Systemic Pathology Flashcards
(31 cards)
What are the complications of HIV?
- Opportunistic Infections
- Tumours
- Central nervous system diseases
How does symptoms change with CD4 and RNA over time?
What are the HIV opportunistic infections?
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
What is this showing?
Endoscopy:
Oesophageal ulcer
CMV
What is this?
(a) CMV nuclear inclusion
(b) Immunohistochemistry
for CMV
What are the HIV associated tumours?
• Kaposi’s sarcoma:
HHV-8
• Lymphoma:
systemic, CNS or body cavity based
B cell lymphomas
EBV
• Others:
Squamous cell carcinoma
Anus and cervix
HPV
How does a Kaposi sarcoma look Histologically?
A. The dermis is expanded by a solid
tumour.
B. Fascicles of relatively monomorphic
spindled cells, with slit-like vascular
channels containing erythrocytes.
C. The nuclei of the tumour cells
demonstrate immunoreactivity for
HHV-8.
What CNS diseases does HIV cause?
- Progressive encephalopathy = AIDS dementia complex
- Plus opportunistic infections and tumours
What does CNS HIV lymphoma look like?
What is the pathology of mTB?
- Caseating granulomas
- Demonstration of acid fast bacilli
- Cavitating lesions
What kind of granuloma is this?
Caseous
Where can TB infect?
• Lung
• Lymph node
• Bone: e.g. vertebra- potts
• Heart: e.g. pericarditis
• GIT: e.g. peritonitis
• CNS: e.g. meningitis
etc.
What are the extrapulmonary features of mTB?
What is the pathology of sarcoidosis?
- Non-caseating granulomas
- A diagnosis of exclusion.
What is this?
Sarcoidosis
Where can sarcoid effect?
- 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
What is IgG4 related disease?
- Inflammation dominated by IgG4 antibody producing plasma cells
- Fibrosis, obliteration of veins
What is this?
IgG4
Where does IgG4 related disease effect?
- Salivary and lacrimal glands: Mikulicz syndrome
- Thyroid: Riedel thyroiditis
- Peritoneum: Retroperitoneal fibrosis
- Liver: Biliary obstruction
- Pancreas: Autoimmune pancreatitis
- Mass lesions: Inflammatory pseudotumour
What can alcohol cause?
• 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!)
• Pancreas: acute pancreatitis, chronic pancreatitis
• Fetal alcohol syndrome
• Cancer: oral cavity, pharynx. oesophagus, liver and breast
What are the stages of ALD?
Normal
Steatosis
Steatohepatitis
Fibrosis
Cirrhosis
HCC
10
10
Where does CF present?
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
What is amyloid?
Deposition of an abnormal proteinaceous substance in non branching
fibrils, 7.5-10nm diameter
• Always contains P component
• Beta-pleated sheet structure
• A variety of proteins can take on this conformation
• Resistant to enzymic degradation
