Gross Microscopic

GIT -greasy appearance

Fatty liver Pale yellow discoloration
Causes- alcohol level-
Alcohol -steathosis
Hepatitis -steatohepatitis
Alpha-1antitripsin -cirrhosis
Hemochromatasis
Biliary scirosis
Liver cirrhosis -pale -high parenchyma nodule
-multiple variable sized nodules -loss of normal vascular
-*nodules <3mm(small) -regeneration of new hepatocyte
>3mm(big) -Fibrous septa

Chronic cholecystitis secondary to cholelithiasis
-enlarged gallbladder -Chronic inflammation cells (lymphocyte)
-thick fibrous wall(stone-inflammation-fibrous) -flattened mucosa layer(atrophy)
-ulcerated lumen -invaginated gland to sinus (rutenzki ascoff sinus)
*normal=
- thin wall
-green outside/black outside

Transverse colon carcinoma -obstruction

-cauliflower appearance
-witish,yellowish mass
-dilated(proximal),loss of folding(sebab fluid and
contents of intestine will try to move but cannot
sebab block hence it just dilates)
-narrowed(distal)
colon adenocarcinoma Tumor(onto) obstructing the lumen causing a Infiltrive tumor composed of malignant glands
dilation at the proximal part Must noe dukes criteria ( determined by dept of
invasion)
A Mucosa only
B Mucosa+serosa
C Lymph nodes
D metastasis

Sigmoid colon: villous adenoma with malignant -mass of tumor Infiltriv tumor composed of malignant glands
change -cauliflower like mass projecting in normal
surrounding mucosa
-

RESPI
Lung TB

(sorry I loss focus at the end part T-T)

Mira can u pls add for dis one
Pls and tq =)
CARDIO -pale(Infracted area) -necrosis
AMI -old(with fibrosis –new tissue) No nucleus
Subendocardial infract with hemorrhagic rim in *if new (must be distend) Banyak eosinophils and neutrophils
the upper part Dissolved area
Causes
-atherosclerosis (complete)
-embolism superimposed by thrombus

Aortic atheroma severe Severe atherosclerosis Atheroma( ulceration of intima)

Words from slide: Distorted lumen Foam cells
• Ulceration, rupture or erosion of the Ulcerative intima( fatty streaks) Cholesterol cap
luminal surface of the atheromatous Hyaline cap
plaques Calcification
• Severe aortic atherosclerosis involving
nearly the entire intimal surface with *complication: thromboembolism
ulceration of atheromatous plaques Aneurysm

Aortic atheroma moderate

Words from slide:
• Elevated plaque
• Yellowish atheromatous plaques over
much of its intimal surface
Fatty streak • Multiple, yellow, flat spots <1 mm lipid-filled foam cells
• Elongated fatty streak coalesce into elongated streaks 1 cm or
• Composed of lipid-filled foam cells longer
• Precursors of atheromatous plaques
• Appear in aorta of some children < 1 year
and all children > 10 years

Heart perforated AMI -enlarged heart

Will cause: -ruptured of ventricular wall
 arrhythmia –death -rupture of papillary muscle
 1st week –necrosis-dilation/enlargement
of heart- cardiac tempony-death

REPRO Adenomyosis Adenomyosis

Female genital system -appears like normal myometrium -presence of endometrial gland at myometrium
Leimyoma and adenomyosis -enlarged uterus
Leiomyoma
Leiomyoma
-whitish colored perforation of cell
-well circumscribed
Leiomyomata, sec endometriosis  Identify location -perforation of smooth muscles
-intramural(big onto) -interlacing bundle of smooth muscle fibers
-subserosal small on the side)
 Measuring
-?
 Features
-well circumscribed
-grayish whitish

Leiomyomataous polyps -prolapsed

Leimyoma subserosal
ENDOCRINE -Enlarged thyroid Expected microscopy
Multinodular goiter -Asymmetrical -foam cell
 Cross section -fibrosis
-multinodular -calcification
-variable seized
-nodules separated by fibrous tissue
-brownish +jellylike= colloid
-whitish + nonsolid like = edematous
change

Thyroid follicular adenoma • Solitary, spherical lesion, well defined,

intact capsule
• Intact well-formed capsule encircling the
tumor
X colloid

Thyroid follicular adenoma with b/g of hashimoto

disease
Thyroid papillary carcinoma with LN metastasis • Infiltrative, rarely encapsulate gray –
white, firm
• Foci of calcification / cystic change
• Multifocal lesion
• Papillary projection
• Containing areas of fibrosis and
calcification

Thyroid papillary carcinoma • Papillary (small) • Contents of solid area

• Hemorrhage(black) -papillary (true, got fibrovascular core)
• Cyst change filled with blood -nucleus ( nucleus grove orphan annes
• Solid area eye/ round glass, pseudo inclusion)
-psamoma bodies

BREAST • No necrosis • Proliferation of ducts

Fibroadenoma got from lumpectomy • Well circumscribed • Intracalaniculi
• Gayish,whitsh • Mix tumor
• Size?nanti during exam BAWAK RULER
• Mobile
Breast ductal carcinoma • Yellowish, grayish mass • High n:c ratio
*yellow spot-area of necrosis • Atypical cells
Grading
Grading 1 2 3 Prognostic factor
Tubules 70% <70% - -size
Num of Few Mild Plenty -lymph node status
mitosis -grad
Nucleus Few Mild Severe -hormonal status( estrgn,prgstrn +ve= good)
pleomorfism (estrgn prgstrn –ve = bad)
-crb2
-Stage (early?late?)
-infiltrive or not

1.Reminder

Mobile= breast adenoma

Metastasis = breast ca

*tapi SLIGHT MOBILE =could either be adenoma or ca..must SEE OTHER FEATURES AS WELL

2.Additional info

-how peur de orange devlbd?

Tumor- compression of breast cells-accumulation of fluid-edema-peur de orange

3. steps when in front of specimen

-morphology
-size
-microscopy