Pathology Flashcards - AAPA Study Guide
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Questions and Answers

What is the definition of Aspergillosis?

Dichotomous branching, hyphae with frequent septation, diameter ranges from 2.5 to 4.5 μm.

What characterizes Mucormycosis?

Large, nonsepta hyphae with 90-degree angle branching and nonparallel walls.

Bronchoalveolar lavage showing larval forms of ___________________ in a background of many hemosiderin laden macrophages.

Strongyloides

Transbronchial biopsy showing an intrapulmonary vessel surrounded by pink amorphous material indicates ____________.

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

What does the term 'Diffuse alveolar damage (DAD)' refer to?

<p>Organizing to fibrotic phase; clinical manifestation: ARDS.</p> Signup and view all the answers

What is bronchiectasis characterized by?

<p>Residual epithelium with necrotizing inflammation, bronchial destruction, and recurrent infection.</p> Signup and view all the answers

What are 'lines of Zahn'?

<p>Interdigitating areas of pale pink and red that form a thrombus.</p> Signup and view all the answers

What is the characteristic histology of squamous cell carcinoma of the lung?

<p>Pink cytoplasm with distinct cell borders and keratin pearls.</p> Signup and view all the answers

What features characterize Large Cell Neuroendocrine Carcinoma (LCNEC)?

<p>Organoid, nesting patterns, abundant cytoplasm, nuclear pleomorphism.</p> Signup and view all the answers

What does carcinosarcoma of the lung exhibit?

<p>Mixture of carcinomatous and sarcomatous elements.</p> Signup and view all the answers

What histological feature is noted in pleomorphic adenoma of the lung?

<p>Less cartilaginous stroma with small branching ductules.</p> Signup and view all the answers

Partial architectural effacement is due to infiltration by ____________ caused by Epstein-Barr virus.

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

What histological findings are associated with herpes simplex virus lymphadenitis?

<p>Well circumscribed necrosis and cells with intranuclear inclusions.</p> Signup and view all the answers

What is Toxoplasmosis caused by?

<p>Common obligate intracellular parasite T. gondii.</p> Signup and view all the answers

Systemic erythematosus lupus of LN shows necrosis of lymph node parenchyma with many ____________ patients having cervical lymphadenopathy.

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

What does hemangioma of the lymph node consist of?

<p>Congested capillaries.</p> Signup and view all the answers

What characterizes Kaposi sarcoma (KS) of the lymph node?

<p>Curved fascicles of spindle cells with extravasated red blood cells.</p> Signup and view all the answers

What does Acute Lymphoblastic Leukemia (ALL) exhibit in lymph nodes?

<p>T lymphoblasts in lymph node; starry sky pattern.</p> Signup and view all the answers

In Langherhans cell histiocytosis, what is preserved?

<p>Follicular centers.</p> Signup and view all the answers

What is a defining characteristic of Hereditary Spherocytosis (HS)?

<p>Small red blood cells that lack a central zone of pallor, known as spherocytes.</p> Signup and view all the answers

What does Chronic Lymphocytic Leukemia (CLL) show in lymph nodes?

<p>Proliferation center containing mature lymphocytes.</p> Signup and view all the answers

Reed-Sternberg cells in Classic Hodgkin Lymphoma must have less than 2 nucleoli in separate nuclear lobes.

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

When inflamed, a dentigerous cyst appears microscopically as a nonspecific, squamous epithelial lined cyst with acute and chronic ____________.

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

What is the most conspicuous microscopic feature of Odontogenic Keratocyst (OKC)?

<p>Basal layer hyperchromatism.</p> Signup and view all the answers

What is seen in the cyst lining of a dermoid cyst of mandible and maxilla?

<p>Orthokeratotic stratified squamous epithelium, sebaceous glands, and eccrine sweat glands.</p> Signup and view all the answers

What is the histological characteristic of thymoma?

<p>Low magnification with lobulated architecture and cellular lobules.</p> Signup and view all the answers

What type of pattern does a thymic carcinoid exhibit?

<p>Organoid pattern with islands, ribbons, and rosettes of small round cells.</p> Signup and view all the answers

What features are noted in thymic NET?

<p>Larger cells with more cytoplasm than small cell carcinoma.</p> Signup and view all the answers

What histological characteristic is associated with lipoma?

<p>Necrotic adipocytes.</p> Signup and view all the answers

What is the definition of a normal adrenal gland?

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What is cellular spindling of pheochromocytoma?

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What does pT3 invasion of kidney by pheochromocytoma indicate?

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What is the significance of the Zona fasciulata and Zona glomerulosa in adrenal glands?

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What do the top half of the picture and bottom half of the picture represent?

<p>Zona reticularis and Zona fasciulata respectively</p> Signup and view all the answers

Which is the correct pT for adrenal cortical carcinoma with extra-adrenal adipose invasion?

<p>pT3</p> Signup and view all the answers

What is the classification for a pheochromocytoma that is 3 cm and confined to the adrenal gland?

<p>pT1</p> Signup and view all the answers

Which of these tumors arises from within the adrenal gland?

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

What does Beckwith-Wiedemann syndrome represent in adrenal pathology?

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What is the most common cause of adrenal parasitic cysts?

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

What is diffuse oncocytoma of adrenal glands?

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What characterizes pheochromocytoma histologically?

<p>Sheets of cells with uniform nuclei</p> Signup and view all the answers

What disease is characterized by granulomatous inflammation with epithelioid cells?

<p>Crohn's disease</p> Signup and view all the answers

What is condyloma acuminatum?

<p>Genital wart</p> Signup and view all the answers

What is a hallmark of anal canal adenocarcinoma?

<p>Pagetoid spread</p> Signup and view all the answers

What characterizes basal cell carcinoma of the perianal area?

<p>Cell clusters with peripheral palisading of nuclei</p> Signup and view all the answers

What are the histological characteristics of secondary anal Paget disease with associated adenocarcinoma?

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What does small cell carcinoma of the anus resemble?

<p>Pulmonary counterpart</p> Signup and view all the answers

What is the prognosis for anal squamous cell carcinoma?

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What are the histological features of melanoma of the perianal area?

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What condition is characterized by marked neutrophilic infiltrates?

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

What histological feature is associated with Measles?

<p>Marked lymphoid hyperplasia</p> Signup and view all the answers

What is signet ring cell carcinoma of the appendix?

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What is a GIST of the appendix?

<p>Bland eosinophilic spindle cell tumor</p> Signup and view all the answers

What is the characteristic architecture of LAMN?

<p>Villous architecture</p> Signup and view all the answers

What does a urachal cyst look like histologically?

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What are the histological features of cystitis cystica?

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What are cystitis glandularis characteristics?

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What is schistosomiasis and its histological finding?

<p>Eggs in ureter</p> Signup and view all the answers

What is intestinal metaplasia of the bladder?

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What condition is characterized by Michealis-Gutmann bodies?

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

What is characteristic of urothelial carcinoma?

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What are the features of SCC of the bladder?

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What characterizes paraganglioma of the bladder histologically?

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What is noted in acute bacterial osteomyelitis?

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What is the histological finding in rheumatoid arthritis?

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What are diagnostic features of Paget disease?

<p>Increased osteoclastic and osteoblastic activity</p> Signup and view all the answers

What is characteristic of osteosarcoma?

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What describes osteoblastoma histology?

<p>Anastomosing trabeculae of osteoid and woven bone</p> Signup and view all the answers

What characterizes chondrosarcoma histologically?

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What is seen in angiosarcoma?

<p>Obvious atypia of tumor cells</p> Signup and view all the answers

What are the characteristics of Ewing sarcoma?

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What peculiar feature helps diagnose acute myelogenous leukemia?

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What defines Polycythemia Vera?

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What is a key feature of basophils?

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What defines eosinophils?

<p>Coarsely granular cytoplasm and horseshoe shaped nucleus</p> Signup and view all the answers

What characterizes monocytes?

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What does Howell-Jolly bodies indicate?

<p>Multiples of basophilic particles in erythrocytes</p> Signup and view all the answers

What histological finding is associated with CMV infection?

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What is Gaucher disease?

<p>An autosomal recessive disease due to accumulation of glucocerebroside</p> Signup and view all the answers

What characterizes fat necrosis of breast tissue?

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Which statement is true about proliferative fibrocystic changes in the breast?

<p>Proliferative fibrocystic change has an associated 1.5 - 2 fold increased lifetime risk of breast cancer</p> Signup and view all the answers

What does fibrocystic change feature?

<p>Low power stellate configuration</p> Signup and view all the answers

What characterizes a fibroadenoma?

<p>Most common benign tumor of the female breast</p> Signup and view all the answers

What is a key feature of phyllodes tumor?

<p>Leaf-like epithelial pattern</p> Signup and view all the answers

What is a pleomorphic adenoma?

<p>Architecture includes tubules and sheets lined by two types of cells</p> Signup and view all the answers

What does LCIS involve?

<p>Filling and expanding acini of terminal duct lobular unit</p> Signup and view all the answers

What defines DCIS?

<p>Intraductal epithelial proliferation with low grade nuclear atypia</p> Signup and view all the answers

What characterizes Paget disease of the breast?

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What is BRAC1 carcinoma?

<p>Invasive carcinoma with high nuclear grade</p> Signup and view all the answers

What does BRAC2 carcinoma usually show?

<p>Features of high-grade invasive ductal carcinoma</p> Signup and view all the answers

What characterizes squamous metaplasia of the cervix?

<p>Discernible interface between two types of epithelium</p> Signup and view all the answers

What are the features of SCC of the cervix?

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What are the histological features of adenocarcinoma of the cervix?

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What leads to Wernicke-Korsakoff syndrome?

<p>Thiamine deficiency</p> Signup and view all the answers

What is bronchial atresia?

<p>Bronchioles plugged by mucus</p> Signup and view all the answers

What condition is indicated by ferruginous bodies in the lungs?

<p>Asbestosis Pneumoconiosis</p> Signup and view all the answers

What is seen in Coal Worker's Pneumoconiosis?

<p>Anthracotic pigment</p> Signup and view all the answers

What characterizes silicosis?

<p>Silicotic nodules within lung parenchyma</p> Signup and view all the answers

What features of panacinar emphysema?

<p>Airspace enlargement and fragmented alveolar walls</p> Signup and view all the answers

What histological feature is indicative of tuberculosis?

<p>Caseating granulomas</p> Signup and view all the answers

Study Notes

Normal Adrenal Gland

  • Adrenal glands are essential for hormone production and stress response.
  • Structure includes three main zones: zona glomerulosa, zona fasciculata, and zona reticularis.

Cellular Spindling of Pheochromocytoma

  • Characteristic histological appearance indicating the growth pattern of pheochromocytoma.
  • Contains uniform nuclei in cell sheets, commonly associated with adrenal tumors.

Pheochromocytoma and pT3 Kidney Invasion

  • pT3 classification indicates invasion beyond the adrenal gland into adjacent structures, such as the kidney.
  • Important for staging and treatment planning in adrenal tumors.

Adrenal Cortex Zones Identification

  • Top half of the image is labeled as zona fasciculata, responsible for cortisol production.
  • Bottom half is zona glomerulosa, which produces aldosterone.

Adrenal Cortex Zones Identification II

  • Top half of the image is zona reticularis, which produces androgens.
  • Bottom half remains zona fasciculata.

Adrenal Cortical Carcinoma Staging

  • pT3 indicates invasion into extra-adrenal adipose tissue, not adjacent organs.
  • Distinctions: pT1 (organ confined ≤ 5 cm), pT2 (> 5 cm), pT4 (invasiveness into adjacent organs).

Classification of Pheochromocytoma

  • pT1 classification for tumors < 5 cm confined to the adrenal gland.
  • Relevant for prognosis and treatment choices.

Origin of Pheochromocytoma

  • Pheochromocytoma arises specifically from adrenal gland tissue, distinguishing it from other paragangliomas.

Beckwith-Wiedemann Syndrome

  • Adrenal cytomegaly with large bizarre nuclei indicative of fetal cortex findings.
  • Associated with various embryonic tissue growths and congenital abnormalities.

Common Cause of Adrenal Parasitic Cysts

  • Echinococcus granulosus identified as the most common causative agent of adrenal cysts.
  • Other parasites like Taenia solium affect different tissues (muscle/brain).

Oncocytoma Characteristics

  • Composed of polygonal oncocytes with granular eosinophilic cytoplasm.
  • Usually benign but relevant for differential diagnosis of adrenal lesions.

Crohn's Disease Features

  • Characterized by granulomatous inflammation and presence of giant cells.
  • Involves significant lymphocyte infiltration.

Condyloma Acuminatum

  • Genital warts are noted for parakeratosis and koilocytic changes, linked to HPV infection.

Anal Canal Adenocarcinoma

  • Notable for pagetoid spread, indicating invasive characteristics and associated malignancies.

Basal Cell Carcinoma in Perianal Area

  • Exhibits peripheral palisading of nuclei, a histological hallmark of basal cell carcinoma.

Secondary Anal Paget Disease

  • Defined by pale staining intraepidermal neoplastic cells with abundant mucin.

Small Cell Carcinoma of Anus

  • Poorly differentiated neuroendocrine tumors presented as nests of small cells.
  • Similar morphology to pulmonary small cell carcinoma.

Squamous Cell Carcinoma (SCC) of Anus

  • Can be keratinizing or nonkeratinizing; keratinizing is more common below the dentate line.

Melanoma of Perianal Area

  • Appears similar to hemorrhoidal lesions but contains pigmented epithelioid or spindle cells.
  • Describes junctional components in typical presentations.

Acute Appendicitis

  • Identified by marked neutrophilic infiltration as a key histological feature.

Measles Pathology

  • Present with marked lymphoid hyperplasia and multinucleated giant cells in lymphoid tissue.

Signet Ring Cell Carcinoma of Appendix

  • Infiltrative carcinoma typically metastasizing to ovaries, characterized by signet ring morphology.

GIST of Appendix

  • Bland spindle cell tumor with extracellular collagen globules; often expands the appendiceal wall.

Low-Grade Appendiceal Mucinous Neoplasm (LAMN)

  • Occurs mainly in older adults, correlates with dilated appendix and luminal mucin presence.

Urachal Cyst Characteristics

  • Cystic structures lined by benign urothelium, indicative of urachal anomalies.

Cystitis Cystica

  • Identified by superficial nests of urothelial mucosa exhibiting cystic changes.

Cystitis Glandularis

  • Nests of urothelium associated with columnar cells and calcium oxalate crystals.

Schistosomiasis Pathology

  • Presence of schistosomiasis eggs with significant inflammatory reactions within the bladder.

Intestinal Metaplasia of Bladder

  • Shows a transition to intestinal-type mucosa among typical urothelium.

Malakoplakia

  • Characterized by the presence of Michaelis-Gutmann bodies, indicative of chronic infection or inflammation.

Urothelial Carcinoma Features

  • High-grade lesions frequently show areas of squamous differentiation and bizarre nuclear pleomorphism.

Squamous Cell Carcinoma of Bladder

  • Exhibits irregular sheets of malignant squamous cells with destructive stromal invasion.

Paraganglioma of Bladder

  • Zellballen formation with abundant eosinophilic granular cytoplasm typical of neuroendocrine tumors.

Acute Bacterial Osteomyelitis

  • Histological presence of neutrophils, lymphocytes, and plasma cells indicating infection.

Rheumatoid Arthritis

  • Characterized by dense perivascular infiltrates of T lymphocytes and plasma cells.

Paget Disease

  • Increased osteoclastic and osteoblastic activity with typical radiologic findings.

Osteosarcoma Features

  • Notable for permeative growth patterns and disorganized woven bone formation.

Osteoblastoma Characteristics

  • Defined by anastomosing trabeculae of bone lined by active osteoblasts.

Chondrosarcoma Presentation

  • Atypical cellular clustering amidst a cartilaginous matrix.

Angiosarcoma Characteristics

  • Displays high cellular atypia with necrosis and significant mitotic activity.

Ewing Sarcoma Histology

  • Small, round, uniform cells with scant cytoplasm and indistinct membranes.

Acute Myelogenous Leukemia

  • Presents with increased cytoplasmic granularity and Auer rods in affected leukocytes.

Polycythemia Vera (PV) Features

  • Hypercellularity with predominant erythroid and megakaryocytic lineages.

Basophil Characteristics

  • Smaller than other leukocytes, with a distinctive unsegmented nucleus and blue granules.

Eosinophil Features

  • Characterized by horseshoe-shaped nuclei surrounded by refractile orange granules.

Monocyte Description

  • The largest leukocyte, typically round with pseudopod-like extensions and abundant light blue cytoplasm.

Howell-Jolly Bodies

  • Basophilic particles in erythrocytes indicate megaloblastic anemia or abnormal erythropoiesis.

CMV Pathology

  • Presents with characteristic nuclear inclusions and overlaps clinically with EBV.

Gaucher Disease Overview

  • Autosomal recessive disorder showing accumulation of glucocerebroside in histiocytes.

Fat Necrosis of Breast Tissue

  • Associated with traumatic injury or surgical procedures leading to necrotic adipose changes.

Proliferative Fibrocystic Changes

  • Associated with a 1.5 - 2 fold increased lifetime risk of breast cancer.

Complex Sclerosing Lesion Features

  • Stellate configuration with central fibrosis and ducts radiating outwards.

Fibroadenoma

  • Most common benign breast tumor characterized by biphasic proliferation of stroma and glandular epithelium.

Phyllodes Tumor

  • Displays a leaf-like pattern due to exaggerated intracanalicular growth.

Pleomorphic Adenoma Description

  • Contains diverse structures, lined by inner epithelial cells and outer myoepithelial cells.

Lobular Carcinoma In Situ (LCIS)

  • Involves terminal duct lobular units with loosely cohesive cell patterns.

Ductal Carcinoma In Situ (DCIS)

  • Characterized by intraductal proliferation with low-grade nuclear atypia and cribriform patterns.

Paget Disease of the Breast

  • Involves neoplastic cells within the epidermis, indicative of underlying ductal carcinoma.

BRCA1 Carcinoma

  • High nuclear grade cells with minimal gland formation, indicative of aggressive breast cancer type.

BRCA2 Carcinoma

  • Typically presents as invasive ductal carcinoma with high-grade features and pushing margins.

Squamous Metaplasia of Cervix

  • Noteworthy cytological changes at the interface of squamous epithelium and metaplastic cells.

Cervical Squamous Cell Carcinoma

  • Poorly differentiated neoplastic nests surround benign endocervical glands, indicating invasion.

Adenocarcinoma of Cervix

  • Characterized by columnar cells with mucin-depleted cytoplasm and brisk mitotic activity.

Wernicke-Korsakoff Syndrome Mechanism

  • Thiamine deficiency impacting enzymatic functions essential for neuronal health.

Bronchial Atresia

  • Congenital anomaly characterized by mucus plug in bronchi, leading to peripheral obstruction.

Asbestosis Pneumoconiosis

  • Presence of ferruginous bodies within lung tissue represents asbestos-related pathology.

Coal Worker’s Pneumoconiosis

  • Accumulation of anthracotic pigment causing fibrogenic responses leading to lung disease.

Silicosis

  • Silicotic nodules in pulmonary tissue### Thrombus Formation
  • Layers of red cells, platelets, and fibrin accumulate in vessels during thrombus development.

Squamous Cell Carcinoma of Lung

  • Characterized by pink cytoplasm, distinct cell borders, and keratin pearls.

Large Cell Neuroendocrine Carcinoma (LCNEC)

  • Exhibits organoid, nesting, palisading, trabecular, solid patterns, and rosette-like structures.
  • Features abundant cytoplasm, coarse chromatin, nuclear pleomorphism, and prominent nucleoli.

Carcinosarcoma of Lung

  • Comprises both carcinomatous and sarcomatous elements.
  • Typically has a squamous carcinoma component, though glandular or neuroendocrine components may also appear.

Pleomorphic Adenoma of Lung

  • Contains less cartilaginous stroma compared to its salivary gland counterpart.
  • Features small branching ductules and nests, tubules, and trabeculae.
  • Composed of round or oval epithelial cells and myoepithelial cells within chondromyxoid or fibromyxoid stroma, often with focal hyalinization.

Epstein-Barr Virus (EBV)

  • Causes partial architectural effacement in lymph nodes due to extensive immunoblast infiltration, resembling Reed-Sternberg cells with atypical features.

Herpes Simplex Virus Lymphadenitis

  • Associated with well-circumscribed necrosis and hyperplasia in follicular and paracortical areas.
  • Characterized by intranuclear inclusions, especially at the edges of necrotic zones.

Toxoplasmosis

  • Caused by the obligate intracellular parasite T. gondii.
  • Can be asymptomatic, cause lymphadenitis, or lead to acute infections during pregnancy, affecting the fetus.
  • Marked by follicular hyperplasia with frequent mitotic figures and epithelioid granulomas with indistinct margins.

Systemic Erythematosus Lupus of Lymph Nodes

  • Features necrosis of lymph node parenchyma, debris, ghost cells, and characteristic purple lumpy confluent hematoxylin bodies at necrotic edges.
  • Most patients present with cervical lymphadenopathy.

Hemangioma of Lymph Node

  • Characterized by congested capillaries.
  • May present as discrete mass lesions, classified as capillary or cavernous.

Kaposi Sarcoma (KS) of the Lymph Node

  • Resembles skin tumors, presenting with spindle cells in curved fascicles and slit-like vascular spaces.
  • Displays extravasated red blood cells and frequent mitotic figures; spindle cells have pale cytoplasm and elongated nuclei.

Acute Lymphoblastic Leukemia (ALL)

  • Identified by T lymphoblasts producing a "starry sky" pattern in neck lymph nodes.

Langerhans Cell Histiocytosis

  • Partial effacement of lymph nodes occurs while preserving follicular centers.
  • Infiltration by Langerhans cells, characterized by size (12-15 microns), abundant pale eosinophilic cytoplasm, and irregular nuclei.

Hereditary Spherocytosis (HS)

  • Identified by small RBCs lacking a central zone of pallor, known as spherocytes.

Chronic Lymphocytic Leukemia (CLL)

  • Depicted in H&E stained slides showing proliferations of mature lymphocytes, including larger lymphocytes with enlarged central nucleoli.

Classic Hodgkin Lymphoma

  • Diagnostically relies on the presence of Reed-Sternberg cells, which feature at least two nucleoli in separate nuclear lobes.

Dentigerous Cyst

  • Appears as a nonspecific squamous epithelial lined cyst with acute and chronic inflammation when inflamed.
  • Also known as a follicular cyst.

Odontogenic Keratocyst (OKC)

  • Distinguished by prominent basal layer hyperchromatism.

Dermoid Cyst of Mandible and Maxilla

  • Lined with orthokeratotic stratified squamous epithelium and contains sebaceous glands, eccrine sweat glands, and variable hair follicles.
  • Cyst contents typically include keratin flakes, cholesterol clefts, hair, nails, and necrotic debris.

Thymoma

  • Displays lobulated architecture with cellular lobules and fibrous bands.
  • Classified as a malignant epithelial tumor of the thymic gland.

Thymic Carcinoid

  • Features an organoid structure with small round cells forming islands, ribbons, and rosettes.
  • Minimal cytoplasm, salt and pepper chromatin, with no or rare mitotic activity.

Thymic Neuroendocrine Tumor (NET)

  • Composed of larger cells with abundant cytoplasm, displaying an organoid growth pattern and spindle cell foci.

Lipoma

  • Characterized by necrotic adipocytes.

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