Histology

Question 1

Describe neutrophils

Answer 1

Poly-lobar nuclei (3-5)

Question 2

What are neutrophils associated with

Answer 2

• Associated with acute inflammation

In a biopsy of acute appendicitis- will see neutrophils in the walls and lumen of the crypts of the appendix.

Question 3

Describe lymphocytes and plasma cells

Answer 3

Slightly bigger than RBCs

Large nuclei:cytoplasm ratio

Question 4

What are lymphocytes associated with

Answer 4

• Associated with: chronic inflammation
(lymphomas)
Seen in ulcerative colitis

Question 5

What’s important to remember about chronic inflammation

Answer 5

Can still get acute exacerbations on top of it- so may see both neutrophil and lymphocyte infiltration

Question 6

Describe lymphomas

Answer 6

Sheets of lymphocytes- monoclonal expansion
With macrophages and apoptotic debris dispersed in among the sheets of lymphocytes- ‘starry sky’ appearance
Need to use clinical context, along with chemical and immhunohistochemical markers to distinguish lymphomas from a particularly aggressive example of chronic inflammation.

Question 7

Describe eosinophils

Answer 7

Bi-lobed nuclei with orange/red cytoplasmic granules

Question 8

What are eosinophils associated with

Answer 8

• Associated with:
Allergic reactions
Parasitic infections (depending on type of T-cell response triggered)- eosinophils both in blood and infected tissue
Tumours e.g. Hodgkin’s disease (background of eosinophils- reactive increase in eosinophils from immune response against tumour).

Question 9

Describe eosinophilic oesophagitis

Answer 9

Will see concentric rings in oesophagus.
Will see eosinophils invading the oesophageal epithelium
Known as asthma of the oesophagus- allergic response to ingested antigens.

Question 10

Describe mast cells

Answer 10

Large nuclei and granulated

Question 11

What are mast cells associated with

Answer 11

Urticaria

Question 12

Describe macrophages

Answer 12

Large cytoplasm

Question 13

What are macrophages associated with

Answer 13

• Associated with:
Late acute inflammation
Chronic inflammation (including granulomas)

Question 14

What is important to remember about checking sputum samples

Answer 14

Want to check if this is just the patient’s saliva or is actually representative of what’s happening inside the bronchi.
A good test for this is to look for ‘black’ macrophages which have phagocytksed Carbon from inhaled particulate matter.

Question 15

Describe granulomas

Answer 15

Macrophages become secretory as well as phagocytic- so cytoplasm increases in size (to accommodate Golgi, SER etc)- thus see epithelioid like macrophages with giant cells

Question 16

Describe the Ziehls-Nielson stain for TB

Answer 16

Acid fast stain- will show rad bacilli