Pathology Case Studies: Fibrinoid Necrosis and Metaplasia
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Questions and Answers

What is the affected tissue?

Artery

What is the diagnosis?

Fibrinoid necrosis in an artery

Identify the labelled structures:

1 = Endothelial and inflammatory cells 2 = Pink fibrinous material

Mention two main causes that lead to this condition.

<p>1-Autoimmune diseases, 2-Malignant hypertension</p> Signup and view all the answers

Mention two microscopic features.

<p>1-Circumferential bright pink area of fibrinoid necrosis, 2-Marked/severe inflammation or vasculitis (neutrophils with dark nuclei)</p> Signup and view all the answers

Identify the labelled structures:

<p>1 = Lymphocytes 2 = Blood vessels 3 = Normal cells (normal columnar epithelium) 4 = Squamous Metaplasia</p> Signup and view all the answers

Describe what is seen in the picture.

<p>In the center, focus of squamous metaplasia of endocervix but at the both margin shows the normal columnar epithelium</p> Signup and view all the answers

Is it atypical or not?

<p>False</p> Signup and view all the answers

What is the diagnosis?

<p>Typical squamous metaplasia of endocervix</p> Signup and view all the answers

What is the name of the condition when dysplasia is involved in the full thickness?

<p>Squamous carcinoma in-situ</p> Signup and view all the answers

What is the cause of this condition?

<p>The columnar cells are replaced by squamous cells</p> Signup and view all the answers

Mention the microscopical features seen in the picture.

<ul> <li>Normal columnar epithelium at both margins, - Central focus of squamous metaplasia, - Lymphocytic infiltration</li> </ul> Signup and view all the answers

What is the excised organ that is shown in the gross picture?

<p>Gallbladder</p> Signup and view all the answers

Write one gross feature.

<p>Congestion, redness, thickness of the wall</p> Signup and view all the answers

Give two histopathological features in the histological picture.

<p>Infiltration of many neutrophils in the mucosa of the gallbladder, vascular congestion</p> Signup and view all the answers

What is the diagnosis?

<p>Acute cholecystitis</p> Signup and view all the answers

What is the probable etiology?

<p>Stone obstructed the neck</p> Signup and view all the answers

Identify the structures pointed in figure 1:

<p>Red arrow = Vascular congestion Blue arrow = Neutrophils</p> Signup and view all the answers

What is the type of inflammation here?

<p>Chronic granulomatous inflammation</p> Signup and view all the answers

Identify the cells in the histological picture:

<p>1 = Epithelioid cells 2 = Langhans giant cell</p> Signup and view all the answers

Describe what you see in the gross picture.

<p>Swelling and scarring</p> Signup and view all the answers

What is the diagnosis?

<p>Tuberculous lymphadenitis</p> Signup and view all the answers

What is the type of necrosis if present?

<p>Caseous necrosis</p> Signup and view all the answers

Is the disease caused by a microorganism?

<p>True</p> Signup and view all the answers

What is the causative microorganism?

<p>Mycobacterium tuberculosis</p> Signup and view all the answers

What is the stain used and color (appearance)?

<p>Name: Acid fast bacilli (AFB) stain, Color (appearance): Red or pink color and rods shape</p> Signup and view all the answers

Identify the labelled structures in figure 1:

<p>1 = Melanocytes (nevus cell) 2 = Melanophages</p> Signup and view all the answers

What is the diagnosis?

<p>Intradermal Nevus (Benign)</p> Signup and view all the answers

What is the malignant tumor?

<p>Melanoma</p> Signup and view all the answers

What is the characteristic appearance (features) of the cells in figure 2?

<p>1-The cells are small, round, or spindle-shaped, typically arranged in nests and clusters, 2-Symmetrical (Circumscribed), 3-Has different colors (Pink – Tan – Brown etc)</p> Signup and view all the answers

Give two histopathologic features.

<p>1-Proliferating benign intradermal melanocytes, 2-Nevus cells.</p> Signup and view all the answers

Study Notes

Case #1: Fibrinoid Necrosis in an Artery

  • Affected tissue: Artery
  • Diagnosis: Fibrinoid necrosis in an artery
  • Labelled structures:
    • Endothelial and inflammatory cells
    • Pink fibrinous material
  • Gross features:
    • Circumferential bright pink area of necrosis with inflammation
  • Main causes:
    • Autoimmune diseases
    • Malignant hypertension
  • Microscopic features:
    • Circumferential bright pink area of fibrinoid necrosis
    • Marked/severe inflammation or vasculitis (neutrophils with dark nuclei)

Case #2: Squamous Metaplasia

  • Labelled structures:
    • Lymphocytes
    • Blood vessels
    • Normal cells (normal columnar epithelium)
    • Squamous Metaplasia
  • Description:
    • Central focus of squamous metaplasia of the endocervix with normal columnar epithelium at both margins
  • Atypicality: Typical, just one type of cell replaced by another type (metaplasia not dysplasia)
  • Diagnosis: Typical squamous metaplasia of the endocervix
  • Full-thickness dysplasia: Squamous carcinoma in-situ
  • Invading the basal layer: Malignant tumor
  • Cause: Columnar cells are replaced by squamous cells
  • Microscopical features:
    • Normal columnar epithelium at both margins
    • Central focus of squamous metaplasia
    • Lymphocytic infiltration

Case #3: Acute Cholecystitis

  • Excised organ: Gallbladder
  • Gross feature: Congestion, redness, thickness of the wall
  • Histopathological features:
    • Infiltration of many neutrophils in the mucosa of the gallbladder
    • Vascular congestion
  • Diagnosis: Acute cholecystitis
  • Probable etiology: Stone obstructed the neck
  • Labelled structures:
    • Red arrow: vascular congestion
    • Blue arrow: neutrophils

Case #4: Tuberculous Lymphadenitis

  • Type of inflammation: Chronic granulomatous inflammation
  • Cells in the histological picture:
    • Epithelioid cells
    • Langhans giant cells
  • Gross picture description: Swelling and scarring
  • Diagnosis: Tuberculous lymphadenitis
  • Type of necrosis: Caseous necrosis
  • Cause: Mycobacterium tuberculosis
  • Etiology: Mycobacterium tuberculosis
  • Stain used: Acid-fast bacilli (AFB) stain or Ziehl-Neelsen Stain
  • Color: Red or pink color and rod shape

Case #5: Intradermal Nevus

  • Labelled structures in figure 1:
    • Melanocytes (nevus cell)
    • Melanophages
  • Diagnosis: Intradermal Nevus (Benign)
  • Malignant tumor: Melanoma
  • Characteristic appearance of cells in figure 2:
    • Small, round, or spindle-shaped cells
    • Typically arranged in nests and clusters
    • Symmetrical (Circumscribed)
    • Different colors (Pink – Tan – Brown etc)
  • Histopathologic features:
    • Proliferating benign intradermal melanocytes
    • Nevus cells concentrated in the dermis

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Description

Explore two fascinating pathology cases in this quiz, focusing on fibrinoid necrosis in arteries and squamous metaplasia in the endocervix. Each case delves into the affected tissues, microscopic features, and diagnosis, helping you understand the complexities of pathological changes in tissues.

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