2 February 2022: Best Authors of 2021

Congratulations to the winners of the PathologyOutlines.com 2021 Best Author Award! This was a very competitive award and we greatly appreciate the contributions of those named below in addition to those of our other diligent authors in 2021, all of whom you can view here. You can view the winners from past years here.

Here are the 2021 winners:

  1. Oral cavity & oropharynx > Oropharynx squamous cell carcinoma > HPV negative: Written by Katherine Hulme, M.B.Ch.B. and Ruta Gupta, M.D. 
  2. Uterus > Stromal tumors > Low grade endometrial stromal sarcoma: Written by Elizabeth Kertowidjojo, M.D., Ph.D., M.P.H. and Lora Hedrick Ellenson, M.D. 
  3. Breast > Papillary carcinoma > Solid papillary carcinoma: Written by Sofia Lérias, M.D. and Melinda Lerwill, M.D. 
  4. CNS tumor > Other tumors > Hemangioblastoma: Written by Rebecca Yoda, M.D. and P.J. Cimino, M.D., Ph.D. 
  5. Liver > Other malignancies > Hepatoblastoma: Written by Rui Caetano Oliveira, M.D. and Maria Augusta Cipriano, M.D. 

If you are interested in being an author for PathologyOutlines.com, please send your CV and a list of topics or chapters you are interested in writing / reviewing to our author coordinators at Authors@PathologyOutlines.com. You may also review your qualifications here.

11 January 2022: Image Quiz #73

Author: Raul S. Gonzalez, M.D.

Which of the following typically causes bland cholestasis as seen on a liver biopsy?

Select an answer:

A. Amoxicillin / clavulanate injury

B. Anabolic steroid injury

C. Chronic large duct obstruction

D. Primary biliary cholangitis

E. Primary sclerosing cholangitis

To sign up for our biweekly image quiz newsletters and more, visit pathologyoutlines.com/subscribe.html.

24 August 2021: Image Quiz #63

Author: Raul S. Gonzalez, M.D.

A patient presents with fever, jaundice and abdominal pain. Liver enzymes are elevated and a liver biopsy is performed. You see the following finding. Based on this, which of the following steps may be included in the patient’s therapy?

Select an answer:

A. Antibiotics

B. Bile duct excision

C. Platinum based chemotherapy

D. Steroids

E. Ursodeoxycholic acid

To sign up for our biweekly image quiz newsletters and more, visit pathologyoutlines.com/subscribe.html.

13 July 2021: Image Quiz #60

Authors: Rong Xia, M.D., Ph.D.Xuchen Zhang, M.D., Ph.D.

Which of the following is true about this liver tumor?

Select an answer:

A. Most commonly seen in adults with a male predominance

B. Grossly characterized by large, poorly defined or infiltrative masses, with variable calcifications

C. Histologically characterized by nests of spindled and epithelioid cells surrounded by a desmoplastic stroma with occasional psammomatous calcification and ossification

D. Often shows vascular invasion with high tumoral recurrence rate

E. Positive for AE1/AE3, vimentin, HepPar1 and AFP

To sign up for our biweekly image quiz newsletters and more, visit pathologyoutlines.com/subscribe.html.

28 April 2021: Pathology Images of the Week

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

Ovary > Mucinous borderline tumor / atypical proliferative mucinous tumor

Multiloculated cyst with mucinous contents and smooth external surface.

Contributed by Russell Vang, M.D.

Placenta > Decidual arteriopathy

Advanced decidual arteriopathy with fibrinoid necrosis. Arteries are distended and show endothelial injury (detachment from the wall, arrow) and fibrinoid necrosis of the media (*). 200x original magnification.

Contributed by Jonathan L. Hecht, M.D., Ph.D.

Breast > Tubular adenoma

Eosinophilic secretions present in the lumens of some of the tubules (H&E, 20x magnification).

Contributed by Joshua J.X. Li, M.B.Ch.B. and Gary M. Tse, M.B.B.S.

Breast > Metaplastic carcinoma

Moderate to markedly cytologic atypia and frequent mitosis (200x).

Contributed by Huina Zhang, M.D., Ph.D.

Placenta > Maternal vascular malperfusion

Infarction (fresh): infarcts are typically pyramidal shape and involve the maternal floor of the placenta. Older infarcts are white, while more recent infarcts are red / heterogeneous in the fresh state.

Contributed by Jonathan L. Hecht, M.D., Ph.D.

Salivary glands > Acinic cell carcinoma

Parotid gland FNA of acinic cell carcinoma. The neoplastic cells are large with abundant finely vacuolated to granular cytoplasm (Diff-Quik).

Contributed by Arash H. Lahouti, 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 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.

21 April 2021: Pathology Images of the Week

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

Kidney nontumor > Acute pyelonephritis

Acute inflammation / pus in renal calyx.

Contributed by Jian-Hua Qiao, M.D.

Liver & intrahepatic bile ducts > Combined hepatocellular carcinoma-cholangiocarcinoma

Unequivocal cholangiocytic (red arrow) and hepatocytic (blue arrow) areas of cell differentiation. The hepatocytic area shows tumor cells organized in trabeculae (H&E 100x).

Contributed by Aurélie Beaufrère, M.D.

Bone marrow neoplastic > Myeloid neoplasms with germline predisposition and other organ dysfunction with GATA2 mutation

Bone marrow core biopsy of the same patient shows megakaryocytic dysplasia (small, hypolobated) (H&E, 40x).

Contributed by Wei Wang, M.D., Ph.D.

CNS tumor > Pituicytoma

Nuclear expression of TTF1 is ubiquitous.

Contributed by Federico Roncaroli, M.D.

Muscle & peripheral nerve nontumor > Immune mediated necrotizing myopathy

Thigh muscle from a 49 year old woman with progressive proximal weakness and creatine kinase in the 7,000s. Histology shows a pauci-inflammatory IMNM. The necrotic fibers are randomly distributed and temporally heterogeneous. There is also moderate fiber size variation and frequent internalized nuclei, suggesting that myofiber damage has been going on for a while (H&E, 20x).

Contributed by Chunyu “Hunter” Cai, 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 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.

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.

23 February 2021: Image Quiz #50

Authors: Zachary Dong, M.D.Kimberley J. Evason, M.D., Ph.D.

Which of the following is true about this liver lesion?

Select an answer:

A. It usually communicates with intrahepatic bile ducts

B. The epithelium is usually CK20+

C. The stroma is usually ER / PR-

D. There is a strong female predominance

E. These lesions are most commonly multifocal

To sign up for our biweekly image quiz newsletters and more, visit pathologyoutlines.com/subscribe.html.

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.