patho

Diagnosis: Lobar

pneumonia, Red

hepatization

Describe:

Section in the lung shows:

All the alveolar spaces:

contain a network of

fibrin entangling many

intact red blood cells

and some intact

polymorphs &

macrophages.

 The alveolar walls:

edema and congested

capillaries.

Diagnosis: Fibrinous peritonitis,

intestine

Describe: Section in small intestine

shows:

covering peritoneum: shedded

serosal cells. Covered by

network of fibrin entangling

acute inflammatory cellular

infiltrate (exudate)

 Sub serosal connective tissue:

edema, congested capillaries,

formed of acute inflammatory

cellular infiltrate = many

polymorphs and few

macrophages.

 Intestinal mucosa and

submucosa are normal

Diagnosis: Acute suppurative

appendicitis

Describe:

Transverse section in the

appendix shows:

mucosal glands: partly sheded

ulcerated.

mucosa, submucosa,

musculosa, Serosa: edema,

congested capillaries, dense

acute inflammatory exudate 

infiltration by PMNs, pus cells,

macrophages

 Lumen: of the appendix

contains a fibrin network +

necrotic sheded mucosal cells

+ PMNs + pus cells

Diagnosis: Lobar

pneumonia, Red

hepatization

Describe:

Section in the lung shows:

 All the alveolar spaces:

contain a network of

fibrin entangling many

intact red blood cells

and some intact

polymorphs &

macrophages.

 The alveolar walls:

edema and congested

capillaries.

Acute inflammatory cells:

Section at acute

inflammation:

Congested capillaries,

dense acute inflammatory

cellular infiltrate (exudate)

formed of:

• many PNMLs

(segmented nucleus)

• few macrophages

(larger cells with ovoid

indented nucleus)

Chronic inflammation:

Chronic inflammatory cells:

• Lymphocytes (small

rounded cells with small

rounded dark nuclei,

inconspicuous

cytoplasm)

• Plasma cells (eccenteric

nucleus)

• Macrophages (larger

than lymphocytes with

abundant cytoplasm and

ovoid indented nuclei)

Diagnosis: myocardial

scar (healed MI)

Section in the

myocardium (cardiac

muscle) showing:

• Areas of scar tissue.

• The scar tissue is

homogenous pink with

dilated capillaries and

some fibroblasts.

• The adjacent cardiac

muscle fibers: red and

slightly atrophic with

pyknotic nuclei.

Diagnosis: squamous cell

papilloma

section in a non-capsulated

benign tumor formed of:

• Papilla with Branching core

of connective tissue covered

by a thick hyperplastic

stratified squamous

epithelium.

N.B:

• acanthiosis (increase prickle cell

layer), parakeratosis (nucleated

surface keratin), hyperkeratosis

(excessive keratin)

• The core shows blood vessels.

Diagnosis: Adenomatous polyp

(adenoma), intestine

Describe:

benign tumor formed of :

 Proliferated acini (glands)

 variable in size and shape

 lined by one layer of columnar

mucin secreting cells with basal

nuclei.

 Some are lined by dysplastic

epithelium shows mucin

depletion, hyperchromatic,

elongated pseudostratified

nuclei.

 vascular connective tissue

stroma

 between the glands with few

inflammatory cells.

Diagnosis: Fibroadenoma

pericanalicular

Section in a benign tumor

formed of:

• Proliferated glands (ducts),

rounded or oval in cut

section with patent lumen.

• lined by two layers of cells,

outer flattened and inner

cubical.

• The ducts are separated by

delicate fibrous tissue

containing blood vessels and

few lymphocytes.

• The tumor is surrounded by

a fibrous capsule.

Diagnosis:

Fibroadenoma Intracanalicular

Section in a capsulated benign

tumor formed of:

• Proliferated ducts,

compressed (obliterated

lumen)

• lined by two layers of cells,

outer flattened and inner

cubical.

• ducts are invaginated by

Excess fibrous tissue giving

the false impression that the

epithelium surround the

fibrous tissue in some areas

(intracanalicular).

• Tumor is surrounded by

fibrous capsule

Diagnosis: lipoma

Section from a benign

tumor shows:

 A fibrous capsule

surrounds the tumor

and sends fibrovascular septa dividing

the tumor into lobules.

 The lobules are formed

of *mature fat cells:

large, polygonal and

vacuolated. *nuclei:

flattened, compressed

against cell membrane

(signet ring

appearance).

Diagnosis: Squamous cell

carcinoma insitu:

Section in uterine cervix

• Squamous metaplasia +

full thickness high grade

dysplastic changes

• Cells:

loss of orientation, large

hyperchromatic

pleomorphic nuclei + high

nucleocytoplasmic ratio

Diagnosis: squamous cell carinoma

section in skin shows:

• Sheets of malignant epithelial

cells infiltrating the dermis

• focal ulcerated epidermis.

• tumor masses variable in size

and shape

• Their periphery: layer of dark

stained small basal like cells,

inner to this are polyhedral cells

and the central cells show a red

stained keratin pearls (cell nest).

• The malignant cells: variable in

size and shape with abundant

pink cytoplasm, and large

hyperchromatic nuclei showing

prominent nucleoli.

Diagnosis: Infiltrating duct

carcinoma, breast.

Section in breast showing:

Infiltrating sheets of

malignant epithelial cells

separated by excessive dense

fibrous tissue

• malignant cells: Rounded to

polyhedral, variable in size

• Nuclei: large pleomorphic

hyperchromatic,

• prominent nucleoli

• mitotic figures.

Diagnosis: Adenocarcinoma,

colon

Describe:

Section in colonic wall shows:

* malignant tumor:

 irregular acini

 infiltrating submucosa and

muscle layer (musculosa).

 acini vary in size and shape

 lined by one or more layers

of malignant cells (loss of

polarity)

 malignant cells vary in size

and shape.

 Nuclei: large,

 hyperchromatic

 Mitotic figures

Diagnosis: Metastatic

carcinoma at lymph node

Section in enlarged lymph

node:

• Partial replacement of

nodal tissue by

malignant tumor

deposits

• Tumor: solid masses of

malignant cells variable

at size and shape

• Hyperchromatic nuclei

• Abundant mitosis

• Tumor emboli at

lymphatics

Diagnosis: Spindle cell

sarcoma (Fibrosarcoma)

Section in a malignant

tumor showing:

Proliferated spindle cells

arranged in fascicles 

herring bone pattern. The

cells have dark elongated

nuclei high nucleocytoplasmic ratio and

mitotic figures.

The background shows

little amount of collagen

Diagnosis: Chronic venous

congestion, Lung

Describe:

Section in lung shows:

 The alveolar walls: thickened

 interstitial edema and

congested capillaries.

 alveolar spaces: homogenous

pink transudate entangling

red cells, hemosiderin

granules, and heart failure

cells.

 HEART FAILURE CELLS: large

rounded phagocytic cells

engulfing brown hemosiderin

granules.

Diagnosis: Chronic venous

congestion, liver

Describe:

Section in liver shows:

• central veins and

sinusoids: dilated and

congested.

• liver cells in the center of

lobules: atrophic.

• liver cells in the

periphery of lobules:

cloudy swelling and fatty

degeneration.

• Kupffer cells are

distended with brown

hemosiderin granules

Diagnosis: recent

thrombus

Transverse section in a

blood vessel:

• The lumen is occluded

by a thrombus:

• red mass transversed

by pale structurless

lines formed of fused

platelets (lines of

zahn)

• In between lines of

zahn: network of fibrin

entangling red and

white blood cells.

Diagnosis: Infarction,

spleen:

Section in spleen

showing two zones:

• Zone of infarction:

structurless pink area

of coagulative necrosis

• Red and white pulp:

ghosts

• The adjacent spleen is

normal

• In-between two zones:

zone of congestion

Diagnosis: Infarction, lung

Describe:

Section in lung shows two zones:

The infarct:

 atrophic alveolar walls  thin

fibrous septa

 alveolar spaces: many intact

and haemolysed red blood cells

and SHADOWS of heart failure

cells.

The rest of the lung:

 picture of chronic venous

congestion (describe).

 Pleura opposite the infarct:

fibrinous pleurisy (describe)

Diagnosis: Caseating tuberculosis,

lymph node:

Section in enlarged lymph node:

• Lymph node structure is partially

effaced and replaced by

homogenous pink caseous

material entangling blue nuclear

fragments

• Multiple tubercles surrounding

the caseation

• Tubercle: the microscopic unit of

TB = large pink epitheloid cells,

langhan’s giant cells (peripheral

horse shoe arrangement of

nuclei) and lymphocytes

Diagnosis: Miliray

tuberculosis, lung

Describe:

Section in the lung shows:

 Small many miliary

tubercles scattered in the

interstitial lung tissue

perivascular.

 tubercle is formed of

epithelioid cells, langhan's

giant cells and

lymphocytes.

 Minimal casation & absent

fibrosis

Diagnssis: Madura foot,

actinomycosis

Section from skin showing:

Many abscesses

surrounded by fibrosis.

• Each abscess consists of

blue fungal colonies

surrounded by

neutrophils and

macrophages.

• The fungal colonies: dark

blue hyphae attached to

pink stained club

shaped peripheral

structures.

D

Diagnosis: Bilharziasis, colon

Describe:

Section in Colonic Mucosa

shows:

 Many bilharzia ova in

submucosa with yellowish

refractile shell.

 Some are fresh showing

pink miracidia and others

are calcified(dark blue).

 Ova are surrounded by

bilharzial reaction

(lymphocytes, plasma cells

macrophages, eosinophils,

fibrosis)

Diagnosis: Bilharzialpolyp,

colon

Describe:

Section in a polyp shows:

 central core of vascular

connective tissue

 fresh, degenerated and

calcified ova (describe)

 surrounded by bilharzial

reaction (lymphocytes,

plasma cells, macrophages,

eosinophils, fibrosis)

 Hyperplastic covering

mucosa (increased number

of mucosal glands)

Diagnosis: section from the urinary

bladder wall shows:

Bilharzia ova are deposited mainly in

the submucosa and less in the other

layers.

• The ova are surrounded by

lymphocytes plasma cells,

eosinophils. Old lesions show

fibrosis.

• The mucosa: hyperplasia, atrophy,

ulceration or squamous

metaplasia

• The hyperplastic epithelium dips

down into the submucosa 

epithelial nests (Brunn's nests),

Some nests show central

degeneration  cyst formation

(cystitis cystica).

Diagnosis: Bilharzial

periportalfibrosis

Describe:

Section in the liver shows:

 portal tracts: wide fibrous

expansion + Bilharzial ova

surrounded by bilharzial

reaction(lymphocytes, plasma

cells, macrophages,

eosinophils and fibrosis)

 newly formed capillaries,

some of them are dilated

(angiomatoid), newly formed

bile ducts

 Brown bilharzial pigments

within kupffer cells

 liver lobules are normal.

Cytology film

Cervical smear stained by PAP

stain

Cytology PAP smear

Masson trichom special stain

Section in fibrous tissue

Masson trichom stains the

collagen bundles green

Prussian blue special stain

Section in liver hemochromatosis

Cells show blue hemosedrin

pigment

Appears brown in H&E section

Immune histochemical stain by

Cytokeratin

Section at adenocarcinoma

Cytoplasmic brown staining by

cytokeratin antibody

Immunehistochemical stain by CD 20

Section at large B cell lymphoma

Membranous brown stain by CD 20

(pan B antibody)