Cystic medial necrosis: weakening of connective tissue
Pink elastic fibers are disrupted by pools of blue mucinous ground substance
Liver congestion due to CHF
persinusoidal fibrosis and centrilobular sinusoidal dilation
Dilated cardiomyopathy
nonspecific cellular abnormalities: variation in myocyte size, vacuolation, loss of myofibrillar material and fibrosis
Hypertrophic cardiomyopathy
Hypertrophic myocardial fibers with prominent dark nuclei along with interstitial fibrosis
REstrictive cardiomyopathy: hemochroatosis
Prussian blue stain: excessive deposition of iron
Restrictive cardiomyopathy: amyloidosis
amorphous deposits of pale pink material between myocardial fibers
viral myocarditis
interstitial lymphocytic infiltrates: Note most common viral agent: Coxsackie virus
Rheumatic fever
Achoff bodies
Atrial myoxoma
Hypocellular myxoid mass with polygonal cells or elongated cell shape. Mono or multinuclear Finely vacuolated eosinophilic (stain) cytoplasms
Metastatic melanoma
areas of brown/black pigment: characteristic of melanoma
Achalasia
Lymphocytic infiltration of Auerbach's plexus eventually overtaking ganglion cells
Barrets Esophagus
Metaplasia: Normal stratified squamous epithelium change to gastric and/or colonic columnar cells
Characteristic goblet cells
NOTE: colonic cells are associated with increased risk of malignancy
Espohageal Adenocarcinoma
variable nuclear size, variable nuclear staining and variable
nuclear shape.
Mitotic figures in the neoplastic cells are abundant.
Acute Gastritis
Gastric mucosa invaded with infiltration of neutrophils
Heliobactor Pylori
Small curved to spiral rod-shaped bacterium is found
in the surface epithelial mucus: methylene blue stain.
Atrophic Gastritis
Intestinal-type epithelium with numerous goblet cells (stained blue with the Alcian blue stain) has replaced the normal gastric mucosa. Mild chronic inflammation is noted by the presence of neutrophils in the lamina propria.
Gastric adenocarcinoma
The neoplastic glands of gastric adenocarcinoma demonstrate mitoses, increased nuclear/cytoplasmic ratios and hyperchromatism
Signet ring cell pattern
Gastric glands not visible
Gastric lymphoma
Infiltration of mucosa by atypical lymphoid cells
Characteristic: lymphoepitheleal lesions
Carcinoid tumor (gastric)
"Endocrine pattern" (nests of cells separated by thin-walled vessels) with less than 2 mitoses/10 HPF. Uniformity of cells and nuclei, normal nuclear/cytoplasmic ratio, small nucleoli, stippled chromatin
Celiac DZ
Blunting/flattening of intestinal villi
Note: DQw2 histocompatibility antigen shows in 95% of patients
Chron's DZ
Transmural lesions
Inflammatory cells appear as nodular infiltrates on the serosal surface with pale granulomatous centers.
epithelioid cells, giant cells, and many lymphocytes
Ulcerative Colitis
Crypt Abcesses
Neutrophilic exudate is found in glandular lumens.
The submucosa shows intense inflammation. The glands demonstrate loss of goblet cells and hyperchromatic nuclei with inflammatory atypia.
**Increased risk for adenocarcinoma
Solid psuedopallilary tumor
sheets of cells of similar size which display uniformly shaped and sized nuclei and slightly eosinophilic staining cytoplasm
Necrosis is often present and cell death may lead to changes in which finger-like projections of cells, known as pseudopapillae
Mucinous Cystadenoma
“empty” appearing cells
(no nucleus or obvious cytoplasmic structures).
These are the mucin containing cells.
Serous cystadenoma
small cysts which are lined by ciliated cuboidal epithelium, characteristic of serous cystadenoma
Pseudomembranous enterocolitis
Pseudomembrane has numerous inflammatory cells, mainly neutrophils.
Pseudomembrane is usually composed of inflammatory cells, necrotic epithelium, and mucus in which the overgrowth of microorganisms takes place.
Leiomyoma
Elongated spindle cells containing cigar-shaped nuclei
NO evidence of increased mitotic activity is seen
Peutz-Jeghers Syndrome
Distinctive frond-like appearance with a stromal/smooth muscle core
Covered by acinar glands and normal mucosa.
Nuclear atypia is absent
Carcinoid Tumor (Intestine)
Nests of carcinoid tumor have a typical endocrine appearance
collections of small round cells containing nuclei
that are consistent in size and shape and surrounded by cytoplasm which stains pink to pale blue.
Adenomatous polyp
Glands that are more irregular
contain darker and more crowded nuclei.
This neoplasm is benign and well-differentiated, as it still closely resembles the normal colonic structure
