Increased AFP in amniotic fluid/maternal serum
Dating error, anencephaly, spina bifida, (neural tube defects)
Anticentromere antibodies
Scleroderma (CREST)
Anti-desmoglein (anti-desmosome) antibodies
Pemphigus vulgaris (blistering)
Antiglomerular basement membrane antibodies
Goodpasture syndrome (glomerulonephritis and hemoptysis)
Antihistone antibodies
Drug induced SLE (eg. hydralazine, isoniazid, phenytoin, procainamide)
Anti-IgG antibodies
Rheumoatoid arthritis (systemic inflammation, joint pannus, boutonniere deformity)
Antimitochondrial antibodies (AMA)
Primary biliary cirrhosis (female, cholestasis, portal hypertension)
Antineutrophil cytoplasmic antibodies (ANCAs)
Microscopic polyangiitis and eosiniphilic granulomatosis with polyangiitis (Churg-Strauss syndrome) (MPO-ANCA/p-ANCA); granulomatosis with polyangiitis (Wegener; PR3-ANCA, c-ANCA)
Antinuclear antibodies (ANAs: anti-Smith & anti-dsDNA)
SLE (type III hypersensitivity)
Antiplatelet antibodies
Idiopathic thrombocytopenic purpura
Anti-topoisomerase antibodies
Diffuse systemic scleroderma
Anti-transglutaminase/anti-gliadin/ anti-endomysial antibodies
Celiac disease (diarrhea, weight loss)
Apple core lesions on barium enema x-ray
Colorectal cancer (usually left sided)
Atypical lymphocytes
EBV
Azurophilic peroxidase (+) granular inclusions in granulocytes and myeloblasts
Auer rods (AML, especially the promyelocytic M3 type)
Bacitracin response
Sensitive: S. pyogenes (group A);
Bamboo spine on x ray
Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)
Basophilic nuclear remnants in RBCs
Howell-Jolly bodies (due to splenectomy or nonfunctional spleen)
Basophilic stippling of RBCs
Lead poisoning or sideroblastic anemia
Bloody or yellow tap on lumbar puncture
Subarachnoid hemorrhage
Boot shaped heart on x ray
Tetrology of Fallot (due to RVH)
Branching gram (+) rods with sulfur granules
Actinomyces israelii
Bronchogenic apical lung tumor on imaging
Pancoast tumor (can compress cervical sympathetic chain and cause Horner syndrome)
Brown tumor of bone
Hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)
Cardiomegaly with apical atrophy
Chagas disease (trypanosoma cruzi)
Cellular crescents of Bowman capsule
Rapidly progressive crescentic glomerulonephritis
Chocolate cyst of ovary
Endometriosis (frequentyly involves both ovaries)
Circular grouping of dark tumor cells surrounding pale neurofibrils
Homer-Wright rosettes (neuroblastoma, medulloblastoma)
Colonies of mucoid Pseudomonas in lungs
Cystic fibrosis (autosomal recessive mutation in CTFR gene -> fat-soluble vitamin deficiency and mucous plugs)
Decreased AFP in amniotic fluid/maternal serum
Down syndrome or other chromosomal abnormalities
Degeneration of dorsal column fibers
Tabes dorsalis (Tertiary syphilis), subacute combined degeneration (dorsal columns, lateral corticospinal, spinocerebellar tracts affected)
Delta wave on EKG, short PR interval, supraventricular tachycardia
Wolff-Parkinson-White syndrome (bundle of Kent bypasses AV node)
Depigmentation of neurons in substantia nigra
Parkinson disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
Desquamated epithelium cases in sputum
Curschmann spirals (bronchial asthma; can result in whorled mucus plugs)
Disarrayed granulosa cells arranged around collections of eosinophilic fluid
Call-Exner bodies (granulosa cell tumor of the ovary)
Dysplastic squamous cervical cells with raisinoid nuclei and hyperchromasia
Koilocytes (HPV: predisposes to cervical cancer)
Electrical alternans (alternating amplitude on EKG)
Pericardial tamponade
Enlarged cells with intranuclear inclusion bodies
Owl eye appearance of CMV
Enlarged thyroid cells with ground glass nuclei with central clearing
Orphan Annie eyes nuclei (papillary carcinoma of the thyroid)
Eosinophilic cytoplasmic inclusion of liver cell
Mallory body (alcoholic liver disease)
Eosinophilic cytoplasmic inclusion in neuron
Lewy body (Parkinson disease and Lewy body dementia)
Eosinophilic globule in liver
Councilman body (Viral hepatitis, yellow fever), represents hepatocyte undergoing apoptosis)
Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons
Negri bodies of rabies
Extracellular amyloid deposition in gray matter of brain
Senile plaques (Alzheimer disease)
Giant B cells with bilobed nuclei with prominent inclusions (Owls eye)
Reed-Sternberg cells (Hodgkin Lymphoma)
Glomerulus-like structure surrounding vessel in germ cells
Schiller-Duval bodies (yolk sac tumor)
Hair on end (Crew cut) appearance on xray
Beta-thalassemia, sickle cell disease (marrow expansion)
hCG elevated
Choriocarcinoma, hydratidiform mole (occurs with and without embryo, and multiple pregnancy)
Heart nodules (granulomatous)
Aschoff bodies (rheumatic fever)
Heterophilic antibodies
Infectious Mononucleosis (EBV)
Hexagonal double pointed, needle-like crystals in bronchial secretions
Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
High level of D-dimers
DVT, PE, DIC
Hilar lymphadenopathy, peripheral granulomatosis lesion in middle or lower lung lobes (can calcify)
Ghon complex (Primary TB, Mycobacterium bacilli)
Honeycomb lung on x ray or CT
Interstitial Pulmonary Fibrosis
Hypercoagulability (leading to DVTs and vasculitis)
Trousseau syndrome (adenocarcinoma of pancreas and lungs)
Hypersegmented neutrophils
Megaloblastic anemia (B12 deficiency: neurologic symptoms; Folate deficiency: lack of neurologic symptoms)
Hypertension, hypokalemia, metabolic acidosis
Primary hyperaldosteronism (Conn syndrome)
Hypochromic, microcytic anemia
Iron deficiency anemia, lead poisoning, thalassemia (fetal hemoglobin sometimes present)
Intranuclear eosinophil droplet-like bodies
Crowdy type A bodies (HSV or VZV)
Iron containing nodules in alveolar septum
Ferruginous bodies (asbestosis: elevated chance of mesothelioma)
Keratin pearls on skin biopsy
Squamous cell carcinoma
Large granules in phagocytes, immunodeficiency
Chediak-Higashi disease (congenital failure of phagolysosome formation)
Lead pipe appearance of colon on abdominal imaging
Ulcerative colitis (loss of haustra)
Linear appearance on IgG deposition on glomerular and alveolar basement membranes
Goodpasture syndrome
Low serum ceruloplasmin
Wilson disease (hepatolenticular degeneration)
Lumpy bumpy appearance of glomeruli on immunofluorescence
Poststreptococcal glomerulonephritis (due to deposition of IgG, IgM, and C3)
Lytic punched out bone lesions on x ray
Multiple myeloma
Mammary gland, blue domed cyst
Fibrocystic change of the breast
Monoclonal antibody spike
Multiple myeloma (usually IgG or IgA)
Mucin-filled cell with peripheral nucleus
Signet ring (gastic carcinoma)
Narrowing of bowel lumen on barium x ray
String sign (Crohn disease)
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
Granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA) and Goodpasture syndrome (anti-basement membrane antibodies)
Needle shaped (-) birefringement crystals
Gout (monosodium urate crystals)
Nodular hyaline deposits in glomeruli
Kimmelstiel-Wilson nodules (diabetic nephropathy)
Novobiocin response
Sensitive: S. epidermis
Nutmeg apprearance of liver
Chronic passive congestion of liver due to right heart failure or Budd-Chiari syndrome
Onion skin periosteal reaction
Ewing Sarcoma (malignant small blue cell tumor)
Optochin response
Sensitive: S. pneumoniae
Podocyte fusion or effacement on electron microscopy
Minimal change disease (child with nephrotic syndrome)
Polished ivory-like appearance of bone at cartilage erosion
Eburnation (osteoarthritis resulting in bony sclerosis)
Protein aggregates in neurons from hyperphosphorylation of tau protein
Neurofibrillary tangles (Alzheimer disease) and Pick bodies (Pick disease)
Psammona bodies
Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary
Pseudopalisading tumor cells on brain biopsy
Glioblastoma multiforme
Raised periosteum (creating a Codman triangle)
Aggressive bone lesion (eg. osteosarcoma, Ewing sarcoma, osteomyelitis)
RBC casts in urine
Glomerulonephritis
Rectangular, crystal-like cytoplasmic inclusions in Leydig cells
Reinke crystals (Leydig cell tumor)
Recurrent infections, eczema, thrombocytopenia
Wiskott-Aldrich syndrome
Renal epithelial casts in urine
Intrinsic renal failure (eg. ischemia or toxic injury)
Rhomboid crystals, (+) birefringement
Pseudogout (calcium pyrophosphate dihydrate crystals)
Rib notching (inferior surface, on x rays)
Coarctation of the aorta
Ring-enhancing brain lesion on CT/MRI in AIDS
Toxoplasma gondii, CNS lymphoma
Sheets of medium-sized lymphoid cells with scattered pale/tingible body-laden macrophages (starry sky histology)
Burkitt lymphoma (t8:14 c-myc activation, associated with EBV; starry sky made up of malignant cells)
Silver-staining spherical aggregation of tau proteins in neurons
Pick bodies (Pick disease: progressive dementia, changes in personality)
Soap bubble in femur or tibia on x ray
Giant cell tumor of bone (generally benign)
Spikes on basement membrane, dome-like subepithelial deposits
Membranous nephropathy (nephrotic syndrome)
Stacks of RBCs
Rouleaux formation (high ESR, multiple myeloma)
Steeple sign on frontal CXR
Croup (parainfluenza virus)
Stippled vaginal epithelial cells
Clue cells (Gardenella vaginalis)
Streptococcus bovis bacteremia
Colon cancer
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
Birbeck granules (Langherhans cells histiocytosis)
Thousands of polyps on colonoscopy
Familial adenomatous polyposis (autosomal dominant, mutation of APC gene)
Thrombi made of white/red layers
Lines of Zahn (arterial thrombus, layers of platelets/RBCs)
Thumb sign on lateral neck x ray
Epiglottitis (Haemophilus influenzae)
Thyroid-like appearance of kidney
Chronic pyelonephritis (usually due to recurrent infection)
Tram-track appearance of capillary loops of glomerular basement membranes on light microscopy
Membraneoproliferative glomerulonephritis
Triglyceride accumulation in liver cell vacuoles
Fatty liver disease (alcoholic or metabolic syndrome)
Elevated uric acid levels
Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
Waxy casts with very low urine flow
Chronic end stage renal disease
WBC cases in urine
Acute pyelonephritis
WBCs that look smudged
CLL (almost always B cell)
Wire loop glomerular capillary appearance on light microscopy
Diffuse proliferative glomerulonephritis (usually seen with lupus)
Yellowish CSF
Xanthochromia (eg. due to subarachnoid hemorrhages)
