be detected using specific antibodies.
• Electron Microscopy: Ultrastructurally, the cells contain numerous secretory granules containing calcitonin.

Membranous Nephropathy

• Definition: A kidney disease characterized by thickening of the glomerular basement membrane due to the deposition of immune complexes.
• Light Microscopy: Shows diffuse thickening of the basement membrane with granular deposits.
• Immunofluorescence: Demonstrates granular staining for immunoglobulins (IgG) and complement (C3) along the basement membrane.
• Electron Microscopy: Reveals electron-dense deposits located beneath the epithelial cells and within the basement membrane.

Endometrial Hyperplasia

• Definition: Abnormal growth and proliferation of endometrial cells lining the uterus.
• Causes: Can be caused by an imbalance of estrogen and progesterone.
• Types: Classified based on the degree of atypia, which is the presence of abnormal cells.
• Complications: Endometrial hyperplasia carries a risk of progressing to endometrial cancer.

Paget's Disease of Bone

• Definition: A chronic disorder of bone metabolism that results in excessive bone turnover and remodeling.
• Pathogenesis: Characterized by increased osteoclastic activity (bone resorption) followed by increased osteoblastic activity (bone formation).
• Clinical Manifestations: Bone pain, skeletal deformities, and increased risk of fractures.
• Diagnosis: Based on history, clinical examination, radiographic findings, and bone biopsies.

Molecular Classification of Breast Carcinoma

• Molecular subtypes: Based on the expression of specific genes, breast cancers are classified into molecular subtypes that differ in their biological behavior, prognosis, and response to therapy.
• Examples: Luminal A, Luminal B, HER2-enriched, and Basal-like.

Multiple Endocrine Neoplasm (MEN)

• Definition: A group of genetic disorders characterized by the development of tumors in multiple endocrine glands.
• Types:
  • MEN 1: Parathyroid hyperplasia, pancreatic islet cell tumors, and pituitary tumors.
  • MEN 2A: Medullary thyroid cancer, pheochromocytoma, and parathyroid hyperplasia.
  • MEN 2B: Medullary thyroid cancer, pheochromocytoma, and mucosal neuromas.

Prostate Specific Antigen (PSA)

• Definition: A protein produced by the prostate gland.
• Clinical significance: PSA levels are often elevated in men with prostate cancer.
• Limitations: Elevated PSA levels can also occur in benign conditions such as prostatitis (inflammation of the prostate) and benign prostatic hyperplasia (BPH).

Hypersplenism

• Definition: A syndrome in which the spleen is overactive, leading to an excessive destruction of blood cells.
• Causes: Can be caused by various conditions that affect the spleen, including infections, cirrhosis, portal hypertension, and certain hematologic disorders.
• Manifestations: Hypersplenism can manifest as anemia, thrombocytopenia, and leukopenia due to excessive destruction of red blood cells, platelets, and white blood cells, respectively.

Types of Melanoma

• Melanoma: A type of skin cancer that arises from the melanocytes, pigment-producing cells.
• Types:
  • Superficial spreading melanoma: The most common type, often characterized by a flat, spreading lesion with irregular borders and color variations.
  • Nodular melanoma: A subtype of melanoma that often forms a raised, dome-shaped nodule.
  • Lentigo maligna melanoma: Arises from a preexisting lentigo maligna, which is a flat, pigmented lesion.
  • Acral lentiginous melanoma: Occurs on palms, soles, or under the nails.

Seminoma

• Definition: A malignant tumor of the testes that originates from germ cells.
• Pathogenesis: Seminomas are commonly associated with cryptorchidism (undescended testes).
• Histologically: Seminomas are characterized by large, clear cells arranged in sheets and cords.
• Treatment: Highly curable with radiation therapy or chemotherapy.

Test your knowledge on important medical diagnoses and pathological changes, specifically focusing on conditions such as systemic lupus erythematosus, megaloblastic anemia, and leukemia. This quiz covers key diagnostic criteria, associated syndromes, and typical laboratory investigations in pathology.