14 April 2021: Images of the Week

Here is a selection of new images from our free, online textbook:

Skin nonmelanocytic tumor > Atypical fibroxanthoma

Cytomorphologically, lesional cells are highly bizarre and atypical, with marked pleomorphism in size and shape, abundant eosinophilic cytoplasm, occasional multinucleation and numerous mitotic figures, including atypical forms (H&E, 200x).

Contributed by Pavandeep Gill, M.D. and Phyu Aung, M.D., Ph.D.

Stomach > Fundic gland polyp

Cystically dilated glands.

Contributed by Naziheh Assarzadegan, M.D.

Appendix > Enterobius vermicularis

Higher magnification shows Enterobius eggs with 1 flattened side and 1 convex side and a double layer hyaline chitin shell.

Contributed by Eiman Adel Hasby, M.D.

Bone marrow neoplastic > Atypical chronic myeloid leukemia

Bone marrow biopsy from a patient with aCML showing markedly hypercellular bone marrow with markedly increased neutrophils and myeloid precursors and mild dysmegakarypoiesis with no increase in blasts.

Contributed by Ling Zhang, M.D.

Esophagus > Undifferentiated carcinoma

Undifferentiated carcinoma at high power. Sheets of clearly high grade cells without obvious pattern of differentiation into any given cell type.

Contributed by Rondell P. Graham, M.B.B.S.


How can you search the textbook?

For desktop / tablet, you can either use the Google search bar in the upper right corner or visit PathologyOutlines.com and then scroll down to where the 59 chapters are listed, as demonstrated below.

For mobile, visit PathologyOutlines.com, click on “Chapters by Subspecialty” (as demonstrated below) and then click on the subspecialty, chapter and topic.

For any device you can use your favorite browser and type in PathologyOutlines.com in addition to the search term.

7 April 2021: Images of the Week

Here is a selection of new images from our free, online textbook:

Cervix > HSIL / CIN II / CIN III

At high magnification, HSIL / CIN III lacks maturation (400x).

Contributed by Khaled J. Alkhateeb, M.B.B.S.

Ovary > Fibroma

Ovarian fibroma: the cut surface reveals a dense white mass within the ovary (left); outer surface of the fibroma is smooth and lightly vascularized (right).

Contributed by Rex Bentley, M.D.

Testis & epididymis > Adult granulosa cell

Low power view of numerous small uniform spaces (microfollicles) with hyalinized basement membrane material (Call-Exner bodies).

Contributed by Kristine M. Cornejo, M.D.

Microbiology & parasitology > Zygomycetes

Evaluation of fungal forms. H&E stained FFPE tissue showing broad pauciseptate ribbon-like hyphae in necrotic sinonasal tissue.

Contributed by Sixto M. Leal, Jr., M.D., Ph.D.

Skin nonmelanocytic tumor > Syringoma

Histologic sections showing cysts, nests and cords in a paisley or tadpole shaped pattern. No cytologic atypia or mitotic figures are seen (H&E, original magnification 100x).

Contributed by Aadil Ahmed, M.D. and Sara C. Shalin, M.D., Ph.D.


How can you search the textbook?

For desktop / tablet, you can either use the Google search bar in the upper right corner or visit PathologyOutlines.com and then scroll down to where the 60 chapters are listed, as demonstrated below.

For mobile, visit PathologyOutlines.com, click on “Chapters by Subspecialty” (as demonstrated below) and then click on the subspecialty, chapter and topic.

For any device you can use your favorite browser and type in PathologyOutlines.com in addition to the search term.

31 March 2021: Images of the Week

Here is a selection of new images from our free, online textbook:

Lymphoma & related disorders > Aggressive NK cell leukemia

Trephine bone marrow biopsy showing an interstitial neoplastic infiltrate at high power, with moderate cytoplasm, irregular nuclear contours and prominent nucleoli.

Contributed by Siba El Hussein, M.D. and Joseph Khoury, M.D.

Soft tissue > Myxoinflammatory fibroblastic sarcoma

Low power magnification shows a lobulated soft tissue tumor with mixed fibrous and myxoid areas located within subcutaneous tissue.

Contributed by David Suster, M.D.

Stains & molecular markers > DUX4

CIC-DUX4 fusion tumor (DUX4, 10x), involving soft tissue of flank.

Contributed by Bradford Siegele, M.D., J.D.

Skin nontumor > Atrophic papulosis

Superficial and deep perivascular and periadnexal lymphocytic infiltrate (H&E, 40x).

Contributed by Kiran Motaparthi, M.D.

Bone & joints > Ganglion

Myxoid changes (gray-blue areas) are visible in the ganglion wall on the right. The remaining wall is composed of dense pink collagenous stroma. The lining of the wall does not show epithelial cells.

Contributed by Serenella Serinelli, M.D., Ph.D.


How can you search the textbook?

For desktop / tablet, you can either use the Google search bar in the upper right corner or visit PathologyOutlines.com and then scroll down to where the 60 chapters are listed, as demonstrated below.

For mobile, visit PathologyOutlines.com, click on “Chapters by Subspecialty” (as demonstrated below) and then click on the subspecialty, chapter and topic.

For any device you can use your favorite browser and type in PathologyOutlines.com in addition to the search term.

24 March 2021: Images of the Week

Here is a selection of new images from our free, online textbook:

Breast > Filariasis

Classic “double barrel” uterus of the adult female worm (Wuchereria bancrofti) with eggs and developing larvae (microfilariae) in a lymph node (H&E, 10x).

Contributed by Bobbi Pritt, M.D.

Stains & molecular markers > Carbonic anhydrase IX

Diffuse circumferential membranous staining in clear cell RCC.

Contributed by Nick Baniak, M.D.

Stomach > MALT lymphoma

Infiltration and distortion of epithelial structures by aggregates of (usually 3 or more) neoplastic lymphoid cells.

Contributed by Kwun Wah Wen, M.D., Ph.D.

Testis & epididymis > Sex cord-stromal tumors > Leydig cell

Leydig cell tumor with sheets of polygonal cells with eosinophilic cytoplasm (H&E stain; 10x magnification).

Contributed by Manju Aron, M.D.

Autopsy & forensics > Therapy related deaths

Autopsy image of a percutaneous biliary catheter in the portal vein. The biliary drain placement was performed to relieve a biliary stricture but the catheter was placed in the portal vein adjacent to the targeted bile duct resulting in hemoperitoneum. The end of the catheter was cut during removal of the liver as this was an unexpected finding at autopsy.

Contributed by Mark A. Giffen, Jr., D.O.


How can you search the textbook?

For desktop / tablet, you can either use the Google search bar in the upper right corner or visit PathologyOutlines.com and then scroll down to where the 60 chapters are listed, as demonstrated below.

For mobile, visit PathologyOutlines.com, click on “Chapters by Subspecialty” (as demonstrated below) and then click on the subspecialty, chapter and topic.

For any device you can use your favorite browser and type in PathologyOutlines.com in addition to the search term.

17 March 2021: Images of the Week

Here is a selection of new images from our free, online textbook:

Skin nontumor > Warts (verrucae)

Hyperkeratosis, papillomatosis, hypergranulosis, koilocytosis and inward bending of rete ridges at borders of lesion. Dermal papillae show dilated capillaries.

Contributed by Heba Ahmed Abdelkader, M.D.

Small intestine & ampulla > Lymphangioma

Scanning magnification shows the dilated lymphatics in the submucosa of the small intestine (H&E, 2x).

Contributed by Haider A. Mejbel, M.D.

Stomach > Pyloric gland adenoma

High power view of PGA showing small tubular glands with low cuboidal epithelium and bland nuclei.

Contributed by Supriya Srivastava M.D., Ph.D.

Bone & joints > Adamantinoma

Anastomosing thin trabeculae of mildly atypical epithelioid and spindled cells within fibrous stroma.

Contributed by Borislav A. Alexiev, M.D.


How can you search the textbook?

For desktop / tablet, you can either use the Google search bar in the upper right corner or visit PathologyOutlines.com and then scroll down to where the 60 chapters are listed, as demonstrated below.

For mobile, visit PathologyOutlines.com, click on “Chapters by Subspecialty” (as demonstrated below) and then click on the subspecialty, chapter and topic.

For any device you can use your favorite browser and type in PathologyOutlines.com in addition to the search term.

10 March 2021: Images of the Week

Here is a selection of new images from our free, online textbook:

Liver & intrahepatic bile ducts > Chronic antibody mediated rejection

H&E stained section at 20x demonstrating a predominantly mononuclear portal inflammatory infiltrate with spillage into adjacent hepatic parenchyma.

Contributed by Mohamed El Hag, M.D., M.S.

Liver & intrahepatic bile ducts > Hepatoblastoma

Hepatoblastoma, SCUD pattern, with siderophages (secondary to treatment) (H&E 200x).

Contributed by Rui Caetano Oliveira, M.D. and Maria Augusta Cipriano, M.D.

Lung > Minimally invasive adenocarcinoma

Noninvasive lepidic adenocarcinoma (left) juxtaposed with adjacent uninvolved lung parenchyma (right). The lepidic adenocarcinoma is characterized by thickened alveolar septa lined by atypical overlapping cuboidal cells.

Contributed by Jonathan Keow, M.D., Ph.D.

Ovary > Serous tumors > Serous borderline tumor

Inked cyst wall lined by exuberant solid growth of papillary grape-like excrescences.

Contributed by Aarti Sharma, M.D. and Ricardo R. Lastra, M.D.

Placenta > Complete hydatidiform mole

Haphazard circumferential proliferation of cytotrophoblasts and syncytiotrophoblasts is seen around a club shaped villus in this image of a complete mole. Some of the nuclei show considerable atypia and mitoses.

Contributed by Rachelle Mendoza, M.D. and Raavi Gupta, M.D.


How can you search the textbook?

For desktop / tablet, you can either use the Google search bar in the upper right corner or visit PathologyOutlines.com and then scroll down to where the 60 chapters are listed, as demonstrated below.

For mobile, visit PathologyOutlines.com, click on “Chapters by Subspecialty” (as demonstrated below) and then click on the subspecialty, chapter and topic.

For any device you can use your favorite browser and type in PathologyOutlines.com in addition to the search term.

3 March 2021: Images of the Week

Here is a selection of new images from our free, online textbook:

Cervix > HPV related adenocarcinoma (usual type and variants)

Invasive adenocarcinoma, pattern B (H&E stain). Early destructive invasion, in an otherwise well differentiated (pattern A) neoplasm is seen as small irregular glands with prominent inflammation and stromal desmoplasia.

Contributed by Carlos Parra-Herran, M.D.

Stains & molecular markers > HER2 colon

Score 3+, HER2 IHC: the tumor cells of this colorectal adenocarcinoma show strong circumferential membrane staining (200x).

Contributed by Roula Katerji, M.D. and Aaron R. Huber, D.O.

Stains & molecular markers > Pan-TRK (EPR17341) [NTRK]

Infantile fibrosarcoma spectrum of tumors – neonate at birth with a lower thigh mass harboring a TPM3-NTRK1 fusion: panTRK antibody with cytoplasmic expression (400x).

Contributed by Jessica L. Davis, M.D.

Liver & intrahepatic bile ducts > Hepatocellular carcinoma overview

Hepatectomy for hepatocellular carcinoma demonstrating large cytoplasmic hyaline eosinophilic inclusions and trabecular architecture (400x).

Contributed by Irene Y. Chen, M.D.

Small intestine & ampulla > Adenocarcinoma-small intestine

Diagnostic low magnification frozen section image showing complex glandular architecture and desmoplastic stromal reaction (H&E, 40x).

Contributed by Krutika S. Patel, M.B.B.S., M.D. and Annika L. Windon, M.D.


How can you search the textbook?

For desktop / tablet, you can either use the Google search bar in the upper right corner or visit PathologyOutlines.com and then scroll down to where the 60 chapters are listed, as demonstrated below.

For mobile, visit PathologyOutlines.com, click on “Chapters by Subspecialty” (as demonstrated below) and then click on the subspecialty, chapter and topic.

For any device you can use your favorite browser and type in PathologyOutlines.com in addition to the search term.

24 February 2021: Images of the Week

Here is a selection of new images from our free, online textbook:

Colon > Ischemic colitis

Low power image showing crypt injury, marked crypt dropout, lamina propria hyalinization and vascular congestion.

Contributed by Gagandeep Kaur, M.D. and Monika Vyas, M.D.

Lymphoma & related disorders > Richter syndrome

H&E of Richter syndrome, diffuse large B cell lymphoma type. Diffuse sheets of large, atypical cells with finely dispersed chromatin and prominent nuclei.

Contributed by Shahbaz Khan, M.D.

Skin nontumor > Psoriasis

Higher magnification of subcorneal pustule in pustular psoriasis with elongated and dilated capillaries in the papillary dermis. Punch biopsy from the trunk (40x).

Contributed by Viktoryia Kazlouskaya, M.D., Ph.D.

Skin melanocytic tumor > Desmoplastic melanoma

Pure type desmoplastic melanoma consisting entirely of spindle cells in a fibrous stroma without convention melanoma (100x).

Contributed by Gregory A. Hosler, M.D., Ph.D.

Stains & molecular markers > ATM

ATM immunostaining of rectal adenocarcinoma.

Contributed by Joo-Shik Shin, M.B.B.S., Ph.D.


How can you search the textbook?

For desktop / tablet, you can either use the Google search bar in the upper right corner or visit PathologyOutlines.com and then scroll down to where the 60 chapters are listed, as demonstrated below.

For mobile, visit PathologyOutlines.com, click on “Chapters by Subspecialty” (as demonstrated below) and then click on the subspecialty, chapter and topic.

For any device you can use your favorite browser and type in PathologyOutlines.com in addition to the search term.

16 February 2021: Images of the Week

Here is a selection of new images from our free, online textbook:

Bone marrow neoplastic > AML with t(8;21)(q22;q22)

Scattered blasts with prominent eosinophilic granules and rare Auer rods (leftmost blast).

Contributed by Sean Gu, M.D., Ph.D. and Alexa J. Siddon, M.D.

Kidney tumor > Adult renal cell carcinoma – common > Chromophobe eosinophilic variant

Chromophobe renal cell carcinoma eosinophilic variant, demonstrating diffuse marked perinuclear clearing / halos.

Contributed by Timothy Isaac Miller, M.D., M.A. and Maria Tretiakova, M.D., Ph.D.

Liver & intrahepatic bile ducts > Glycogenic hepatopathy

Pale and enlarged hepatocytes in a mosaic pattern with prominent cytoplasmic membranes and scattered background macrovesicular steatosis (200x).

Contributed by Raul S. Gonzalez, M.D.

Ovary > Endometrioid carcinoma

Back to back endometrioid glands; no solid component is seen.

Contributed by Ozlen Saglam, M.D.

Prostate gland & seminal vesicles > Low grade PIN

Atypical acinar cells with few scattered nucleoli growing in a tufted architecture (40x).

Contributed by Nicholas P. Reder, M.D., M.P.H.


How can you search the textbook?

For desktop / tablet, you can either use the Google search bar in the upper right corner or visit PathologyOutlines.com and then scroll down to where the 60 chapters are listed, as demonstrated below.

For mobile, visit PathologyOutlines.com, click on “Chapters by Subspecialty” (as demonstrated below) and then click on the subspecialty, chapter and topic.

For any device you can use your favorite browser and type in PathologyOutlines.com in addition to the search term.

10 February 2021: Images of the Week

Here is a selection of new images from our free, online textbook:

Breast > Sparganosis

Host reaction of rimming chronic inflammation and dense fibrosis around parasite (H&E, 4x)

Contributed by Bobbi Pritt, M.D.

CNS tumor > Pituitary adenoma

Sheet-like proliferation of monomorphous cells. Absence of acinar architecture. Frozen section, 20x.

Contributed by Michael Punsoni, M.D.

CNS tumor > Medulloblastoma, SHH activated

Nodular desmoplastic medulloblastoma, SHH activated. High power H&E shows sheets of undifferentiated cells with scattered mitotic figures and apoptotic bodies. Focal anaplastic features are present (cell wrapping, center of image).

Contributed by John DeWitt, M.D., Ph.D.

Kidney tumor > Adult cystic nephroma

Multiple thin walled cysts with smooth lining.

Contributed by Bonnie Choy, M.D.

Autopsy & forensics > Forensic entomology

The irregular, superficial surface erosion of the skin, usually orange-pink to yellow in color and the absence of hemorrhage is typical of postmortem ant feeding artifact.

Contributed by Priya Banerjee, M.D.


How can you search the textbook?

For desktop / tablet, you can either use the Google search bar in the upper right corner or visit PathologyOutlines.com and then scroll down to where the 60 chapters are listed, as demonstrated below.

For mobile, visit PathologyOutlines.com, click on “Chapters by Subspecialty” (as demonstrated below) and then click on the subspecialty, chapter and topic.

For any device you can use your favorite browser and type in PathologyOutlines.com in addition to the search term.