INCLUSION BODIES DISEASE/CONDITION Other things to REMEMBER

Aschoff bodies Rheumatic Fever Caterpillar cells

Anitschkow cells
Mcallman plaques

Auer rods Acute Myelogenous Clumps of azurophilic granular material

(myeloblast inclusion Leukemia that forms elongated needles seen in the
bodies) cytoplasm of leukemic blasts
Myelodysplastic syndrome

Blue pus Pseudomonas a.k.a. Bacillus pyocyanius

Shanghai fever
Pyocyanin: what causes the blue hue

Bunina bodies Lou Gehrig’s disease  Loss of these bunina bodies in the
(Amyotropic Lateral anterior horn cells (small, round,
Sclerosis) eosinophilic, neuronal c ytoplasmic
inclusions)
 Upper and lower motor neuron s/sx
(e.g. tongue fasciculations)
 Too much GLUTAMATE
 Riluzole, the only FDA approved
treatment, but still NO CURE!!!

Cabot rings  Megaloblastic anemia thin, red-violet staining, threadlike strands in

(erythrocyte inclusion  Hemolytic anemia the shape of a “loop or figure-8” found in
bodies)  Lead poisoning erythroc ytes

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 Call-Exner bodies Granulosa cell tumor  Eosinophilic fluid-filled spaces
between granulosal cells;
composed of membrane-packaged
secretion of granulosa cells;
 formation of liquor folliculi

Clue cells Bacterial vaginosis  Squamous epithelium surrounded

with bacteria
 Etiology: Gardnerella vaginalis
 Foul, fishy smelling, thin, grayish
vaginal discharge
 Vaginal pH is ↑ above 4.5 (№: 4.5)
 Test: KOH wet mount/Whiff’s test
 TX: (non-pregnant)
Metronidazole 500mg bid x 7 days
Clindam ycin cream 2% 1 full
applicator intravaginally at bedtime
x 7 days
(pregnant) Metronidazole 250 mg
TID x 7 days

Councilman bodies  Hepatitis Apoptotic hepatocytes

 Yellow fever Acidophilic inclusions

Cowdry A inclusion  Subacute sclerosing

bodies panencephalitis
(SSPE)
 Herpes simplex
virus lesion

Cowdry B bodies Polio

Creola bodies Bronchial asthma  ciliated columnar cells sloughed

from the bronchial mucosa

also found are:

Eosinophils, Curschmann’s spirals,
Charcot-Leyden crystals

Dense core bodies Carcinoid tumor  Seen on EOM

Produce 5HT:serotonin and kallikrein
(converted to bradykinin)
 W heezing, right-sided heart
murmurs, diarrhea, flushing
 If tumor is confined to GIT  no
carcinoid syndrome bec. Liver
metabolizes 5HT

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  MC site: appendix (others: ileum
and rectum)

Donovan bodies Granuloma inguinale  Seen on tissue crust biopsy

 Chronic slowly progressive disease
 Painless vesicle or indurated papule
 ulcer with beefy red granular
base
 Pseudobubo: subcutaneous
involvement
(NOTE: bubo can be seen in H.ducreyi infection/
Chancroid)

Ferruginous bodies Interstitial lung disease occupations such as shipbuilding, brake

suggestive of Asbestosis fluid mechanic, roofing, plumbing, and
construction

Flexner W intersteiner Retinoblastoma  Leukocoria: Amaurotic cat’s eye:

“true” rosettes white reflex
 Spoke and wheel shaped cells
 the rosette lumen shows similar
staining patterns as in rods and
cones, suggesting that FWrosettes
represent a specific form of retinal
differentiation

Gamma Gandy Sickle Cell disease Focal hemorrhages in congestive

bodies splenomegaly
Due to portal hypertension

Gaucher cells Gaucher’s disease “crinkled paper” or “crinkled tissue”

appearance on the smears of liver and
spleen

Guarnieri bodies Small pox  Appear as pink blobs in the

“Pharaoh Rameses” cytoplasm
 B type: site of viral replication: the
only DNA virus that replicates in
the cytoplasm (should be in the
nucleus)

Handerson-Paterson Molluscum contagiosum

bodies

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Heinz bodies Seen in:  inclusions within red blood cells
NADPH deficiency composed of denatured hemoglobin
G6PD deficienc y  Reactive Ox ygen Species
Chronic Liver disease  “Bite cells” in the spleen
Alpha thalassemia

Hirano bodies  Alzheimer’s disease APOLIPOPROTEIN E4 (APOE4)

 Creutzfeldt-Jakob Pre-Senilin I & II
disease  Phosphorylated Tau proteins 
Neurofibrillary tangles
 ß Amyloid proteins; located in
Chromosome 21 senile plaques
(NOTE: common factor between AD and
Down’s syndrome: chromosome 21)
 Hippocampal brain atrophy
 TACRINE: a medicine for AD but
not used anymore
 DOC: Anti-Acetylcholinesterase
Inhibitor (to prevent further
breakdown of the “already-
depleted” levels of Ach)

Homer W right  Neuroblastoma MC extracranial solid cancer of childhood

“pseudorosettes”  Medulloblastoma MC cancer of infants
 Pinealoblastoma MC Adrenal Medulla tumor in children
 Retinoblastoma (NOTE: Pheochromocytoma is the MC adrenal
medulla tumor in adults)
Neuroblastoma crosses the midline of the
abdomen
(NOTE: Wilm’s tumor does not cross the midline)

Howell- Jolly bodies Hereditary spheroc ytosis  red blood cells that are sphere-
shaped, therefore more prone to
hemolysis
 SPECTRIN defect
Test: Osmotic Fragility Test
 Anemia, hyperbilirubinemia,
splenomegaly, hemolytic crisis

Intracytoplasmic owl’s Cytomegalovirus  W ith a predilection towards the

eyes (a mononucleosis-like salivary glands
disease)  Has the ability to remain latent in
the body; usually affects the
immunocompromised, newborn,
organ-transplant patients
 Can cause hydrops fetalis
 a Human herpervirus 5 (HH-5)
 differentiated from Infectious
Mononucleosis through Heterophile
Test (agglutination of sheep’s

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LE Bodies SLE Type III hypersensitivity reaction
(Hematoxylin bodies) In the HLA region of Chromosome 6
Lewy bodies Dementia with Lewy Bodies
Visual hallucinations
Parkinsonism
Fluctuating alertness
Falls
Capgras s yndrome
Lipschutz bodies Herpes zoster
Varicella
Mallory-Denk bodies Alcoholic hepatitis
Alcoholic cirrhosis
W ilson’s disease
Primary Biliary Cirrhosis
Hepatecellular carcinoma
Morbid obesity
Negri bodies Rabies
Organ of Zuckerkandl Extra-adrenal
or carotid body Pheochromocytoma
blood)
 CMV will be (-) agglutination
 Malar rash / Butterfly rash
 Libmann Sack’s endocarditis
 Myalgia, anemia, joint pains, fever,
fatigue
 Class IV: Diffuse Proliferative
Membranous Glomerulonephritis
(with "wire loop" appearance)
(most severe type)
 Bibasilar reticular pattern in the
interstitial lung disease of SLE
 DsDNA
ALPHA SYNUCLEIN Protein
Posterior parietal atrophy
Enlarged hypoccampi
 Intracytoplasmic highly eosinophilic
 made up of intermediate
keratin filament proteins that have
been ubiquinated, or bound by
other proteins such as heat shock
proteins, or p62
 Intracytoplasmic (esp. in the
Ammon’s horn of the
hippocampus)
 Eosinophilic
 Bullet shaped capsid
 Up to 20 years incubation period
 Is a chromaffin body derived from
the neural crest located at the
bifurcation of the aorta at the
origin of the inferior mesenteric
artery (paraaortic)
 Physiological role: homeostatic
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 regulator of blood pressure,
secreting catecholamines into the
fetal circulation
 Pathological role: a common extra-
adrenal source of 10% of cases of
pheochromocytoma

Orphan Annie eye Papillary Thyroid CA Nuclear inclusions with uniform staining,
which appear empty
 MC type of thyroid cancer
 Thyroglobulin as the tumor marker
 May have “snowflake
appearance” in lung metastasis

Lateral Aberrant Thyroid

(a lymph node metastasis)

Owl’s eyes Hodgkin’s lymphoma Reed Sternberg cells: Mirror images

Has five subtypes: the cardinal histologic feature
1. MC: Nodular  Increased risk in patients with
Sclerosing type history of Infectious Mononuclesis
2. Mixed Cellularity caused by EBVirus
3. Lymphoc yte-rich (T-  Lacunar cells (nucleus in an empty
cell infiltrates) hole)
4. Lymphoc yte  RScells express PAX5 and CD15
predominance and CD30, but negative for other B
5. (B-cell infiltrates) and T cell markers and CD45
6. Lymphoc yte depleted
 worst prognosis (NOTE: Giardia lamblia also has prominent
“owl’s eyes”; Inclusion bodies surrounded
by a halo: “owl’s eyes”: Cytomegalovirus)
correlate with the clinical presentation

Pappenheimer bodies Sideroblastic anemia Abnormal granules of iron inside the

(erythrocyte inclusion Hemolytic anemia RBCs; formed by phagosomes that have
bodies) Sickle cell engulfed excessive amounts of iron

Psammoma bodies  Yolk sac tumor Laminar appearance

 Papillary thyroid CA Acellular
 Meningioma Circular
 Ovarian papillary Eosinophilic
serous cystadenoma
 Papillary renal cell
carcinoma

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Rokitansk y-Aschoff Chronic cholecystitis
bodies

Russell bodies
(plasma cell inclusion Multiple m yeloma  Excessive synthesis of
bodies) immunoglobulins, thus distended
endoplasmic reticulum
 Bone pain
 CRAB Tetrad
 Raccoon eyes
 Mott cells
 “Punched out lesions” or “pepper
pot” appearance of the skull
 Bence-Jones proteins
 Uses ß-2Microglobulin and
monoclonal immunoglobulins as
tumor marker

Salt and pepper Pheochromocytoma testing of catecholamines and

chromatin Medullary thyroid cancer metanephrine
(a.k.a. salt and Neuroendocrine tumors
pepper nuclei or
stippled chromatin)

Schiller-Duval bodies Yolk sac tumor eosinophilic hyaline-like globules both

(sp. Testicular cancer in inside and outside the cytoplasm that
children) contain AFP and alpha 1-antitrypsin

Smudge cells Anaplastic large cell/ null cell Bone marrow infiltration of monoclonal B
(basket cells) lymphoma cells
ALK protein t(2:5)

W arthin-Finkeldey Measles  Multi-nucleated giant cells found

cells (although not specific) in different organs in measles
infection
 Associated with reactive lymphatic
proliferation that express CD3, CD4
and OPD4

W eibel-Palade bodies Two major components Von W illebrand disease: usual cause of
stored within W -Pb: common inherited bleeding disorder
Von Willebrand factor
P-selectin Lymphatic endothelial cell markers

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Zebra bodies Niemann-Pick’s disease Membranous cytoplasmic bodies
(Sphingom yelinase
deficienc y) Concentric membranes or stacks of
membranes

Zellballen clusters Pheochromocytoma Polygonal to spindle chief cells exhibiting

neuroendocrine markers admixed with
sustentacular cells expressing S-100