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Systemic Histopathology Flashcards

(36 cards)

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1
Q

Name the systemic diseases?

A
  • Cancer
  • Connective tissue diseases
  • Vascular diseases
  • Infectious diseases e.g. HIV
  • Non-infectious inflammatory diseases • Drugs/toxins
  • Genetic
  • Others
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2
Q

What are we concerned about it HIV?

A
  • Opportunistic Infections
  • Tumours
  • Central nervous system diseases
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3
Q

Describe the timeline of HIs infection in terms of CD4+ lymphocytes and viral load.

A
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4
Q

Name the opportunistic infections in HIV.

A
  • Pneumocystis jiroveci: pneumonia
  • CMV: especially retina and GIT
  • Candida
  • Tuberculosis and atypical mycobacteria • Cryptococcus: meningitis
  • Toxoplasma gondii: encephalitis and mass lesions
  • JC papovavirus: progressive multifocal leukoencepalopathy • Herpes simplex
  • Cryptosporidium, Isospora belli, microsporidia: GIT
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5
Q

WHAT IS THIS?

A

Endoscopy - oesophageal ulcer

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6
Q

Describe.

A

(a) CMV nuclear inclusion
(b) Immunohistochemistryfor CMV

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7
Q

What are the HIV tumours.

A

• Kaposi’s sarcoma: HHV-8

• Lymphoma:
systemic, CNS or body cavity based B cell lymphomas
EBV

• Others:
Squamous cell carcinoma Anus and cervix
HPV

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8
Q

Describe the pictures.

A

Kaposi’s sarcoma

A. The dermis is expanded by a solid tumour.

B. Fascicles of relatively monomorphic spindled cells, with slit-like vascular channels containing erythrocytes.

C. Thenucleiofthetumourcells demonstrate immunoreactivity for HHV-8.

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9
Q

What is a CNS disease in HIV?

A
  • Progressive encephalopathy = AIDS dementia complex
  • Plus opportunistic infections and tumours
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10
Q

Describe

A

A - Right ventricle is compressed by a SOL - tumour mass

B - Perivascular lymphomatous infiltrate

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11
Q

What pathology do we see in mycobacteria (particularly TB)

A
  • Caseating granulomas
  • Demonstration of acid fast bacilli
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12
Q

Describe.

A

Mycobacterial infection

Granuloma with caseous necrosis

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13
Q

Describe

C

A

Cavitating TB

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14
Q

What sites are affected by mycobacteria?

A
  • Lung
  • Lymph node
  • Bone: e.g. vertebra
  • Heart: e.g. pericarditis
  • GIT: e.g. peritonitis
  • CNS: e.g. meningitis etc.
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15
Q

Name the extra-pulmonary features of mycobacterial infection

A
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16
Q

What is sarcoid pathology?

Study These Flashcards
A
  • Non-caseating granulomas
  • A diagnosis of exclusion.
17
Q

Describe

Study These Flashcards
A

Sarcoid granuloma

18
Q

What are the sites of sarcoid?

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A
  • Lung: scattered granulomas, heal with fibrosis • Lymph nodes: usually hilar and mediastinal
  • Spleen
  • Liver
  • Heart
  • Joints
  • Bone marrow
  • Skin: nodules, plaques or macules
  • Eyes: iritis, choroid retinitis, lacrimal glands • CNS
  • Salivary glands
19
Q

What is the pathology of IgG4 related diseases?

Study These Flashcards
A
  • Inflammation dominated by IgG4 antibody producing plasma cells
  • Fibrosis, obliteration of veins
20
Q

Describe

Study These Flashcards
A

Biopsy of liver

Plasma cell rich, inflammatory infiltrate

Immunohistochemistry for IgG4

21
Q

What are the sites of igG4 Related Diseases?

Study These Flashcards
A
  • Salivary and lacrimal glands: Mikulicz syndrome • Thyroid: Riedel thyroiditis
  • Peritoneum: Retroperitoneal fibrosis
  • Liver: Biliary obstruction
  • Pancreas: Autoimmune pancreatitis
  • Mass lesions: Inflammatory pseudotumour
22
Q

What are the sites of alcohol action?

Study These Flashcards
A
  • Liver: fatty change (steatosis) , fatty liver hepatitis (steatohepatitis), 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!-little red wine)
  • Pancreas: acute pancreatitis, chronic pancreatitis
  • Fetal alcohol syndrome
  • Cancer: oral cavity, pharynx. oesophagus, liver and breast
23
Q

What are the potential long term effects of Ethanol?

24
Q

Name the stages of alcohol induced liver disease?

Study These Flashcards
A
  1. Normal liver
  2. Steatosis - fatty change
  3. Steatohepatitis - ballooning inflammation + fatty change
  4. Fibrosis
  5. Cirrhosis
  6. Hepatocellular carcinoma
25
What are the sites affected in 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
26
What is amyloid?
* Deposition of an abnormal proteinaceous substance in non branching fibrils, 7.5-10nm diameter * Always contains P component - can help identify it * Beta-pleated sheet structure * A variety of proteins can take on this conformation * Resistant to enzymic degradation
27
What are the types of amyloid?
• **AA - derived from serum amyloid A** e.g. Crohn’s Disease, Rheumatoid arthritis - acute phase protein - people with long standing inflammation at risk • **AL - derived from light chains (on immunoglobulin)** e.g. multiple myeloma, B Cell lymphoma
28
What are the other proteins derived from amyloid?
* Transthyretin e.g. mutation * Beta2-macroglobulin – peritoneal dialysis • Abeta2 protein - Alzheimer’s * Insulin, calcitonin – endocrine tumours
29
What stain do we use to recognise amyloid?
* Stains with Congo Red dye * This shows apple green birefringence under polarised light
30
What clinical features would you expect to see in amyloid?
* Proteinuria, renal failure * Restrictive cardiomyopathy, arrhythmias * Autonomic neuropathy * Carpal tunnel syndrome * Macroglossia * Bleeding on injury * Also deposited in blood vessels, endocrine organs, liver, spleen
31
Describe the picture
Accumulation of amyloid in kidney
32
Describe the picture
Amyloid in apple green birefringence
33
Describe the picture.
Electron microscopy in amyloid.
34
Causes of granulomatous inflammation in the liver
* Sarcoid * TB * PBC * Drug-induced * Malignancy
35
What are the different types of liver damage due to alcohol?
steatosis, steatohepatitis, cirrhosis, fibrosis and hepatocellular carcinoma
36
What type of amyloid is associated with multiple myeloma?
AL amyloid

Histopathology (14 decks)

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