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2013-01-04 11:16:53
histo histopath anatomy

laboratory, description of images, associated notes
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  1. Schistosomiasis
    • Gross:  smooth surface
    • Histo: diffuse fibrosis
    • 1. calcified ova (portal and periportal areas)
    • 2. granuloma
    • 3. lymphocyte
  2. Granuloma
    • focus of chronic infeciton
    • microscopic aggregation of macrophages
    • epithelial-like cells surround by collar of mononuclear leukocytes.
    • Giant cells: older granuloma, energy of fibroblasts and CT with epitheloid cells
  3. Giant Cell
    Epitheloid macrophages fuse forming multinucleate giant cells (secretory cells) present in chronic granulomatous formation

    • Types:
    • a. foreign body type - central group of nuclei
    • b. Zanghan's giant cell - tuberculosis, horseshoe formation around periphery

    • Granulomatous inflammation:
    • -  histiocytes (activated macrophages) differentiate to epitheloid macrophages then fuses forming MN giant cell
  4. Virchow's triad
    • 1. EI
    • 2. Stasis/turbulance of blood flow
    • 3. hypercoagability
  5. ARDS
    • Example clinical: chest pain, dyspnea, cyanosis, RF
    • Histo: dilated alveoli lined with eosinophilic matrix, congested alveolar capillaries, edema, amorphous proteinous materal, MN cells and macrophages
  6. Pulmonary congestion/Hemorrhage
    • Example clinical: DOB, fever, pneumonitis, mild effusion, CPA
    • Gross: multiple petichial hemorrhage, consolidation
    • Histo:  --
    • 1. pulmonary congestion of BV, pulmonary edema (pinkis, homogenous, granular), inflammatory infiltrates
    • 2. alveolar hemorrhage
  7. Follicular hyperplasia
    • Case of:  chornic hypertrophic tonsilitis
    • Example clinical: 26F, pain on swallowing, high grade fever at least 2x/mo for 7 conseq years
    • Gross: tonsils enlarged and rubbery
    • Histo: reactive lymphoid follicular hyperlplasia overlying squamous epithelium
    • a. lining epithelium
    • b. lymphoid follicles and germ centers
    • c. diffuse type of cells in lymphoid tissue

    read on adaptive immunity
  8. Hashimoto's thyroiditis
    Case of: 52 year old, enlarged thyroid, elevated TSH, low T4 and FT3, tremor, palpitation

    • Robbin: progressive depletiono f thryoid epithelial cells (thyrocytes) replace byMN cell infiltrates and fibrosis
    • Gross: dark brown and nodular
    • Histo: 
    • 1. thyroid follicles
    • 2. focal lymphoid proliferation
    • 3. hurthle cells

    • Autoimmune thyroiditis
    • - throid acini with diffuse infiltrates of lymphoid and plasma cells
    • - mononuclear inflammatory infiltrates
    • - lymphoid follicles with germinal centers

    • Oncocytic/Hurthle cells
    • - thyroid epithelial cells
    • - eosinophilic granular cytoplasm with slightly enlarged nuclei
  9. Type IV hypersensitivity reaction: Giant cells and macrophages
    Gross: nonencapsulated with prominent fibrosis

    Histo: fibrosis, lymphcytes, macrophages, giant cells

    • Mechanism:
    • a.  APC antigen: CD4+, CD8+ cause cytokine release
    • b.  T cell mediated CD8+ killing of macrophage

    • Delayed type reaction: GRANULOMA 
    • a. perivascular infiltrates of T cells and macrophages
    • 2. replaced by macrophages (epitheloid cells)