TTD Flashcards
(435 cards)
1
Q
when to submit complete appendix
A
grossly normal and mucin accumulation
2
Q
provides cytologic detail and decalcifies bone, for marrow biopsy
A
Zenker’s fixative
3
Q
why use fresh tissue for flow cytometry
A
S-phase determination, no nuclei fragmentation
4
Q
fixative for uric acid crystals
A
ethanol (dissolve in for,alin)
5
Q
volume of fixative
A
15-20x volume of specimen
6
Q
retention times for gross specimen
A
14 days after final report
7
Q
retention times for paraffin blocks and slides, reports
A
10 years
8
Q
retention time for cytology slides
A
5 years
9
Q
short suture
A
superior margin
10
Q
long suture
A
lateral margin
11
Q
volar surface of hand
A
palm
12
Q
volar surface of hand
A
sole
13
Q
divides into medial and lateral parts
A
sagittal plane
14
Q
divides into anterior and posterior
A
coronal
15
Q
divides into superior and inferior
A
transverse
16
Q
organs that require inflation
A
bladder, colon for diverticular disease
17
Q
where to fix lymph nodes
A
Bouin’s fixative
18
Q
type of margin taken parallel to plane of resection
A
en face
19
Q
disadvantage of en face margin
A
distance from lesion cannot be taken, cautery artifact may be present
20
Q
advantage of en face margin
A
10-100 times greater surface area, entire structure can be evaluated
21
Q
type of margin taken perpendicular to plane of resection
A
perpendicular
22
Q
advantage of perpendicular margin
A
exact distance is taken, good when small tissue is negative margin
23
Q
disadvantage of perpendicular margin
A
very little tissue is sampled
24
Q
mordants for ink
A
Bouin’s, dilute acetic acid, methanol
25
tumor sizes measured to nearest?
millimeter (no round off)
26
Tumors that are weighed
parathyroid adenomas, adrenal tumors, sarcomas
27
desmoplastic response
fibrosis so tumors are harder
28
describe necrotic areas
soft and friable
29
renal cell carcinoma (clear cell type)
golden yellow and hemorrhagic
30
normal adrneal or adrenal cortical lesions
orange yellow
31
xanthogranulomatous inflammation
yellow
32
cirrhosis
orange yellow
33
steroid producing tumors
often pale or bright yellow
34
chloroma or any purulent exudate
green
35
prior hemorrhage with oxidation of blood
green (in synovial tissue in hemochromatosis)
36
ochronosis
pale yellow (black or brown)
37
melanosis coli
black mucosa
38
anthracotic pigment
black
39
gout or chondrocalcinosis
chalky white
40
pheochromocytoma (dusky color)
white to tan
41
changes pheochromocytoma color to black, brown or purple
chromaffin reaction
42
well-circumscribed or pushing borders
fibroadenoma, mixed tumor, hamartoma
43
irregular or spiculated tumors
invasive carcinomas, surgical scars
44
jagged or notched borders
cutaneous melanoma
45
serpiginous borders
mucosal shape of colon carcinoma
46
smoothly lobulated
lipoma
47
bosselated (round protuberances)
bone in degenerative joint disease
48
verrucous
cutaneous condyloma
49
papillary
bladder tumors, papillary renal cell carcinoma
50
villous slender projections
villous adenoma of the colon
51
eburnated like ivory
Exposed polished bone surface after loss of cartilage in degenerative joint disease
52
velvety
normal gallbladder mucosa
53
pedunculated (with a stalk)
some colon polyps, achrocordon
54
Sessile (broad-based)
Some colon polyps
55
Macule (flat lesion)
Lentigo, café-au-lait spot
56
Papule (raised lesion)
Mole
57
Friable (soft and falling apart or crumbly)
Papillary renal cell carcinoma, necrotic tumors
58
Excrescence (an irregular outgrowth)
Carcinoma invading through skin
59
Fimbriated (fringe-like)
The normal end of the fallopian tube
60
Exophytic (projecting out from a surface)=
A papilloma in a duct
61
Endophytic (projecting within a space)
inverted papilloma
62
Scabrous (covered with small projections and rough to the touch)
Pleural plaque
63
Papyraceous (like parchment or paper)
Fetus papyraceous – a fetus found within the placental membranes of a twin
64
Currant jelly
postmortem blood clot
65
chicken fat
postmortem blood clot
66
Sugar-coated spleen
Perisplenitis
67
Unripe pear or waterchestnut
Gritty consistency of breast cancer
68
Grape vesicle
The villi of a hydatidiform mole
69
sago spleen
Miliary nodules of amyloidosis
70
Strawberry gallbladder
Cholesterolosis
71
Nutmeg liver
chronic congestion
72
Apple-core lesion
An obstructing colonic adenocarcinoma (as seen on x-ray)
73
Rice bodies
Loose bodies in a joint
74
Lardaceous spleen
Amyloidosis
75
Fish-mouth stenosis
Rheumatic heart valve
76
Vegetation
Thrombus on a heart valve
77
Caseous necrosis
Cheese-like material (especially in tuberculous granulomas)
78
Cannot be identified - what to say
grossly consistent with…
79
fat necrosis
yellow, chalky
80
dissolved with formalin
lipids, carbohydrates
81
may be degraded with picric acid
DNA and RNA
82
adequate fixation time in formalin
6-8 hours
83
effect of temperature on fixation
increased, but also increases rate of autolysis
84
penetration efficiency of fixative
0.1 cm per hour
85
time of removal of tissue from the body to time specimen is in fixative
ischemic time
86
time specimen is in fixative
fixation time
87
formalin is
10% phosphate buffered formaldehyde
88
why buffer formaldehyde
otherwise degrades rapidly and does not preserve nucleic acids well
89
formalin
40% formaldehyde in water
90
10% formalin equals
4% formaldehyde
91
what fixative for lacunar cells of nodular sclerosing variant of Hodgkin's
formalin
92
how to maintain antigenicity in formalin
don't overfix, add zinc
93
rate of formalin fixation
0.4 cm/24 hours
94
dissolves uric acid crystals
formalin
95
calcification in breast dissolve in which fixative
formalin, if over 24 hours
96
fine bubbling of nuclei due to chromatin coalescence
formalin
97
major acute toxic effects of formalin
eye, upper respiratory tract, dermal
98
most people can smell formaldehyde at
0.1-1.0 ppm
99
for molecular studies
70% ethanol
100
composition of Bouin's solution
picric acid, formaldehdye, and acetic acid
101
results in sharp H&E staining
Bouin's
102
can facilitate finding small lymph nodes
Bouin's
103
Lymph nodes are white and fat is yellow
Bouin's
104
prolonged fixation can be sued to decalcify tissue
Bouin's
105
Tissues should not be fixed over 18 hours (will be brittle)
Bouin's
106
How to avoid overfixation in Bouin's
Transfer to ethanol
107
Why should large specimens not be fixed in bouin's
entire thing will be yellow
108
causes degradation of DNA and RNA
picric acid
109
lyses red cells, disslves iron and small calcium deposits
bouin's
110
An explosive if dry and must be kept moist
picric acid
111
color of bouin's
yellow
112
color of b-plus
clear
113
composition of b-plus
buffered formalin with 0.5% zinc chloride
114
used for lymph node fixation, spleens, other issues if lymphoproliferative disorder is suspected
b-plus
115
mercury containing fixative
B-5
116
rapid fixation with excellent cytologic detail
b-plus
117
Excellent antigen preservation for lymphoid markers
b-plus
118
color of zenker's acetic fixative
orange
119
composition of zenker's acetic fixative
potassium dichromate, mercuric chloride, acetic acid
120
length of time for decalcification and cytologic preservation with zenker's
8-12 hours
121
may be used for bone marrow biopsies
Zenker's fixative
122
length of time for soft tissue tumors with muscle differentiation with zenker's
4 hours
123
may be preferred for bloody specimens, with RBC lysed
zenker's
124
penetrates poorly
zenker's
125
what happens to tissue in zenker's >24 hours
may be brittle
126
how to prevent tissues being brittle when in zenker's
transfer to formalin
127
how to remove mercury precipitates
water bath (bone marrows > 1 hour, soft tissue >4 hours)
128
level of antigen preservation for IHC with Zenker's
low
129
interferes with chloroacetate esterase activity
zenker's
130
composition of glutaraldehyde
Glutaraldehyde, cacodylate buffer
131
fixative for electron microscopy
glutaraldehyde
132
treatment with tissues for glutaraldehdye
minced slowly, fixed rapidly, requires refrigeration
133
can result in false positive PAS stains
glutaraldehyde
134
alcohol fixative composition
ethanol and methanol
135
mechanism of action of alcohol fixatives
rapidly displace water and denature protein
136
use for synovial specimens if gout is suspected
alcohol
137
fixatives for smears, touch preps, frozen sections
methanol
138
fixative that dissolves lipids
alcohol
139
example of alcohol-based fixative that doesn't shrink and harden tissue
methacarn
140
fixatives that fix and decalcify tissues
bouin's and zenker's
141
amount of time to decalcify small specimens
1-2 hours
142
time for femoral heads decalcification
1-2 days
143
effect of prolonged decalcification on nuclear antigens
may not be preserved: ER, PR, p53, Ki-67, blood H group
144
where to embed undecalcified sections
plastic
145
neurotoxin, short-term exposure can cause headaches, dizzines, fatigue
xylene
146
where to release bullets and criminal evidence
police, with chain of custody
147
purpose of pathology reports
diagnostic and prognostic information, for research trials and QA, databases and epidemiology, to guide treatment
148
error in report - what to do
unsign, correct, resign - but retain original for documentation purposes
149
measurement of standard cassettes
3 x 2.5 x 0.4
150
thickness of sections
0.3 cm
151
standard microscope slides
7.5 x 2.5
152
why dehydrate tissues
embedding media cannot penetrate tissues with water
153
agent for clearing
xylene
154
why xylene is clearing agent
miscible with alcohol and embedding medium, has a high refractive index
155
infiltration
with paraffin
156
steps in tissue processing
dehydration, clearing, infiltration
157
section slice
4 microns
158
deeper sections
20 microns apart
159
how to submit small punch biopsies
intact and bisected
160
skin shave biopsy
intact and sectioned and perpendicular
161
small intestine biopsies
put on a mesh
162
types of slides for IHC
commercial plus charged slides
163
more adhesive slides
double plus slides
164
how to arrange needle biopsies
in parallel rows perpendicular to slide axis
165
specimens best intact and sectioned before embedding
temporal arteries, vas deferens, small skin punch biopsies <0.4 cm, skin punch with vesicular lesions, skin shave
166
tissues embedded one side up
small specimens in large tissues, en face margins
167
how many levels of tissue to obtain
2-3 levels, first superficial and halfway through
168
slides to order for liver masses
3 h&e plus some unstained
169
immunoperoxidase studies for ABO compatibility
identification of tissue, but decalcification may mess up with H antigens, also only for big tissues
170
HLA typing using PCR
for small tissues
171
polymorphic satellite markers
definite match between patient and specimen
172
extra stain for stomach
alcian yellow
173
extra stains for liver
iron, retic, tri
174
stains for kidney
jones silver, pas, afog
175
extra slides for melanoma
intervening 5 slides
176
spacing for breast slides
equally spaced hundreds of microns
177
extra stain for bone marrow
giemsa
178
acceptable threshold for significant disagreement is
2%
179
retrognosis
trying to determine the size of the tissue in the past
180
seroconversion after needlestick from HbeAg+
30%
181
seroconversion after needlestick from HbeAg-
<6%
182
postexposure prophylaxis for HBV
hyperimmuneglobulin + vaccine within a week
183
risk for HC transmission after needlestick
75%
184
exposure mucous membrane and skin exposure HIV
10% of cases
185
seroconversion to HIV after needlestick
0.30%
186
seroconversion to HIV after mucocutaneous
0.10%
187
TB survives formalin, t/f
TRUE
188
postexposure treatment HIV decreases risk of seroconversion by
81%
189
Symptoms of Creutzfeld Jakob
rapidly progressive dementia, myoclonus, nonspecific neurologic findings
190
way to inactivate CJD
formalin 24 hours, 95% formic acid 1 hour, formalin 24 hours
191
viruses transmitted by cadavers
smallpox, hemorrhagic fever viruses
192
diffuse rash, deep-seated vesicles/pustules, same stafe, hemorrhage into GI tract
smallpox variola major
193
eosinophilic intracytoplasmic viral inclusions in smallpox
Guarnieri bodies
194
no person-to-person spread for anthrax t/f
TRUE
195
eschar with hge, hemorrhagic enteritis, meningitis, mediastinitis
anthrax
196
how to see anthrax after antibiotics
silver stains and IHC
197
encapsulated Gram-positive bacilli with flattened ends in short chains
anthrax
198
plague
Yersinia pestis
199
acute lymphadenitis with surrounding edema
bubonic plague
200
symmetrical, descending pattern of weakness and paralysis with microthrombosis
clostridium botulinum
201
skin ulcer, oculoglandular, pharyngeal, typhoidal
francisella tularensis, tularemia
202
hemorrhagic fever viruses include
filoviruses, ebola, marburg, arenaviruses
203
how long to fix small specimens infectious
4-6 hours
204
larger specimens fixative for infection
72 hours
205
decontaminate with
bleach
206
kind of gloves to prevent puncture injuries
metal mesh and kevlar cloth type gloves
207
radioactive agents patients
sentinel nodes, octreotide lesions
208
halflife of 99mtechnetium
6 hours
209
allowed disposal of radioactives
10 half lives - 60 hours after surgery
210
failure to examine grossly results in discrepancies in what % of cases
5%
211
most common claim filed against pathologists in surgical pathology
misdiagnosis of melanoma
212
found on transbronchial biopsies, vs small cell carcinoma
crushed blue cells
213
to diagnose signet ring carcinoma
mucin stains
214
on smears, plasma cells can closely resemble cells of an
adenoma
215
extranodal locations of lymphoma
skin, nasal cavity, mediastinum, stomach
216
most common missed diagnoses in rib specimens
multiple myeloma, CLL
217
soft tisse lesion that can have atypical cells and look alarming, rapidly growing mass, young adult
nodular fasciitis
218
papillary endothelial hyperplasia aka
Masson lesion
219
papillary endothelial hyperplasia aka Masson lesion vs
angiosarcoma
220
has papillary appearance, golden yellow cytoplasmic pigment, PSA-negative, monster cell
seminal vesicle
221
cells can be bland and mistaken for histiocytes, occur decades after original diagnosis, unusual sites (e.g. eyelid)
metastatic renal cell carcinoma
222
difficult diagnosis in breast specimens
sclerosing adenosis vs invasive carcinoma
223
stains for sclerosing adenosis that will show myoepithelial cells
SMA-actin, P63
224
source of light at the base of the microscope, adjusted by moving circular ring around it
field diaphragm
225
located below stage, can be moved up and down and centered with 2 screws
substage condenser
226
located in substage condenser, adjusted by using a rotating ring in front of condenser
aperture iris diaphragm
227
needs to be changed to optimize contrast in objectives
aperture diaphragm
228
how to change light intensity
transformer
229
ways to increase contrast
(1) closing the aperture diaphragm below 60% (2) lowering substage condenser
230
why increase contrast
look for refractile material
231
drawbacks of increasing contrast
resolution and sharpness are reduced
232
how to adjust for Kohler illumination
(1) open aperture and field diaphgragm completely, at 20x (2) close field diaphragm almost completely (3) raise condenser until edges of diaphragm are sharply focused, condenser usually at highest position, (4) use centering screws on substage condenser to center image of the field diaphragm (5) slowly open the field diaphragm until it disappears from view (6) remove eyepiece objective and look into tube (7) open and close aperture diaphragm until only 66-77% of back lens is illuminated to prevent glare
233
optimal image formation
(1) adjust eyepiece for width to form a single image, (2) close each eye individually to focus eyepiece, (3) adjust illumination
234
why oil immersion lenses provide higher resolution
refractive index of oil is higher than air, lights rays bent to a greater degree, more light
235
use of oil immersion mag
(1) hemepath and (2) small organisms like TB, microsporidia
236
how to scan slide for oil immersion
4x beside oil, also apply ink to area of interest
237
remove oil from slide
xylene
238
objects that have a refractive index different than normal tissue
refractile objects
239
look brighter and shinier than tissues
refractile objects
240
doubly refractile
refractile and polarizable
241
how to see refractile objects
increase contrast
242
light oriented in one specific plane
polarized light
243
how is polarized light produced
use 2 crossed polarizing filters
244
most tissues do not change quality of light
isotropic
245
tissues change direction and speed of light
polarizable, birefringent, anisotropic
246
appears bright in comparison to dark tissue
polarizable, birefringent, anisotropic
247
can reflect light at 2 different wavelengths
dichroic birefringence
248
polarizable that have regular repeating structures
crystalline, amyloid or collagen, polyethylene
249
when can no light pass through polarizer
if polarizer and analyer are at 90 degrees to each other, then polarizer rotates, allows light, appears bright
250
the polarizing disk below the condenser
polarizer
251
polarizing disk above the specimen (top of slide or above objectives)
analyzer
252
determination of positive and negative birefringence
requires using a compensating first order red filter under polarized light
253
determine uric acid crystals from CPPD crystals
positive and negative birefringence, do on crystals in solution and not on fixed tissue
254
refractile but not polarizable
hemosiderin
255
polarizable but not or poorly refractile
amyloid
256
polarizable and refractile
suture material
257
apple green under polarization
amyloid
258
accuracy of measuring estimation from known field diameters
1-2 mm
259
accuracy of direct measurement on the slide
1-2 mm
260
accuracy of vernier scale on movable stage
0.1 mm
261
accuracy of ocular reticle
0.01 mm (10 um)
262
factors that affect size of microscope field
(1) brand, (2) eyepiece and objective magnification, (3) distance between eyepiece and objective, (4) additonal heads (lengthen) and built-in polarizing lenses
263
ways to measure microscope field
(1) mark 2 edges of field on glass slide, measure with rule (2) use Vernier scale, edge of coverslip is a good landmark that can be moved across (3) stage micrometer for direct measurement of HPF
264
typical size of microscope fields
0.05-1 cm
265
formula for measuring size of higher fields
constant = eyepiece mag x obj mag x field diameter
266
formula for area of HPF once field is known
area PHF = 3.1415 x radius^2
267
lobe of a neutrophil nucleus
2 um
268
nucleus of a small lymphocyte
5-6 um
269
red blood cell
7 um
270
histiocyte nucleus
10 um
271
how to measure small breast carcinomas
direct measurement on slides
272
scale located on the stage and divided into millimetres
rule scale
273
scale fixed in position, divided into 10 divisions, each measuring 0.9 mm
vernier scale
274
how to measure on vernier scale
(1) look at the number of mm on rule scale before 0 on vernier, (2) decimal place is where there is alignment between rule and vernier scale (3) measure with object at edge of field of view, then move to other edge, and get the difference
275
eyepiece and objective magnifications are irrelevant to measurement
vernier scale
276
with 2 sets of scales corresponding to X and Y axes
vernier scale
277
more reproducible than other techniques
vernier scale
278
where to find amyloid material
bone marrow (multiple myeloma), medullary carcinoma of thyroid, periarticular tissue in dialysis patients
279
acellular homogenous pink, sometimes with giant cells, congo red +, orange/red without polarization and apple green with polarization
amyloid
280
studies to identify specific types of amyloid
immunoperoxidase studies
281
multiple myeloma IPO for amyloid
lambda, kappa chains
282
medullary carcinoma of the thyroid IPO amyloid
calcitonin
283
dialysis related amyloidosis
b2 microglobulin
284
amyloid p/r status
yes, yes/no
285
bile p/r status
no, no
286
helpful for recognition of HCC
bile
287
is bile pas-positive
yes
288
bone and collagen p/r status
yes, no
289
polarization of normal bone shows
regular osteoid seams (not seen in woven bone)
290
types of collagen polarizable and not polarizable
type 1, yes, type 3 (reticulin), no
291
bone and collagen overstained with congo red?
also apple green with polarization (background must not show staining)
292
stains to identify collagen
trichrome and reticulin
293
lymphoma associated with polarizable collagen
nodular sclerosing Hodgkin disease
294
calcium oxalate p/r status
yes, yes
295
where to find ca oxalate
apocrine cysts of the breast, benign thyroid follicles, giant cells in sarcoidosis
296
flat rhomboid (or needle shaped) colorless or pale yellow crystals
ca oxalate
297
can be source of mammographic calcifications
ca oxalate
298
present in congential hyperoxaluria
ca oxalate
299
calcium phosphate p/r status
no, no
300
where to find ca phosphate
benign and malignant breast lesions, chronic inflammation or necrosis, collagen deposition (heart valves), pulmonary blue bodies
301
purple granular material that are calcium stain +
ca phosphate
302
most common source of mammographic calcifications
ca phosphate
303
ca pyrophosphate p/r status
yes, yes
304
where to find ca pyrophosphate
large joints, periarticular tissues
305
bule to purple short rhomboid crystals (may be needle-shaped)
ca pyrophosphate
306
crystals water soluble and require anaqueous processing
ca pyrophosphate
307
charcot-leyden crystals p/r status
no, yes
308
where to find charcot-leyden crystals
eosinophils (chronic sinusitis, parasitic nifections, asthma)
309
bright red needle like crystals
charcot-leyden crystals
310
corpora amylacea p/r status
no, no
311
where to find corpora amylacea
prostate, brain, lung
312
extracellular laminated light pink spherical structures
corpora amylacea (incidence increases with age)
313
gamna-gandy nodules p/r status
no, yes/no
314
where to find gamna-gandy nodules
spleen, lymph nodes, thymus gland, thyroid, cardiac myxomas
315
granulomas consisting of hemosiderin, calcium, foreign body giant cells, and ovoid or bamboo-shaped structures
gamna-gandy nodules
316
siderotic granulomas found in sites of previous hemorrhage
gamna-gandy nodules
317
can mimic fungal mycella or parasite eggs
gamna-gandy nodules
318
hamazaki-wesenberg bodies p/r status
no, yes
319
where to find hamazaki-wesenberg bodies
areas of prior hemorrhage, lymph nodes sinusoids
320
small round to ovoid brown bodies that may appear budding
hamazaki-wesenberg bodies
321
can mimic pigmented fungal forms or bacteria
hamazaki-wesenberg bodies
322
hemosiderin p/r status
no, yes
323
where to find hemosiderin
any area of hemorrhage, liver in hemochromatosis and hemosiderosis
324
coarse granular brown intra- and extracellular granules, iron stain +
hemosiderin
325
a complex of iron and ferritin
hemosiderin
326
useful in distinguishing prior from intraoperative bleeding
hemosiderin
327
liesegang rings p/r status
no, no
328
where to find liesegang rings
any area of old hemorrhage
329
round extracellular concentric laminated or fibrillated concretions of precipitated proteins
liesegang rings
330
may be mistaken for giant kidney worm or fungal organisms
liesegang rings
331
cornstarch p/r status
yes, no
332
where to find cornstarch
surgical sites
333
3-20 micron spheres, maltese cross appearance after polarization, PAS, MSS+
cornstarch
334
lubricate surgical gloves
cornstarch
335
can incite a granulomatous response
cornstarch
336
formalin pigment p/r status
no, yes
337
most commonly seen in bloody tissues, brown or black finely granular extracellular deposits
formalin pigment
338
due to a reaction between formic acid and heme
formalin pigment
339
how to avoid formalin pigment
use buffered formalin
340
can be mistaken for malaria pigment
formalin pigment
341
gelfoam p/r status
no/yes, no/yes
342
where gelfoam is found
vascular spaces of hemangiomas or other vascular lesions, mark breast biopsy sites
343
irregular fenestrated bluish or clear material
gelfoam
344
stains to help identify gelfoam
elastic stains
345
gold p/r status
yes, no
346
where to find gold
skin, lymph nodes, organs of patients treated with gold for RA
347
small intracellular black particles in histiocytes
gold
348
can mimic mammography calcifications if present in intrammary LNs
gold
349
graft material gore-tex or dacron p/r status
yes, yes
350
look like numerous uniform round filaments with small black granules
graft goretex dacron
351
india ink p/r status
no, no
352
where india ink found
site of biopsied colonic polyps
353
seen as black granular pigment in stroma or within histiocytes
india ink
354
may be useful to document site of previously biopsied polyp that's been removed
india ink
355
melanosis coli p/r status
no, no
356
where to find melanosis coli
lamina propria of colon
357
fine brown to black granules in macrophages, PAS+, silver stain +
melanosis coli
358
associated with anthracende derived bowel cathartics, can cause grossly pigmented colonic mucosa
melanosis coli
359
mercuric chloride p/r status
yes/no, no
360
why mercuric chloride in tissues
if fixatives with mercury
361
appear as dark brown granular extracellular deposits throughout tissue
mercuric chloride
362
metal p/r status
no, no
363
where to find metal
tissue around prosthetic joints
364
appear as small black irregular angulated or needle shaped fragments, intra or extracellular
metal
365
minocycline p/r status
no, no
366
where to find minocycline
thyroid, atheromatous plaques, substantia nigra
367
describe minocycline
black granular pigment
368
myospherulosis p/r status
no, no
369
where to find myospherulosis
nasal cavity and paranasal sinuses
370
sac like structures with outer lipid surrounding endobodies (RBCs)
myospherulosis
371
due to packing with petroleum-based ointment
myospherulosis
372
can be mistaken for protothecosis or fungi
myospherulosis
373
polyethylene p/r status
yes ,yes
374
where to find polyethylene
tissue around prosthetic joints
375
appear as large fragments, filaments, shards, or small intracellular fragments, often with a giant cell reaction, oil red O +
polyethylene
376
polymethyl-methacrylate (bone cement) p/r status
no, no
377
where to find polymethylmethacrylate bone cement
tissue around prosthetic joints
378
appear as round to oval holes surrounded by a giant cell reaction
polymethylmethacrylate (bone cement)
379
dissolves in xylene and may have barium sulfate
polymethylmethacrylate (bone cement)
380
silicone p/r status
no, yes
381
where to find silicone
in tissue around implants, rarely in draining lymph nodes
382
may be removed during processing and appear as empty holes with residual refractile material around the edge
silicone
383
if intracellular, may appear like multiple vacuoles in histiocytes, can be mistaken for lipoblasts
silicone
384
similar appearance to silicone
other organic oils
385
sodium polystyrene sulfonate (kayexalate) p/r status
no, yes
386
where to find sodium polystyrene sulfonate (kayexalate)
GI tract
387
appear as irregular eosinophilic crystals present in the lumen or within ulcers, PAS+ and AFB+
sodium polystyrene sulfonate (kayexalate)
388
may cause necrosis of bowel wall
sodium polystyrene sulfonate (kayexalate)
389
surgical gut suture p/r status
yes, no
390
where to find surgical gut suture
prior biopsy sites (often breast)
391
appear as ovoid deeply eosinophilic monofilament often surrounded by a chronic inflammatory response and giant cells
surgical gut
392
may be mistaken for metaplastic bone
surgical gut
393
nuclei may be spindle shaped due to sterilization by cautery, with jagged edges during resorption
surgical gut
394
composition of photo
specimen to fill frame
395
magnification of photos
take low and high
396
other sutures p/r status
yes, yes
397
may be monofilament or polyfilament, often colorless
sutures
398
may be surrounded by chronic inflammation
absorbable sutures
399
talc p/r status
yes, yes
400
where to find talc
pleura after talc pleurodesis, granulomas in IVDAs
401
appear as irregular clear to yellow crystalline material
talc
402
thorotrast p/r status
no, no
403
where to find thorotrast
liver, spleen
404
coarse light brown or gray granules in histiocytes or stroma, similar to hemosiderin
thorotrast
405
radiocontrast associated with cirrhosis, HCC, bile duct ca and angiosarcoma of spleen
thorotrast
406
half-life of thorotrast
400 years
407
anthracotic pigment p/r status
no, no
408
appearance of anthracosis
black granular deposits in macrophaes, lymph nodes of respiratory tract
409
asbestos fibers p/r status
no/yes, no
410
thin fibers encrusted with beaded protein and iron (ferruginous bodies)
asbestos fibers
411
asbestos looks similar to
aluminum silicate, fiberglass, lung elastin (need spectroscopy)
412
how to quantify and identify asbestos
energy dispersive x-ray analysis
413
insects files and ticks p/r status
yes, yes
414
silica p/r status
yes, no
415
minute polarizable material in histiocytes and fibrotic nodules (lung)
silica
416
plant material p/r status
yes, yes
417
part of plant identified by polarization
cell wall
418
can be useful to document colonic rupture
plant material
419
most precise measurements
ocular reticle
420
has either a line scale or grid on the surface of a disc, used with a focusing objective, distance must be calibrated
reticle (graticule)
421
a glass slide with very accurate scale of known size etched
stage micrometer
422
typical divisions of stage micrometer
1 mm divided into 100 divisions, 1 division = 10 um
423
calibrating a reticle
(1) place into eyepiece (2) view stage micrometer, measure distance between lines on reticle (3) do for all objectives, (4) keep record, include diameter of each microscopic field
424
measuring with a reticle
(1) place reticle on an eyepiece, (2) place calibration line over object or distance, (3) determine number of units on calibration line
425
why wipe xylene away
damage adhesive for objective
426
how many days to dry microscope slides
6-7 days
427
when mounting media is completely dry
1-2 months
428
keep slides from sticking together
adhesive footplate opposite the label
429
when reading slides not dry
can use a bit of xylene under coverslip and then re-apply coverslip
430
where to write notes
footplates
431
where to immerse for 15-30 minutes to restore specimen color
80% ethanol
432
better if inflated fixed
lung, bladder, colon for diverticulosis
433
best photo under saline (delicate tissues) or transillumination through saline, light box
lungs (severe emphysema), papillary structures
434
need to hold something in photo
use hemostat
435
label for photo
surg path number and ruler, not diagonal, ruler closer to specimen than label
