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ABIM - Histology

Histology

QuestionAnswer
Hyaline inclusions in cytosol of hepatocytes Mallory bodies (damaged/ubiquinated intermediate filaments) - alcoholic liver disease
Eosinophilic cytoplasmic inclusions in degenerating sybstantia nigra neurons Lewy bodies - Parkinson's. Lewy Armstrong has Parkinson's.
What is amyloid? protein organized in B pleated sheet --> deposited in interstitial tissue --> organ dysfunction. Many proteins can be converted to amyloid: pre-albumin, calcitonin, light chains (like in multiple myeloma). Amyloid is toxic to neurons. On Chromosome 21.
Tissue biopsy stained with Congo red -- how to tell if you have amyloid? see apple-green colored birefringence in polarized light
Congo red B2 microglobulin, shigella
What is B amyloid associated with? Down's syndrome pts that develop Alzheimer's. Trisomy 21. Amyloid gene is on Chromosome 21, so extra 21 means more amyloid, which is toxic to neurons.
S100 antigen + Stain that signifies that the tissue is of neural crest origin
APUD tumor Precursor Uptake Decarboxylation - tumor from neurosecretory or neuro-crest origin
Name some tumors that would be APUD positive Small cell CA of lung, bronchial carcinoid, neuroblastoma in medulla
Auer rods in a promyeloblast leukemia
hypersegmented neutrophils (> 5 nuclear lobes) B12/folate deficiency
keratin stain for epithelium -- can signify carcinomas (of epithelial origin)
bimentin (blank)
desmin stain for muscle
Dry gangrene in toes DM --> ischemia --> infarction --> coagulation necrosis
Brain infarction is what kind of necrosis Liquefactive
Wet gangrene in toes DM --> ischemia --> infarction --> coagulation necrosis --> infection with an anaerobic organism (e.g. C perfringens) --> liquefactive necrosis
Caseous necrosis caused by what? Mycobacterium or systemic fungi - caseous material is lipid from cell membranes
Fibrinoid necrosis associated with immunologic process
How do you know that a cell is a reticulocyte? Use supravital stain to see the RNA filaments. RNA filaments means that RBC is still synthesizing Hb. Can't see the RNA filaments on Wright Giemsa stain.
What is basophilic stipling? indicates Pb poisoning. The basophilic stipling is ribosomes that can't be broken down, since Pb degrades the enzyme used to break down ribosomes (ribonuclease).
Burr cells/echinocytes A burr cell is an erythrocyte characterized by the presence of multiple small projections distributed across its surface (undulating membrane). The projections tend to be dispersed evenly, have blunt ends, and are uniform in size. These characteristics he
Spur cells/acanthocytes Spur cells or acanthocytes are large erythrocytes covered with spikelike projections that vary in width, length, and distribution. Acanthocytes differ from burr cells in that they are spherocytes with thorns, darkly stained, and have no central pallor.
Echinocytes Echinocytes contain adequate hemoglobin and the spiny knobs are regularly dispersed over the cell surface, unlike those of acanthocytes (spur cells)
WBC with hair-like projections Hairy cell leukemia -- must use TRAP stain (tartrate resistant acid phosphatase stain)
Howell jolly body Spleen not working. basophilic nuclear remnants (clusters of DNA) in circulating erythrocytes. During maturation in the bone marrow erythrocytes normally expel their nuclei, but in some cases a small portion of DNA remains. This DNA appears as a basophil
Heinz body Refractile red cell inclusions of variable size and usually eccentrically located and adhered to the red cell membrane. Seen only with supravital staining with crystal violet, brilliant cresyl blue or on a fresh, wet preparation of blood. Not seen on a Wr
RBC that looks like someone took a bite out of it. Bite cells. Macrophages taking a bite out of RBC's trying to remove the Heinz bodies, which is clumped up denatured Hb on the inside membrane of RBC's.
Photos of abnormal RBC's http://www.som.tulane.edu/classware/pathology/Krause/AbnormalRBC/AbnormalRBC.html
Schistocytes Fragmented RBCs damaged by running into things like thrombi, calcified valves, vessel turbulence, etc.
What are the only diseases to have Auer rods? AML - acute lymphoid leukemia. M2 and M3 (acute promyelocytic leukemia)
In what disease do you find smudge cells? they are fragile leukemic cells that are burst during slide preparation; found in CLL
tennis racket Birbeck granule in a Langerhans cell/histiocyte
Reed Sternberg cell derived from B cells, associated with Hodgkin's lymphoma, CD30 and CD15 positive
in lysosome: buildup of sphingomyelin Niemann-Pick disease is an autosomal recessive disorder affecting lipid metabolism (the breakdown and use of fats and cholesterol in the body) --> Mutations in the SMPD1 gene --> doesn't have an enzyme called acid sphingomyelinase in lysosomes --> can't b
"starry sky" Burkitt's B cell non-Hodgkin's lymphoma with neoplastic B cells as the dark background and macrophages as the white stars
section of cervical or supraclavicular lymph node looks like "fish flesh" Hodgkin's lymphoma
What type of Hodgkin's lymphoma more likely to have Reed Sternberg cells? Mixed cellularity more than nodular sclerosing or lymphocyte predominant
Macrophages with crinkled paper appearance Gaucher's disease. deficiency of glucocerebrosidase --> can't break down glucocerebrosides in lysosome --> accumulation. Have splenomegaly because the macrophages in the red pulp in the spleen are accumulating glucocerebrosides!
Macrophages with soap bubble appearance Niemann-Pick disease is an autosomal recessive disorder affecting lipid metabolism (the breakdown and use of fats and cholesterol in the body) --> Mutations in the SMPD1 gene --> doesn't have an enzyme called acid sphingomyelinase in lysosomes --> can't b
What do you find in people with splenectomys? 1. nucleated RBC's, 2. Howell-Jolly bodies, 3. Target cells (excess membrane can't be removed), 4. thrombocytosis 9platelets normally sequestered in the spleen are now circulating)
giant cells with multiple overlapping nuclei, found in lymphoid tissue Warthin-Finkeldey cells, measles, especially during the prodromal stage.
Alveolar macrophages that look like they have black pigment in them dust cells -- coal/coal workers' pneumoconiosis
What color are squamous cells on the Papanicolaou stain? squamous cells contain keratin, and keratin stains red
Signet ring cells If in stomach, then it's gastric adenocarcinoma - diffuse type. If on both ovaries (hematogenous spread from stomach to ovaries), then it's metastasis from gastric adenocarcinoma - diffuse type. This type of tumor on the ovaries is called a Krukenberg t
PAS-positive macrophage inclusions Periodic acid-Schiff (PAS) is a staining method used in histology and pathology. This method is primarily used to identify glycogen in tissues. Suggests Whipple's disease. Or Paget's.
foamy macrophages Found in lamina propria of the small intestine, infection due to Tropheryma whippelii --> Whipple's disease --> diarrhea, fever, polyarthritis, generalized painful lymphadenopathy, peculiar color to the skin; if find foamy macrophages in HIV+ person, it's
see RBC's inside some trophozoites Entamoeba histolytica - phagocytose RBC's. Resistant to acid so not killed in your stomach from gastric juices --> exists in cecum where there’s an alkaline environment (drills a hole - "lytica" - so you'll see flask shaped ulcers) --> Cecum is drained
Created by: christinapham