pathology mnemonicsHematuria: urethral causes NUTS: Neoplasm Urethritis Tumour Stone Histiocytosis X: hallmark finding "Birbeck's rackets is X": Tennis rackets under electron microscope is Histiocystosis X. Consider 2 tennis rackets in an X formation. Oral cancer risks PATH LAB: Plummer-vinson syndrome Alcohol Tobacco Human papilloma virus Leukoplakia Asbestos Bad oral hygiene Parkinson's disease: symptoms PQRST: Paucity of expression parQinson Rigidity (cogwheel) Stooped posture Tremor at rest · If can't remember that Parkinson's tremor is the one that is "resting tremor", look at the last 3 letters: RST. TTP: clinical features Thrombosis and thrombocytopenia PARTNER together: Platelet count low Anemia (microangiopathic hemolytic) Renal failure Temperature rise Neurological deficits ER admission (as it is an emergency) COPD: blue bloater vs. pink puffer diseases emPhysema has letter P (and not B) so Pink Puffer. chronic Bronchitis has letter B (and not P) so Blue Bloater. Portal hypertension: features ABCDE: Ascites a famous victim): Reduction of Ach . piles) Caput medusae Diminished liver Enlarged spleen Cushing syndrome CUSHING: Central obesity/ Cervical fat pads/ Collagen fiber weakness/ Comedones (acne) Urinary free corisol and glucose increase Striae/ Suppressed immunity Hypercortisolism/ Hypertension/ Hyperglycemia/ Hirsutism Iatrogenic (Increased administration of corticosteroids) Noniatrogenic (Neoplasms) Glucose intolerance/ Growth retardation Duchenne vs. Thyroid carcinoma: frequency "Please Feel My A$$": In order of most frequent to least frequent. and in order from least aggressive to most aggressive: Papillary carcinoma Follicular carcinoma Medullary thyroid carcinoma Anaplastic carcinoma Parkinson's symptoms RATS Rigitidy (cogwheel) Akinesia Tremor (resting) Shuffling gate Thrombus: possible fates DOPE: Dissolution Organization & repair Propagation Embolization Pick's disease: features PICK: Progressive degeneration of neurons Intracytoplasmic Pick bodies Cortical atrophy Knife edge gyri Alzheimer's disease: features RONALD (Ronald Reagan. Becker Muscular Dystrophy (BMD): Badly Made Dystrophin (a truncated protein). Becker Muscular Dystrophy Duchenne Muscular Dystrophy (DMD) : Doesn't Make Dystrophin.Bleeding (haematemesis. · Korsakoff's psychosis (chronic phase): Retrograde amnesia Anterograde amnesia Confabulation Korsakoff's psychosis Pneumothorax: presentation P-THORAX: Pleuretic pain Trachea deviation Hyperresonance Onset sudden Reduced breath sounds (& dypsnea) Absent fremitus X-ray shows collapse Multiple endocrine neoplasia III: components MEN III is a disease of 3 M's: Medullary thyroid carcinoma Medulla of adrenal (pheochromocytoma) Mucosal neuroma Virchow's triad (venous thrombosis) "VIRchow": Vascular trauma Increased coagulability Reduced blood flow (stasis) Thrombotic thrombocytopenic purpura: signs FAT RN: Fever Anemia Thrombocytopenia .Old age Neurofibrillary tangles Atrophy of cerebral cortex (diffuse) Language impairment Dementia (MC in elderly)/ Down’s syndrome Wernicke-Korsakoff's psychosis: findings COAT RACK: · Wernicke's encephalopathy (acute phase): Confusion Ophthalmoplegia Ataxia Thiamine tx. APKD: signs. better when lean forward] Dandy-Walker syndrome: components "Dandy Walker Syndrome": Dilated 4th ventricle Water on the brain Small vermis Blood disorders: commoner sex HE (male) gets: . stones.Renal problems Neurologic dysfunction Parkinson's disease: symptoms PQRST: Paucity of expression parQinson Rigidity (cogwheel) Stooped posture Tremor at rest · If can't remember that Parkinson's tremor is the one that is "resting tremor". look at the last 3 letters: RST. accelerators 11 B's: · Signs: Bloody urine Bilateral pain [vs. complications. which are usually unilateral pain] Blood pressure up Bigger kidneys Bumps palpable · Complications: Berry aneurysm Biliary cysts Bicuspid valve [prolapse and other problems] · Accelerators: Boys Blacks Blood pressure high Pericarditis: findings PERICarditis: Pulsus paradoxus ECG changes Rub Increased JVP Chest pain [worse on inspiration. HEmophilia (X-linked) HEinz bodies (G6PD deficiency. classic triad "Iron man triathalon": Iron man: deposition of iron in many body tissues. · Triathalon has 3 components. causing HEmolytic anemia: X-linked) HEmochromatosis (male predominance) HEart attacks (male predominance) HEnoch-Schonlein purpura (male predominance) SHE (female) gets: SHEehan's syndrome Ovarian cancers: important types. "CRISP PIG burgers": Chronic ulceration Raynaud's phenomenon Intermittent claudication . which match triad: Swimming: Skin pigmentation Biking: Bronze diabetes Marathon: Micronodular pigment cirrhosis · Buerger's disease features "burger SCRAPS": Segmenting thrombosing vasculitis Claudication (intermittent) Raynaud's phenomenon Associated with smoking Pain. by WHO classification · Surface: "My Sister Began Experiencing Cancer": Mucinous Serous Brenner Endometrioid Clear · Germ cell: "Doctor Examined The Ovaries": Dysgerminoma Endometrial sinus Teratoma Ovarian choriocarcinoma · Sex cord: "She Felt Grim": Sertoli-Leydig Fibroma Granulosa-theca · Metastatic "Killed": Krukenberg Haemochromatosis definition. if hungry for more detail [sic]. even at rest Superficial nodular phlebitis · Alternatively. Conjunctivitis (non-exudative) Rash (polymorphous non-vesicular) Edema (or erythema of hands or feet) Adenopathy (cervical. VT. epidemiology . Achalasia: 1 possible cause. septum. 1 treatment aCHAlasia: 1 possible cause: CHAgas' disease 1 treatment: Ca++ CHAnnel blockers MI: post-MI complications ACT RAPID: Arrhythmias (SVT.Segmenting. VF) Congestive cardiac failure Tamponade/ Thromboembolic disorders Rupture (ventricle. even at rest Phlebitis (superficial nodular) Idiopathic Gangrene Cardiovascular risk factors FLASH BODIES: Family history Lipids Age Sex Homocystinaemia Blood pressure Obesity Diabetes mellitus Inflammation (raised CRP)/ Increased thrombosis Exercise Smoking Kawasaki Disease Criteria "Be careful when riding a Kawasaki motorcycle. you might get CREAMed. action. often unilateral) Mucosal involvement (erythema or fissures or crusting) To have Kawasaki disease you must have fever for greater than 5 days plus 4 of the above. papillary muscle) Aneurysm (ventricle) Pericarditis Infaction (a second one) Death/ Dressler's syndrome MI: sequence of elevated enzymes after MI "Time to CALL 911": · From first to appear to last: Troponin CK-MB AST LDH1 Pick's disease: location. thrombosing vasculitis Pain. Bronchial obstruction: consequences APPLE BABE: Atelectasis Pleural adhesions Pleuritis Lipid pneumonia Effusion->organisation->fibrosis Bronchiectasis Abscess Broncho and lobar pneumonia Emphysema Respiratory distress syndrome in infants: major risk factors PCD (Primary Ciliary Dyskinesia. since epidemiology is elderly & more common in women. Nasopharyngeal malignant cancers NASOPharyngeal: Nasophayngeal Adenocarcinoma Squamous cell carcinoma Olfactory neuroblastoma Plasmacytoma Baldness risk factors "Daddy Doesn't Deny Getting Hair Implants": Diet Disease Drugs Genes Hormones Injury to the scalp . causing cortical atrophy. An old woman.· Pick axes are Picking away at the old woman's cerebral cortex. 2 pick axes on her brain: frontal lobe and anterior 1/3 of temporal. a cause of Respiratory distress syndrome): Prematurity Cesarean section Diabetic mother Carcinomas having tendency to metastasize to bone "Particular Tumours Love Killing Bone": Prostate Thyroid Lung Kidney Breast Takayasu's disease is Pulseless disease "Can't Tak'a ya pulse" (Can't take your pulse): Takayasu's disease known as Pulseless disease. MI: sequence of elevated enzymes after MI "C-AST-Le" (castle): CK-MB first AST second LDH third · Also: can use the last 'E' for ESR. since pulse is weakened in the upper extremities. · Keeping P's straight: Pan is antitrypsin Renal failure (chronic): consequences ABCDEFG: Anemia -due to less EPO Bone alterations -osteomalacia -osteoporosis -von Recklinghausen Cardiopulmonary -atherosclerosis -CHF -hypertension -pericarditis D vitamin loss Electrolyte imbalance -sodium loss/gain -metabolic acidosis -hyperkalemia Feverous infections -due to leukocyte abnormalities and dialysis hazards GI disturbances -haemorrhagic gastritis -peptic ulcer disease -intractable hiccups . Bottom=Chronic disease. chronic disease TIBC levels at the: Top=Iron deficiency.Anemia: TIBC finding to differentiate iron deficiency vs. most important feature of each "Cigarettes Is Primary Problem": · Types: Centrilobular Irregular Pancinar Paraseptal · Most important feature for each type (in order as above): Cigarrettes Inflammation healed to scar Protease inhibitor deficiency (a1-antitrypsin) Pneumothorax · "Cigarettes is primary problem" used since cigarettes is most common cause of emphysema. Endometrial carcinoma: risk factors ENDOMET: Elderly Nulliparity Diabetes Obesity Menstrual irregularity Estrogen therapy hyperTension Emphysema: types. . · cAMP: Tx involves high dose of beta blockers (beta receptors work via cAMP) · Alternatively: "S#IT storm": Surgery. Syndrom=Throm. Infection/ Illness. · Alternatively: Wiskott=Hot. Tabes Dorsalis morphology DORSALIS: Dorsal column degeneration Orthopedic pain (Charcot joints) Reflexes decreased (deep tendon) Shooting pain Argyll-Robertson pupils Locomotor ataxia Impaired proprioception Syphilis TB: features TB is characterised by 4 C's: Caseation Calcification Cavitation Cicatrization Wiskott-Aldrich syndrome: symptom triad "PET WASP": Pyrogenic infections Eczema Thrombocytopenia · WASP is the name of the causitive agent: Wiskott-Aldrich Syndrome Protein. Hyperthyroidism. Aldrich=Itch.Endometrial carcinoma: risk factors HONDA: Hypertension Obesity Nulliparity Diabetes Age (increased) Thyroid storm characteristics "Storm HITS girls cAMP": Thyroid storm due to: Hyperthyroidism Infection or Illness at childbirth Trauma Surgery · girls: Thyroid storm more common in females. Trauma. Key processes in atherosclerosis are intimal thickening and lipid accumulation. Conjunctival. 8.Vascular immunomarkers include: CD31.macrophages. Vasculitis of arteries: inflammation arrows on arteries.Atherosclerotic plaque consists of 3 components: a)cells . granular mucosa Originates at rectum Neutrophil invasion Stools bloody Copyright reserved Dr.Kawasaki disease: features Disease name: a Kawasaki motorcycle. soles: red palms.ANCA are antineutrophil cytoplasmic antibodies seen in patients with vasculitis. 4. oral erythema: red eyes.The two most important causes of aortic aneurysms are atherosclerosis and cystic medial degeneration of the arterial media. 2.Vasculitis are divided into three types : large vessel including giant cell and takayasu’s ( granulomas).com 200 KEY POINTS IN SPECIAL PATHOLOGY 4TH YEAR MBBS BY DR EJAZ WARIS.CD34 and vWF.including SMCs. soles.These components are arranged in central core and fibrous cap.ChurgStrauss syndrome and Microscopic polyarteritis. Cervical lymphadenitis: enlarged cervical nodes with inflammation arrows.hakeem-sy. Fever: thermometer. Treat with aspirin: aspirin headlight. Ulcerative colitis: features ULCERATIONS: Ulcers Large intestine Carcinoma [risk] Extraintestinal manifestations Remnants of old ulcers [pseudopolyps] Abscesses in crypts Toxic megacolon [risk] Inflamed. 7. 6. red.The lesion is caused . mouth. 3. Erythema of palms. Generalized rash: rash dots. Cardiovascular sequelae [20%]: inflammation arrows on cardiac arteries. epidemic in Japan: Japanese child rides the motorcycle.Lobular capillary hemangioma ( Pyogenic granuloma ) is a common oral benign tumor occurring as polypoidal form attached to mucosa.and leukocytes.b)ECM and c)Intracellular and extracellular lipid. Usually young children.c-ANCA are seen in Wegener’s granulomatosis and p-ANCA seen in Microscopic polyangiitis and Churg-Straus syndrome.Kaposi’s sarcoma is the most common AIDS associated cancer in US. ASSOCIATE PROFESSOR HISTOPATHOLOGY AMDC 1. 5.Syrian / www.medium vessel including PAN(fibrinioid necrosis ) and Kawasaki’s disease and small vessels including Wegener’s. Giant cell tumor of bone consists of Mononuclear stromal cells ( the main neoplastic element ) and evenly placed multinucleated giant cells.patternless sheet like arrangement and small cell components with high N/C ratio.Immunomarker is CD 15 and CD 30. 25.Infections – commonest is Tuberculosis and Malignancies which may be primary ( Lymphoma ) or metastatic.Plaque and nodule.eosinophilic granular bodies and microcysts are seen in low grade Pilocytic astrocytoma.are foci of swollen eosinophilic collagen surrounded by lymphocytes . 15.Rheumatoid nodules consist of central zone of fibrinioid necrosis surrounded by a prominent rim of epithelioid histiocytes and numerous lymphocytes and plasma cells. 12.Scharff Bloom Richardson system grades the Breast carcinoma. 20. 19.Indian file pattern of tumor cells with monomorphic morphology is seen in Infiltrating lobular carcinoma of breast.Rosenthal fibers.Ewing Sarcoma (PNET) of bone consists of malignant round to oval tumor cells with .Clear cell and chordoid types of meningiomas fall into atypical variety and Papillary and Rhabdoid types fall into malignant variety.necrosis.c) Malignant type – more than 20 mitoses per 10 HPF or loss of differentiating features.Meningiomas are divided into 3 categories:a) simple benign type ( WHO grade 1). 27. 21.The thalassemia syndromes are a heterogenous group of inherited disorders caused by genetic lesions leading to decreased synthesis of either the alpha or beta globin chain of HbA.consisting of large aggregates of urate crystals surrounded by an intense inflammatory reaction of macrophages. 18.linked with history of childhood radiation. 22.show intranuclear inclusions and intranuclear grooves..In Myocardial infarction.Diagnosis rests on nuclear features . 24.Myxoma is the most common primart tumor of heart in adults and Rhabdomyoma is most commonest in children. 29.Synovial Sarcoma shows dual line of differentiation ( both epithelial like and spindly mesenchymal cells are seen ).WHO grading of Astrocytoma include : Grade I: low grade .Reed Sternberg cell is the hall mark of Hodgkin’s Lymphoma .Grade III: Anaplastic ( mitoses and endothelial proliferation) and Grade IV : Glioblastoma Multiforme ( necrosis).transitional.coagulation necrosis starts in 4 to 12 hrs and collagen deposition starts in 10 to 14 days.pathognominic of Rheumatic fever.5-9/10HPF : Borderiine STUM P and > 10/10HPF: Leiomyosarcoma).Papillary carcinoma is the commonest thyroid malignancy.Aschoff bodies .(PPN).Tophi are pathognomonic hallmark of gout. 28.the nuclei typically are optically clear ( empty)Orphan Annie appearance. b ) no of mitoses and c)atypia and pleomorphism. 26.Leiomyomas are differentiated from leiomyosarcoma on three basis .lymphocytesand large foreign body giant cells.Syncitial. 9. 14. atypia .b)atypical –show 4 to 19 mitoses / 10HPF or show 3 of following 5 features: hypercellularity.by KSHV and shows three morphological stages : Pact. necrosis and number of mitoses ( < 5/10HPF: Leiomyoma.occasional plasma cells and plump macrophages called Anitschkow cells. 11.psamommatous and secretory types fall into type 1. Grade II: Diffuse fibrillary.Causes of enlarged lymph node include : Reactive lymph node enlargement.It includes : a ) tubule formation .Dukes stage C refers to involvement of lymph nodes in carcinoma of the large bowel.Medullary Carcinoma is linked with amyloid deposition. 23. 13.macronucleoli.fibroblastic. 16. 10.The thought of origin is post germinal center B-Cell. 17. Chronic cholecystitis is the inflammation of gall bladder revealing subepithelial fibrosis and chronic inflammation in the lamina propria.Hydatidiform mole is characterized by cystically dilated avascular chorionic villi with trophoblastic proliferation.transmural inflammation. 40.Laurens classification of gastric carcinoma include diffuse (signet ring cells) and intestinal types.Malignant Melanoma shows two patterns of growth : radial and vertical. 47.Active cirrhosis means the presence of piecemeal necrosis.Panacinar emphysema is linked with alpha 1 antitrypsin deficiency. 51.crypt destruction.characterized by goblet cells and villous morphology.Lupus nephritis is of 6 classes : Class 1: no change . 55.Crohn’s disease is characterized by strictures.peptic ulcer disease.cryptitis. 53. 43.Total score is 24.Carcinoid tumors common sites include small intestine and tip of appendix.Ulcerative colitis is characterized by pseudololyps.Fibroadenoma is commonest benign tumor of breast in young females. 48. 45.crypt distortion and crypt abscess formation.Reid index is the ratio of thickness of the mucous gland layer to the thickness of the wall between the epithelium and cartilage. class II: 34. 38.The nature and extent of the vertical growth phase determine the biologic behavious of malignant melanoma. 46. 32. 36.Osteosarcoma is confirmed by the presence of malignant lace like osteoid surrounded by tumor cells. 49. 31.Adenoma is the commonest tumor Pituitary gland. 52.Active inflammation is signified by the presence of neutrophils within the glandular and surface epithelial layer. 35.Choriocarcinoma shows no chorionic villi. 57.which rarely metastasize.Invasive ductal carcinoma of breast is the commonest malignant tumor of breast.Follicular carcinoma of thyroid is confirmed by capsular and vascular invasion by tumor cells.It is locally aggressive tumor.Immunomarkers include Chromogranin and synaptophysins.It is the most radiosensitive.Knodell Score is done to evaluate the grade and stage of hepatitis activity.sinuses and granulomas.Cirrhosis of liver is characterized by nodules of variable sizes composed of benign hepatocytes and separated by thin fibrous tissue septae infiltrated by chronic inflammatory cell infiltrate.It comprises of A . 50. 42.Asbestos is linked with Mesothelioma and Bronchogenic Carcinoma.Peripheral palisading is seen in nests of tumor cells in Basal cell carcinoma ( Rodent ulcer). 39. 44. 56.The histologic hall mark of Paget’s disease of bone is mosaic pattern of lamellar bone.superficial ulcers.Immunomarker is BER-EP4.Pleomorphic adenoma is the commonest benign tumor of salivary gland. 41.it comprises of : portal inflammation. 37. 33.Bronchiectasis is a disease characterized by permanent dilation of bronchi and bronchioles caused by destruction of the muscle and elastic tissue resulting from or associated with chronic necrotizing infections.The cells are monomorphic with abundant granular cytoplasm.Metavir score is another criteria of grading and staging of liver activity.It is increased in Chronic bronchitis.Helicobacter pylori is linked with chronic gastritis. 54.intralobular inflammation and fibrosis.gastric carcinoma and gastric MALT lymphoma.piecemeal necrosis.Seminoma is the commonest malignant tumor of testis in adults.cytoplasm containing glycogen.Barett’s esophagus is linked with esophageal adenocarcinoma.deep linear ulcers.Immunomarker is CD99(MIC-2) 30. 58.Three complications include three P’s: Papillary necrosis. 77.HER-2/neu positive tumors carry poor prognosis.Yolk sac tumor shows Schiller Duval bodies.Multiple Myeloma is characterized by bence jones proteinuria.cast nephropathy.( types 16.Dysgerminoma is the counterpart of seminoma in females.the most common cervical carcinoma.PT1 is for lamina propria and PT2 is for muscle wall invasion in Transitional cell tumors. 63.atypical suamous cells of undetermined significance. 70.thyroidization and chronic interstitial inflammation.All patterns of Hepatocellular carcinomas have a strong propensity for invasion of vascular channels.Immature or malignant teratomas show sheets of undifferentiated cells.Chronic pyelonephritis is characterized on gross examination by a corticomedullary scar and on microscopy by tubular atrophy and dilation. 66.Bethesda system divided into ASCUS.Acute pyelonephritis is characterized by patchy interstitial suppurative inflammation.Crescents are seen in rapidly progressive glomerulonephritis.Renal cell carcinoma has the tendency to metastasize widely before giving rise to any local symptoms or signs. 76. 60. 72.Seminomatous germ cell tumors are radiosensitive and chemo responsive while non seminomatous tumors are vice versa.LSIL-low grade squamous intraepithelial lesion( Koilocytosis and mild dysplasia) and HSIL – High grade squamous intraepithelial lesion ( Moderate and severe).Diabetic glomerulosclerosis is characterized by capillary basement membrane thickening.unless proved otherwise.pyonephrosis and perinephric abscess.diffuse thickening of the glomerular capillary wall with silver spikes are seen in membranous glomerulonephritis and focal thickening of glomerular basement membrane with silver tram track appearance is seen in membranoproliferative glomerulonephritis.Tubular carcinoma of breast carries the best prognosis.33).Hyaline arteriosclerosis is benign hypertensive vascular change showing thickening and hyalinization of the walls with narrowed lumina of small vessels. 69. 74.31. 78. 80. 59.papillary .18.Teratomas in males are malignant.low grade papillary urothelial carcinoma and high grade papillary urothelial carcinoma. 61.Gleason Score is done for the grading of Prostatic adenocarcinomas.Granulosa cell tumor shows Call exner bodies. 71. 65.for activity and F for fibrosis.hypercalcemia. 68. 67.intratubular aggregates of neurtophils and tubular necrosis.Furrhman Grading is done for Renal cell carcinoma.Renal cell carcinoma is of 4 major types: clear cell – the most common type. 79.kimmelstiel-wilson nodules (PAS positive). 62.Human Papilloma Virus is the etiologic agent of Squamous cell carcinoma of the cervix .capsular drops and fibrin caps 64.diffuse mesangial sclerosis .not seen in a benign teratoma.ER – PR postivie breast carcinomas carry better prognosis and are responsive to antiestrogen drugs.Perineural invasion is depicted by prostatic and pancreatic adenocarcinomas. 81. 73.Alpha fetoprotein is the tumor marker of HCC and CEA is the tumor marker of carcinoma of the colon.Squmaous cell carcinoma is characterized by sheets and groups of pleomorphic malignant .WHO grades Transitional cell tumors into Urothelial papilloma.chromophobe and bellini duct carcinoma. 75.urothelial neoplasm of low malignant potential.hyperuricemia and light chain deposition disease.Hyperplastic arteriosclerosis is malignant vascular hypertensive change showing fibrosis with onion skin type layering of wall. Burkitt’s lymphoma carries 100% mitotic index. 82. 83.Neuroblastoma.medullary carcinoma thyroid and parathyroid hyperplasia.intracellular bridges and keratin epithelial pearls are seen.Hypercalcemia is shown by squamous cell carcinoma of lung.Small cell carcinoma of the lung shows maximum paraneoplastic syndromes – most common cushing like picture and ADH like morphology.Simple and atypical are two types of endometrial hyperplasia.Individual cell keratinization.lymphocyte depletion. Few Characteristics Exclusive to Lesions .e.nodular sclerosis and mixed cellularity ( CD 15 +.Desmin is positive in skeletal muscle tumors. 93. 95. 87.Chicken wire calcification is seen in chondroblastoma.DeQuervain’s type shows presence of granulomas. 103.Whorls like arrangement – Meningioma. 96.LCA is the universal leukocyte marker. 94.PTEN is the antioncogene altered in endometrial hyperplasia and adenocarcinoma.squamous epithelial cells with hyperchromatic nuclei and pale cytoplasm.Signet ring cells – Poorly differentiated mucin secreting adenocarcinoma.with the exception of parathyroid involvement.Hodgkin’s Lymphoma is divided into five types : one set include Lymphocyte rich. 100.Glandular wall sharing is one of the hall mark sign of adenocarcinomas.MEN2-B is same as 2A.EIN is the new term assoiated with endometrial hyperplasia. 92.Peripheral Palisading – Basal cell carcinoma.Endometriosis is the presence of normal endometrial glands. .5 in T cells.Adenocarcinomas are characterized by back to back glandular structures lined by pleomorphic malignant epithelial cells with hyperchromatic nuclei and eosinophilic cytoplasm.Epithelioid and sarcomatoid types are noted in a mesothelioma.CD19.Medulloblastoma and Retinoblastoma etc. 91.stroma and hemosiderin laden macrophages outside uterus.Pseudopalisading in tumor – GBM.pancreas and pituitary. 105.Endometrial carcinoma arises on two backgrounds: hormone dependent with good prognosis and vice versa with poor prognosis(clear and papillary types).Squamous cell carcinoma of lung is strongly associated with smoking.Acute appendicitis is depicted by the presence of neutrophils in the muscularis layer.g Lymphoma.Rapid revision: 101.Round blue cell tumors of childhood include tumors with blue cell morphology with scanty cytoplasm.Hashimoto’s thyroiditis shows lymphoid follicles with germinal centers and hurthle cells.CD20 AND CD79a is positive in B-cells and CD 2.3.The primary feature of primary biliary cirrhosis is the non suppurative inflammatory destruction of medium sized intrahepatic bile ducts. 90.Cytokeratin is the immunomarker for epithelial tumors and Vimentin is the marker for mesenchymal tumors.The separate set includes nodular lymphocyte predominance ( CD45 +). 84.Calretenin is the immunomarker for mesothelioma. 89.Keratin pearls – Squamous cell carcinoma. 98.MEN TYPE 1 or Wermer syndrome shows abnormalities in 3 P’s : Parathyroid. 102.Melan-A and HMB45 is positive for Melanomas.Antoni A cellular areas and Antoni B myxoid areas are seen in Schwanommas. 86.Pheochromocytoma is composed of polygonal to spindle shaped chromaffin cells clustered with the sustentecular cells into small nests of alveoli ( Zell ballen appearance) by a rich vascular network.90% patients are positive for antimitochondrial antibodies. 104.4. 88.Benign prostatic hyperplasia includes two components : Glandular and fibromuscular.CD 30 +). 97.DHT is the source of hyperplasia. 99. 85.MEN -2A or Sipple syndrome shows pheochromocytoma. Non Hodgkin’’s Lymphoma : Sheets of monotonous population of atypical lymphoid cells with hyperchromatic nuclei and scanty cytoplasm.Chicken wire calcifications – chondroblastoma.Psamomma bodies – Papillary carcinoma thyroid.Piecemeal necrosis – Chronic active hepatitis.Mallory bodies – Alcoholic cirrhosis.Angiosarcoma: Sheets of malignant oval to spindly cells with hyperchromatic nuclei.Papillary carcinoma thyroid : Papillary structures with fibrovascular cores lined by pleomorphic malignant epithelial cells with Orphan Annie nuclei.Basal cell carcinoma ( Rodent ulcer ) .Meningioma : whorls and bundles of oval to fusiform to polygonal cells with regular nuclei.Seminoma : Sheets and groups of seminoma cells with hyperchromatic vesicular nuclei and water clear cytoplasm.aggregates and packets of monomorphic cells with round to oval nuclei and granular cytoplasm.Hemangioma : Aggregates of closely arranged thin walled vascular channels lined by benign endothelium and separated by scanty fibrous stroma.Psamomma bodies are present.Squamous cell carcinoma : sheets and clusters of pleomorphic malignant squamous epithelial cells with hyperchromatic nuclei and pale cytoplasm.Oat cells – Small cell carcinoma lung.intercellular bridges and individual cell keratinization are seen.These tumor cells arranged in lobules separated by fibrous tissue septae infiltrated by lymphocytes. . 110.Meningioma. Nests and groups of pleomorphic basaloid cells with hyperchromatic nuclei and scanty cytoplasm. 108 .Chromogranin positive. 109.106.Hair in tumor – Benign cystic teratoma ( dermoid cyst ) 120.macrophages and eosinophils ( Characteristic feature).Reed Sternberg cells are hall mark. 114. 131. 128.Carcinoid tumor : nests.Verocay bodies ( Antoni A and B ) – Schwanomma.plasma cells.Abnormal mitoses and focal necrosis is noted in high grade sarcomas.Osteoid formation – Osteosarcoma.Capsular / vascular invasion – Follicular carcinoma thyroid. 119. 113.Sarcoma : Sheets of malignant oval to spindly cells with hyperchromatic nuclei .Nuclear Grooves are seen. 118.Eosinophilic secretions are noted. 125.Yolk sac tumor : sheets and nests of pleomorphic malignant oval to polygonal cells forming schiller duval bodies. 122. 116.Wall sharing is noted.Mitoses can be seen. 127. 123.Reed Sternberg cells – Hodgkin’s Lymphoma.Peripheral palisading is noted at the periphery of nests. 133.Call exner bodies – Granulosa cell tumor.Adenocarcinoma : Back to back closely packed gland like structures lined by pleomorphic malignant epithelial cells with hyperchromatic nuclei and eosinophilic cytoplasm.Stellate cells – Cardiac myxoma.Mitoses are noted. 107.Amyloid – Medullary carcinoma thyroid.Indian file pattern – Lobular carcinoma breast. 130. 111.Psamomma bodies may also be seen. 117. 132. 112.Papillary serous ovarian tumors. 129. Typical descriptions / Key Points of Few common major Lesions : 121. 126.Hodgkin’s Lymphoma : Heterogenous population of cells including lymphocytes.Keratin epithelial pearls. 124.Mitoses are noted. 115.Schiller Duval bodies – Yolk sac tumor. thyroid cyst / nodule. 160. 149.Melan – A.CD19.WHO grading of Astrocytoma.CD 15 & CD 30 – Reed Sternberg cells / Hodgkin’s. 151.134.Duke’s Staging : Carcinoma colon .Ulcer Intestine : Tuberculosis.Desmin – Muscle marker.Knodell score : Chronic hepatitis / cirrhosis / liver activity.follicular adenoma.Enlarged cervical lymph node : Reactive lymph node enlargement .meningioma.non specific abscess. ( Ann Arbor) Important DIFFERENTIAL DIAGNOSIS in special pathology “ 159.LCA – Leukocyte common antigen – Lymphomas.Pigment deposition is noted.Brown black pigment in liver : Haemochromatosis.metastatic melanoma. 141.CD20. Cold nodule thyroid : Benign hyperplastic colloid nodule.Lump Breast in 40 yrs old female : Carcinoma breast.thyroid tissue can be seen. 139. 155.4.Perforation.pilocytic astrocytoma.sheets and groups of pleomorphic malignant epithelial cells with hyperchromatic nuclei and eosinophilic cytoplasm . 165.Malignant melanoma.FIGO grading / staging : Carcinoma endometrium and cervix. Cytokeratin – Carcinomas.follicular variant of papillary carcinoma thyroid.Carcinoma.Typhoid. 164. Metastatic malignancy.sebaceous glands. 140. 145.follicle like arrangement in thyroid : Follicular adenoma.Liver cirrhosis : Nodules composed of benign hepatocytes separated by thin fibrous tissue septae.Ductal carcinoma breast : Ductal structures.Bile pigment in cholestasis.Chromogranin – Neuroendcrine marker . Famous GRADING / STAGING to be Learnt by heart: 148. 143.CD3. 135.Fuhrmann’s Grading : Renal cell carcinoma.Hodgkin’s Lymphoma staging. 169.fibrocystic disease.Clinical outcome of a malignant tumor rests mainly on staging/lymph node invasion / .TNM Staging of Lung.lipofuscin pigment in aging. 152. 157.carcinoid. TYPICAL immunomarkers : 138.Bloom Richardson grading : Breast carcinoma. 146.Malignant melanoma : Sheets of malignant oval to polygonal cells with hyperchromatic nuclei and prominent pink nucleoli.Other types of tissue like nervous.Active gastritis or colitis means presence of polymorphs .Gleason’s Score : Carcinoma Prostate.CD79a – B cell Lymphoma Marker. 147. nEural marker.Lauren’s Classification : carcinoma stomach.fomalin pigment. 153.S-100 – Melanoma . 158.Inflammtory bowel disease. Some other Last Points in Special Pathology not to be missed: 167.Meningioma : WHO grading. 137. 142.follicular carcinoma.crypt abscess means presence of collections of neutrophils in glands or crypts lumen. 161.5 . 150.schwanomma.Vimentin – Sarcomas.Lymphoma . 168. 156.Carcinoma thyroid. 136.Posterior fossa brain tumors : Medulloblastoma.8 – T cell Lymphoma Marker.Tuberculous lymph node.Teratoma : Cystic lesion lined by benign stratified squamous epithelium and cyst wall showing hair follicles.fibroadenoma. 154. 162. 163. 144. 196.Routine histopathological stain is Haematoxylin and Eosin.The granulomas of sarcoidosis are characteristically non caseating.Alcian blue is the stain used to look for mucin. 199.When give Differential diagnosis of any lump always go in this order : infections.LDL.Adenoid cystic carcinoma is a common malignant salivary gland tumor. 200.RFT’s mean BUN and serum creatinine.Sudan black and Oil Red 0 are special stains for fat.Triglycerides. in the central nervous system[3] Peritoneal and Pleural Mesothelioma Somatostatinoma (pancreas)[4] . 185.T3.VLDL.HDL.lung and abdominal lymph nodes.T4. 192. 198.the anemia of chronic disease and b thallesemia minor. 191.PAS-D.mets.Perls Prussian blue stain is used to look for iron.The most frequent causes of mild anemia with hypochromia and microcytosis are iron deficiency anemia.Incisional biopsy.FNAC deep lumps common sites include – Liver. 179.GMS stain is done for fungus.FNAC common sites for superficial lumps – lymph nodes. 186. 178.thyroid and breast. Psammoma bodies are commonly seen in certain tumors such as: Papillary thyroid carcinoma Papillary renal cell carcinoma Ovarian papillary serous cystadenocarcinoma[2] Endometrial adenocarcinomas (Papillary serous carcinoma ~3%-4%) Meningiomas. 174. 193. 170. 197.Common Histo fixative is 10 % Formalin.Lipid Profile include : Cholesterol. 189.SGOT.Special Liver stains include : PAS.Cardiac Profile include : Troponin.LFT’s mean Serum billirubin.The majority of salivary gland tumors occur in parotid and most common tumor is Pleomorphic adenoma.The hallmark of the megaloblastic anemia is the finding of megaloblastic erythroid hyperplasia in the bone marrow.Biopsy is always preferable over FNAC.ZN stain is done to look for AFB ( Acid fast bacillus ) in Tuberculosis.Methenamine silver and PAS stains are done for kidney biopsies to see thickening of basement membrane of capillaries.benign tumors and than malignant tumors.It tends to spread vertically more than horizontally.Van gieson and masson trichrome stains are done to look for collagen fibers / fibrosis. 177. 187.Common Cytology fixative is 95% ethyl alcohol. 175.salivary glands. 183. 176. 188. 195.SGPT.Trucut biopsy. ( Gomori methenamine silver ) 181.Nodular melanoma has two pattern of growths.Special stains / Immunostains are needed when diagnosis cannt be made with a Routine stain.LDH. 173.Creatine Kinase .Reticulin.Kaiserling solution is used to keep specimens fixed in museums for long term.FNAC of deep seated lumps need help of Ultrasound /CT. 190.serum albumin. 182.horizontal and vertical.Biopsies are of many types : Excision biopsy. 180.Thyroid function tests include TSH.LDH. 171. 184. 194.Routine cytological stain is Giemsa and Papanicoalau( for nucleus ). 172. Prolactinoma of the pituitary [5] Mesothelioma. in membranes that line body cavities .