Pathology Flashcards - AAPA Study Guide

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 ____________.

amyloidosis Signup and view all the answers

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

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

What is bronchiectasis characterized by?

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

What are 'lines of Zahn'?

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

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

Pink cytoplasm with distinct cell borders and keratin pearls. Signup and view all the answers

What features characterize Large Cell Neuroendocrine Carcinoma (LCNEC)?

Organoid, nesting patterns, abundant cytoplasm, nuclear pleomorphism. Signup and view all the answers

What does carcinosarcoma of the lung exhibit?

Mixture of carcinomatous and sarcomatous elements. Signup and view all the answers

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

Less cartilaginous stroma with small branching ductules. Signup and view all the answers

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

immunoblasts Signup and view all the answers

What histological findings are associated with herpes simplex virus lymphadenitis?

Well circumscribed necrosis and cells with intranuclear inclusions. Signup and view all the answers

What is Toxoplasmosis caused by?

Common obligate intracellular parasite T. gondii. Signup and view all the answers

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

lupus Signup and view all the answers

What does hemangioma of the lymph node consist of?

Congested capillaries. Signup and view all the answers

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

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

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

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

In Langherhans cell histiocytosis, what is preserved?

Follicular centers. Signup and view all the answers

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

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

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

Proliferation center containing mature lymphocytes. Signup and view all the answers

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

False Signup and view all the answers

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

inflammation Signup and view all the answers

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

Basal layer hyperchromatism. Signup and view all the answers

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

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

What is the histological characteristic of thymoma?

Low magnification with lobulated architecture and cellular lobules. Signup and view all the answers

What type of pattern does a thymic carcinoid exhibit?

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

What features are noted in thymic NET?

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

What histological characteristic is associated with lipoma?

Necrotic adipocytes. 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?

Zona reticularis and Zona fasciulata respectively Signup and view all the answers

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

pT3 Signup and view all the answers

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

pT1 Signup and view all the answers

Which of these tumors arises from within the adrenal gland?

Pheochromocytoma 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?

Echinococcus Signup and view all the answers

What is diffuse oncocytoma of adrenal glands?

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What characterizes pheochromocytoma histologically?

Sheets of cells with uniform nuclei Signup and view all the answers

What disease is characterized by granulomatous inflammation with epithelioid cells?

Crohn's disease Signup and view all the answers

What is condyloma acuminatum?

Genital wart Signup and view all the answers

What is a hallmark of anal canal adenocarcinoma?

Pagetoid spread Signup and view all the answers

What characterizes basal cell carcinoma of the perianal area?

Cell clusters with peripheral palisading of nuclei 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?

Pulmonary counterpart 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?

Acute appendicitis Signup and view all the answers

What histological feature is associated with Measles?

Marked lymphoid hyperplasia 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?

Bland eosinophilic spindle cell tumor Signup and view all the answers

What is the characteristic architecture of LAMN?

Villous architecture 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?

Eggs in ureter 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?

Malakoplakia 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?

Increased osteoclastic and osteoblastic activity Signup and view all the answers

What is characteristic of osteosarcoma?

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What describes osteoblastoma histology?

Anastomosing trabeculae of osteoid and woven bone Signup and view all the answers

What characterizes chondrosarcoma histologically?

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What is seen in angiosarcoma?

Obvious atypia of tumor cells 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?

Coarsely granular cytoplasm and horseshoe shaped nucleus Signup and view all the answers

What characterizes monocytes?

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What does Howell-Jolly bodies indicate?

Multiples of basophilic particles in erythrocytes Signup and view all the answers

What histological finding is associated with CMV infection?

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What is Gaucher disease?

An autosomal recessive disease due to accumulation of glucocerebroside 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?

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

What does fibrocystic change feature?

Low power stellate configuration Signup and view all the answers

What characterizes a fibroadenoma?

Most common benign tumor of the female breast Signup and view all the answers

What is a key feature of phyllodes tumor?

Leaf-like epithelial pattern Signup and view all the answers

What is a pleomorphic adenoma?

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

What does LCIS involve?

Filling and expanding acini of terminal duct lobular unit Signup and view all the answers

What defines DCIS?

Intraductal epithelial proliferation with low grade nuclear atypia Signup and view all the answers

What characterizes Paget disease of the breast?

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What is BRAC1 carcinoma?

Invasive carcinoma with high nuclear grade Signup and view all the answers

What does BRAC2 carcinoma usually show?

Features of high-grade invasive ductal carcinoma Signup and view all the answers

What characterizes squamous metaplasia of the cervix?

Discernible interface between two types of epithelium 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?

Thiamine deficiency Signup and view all the answers

What is bronchial atresia?

Bronchioles plugged by mucus Signup and view all the answers

What condition is indicated by ferruginous bodies in the lungs?

Asbestosis Pneumoconiosis Signup and view all the answers

What is seen in Coal Worker's Pneumoconiosis?

Anthracotic pigment Signup and view all the answers

What characterizes silicosis?

Silicotic nodules within lung parenchyma Signup and view all the answers

What features of panacinar emphysema?

Airspace enlargement and fragmented alveolar walls Signup and view all the answers

What histological feature is indicative of tuberculosis?

Caseating granulomas 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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Test your knowledge on key concepts in pathology with these flashcards covering adrenal gland structures, pheochromocytoma characteristics, and zonal anatomy. Perfect for AAPA exam preparation.