Histopathology 13 - Histopathology of Systemic Disease Flashcards
(25 cards)
What can JCV infection in HIV positive patients lead to?
Progressive multifocal leukoencephalopathy
What is the most common opportunistic infection in HIV positive patients?
CMV - affects retina and GIT
Recall causes of menigitis/encephalitis in HIV
meningitis - cryptococcus
encephalitis - toxoplasma gondii
Which cancers does HIV predispose you to?
Kaposi’s sarcoma
lymphoma - B cell, EBV
SSC, anus and cervix, HPV
Which herpes virus causes kaposi sarcoma?
HHV8
what is the defining histological feature of Mycobacteria?
Caseating granulomas (necrotic centre)– immunocompetent people
stains w/ acid fast bacilli
Cavitating TB – where is the predilection?
lung apices
What is the main histological finding in sarcoidosis?
Non-caseating granulomas
collection of macrophages with cuff of lymphocytes around
How does end-stage sarcoidosis appear on CXR?
‘Honeycomb’ lung
define IgG4 related disease
Inflammation by IgG4-AB producing plasma cells (polyclonal)
Fibrosis and obliteration of veins
Describe the histological features of IgG4 related disease
plasma rich cells, inflammatory infiltrate
What colour does IgG4 stain when positive?
Brown
Recall 3 diseases caused by IgG4 inflammation
Salivary and lacrimal glands: Mikulicz syndrome
Thyroid: Riedel thyroiditis
Peritoneum: Retroperitoneal fibrosis
Liver: Biliary obstruction
Pancreas: Autoimmune pancreatitis
Mass lesions: Inflammatory pseudotumour
Recall the histolpathological features associated with alcohol
Liver
fatty change (steatosis), steatohepatitis (neutrophils, mallory denk), cirrhosis, liver cell cancer (hepatocellular carcinoma)
GI Tract
acute gastritis, oesophageal varices
Nervous system
peripheral neuropathy, Wernicke-Korsakoff syndrome etc.
Cardiovascular system
dilated cardiomyopathy, hypertension, atheroma (and decreases it)
Pancreas
acute pancreatitis, chronic pancreatitis
Cancer
oral cavity, pharynx. oesophagus, liver and breast
Fetal alcohol syndrome
What is the structure of amyloid?
Beta pleated sheet that forms non-branching fibrils
Always contains P-component
resistant to enzymatic degradation
AA vs AL amyloidosis
AA
derived from serum amyloid A
e.g. RhA, Crohn’s Disease / chronic inflammatory diseases
AL
derived from light chains
e.g. multiple myeloma, B cell lymphoma
What is the cause of AA amyloidosis?
Chronic inflammation
Which conditions are particularly implicated in the development of AA amyloidosis?
Crohn’s
Rheumatoid arthritis
What conditions can cause AL amyloidosis?
Myeloma
B cell neoplasms
What is the link between transthyretin and amyloidosis?
Transthyretin mutation can –> cardiac amyloid
What proteins are implicated in the second classification of amyloidosis?
Transthyretin (e.g. mutation)
Beta2-macroglobulin
peritoneal dialysis
Abeta2 protein
Alzheimer’s
Insulin, calcitonin
endocrine tumours
What stain can be used for amyloid?
Congo red - gives green birefringence under polarised light
Recall the features of cystic fibrosis
Pancreas
duct obstruction, exocrine atrophy
Salivary glands
duct obstruction, atrophy
Intestine
meconium ileus
Liver
biliary obstruction, cirrhosis
Lung
bronchial obstruction, superimposed infection with abscess formation (Staphylococcus aureus, Haemophilus influenzae and Pseudomonas aeruginosa)
Male genital tract
infertility, absence of the vas
Histological features of amyloidosis
