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Flashcards in Pathology Deck (107):
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Psoriasis

Salmon-plaques-silvery white scales (Koebner Phenomenon), test tubes in a rack appearance, auspitz signs, Munro microabscess

1

Seborrheic Dermatitis

Erythematous-yellow, greasy base, with extensive scaling and crusting dandruff, follicular lipping,

2

Lichen Planus

Pruritic,purple,polygonal,planar papules and plaques, itchy,violaceous, flat-topped papules (wickham striae), interface dermatitis, sawtoothing, civatte or colloid bodies and lichen planopilaris.

3

Granulomatous Uveitis (uvea)

Sarcoidosis (complication), mutton-fat keratin precipitates ant segment, candle wax dripping post segment.

4

Impetigo

Mauled and pustules - honey-colored crusts, imp contangiosa-GABHS; PSGN complication; imp bullosa, staph aureus. Sub corneal pustule beneath stratum corneum

5

Hypertensive retinopathy

Arteriolosclerosis, copper wiring, silver wiring, cotton-wool spots, focal choroidal infarcts (elschnig pearls), DM retinopathy

6

Central retinal artery occlusion

Hollenhorst plaques, cherry red spots in macula

7

Age-related macular degeneration

Irreversible blindness; "drusen" yellow deposits in macula; choroidal neovascularization

8

Retinitis pigmentosa

Asst w/ "Refsum disease"
apoptosis of rods and cones
Waxy pallor of the optic disk
Early night blindness

9

Retinoblastoma

Most common 1 intra-ocular malignancy in children
Most common presentation is leukocoria
"Flexner-Wintersteiner Rosettes

10

Papilledema

Optic nerve swelling inc ICP
Blurred disk borders on fundoscopy

11

Fibroadenoma

Breast

Most common Popcorn calcification

12

Phylloides tumor

Breast

Bulky tumor from tumor cells
Leaf-like extensions

13

Intraductal papilloma

Breast

Most common "bloody nipple discharge" <50
Develop in lactiferous ducts or sinuses

14

Lobular CIS

Breast

Dyscohesive cells w/ oval or round nuclei and small nucleoli
Lack-protein adherin

15

Invasive ducktail carcinoma

Breast

Most common type of Breast Ca (70%)
Grating sound (like cutting a water chestnut)

16

Invasive lobular carcinoma

Breast

Most common cause of bilateral breast cancer
Signet ring cells in Indian file pattern

17

Medullary carcinoma

Breast

Fleshy mass with syncytium sheets of large cells with vesicular, pleomorphic nuclei, and prominent nucleoli

18

Mucinous carcinoma

Breast

Soft/rubbery mass
"Pale gray-blue gelatin"

19

Inflammatory breast cancer

P'eau de orange
Worst prognosis
High degree and aneuploidy
Tumor emboli
Persistent e-cadherin nuclei

20

Uteropelvic Junction Obstruction

Kidney

Most common cause of hydronephrosis in infants and children
Left ureter
Bilateral in infants/unilateral in adults

21

Methysergide (ergot derivative)

Anti migraine drug to cause peritoneal fibrosis

22

Acute cystitis

Kidney

Triad: dysuria, suprapubic pain, frequency (q15-20mins)
Suppurative neutrophilic infiltration
Hyperemic bladder with exudation

23

Acute bacterial cystitis

Kidney

Most common bacteria: PEEK
Proteus, E. coli, Enterobacter, Klebsiella

24

Interstitial cystitis (hunner ulcer)

Inflammation and fibrosis
Glomerulations
Mast cells

25

Malacoplakia

E. coli; soft, yellow mucosal plaques
Large foamy macrophages (machaelis-gutmann bodies)

26

Urothelial CA in situ

Pagetoid spread
Mucosal thickening w/o intra luminal mass

27

Reiter syndrome

Conjunctivitis, urethritis, arthritis

28

Testicular torsion

Twisting of the spermatic cord
"Bell-clapper deformity"
Hemorrhagic testicular infarction

29

Yolk sac tumor

Testis

Lace-like cell network
Homogenous,yellow-white,mutinous appearance
"Schiller duval bodies"
A-feto protein, A1-anti trypsin

30

Teratoma

Hester-skeeter collection
Malignant transformation
Painless enlargement of the testis
Para-aortic>mediastinal>supraclavicular

31

Leydig cell tumor

Crystalloids of Reinke

32

Sertoli cell tumor

Crystalloids charcot-bottcher

33

Testicula lymphoma

Most common form of testicular neoplasms in men over 60 years of age.

34

Acute bacterial prostatitis

E. coli; (-), intraprostatic of urine,lymphohematogenous routes
Fever,chills,dysuria
DRE: prostate exquisitely tender and boggy

35

Chronic bacterial cystitis

Low back pain, dysuria, perineal and suprapubic discomfort
Recurrent UTI's caused by the same organism

36

Benign prostatic hyperplasia

Peri urethral transition zone
Median lobe hyper trophy
Modular hyperplasia- hallmark finding
-- due to actions of dihydrotestosterone(hyperplasia of stromatolites cells

37

Prostate adenocarcinoma

Most common form of cancer in men
Tied w/colorectal cancer
Acinar variant (70%cases)
Posterior peripheral zone

38

Pelvic inflammatory disease

(Female genital)

Turbo-ovarian abscesses, pyosalphinx
Comp: follicular salphigitis & hydrosalphynx leading to infertility/ectopic pregnancy
"Violin-string adhesions in fitz Hugh-Curtis syndrome
Bacteremia

39

Bartholin cyst

(Vulva)

Perineal pain, local discomfort
Marsupial inaction

40

Lichen sclerosis

(Vulva)

Aka chronic atrophic vulvitis
4 cardinal: thinning with rete pegs, hydrophilic degen of basal cells, collage nous fibrous tissue and lymphocytic
Vaginal dryness,stiffening and constriction.

41

Lichen simplex chronicus

(Vulva)

Aka: sq. hyperplasia, hyperplastic dystrophy
Epith. thickening, exp stratum granulosum,hyperkeratosis
Leukoplakia

42

Keratinizing SCCA, vulva

(Vulva)

Nest and tongues of malignant squamous cells with prominent "keratin pearls"
Not asst with HPV

43

Papillary hidradenoma

(Vulva)

Circumscribed nodule-labia majora
Identical to Intraductal papilloma a of the breast

44

Condyloma acuminata

(Vulva)

HPV 6 & 11
Koilocytic atypia
Not precancerous lesions

45

Septate vagina

Failure fusion of Müllerian ducts
Uterus didelphys
In utero exposure to DES

46

Vaginal adenosis

Red, granular areas contrasting with normal mucosa
Columnar mutinous epith
May progress to clear celladenocarcinoma of the vagina

47

Gartner duct cyst

(Vagina)

Derived from wolfian (mesonephric) duct
Submucosal fluid filled cyst

48

Embryonal rhabdomyosarcoma

Aka: sarcoma botryoides
Grape-like clusters

49

Cervical cancer

HPVs infect immature cells at sq columnar junction
Koilocytic atypia
E6 and E7 proteins-involve in RD inactivation

50

Endometriosis

Chocolate cyst (red-blue, yellow-brown)
Infertility most common presentation

51

Adenomyosis

Endometrial tax within the uterine wall
Irregular nests of endometrial stroma
Menometrorrhagia (irreg and heavy menses)

52

Endometrial hyperplasia

Asst with prolonged estrogen stimulation of the endometrium
Invariably leads to endometrial adenocarcinoma

53

Endometrial carcinoma

Most common invasive CA in female genital
Peak 55-65 y/o
With signs of stromal invasion.

54

Myoma uteri

Most common benign tumor in women
"Whirled pattern of smooth muscle bundles"
Degeneration-red or corneus, hyaline,myxomatos, calcific, cystic, catty

55

PCOS

Aka: stein-leventhal syndrome, numerous cystic follicles or follicle cyst.
Thickened,fibrotic superficial cortex w/ innumerable follicle cysts (follicular hyperthecoses)

56

Serous tumors, ovaries

Psamomma bodies
Using Sassone and Lerner criteria

57

Mutinous tumors, ovary

Multiloculated tumors filled with sticky, gelatinous fluid rich in glycoproteins

58

Pseudomyxoma peritonei

Rupture of mucinous tumors

59

Brenner tumor, ovary

Sharply demarcated nests of epithelial cells (walthard cells rests)

60

Mature teratoma

Aka: dermoid cyst
Most common ovarian GCT
Cyst containing hair & cheesy sebaceous materials
Malignant transformation

61

Monodermal or specialized tearatomas

Strums ovarii-hyperthyroidism
Ovarian Carcinoid-produces serotonin & carcinoid synd.
Stromal carcinoid-combination of struma ovarii and ovarian carcinoid

62

Dysgerminoma

Ovarian counterpart of Seminoma
Unilateral 80-90%, polyhedral cells w scant fibrous stroma
Malignant but only 1/3 are aggressive

63

Yolk sac tumor

Rich in A-fetoprotein & A1 antitrypsin
Glomerulus-like structure (Schiller-duval bodies)

64

Granulosa cell tumor

Elaborate large amount of estrogen
Glan-like structure ("call-exner bodies")
Tumor marker:inhibin

65

Meig syndrome

Fibrous and thecomas

Ovarian tumor
Hydrothorax
Ascites

66

Androblastoma

Musculinization
Sertoli cells or leydig cells interspersed with stroma

67

Krukenberg tumor

Bilateral metastasis
Mucin producing, signet ring cancer cells
Gastric in origin

68

Ectopic pregnancy

Ampulla-most common site
Prior pelvic inflammatory disease-most common predisposing factor
Morp: hematosalphynx

69

Placenta previa

Placental implants very near to the cervical os
Partial, marginal, total, low-lying
Painless vaginal bleeding during the 3rd trimester

70

Placental abruption

Premature separation due too retroperitoneal clot
RF: Hypertension, smoking cocaine addiction
Painful vaginal bleeding during 3rd trimester

71

Placenta accreta

Partials or complete absence of fibrinoid layer (Nitabach layer)
Attached-accreta
Invades-increta
Penetrates-percreta

72

Placental infections

Comp: PROM
Grp B pathogens most common pathogen
TORCHES
Morp: greenish opaque and membranes, dense band like exudate a on amniotic surface
Comp:neonatal sepsis and meningitis

73

Pre eclampsia

Hypertension
Edema
Proteinuria
Usually begins at 32nd weeks AOG

74

Eclampsia

Pre eclampsia with convulsions

75

Hydatidiform mole

GTD

Grape-like structures
Circumferential trophoblast proliferation
Extra villus islands
Tumor marker: b-HCG

76

Invasive mole

GTD

Morp: invasion of the myometrium by hydrophic chorionic villi
Hematogenous

77

Choriocarcinoma

GTD

Mixed proliferationsof syncytiotrophoblast and cytotrophoblast
Invasion of underlying myometrium
Most commonly metastasize to lung and vagina

78

Placental site trophoblast tumor

GTD

Intermediate trophoblast
Malignant trophoblastic cells diffusely infiltrating the myometrium

79

Guillain-Barre Syndrome

Campy jejuni infxn
Ascending motor paralysis
Aminocytologic dissociation

80

Spinal Muscular Dystrophy

Aka: infantile motor neuron disease
Ant. Horn cell destruction
SMN1
Panfascicular

81

Myotonic dystrophy

CTG trinucleotide repeats
Morp: Subsarcolemmal band of cytoplasm (ring fiber)
Sarcoplasmic mass

82

Mitochondrial myopathies

Proximalk muscle weakness
MELAS syndrome (mitochondrial enceph, lactic acidosis, stroke-like episodes), Ragged red fibers-irreg fibers w/ subsarcolemmal
Parking lot inclusions

83

Dermatomyositis

Heliotrope rash
Gottron lesions

84

Osteogenesis imperfecta

Brittle bone disease
Type 1 collagen def
Most common inherited
Blue sclerae

85

Osteopetrosis

Aka: marble bone disease, Albers Schöenberg dse.
Impaired function of osteoclasts
Absence of medullary canal
"Erlenmeyer flask deformity"

86

Osteoporosis

Post menauposal-thin, perforated trabecular plates w/ loss interconnections
Senile-thin cortex, widened haversian systems

87

Paget's disease

Aka: osteitis deformans
Mosaic pattern-jigsaw puzzle appearance
Leontiasis ossea, platybasia
"Chakstick-typen fracture"

88

Hyperparathyroidism

Osteitis fibrosa cystica or Von recklinghausen disease of bone.
Dissecting osteitis
Brown tumor

89

Osteonecrosis

Avascular necrosis
"Legg-Calvé-Perthes disease" in children
Creeping substition

90

Pyogenic osteomyelitis

Staph aureus most common cause
Salmonella patients with sickle cell diasease

91

Osteomyelitis

Subperiosteal abscesses with draining sinus
Sequestrum, involucrum, Brodie abscess

92

Osteoid osteoma

Nidus formation, hemorrhagic gritty tan tissue

93

Osteosarcoma

Most common malignant bone tumor
Most common location-metaphysis of long bone
Lace-like pattern, Colman triangles and sunburst appearance

94

Chondroblastoma

Chicken wire pattern
2nd most common malignant bone tumor
Anaplastic chondrocytes

95

Fibrous dysplasia

Polyostotic fibrous dysplasia with cafe au lait spots and endocrinopathies (mc-cune Albright syndrome)-precocious puberty

96

Ewing sarcoma

Mutation in EWS gene on chrom#22
Homer-right rosettes
Onin-skin appearance

97

Giant cell tumor

Aka: osteoclastoma
Mutations in RANK/RANKL signaling pathway

98

Degenerative osteoarthritis

Mushroom-shaped outgrowths (osteophytes)
DIP: heberden nodes
PIP: Bouchard nodes
Joint mice, eburnated

99

Rheumatoid arthritis

Panus formation
Rheumatoid nodules

100

Ankylosing spondylitis

Asst with HLA-B27
bamboo spine deformity

101

Reiter syndrome

Aka: reactive arthritis, shige,salmo,yersi,campy,chlamy
Triad: uveitis, urethritis,arthritis
Balanitis circinata, keratoderma blenorrhagica

102

Psoriatic arthritis

Sausage-shaped DIP
Pencil in cup deformity

103

Gout

Acute gouty arthritis-crystallization of urates
Chronic gouty arthritis-tophi
(-)bifringent, (+)podagra

104

Transtentorial herniation

CNIII compression
Kernohan's notch
Duret hemorrhages

105

Epidural hematoma

Arterial bleed (bone and dura), frax of temporotemporal bone (ptyrion)
Middle menigeal artery
CT scan: lenticular shaped lesion
Lucid interval

106

Subdural hematoma

Venous bleeding (dura and arachnoid)
Bridging veins
CT scan: crescent shape lesions
Delayed, fluctuating levels of consciousness, Subdural memb.