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31 Cards in this Set
- Front
- Back
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name the type of biopsies |
needle biospsy endoscopic biopsy incisional biopsy resection specimen |
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types of cytology |
Exfoliative cytology – cells shed, scraped, or brushed off an epithelial surface Fluid cytology – cells withdrawn from fluid in which they are suspended Washing cytology – cells flushed out of organ using an irritating fluid Fine-needle aspiration cytology – cells sucked out of solid tissue using thin needle and syringe |
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Themost important fixative agents in pathomorphology |
Formalin Ethyl acohol Gultar aldehyde Osmium tetroxide |
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types of stains |
H&E o Van Gieson’s – connective tissue=red and everything else=yellow o Azan – nuclei, RBCs, fibrin, fibrinoid, acidophilic cytoplasm=red and everything=blue o Congo red – amyloid=red o Prussian blue – blue=hemosiderin (iron) o Silver stain – nerve fibers, reticulum fibers, and bacteria o Papanicalaou – mult counterstaining dyes, imp in cancer screening |
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Cellular response to pathological stimuli |
Adaptation – increased or decreased activity, alteration in morphology o Acute cell injury – reversible and irreversible (including cell death) o Intra- and extracellular accumulation |
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Morphology of reversible cell injury |
2 patterns: o Cellular swelling – loss of func of ion pumps => cell incapable of maintaining ionic and fluid homeostasis o Fatty change – occurs in hypoxic injury and various forms of toxic or metabolic injury Encountered in cells involved in and dependent on fat metabolism |
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Morphology of irreversible cell injury |
• Associated with extensive damage to all cellular membranes, swelling of lysosomes, and vacuolization of mitochondria => continuedloss of proteins, coenzymes, and RNA• Nuclear changes: o Karyolysis – basophilia of chromatin fades, reflecting DNAase activity o Pyknosis – nuclear shrinkage & increased basophilia – DNA condenses into solid basophilic mass Also seen in apoptosis o Karyorrhexis – pyknotic or partially pyknotic nucleus undergoes fragmentation cytoplasm looks vacuolated and moth eaten |
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2 characteristics of irreversibility |
Inability to reverse mitochondrial dysfunco Development of profound disturbances in membrane func |
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what results from malfunction of sodium-potassium pump with accumulation of sodium ions within the cel |
hydropic swelling |
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Cellular swelling (or cloudy swelling) may occur due to cellular hypoxia, which damages the sodium-potassium membrane pump; it is reversible when the cause is eliminated |
Cellular swelling is the first manifestation of almost all forms of injury to cells. When it affects many cells in an organ, it causes some pallor, increased turgor, and increase in weight of the organ. On microscopic examination, small clear vacuoles may be seen within the cytoplasm; these represent distended and pinched-off segments of the endoplasmic reticulum. |
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The ultrastructural changes of reversible cell injury include: |
Blebbing• Blunting• distortion of microvilli• loosening of intercellular attachments• mitochondrial changes• dilation of the endoplasmic reticulum |
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what stain do you use for lipids when on a parafin block |
sudan/oil red |
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causes of fatty liver |
alcoholsin DM Poison |
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intracellular protein accumulations |
o hyaline droplet degeneration – renal proximal tubule in renal diseases associated with proteinuria microscopic feat: small, eosinophilic dropletso alcoholic hyaline – aka Mallory bodies – eosinophilic intracytoplasmic accumulation in liver cells characteristic of alcoholic liverdisease accumulation of keratin intermediate filaments microscopic feat: irregular eosinophilic networko Cornil cells – rhinoscleroma and nonspecific chronic inflammations accumulation of immunoglobulins in ER microscopic feat: homogenous eosinophilic inclusion => Russel body after cell dies (made up only of immunoglobulins)o inclusions in AAT deficiency – genetic disorder in which -1-antitrypsin (AAT) accumulates in ER of hepatocytes microscopic feat: mult esosinophilic globular inclusionso keratinic – occurs in stratified squamous epithelium hyperkeratosis – hyperplasia of stratum corneatum parakeratosis – retention of nuclei in stratum corneum dyskeratosis – keratinization of cells below stratum granulosum hetertropic keratinization – keratinization of mucous membranes |
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extracellualar protein accumulations |
collagen – excessive collagen synthesis or defect in collagen synthesis quantitative (fibrosis) – chronic inflammations, fibrous atrophy, scleroderma qualitative – Ehlers-Danlos syndromeo hyaline change – associated with impregnation of stroma by unknown protein seen in old age or secondary to other pathologic processes observed in old scars, walls of arterioles, and kidney in HTN and DM• kidney: in glomeruli, can only observe pink homogenous material without any spaces• arteries: walls of blood vessels, also homogenous pink gross feat: white firm irregular areas in splenic capsule microscopic feat: H&E stain – homogenous eosinophilic masso amyloidosis – accumulation of special kind of complex protein (amyloid) composed of fibrillar protein and P component heterogenous disease found in mult myeloma, chronic renal failure, and Alzheimer’s occurs in: liver, spleen, kidneys, GI, adrenals, lymph, heart, thyroid, and pancreas gross feat: enlargement of organs and firm waxy appearance microscopic feat: H&E – homogenous eosinophilic glassy masso fibrinoid degeneration/necrosis – accumulation of amorphous protein material (fibrinoid = fibrin, IgG, IgM, acid aminoglycans, C3,amino acids) found in connective tissue and walls or arteries and arterioles in systemic connective tissue disorders microscopic feat: H&E – homogenous eosinophilic masses |
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glycogen accumulations |
seen in liver, -islet cells, renal tubules, heart, and skeletal muscle liver: glycogen accumulation within nuclei periodic acid sheath (PAS) – stain used to see glycogen and may also stain mucouso can be caused by: DM, prolonged fever, old patientso microscopic feat: nuclear accumulation in DM, chronic heart failure, acromegaly, and Wilson’s disease• glycogenoses – (storage diseases)o von Gierkeo Pompeo Forbeso Anderseno McArdleo Hers also mucopolysaccharidosis |
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lipid accumulations |
abnormal accumulation of triglycerides, cholesterol, cholesterol esters, and phospholipids caused by toxins (ethyl alcohol), drugs (anti-tumor, anti-neoplastic), hypoxia, hyperemia, hyperlipidemia, DM Sudan or oil red staining to visualize neutral fats cholesterol and cholesterol ester degeneration – increased level of cholesterol (hyperlipidemia, pregnancy, DM, hypothyroidism) –accumulation of cholesterol esters in macrophages or extracellular cholesterol crystals microscopic feat: foam cells and cholesterol crystalso phospholipid accumulation – lysosomal storage diseases Tay-Sachs disease – hexosamidase -subunit deficiency => accumulation of GM2 in neurons and gangliosides |
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pigment accumulations |
results from lack of enzymes capable of itsdegradation or transport to other site exogenous-anthracosis and tatoos endogenous- lipfuscin melanin hemosiderin – hemoglobin derived |
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. Pathologic calcifications |
dystrophic and metastatic dystrophic – can be observed in necrosis, plaques, and parasite infectionso retention of calcium in previously affected tissues or organso no increase in serum Ca2+o gross: white firm depositso micro: basophilic, amorphous granular or lamellated deposits metastatic – seen in Pagets disease, excessive vit. D, sarcoidosis, renal failureo retention of calcium in previously non-affected tissues or organso associated with increased serum Ca2+o Ca2+ salts stain viole |
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what are the characteristics fo necrosis |
Increased eosinophilic(pink) o glassy o attract calcium salts o pyknosis, karyolysis, karryohexis o Loss of nuclei o Loss of striation (especially with cardiac cells – “wavy” appearance of necrotic cardiomyocytes) o Presence of neutrophils o Macrophages to engulf necrotic mass o Scarring |
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coagulative necrosis |
hypoxic death eg MI or splenic infarct heterolysis or autolysis can see 3 layers Normal tissue Fibrous tissue – formation of capsule – organism trying to confine necrosis – composed of fibrous connective tissue and bloodvessels – also found in kidney Necrosis – can observe carbohydrate accumulation, Ca2+ deposition, accumulation of hemosiderin within necrotic masses |
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caseous necrosis |
TB Slightly pale pink – similar to epithelioid cells – actually special macrophages Multinucleated giant cells – Langhans cells In center of inflamed areas, can find fascious necrosis No cells in necrotic masses, which can calcify Gross feat: looks like white cheese |
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gangrenous necrosis |
coagulative necrosis but for the entire limb which has lost blood supply wet gengrene if liquefactive pattern because of bacteria |
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fat necrosis |
Pancreas releases enzymes that digest nearby fat tissueo Gross feat: aka Balser necrosis – looks like foamo Partially destroyed adipocyteso Can observe Ca2+ salts (deep violet on slides)o Can also observe accumulation of neutrophils and inflammatory cells white areas - fat saponification |
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Liquefactive necrosis |
digestion of content of cells by proteases and hydrolases (from neutrophils) – generally observed in purulentformation in abcesses (accumulation of neutrophils with formation of mass including cells and bacteria or fungi) o Hypoxy of CNS – due to embolus of cerebral artery o Don’t observe scar formation, but large areas filled with fluid (lacunae) Scarring only in small lesiono May see RBS extravasation => hemosiderin deposit |
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Coagulative and liquefactive necrosis |
rare combination of necrosis in liver in viral infections – involves almost complete necrosis ofentire organo Cells have no nuclei and have eosinophilic mass inside cellso Cells of bile ducts are mostly preserved and not as affected as other cellso Dark spots on slide are abnormal accumulation of bileo Mild inflammatory accumulation |
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fibrinoid necrosis |
immune complex deposition in vessels -imflammed then thrombosis |
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apoptosis |
(nucleus first, cell membrane last) no inflammation Cell shrinkageo Chromatin condensationo Formation of cytoplasmic blebs and apoptotic bodieso Phagocytosis of apoptotic cells |
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features of necrosis |
1. eosinophilic2. anucleus3. disruption of architecture4. inflammatory infiltrate |
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what makes up calcium soap in fat necrosis |
free fatty acids + calcium seen as amorphorous basophillic deposits between fat cells |
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where can you find liqeufactive necrosis |
Brain liver- massive damage(if focal damage=coagulative) caused by poisonous mushrooms and carbon tetrachloride abscesses |
