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63396 - ИЗПИТНИ препарати Кл.патология
63396 - ИЗПИТНИ препарати Кл.патология
Histopathology
Chronic atrophic gastritis
• The most common inflammatory
disease of the stomach. 2 types –
superficial and profound.
•Microscopic findings :
nflammatory cells infiltrate (Ly,Pl)
in surface or/and in deeper layers of
the mucosa;
40x atrophy of the glands and
replacement with fibroconnective
tissue;
•metaplasia: Intestinal type in
antrum - replacement of foveolar
globet cell epithelium with intestinal mucous
metaplasia Goblet cell and Paneth cells)
Pseudopyloric type (replacement of
the body glandular chief and parietal
cells with mucus neck cells).
PAS 400x
atrophy of the epithelial elementes
Large bowel
carcinoma
The most common malignant tumor of GIT is
adenocarcinoma – high, low and moderatly
differentiated. Irregular “back to back”
atypical glands composed of tall, columnar
cells, with large elongated polymorphic
nuclei with moderately condensed
chromatin. Secundary lumena are seen
100x inside the lumena of glands, due to
necrosis.
400x
Toxic necrosis of the liver
•3 types of necrosis:
• Diffuse: involve
zone 2
almost all the cells in
groups of lobules (in
acute viral hepatitis B
zone 1
and C, or drugs and
40x
toxicity).
• Zonal: centrilobular mostly in
zone 3, ischemic injury; midzonal,
in zone 2,
•Focal: involve small groups
irregulary (drugs, viral, tbc,
fungus).
100x
Cirrhosis of the liver
micronodules • The normal microscopic structure of
the liver is impaired
• Liver parenchyma is organized in
fibrous septa
micronodules, devoid of central
Infiltrates lymphocytic
veins and having fibrous septa
dividing them.
Infiltrates lymphocytic
• Reactive bile duct proliferation in the
septa is present (arrows)
micronodules
• Inflammatory infiltrates
(lymphocytic) might be more or less
prominent
• Tips
• Use magnification 100-200x
Microscopically it is presented by
400x trabecular growth pattern,
composed of cells resembling
hepatocytes with vesicular nuclei,
and prominent nucleoli.
terminal
not involved bronchiole
alveoli
anthracosis
Ddistended
respiratory
Ddistended bronchiole
40x respiratory
bronchiole
• Distension of the respiratory bronchiole in
the centre of lobules.
• Surrounding alveoli are not distanded 400x
• The alveolar walls are thin and stretched.
• Spurs of broken septa are seen.
• Chronic inflammation in terminal spurs of broken septa
bronchioles
Acute lung abscess
• An acute inflammatory
disease of lung.
•Destruction of lung parechyma
with suppurative exudate and
puss bodies in lung cavity.
• Acute inflammation around
cavity initially and later turns
into chronic inflammatory cells
(lymphocytes, plasma cells and
100x macrohages).
400x
Silicosis of the lungs
Silica cristals
40x
40x
400x
Acute bacterial myocarditis
An acute inflammatory disease
of the heart. The findings are
predominated by exudate
composed of neutrophils with
some lymphocytes, plasma cells
and macrophages.
40x
Foci of myocardial damage
(swollen myocardiocytes without
exudate nuclei) are found
After careful examination,
bacterial
colonies
bacterial colonies might be seen .
400x
Chronic pyelonephritis
A chronic inflammatory disease if the kidney. The pathological changes
are predominant in the interstitium of kidney :
1. Chronic interstitial inflammatory
reaction - lymphocytes, plasma cells
and macrophages (some prominent
aggregations of inflammatory cells are
designated with blue arrows) Single
inflammatory cells are evident almost
everywhere in the interstitium (see
small blue dots)
2. The tubules are seen with atrophy
and dilatation, some containing
eosinophilic proteinous casts (known
as thyroidisation of tubules -
designated with green arrows)
3. Glomerular hyalinosis and delicate
400x periglomerular fibrosis (designated
with arrow contours).
Focal diabetic
glomerulosclerosis
Known as Intercapillary nodular
glomerulosclerosis (also called
Kimmellstiel – Willson lesion)
nodular
the glomerulus (see blue arrows).
deposits
The nodules are surrounded by
compressed capillaries and accompanied
by increased mesangial matrix (difficult to
distinguish).
Increased
mesangial
matrix
400x
Subacute glomerulonephritis
Leucocytic infiltration
400x
40x
The light microscopy criteria include:
Presence of “crescents” pattern inside the
Bowman’s capsules of the glomeruli. The
“crescents” are composed of proliferated
polygonal or elongated parietal cells of
Bowman’s capsules.
Proliferation of endothelial and mesangial
cells might be present in the glomerular tufts
. Leucocytic infiltration is present in.
Renal cell carcinoma
• A malignant organ-specific tumor of
kidney, originating from tubular cells.
normal kidney
• The presented case is a clear cell type –
the most common one.
• The tumor cells are with clear cytoplasm
(due to accumulation glycogen and lipids
40x
and removal of them from cytoplasm
during processing of tissues). The cellular
membranes are very well contoured.
• Tumor cells are arranged in several
different paterns - solid, trabecular and
tubular, separated by delicate
vascularised stroma.
use magnification 100-400x
400x
Squamous cell carcinoma of penile
400x
Benign prostatic hyperplasia
Predominantly glandular
100x
Prostatic carcinoma
A malignant tumor of prostatic gland.
(relatively well –differentiated type)
Histological findings :
Architectural changes are presented by:
back-to-back arrangement of the glands
and loss of intra-glandular papillary
convolutions
•Stroma – is invaded, scant, or no
stroma separates the tumor glands
•Pattern of the glands:
Small or medium –sized, lined by single
layer of tumor cells (in well –
differentiated tumors )
100x -Cribriform or fenestrated gland appearance (moderatly–
differentiated tumors) (not this one)
-Solid or trabecular pattern (poorly–differentiated tumors)
(not this one)
•Tumor cells – do not show usual sign
of malignancy May be clear, dark or eosinophilic
CIN (cervical intraepithelial
A premalignant lesion of the neoplasia)
squamous nonkeratinising
epithilium of cervix of the The whole
uterus (PVCU). thickness of the
CIN: The dysplastic epithelium is
abnormalities are: affected (CIN III)
•crowding of cells
•pleomorphism
•high nucleo/cytoplasmic ratio 400x
(1/1)
•hyperchromasia - coarce,
irregular nuclear chromatin
•many mitoses
Koilocytes features :
Nuclear enlargement
Irregularity of the nuclear
membrane contour Koilocytes
Nuclear hyperchromasia , optic 100x
clear area around the nucleus
(perinuclear halo). 400x
Invasive cervical carcinoma
nests of non-
keratinizing
squamous cell
cancer
400x
Benign ovary mucinous
cystadenoma
• On histologic
examination, benign
mucinous tumors are
characterized by a lining
100x
of tall columnar epithelial
cells with apical mucin
and absence of cilia, akin
to benign cervical or
intestinal epithelia.
Tips
use magnification 100-400x
400x
Serous papillary carcinoma of the
ovary
A malignant tumor of the ovaries.
Histological findings :
100x
100x
Simple fibrocystic change of the
breast
Sclerosing Dilation of ducts, adenosis
adenosis (enlargement, and increase in
the number of glands than
Not really?! :/
usual in the terminal ducto-
lobular unit) and fibroses of the
stroma
Mild epithelial hyperplasia in the
terminal ducts may be present (in cases
of proliferate fibrocystic changes). NOT IN
40x THIS CASE!
Apocrine metaplasia is
common in the ducts. It is
found in cystically dilated duct.
Notice the eosinophilic
Apocrine metaplasia epithelium that is covering the
duct.
400x
Invasive NOS (ductal) carcinoma of
the breast
The most common female malignant organ-
specific tumor of the breast, known as
Carcinoma of no special type (NST) or not
otherwise specified (NOS)
Histological findings :
Some larger
tumor nests
100x and glands
Choriocarcinoma
A malignant tumor with origin
from placental villi.
•Absence of identifiable
placental villi
•The parenchyma of the
tumor is presented by masses
and columns of highly
anaplastic and bizarre
40x cytotrophoblastic and
syncytiotrophoblastic cells
which are intermixed.
• Invariable presence of
haemorrhages and necrosis.
•Invasion of the underlying
myometrium and other
structures, blood vessels and
lymphatics can be seen (not
present in this case)
400x
Infant neonatal respiratory distress
syndrome
40x
400x
Chronic myelocytic leukaemia in liver
Histological findings :
Histological findings :
Hyperplastic stage)
•Tall columnar follicular epithelium with papillary infoldings and
formation of new follicles
400x
Toxic goiter in Graves` disease
Histological findings :
Histological findings :
400x
Papillary thyroid cancer
• A malignant tumor
presented by papillary
structure with central
fibrovascular stalks, covered
by single layer of overlaping
columnar tumor cells and
usually accompanied by
normal thyroid follicles.
• Tumor cells: characteristic
nuclear features (dispersed
chromatin imparting it ground
glass or optically clear
appearance – (Orphan Annie eyes).
•Psammoma bodies,
400x concentric and calcified are
found in the stroma.
400x 400x
Tips
100x •Use magnification 100-400x
Neurinoma
A benign tumor of CNS arising from
Schwann cells. The tumor is
composed of fibrocellular bundles
forming whorled pattern. There are
areas of of densely cellularity (Antoni
A pattern), alternated with loose
100x
acellular zones (Antoni B ). Antoni A
pattern show palisaded parallel nuclei
called Verocay bodies.
Tips
use magnification 100-400x
400x
Used literature
1. Kumar, V., Abbas, A.K.
Pathologic Basis of
Disease (Robbins
)
Pathology) 8 Ed.
Saunders, Philadelphia,
2009.
2. MOHAN, H. Textbook of
Pathology 6 Ed. Jaypee
Brothers Medical
Publishers, New Delhi,
2010.