26 January 2021: Image Quiz #48

Authors: Cade Arries, M.D., Elizabeth Courville, M.D.

A 45 year old man with a history of renal transplant presented with lymphadenopathy. A lymph node biopsy was performed. A representative image is shown. The large atypical cells are positive for CD30 and CD15 with dim PAX5 nuclear positivity and dim and variable CD20 expression. CD3 and CD45 are negative. Which of the following is the most appropriate diagnosis?

Select an answer:

A. Classic Hodgkin lymphoma posttransplant lymphoproliferative disorder

B. Monomorphic posttransplant lymphoproliferative disorder (diffuse large B cell lymphoma)

C. Nondestructive posttransplant lymphoproliferative disorder (florid follicular hyperplasia)

D. Polymorphic posttransplant lymphoproliferative disorder

See the answer

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12 January 2021: Image Quiz #47

Author: Jian-Hua Qiao, M.D.

An 80 year old Caucasian woman had a thyroid mass and a 1 cm pulmonary lesion. CT guided transthoracic needle biopsy was performed to rule out metastatic tumor. Microscopic examination of core needle biopsy tissue reveals the following lesion. What is your diagnosis?

Select an answer:

A. Metastatic thyroid papillary carcinoma

B. Minute pulmonary meningothelial-like nodule

C. Pulmonary carcinoid tumor

D. Pulmonary meningioma

E. Pulmonary paraganglioma

See the answer

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30 December 2020: Images of the Week

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

MDM2

Corresponding MDM2 IHC in an atypical lipomatous tumor / well differentiated liposarcoma highlighting scattered nuclei within fibrous septa in a strong, diffuse pattern.

Contributed by Jennifer Yoest, M.D. (source: University of Michigan Virtual Slide Box)

Papillary thyroid carcinoma > Diffuse sclerosing

DSV PTC shows prominent and extensive intratumoral interstitial sclerotic stroma. Malignant cells grow in an irregular infiltrative pattern and show typical nuclear features of PTC.

Contributed by Livia Florianova, M.D., M.Sc. and Marc Pusztaszeri, M.D.

Chondromyxoid fibroma

The cellular population within the nodules shows spectrum of differentiation, comprising of stellate to spindle mesenchymal cells in a myxoid background at one end, as seen in this example, to well developed hyaline cartilaginous differentiation on the other end.

Contributed by Nasir Ud Din, M.B.B.S.

Placenta accreta, increta and percreta

A chorionic villous implants directly onto myometrial fibers with no intervening decidua.

Contributed by Fabiola Medeiros, M.D.

Fibroepithelial (stromal) polyp

Fibroepithelial polyp excision showing polypoid lesion with stromal component extending up to epithelium.

Contributed by Albert Alhatem, M.D. and Debra S. Heller, 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 61 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.

29 December 2020: Image Quiz #46

Authors: Aysha Mubeen, M.D., Arun Gopinath, M.D.

The grossing protocol for examination of the fallopian tube to identify the diagnosis in the photomicrograph should:

Select an answer:

A. Ensure complete evaluation of the fallopian tube in all cases

B. Increase detection of precursor lesions in at risk women

C. Require multistep levels in at risk women

D. Require tangential sectioning of the infundibulum and fimbrial segment to allow maximal exposure

See the answer

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16 December 2020: Micro Images of the Week

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

Adenosis

Expanded terminal duct lobular unit and adjacent (upper left) normal size terminal duct lobular unit (H&E, 4X).

Contributed by Julie M. Jorns, M.D.

Congenital mesoblastic nephroma

Tumor composed of intersecting fascicles of spindle cells.

Contributed by Ellen D’Hooghe, M.D. and Gordan M. Vujanic, M.D., Ph.D.

Large B cell lymphomas: ALK+ LBCL

ALK positive large B cell lymphoma with ALK positivity (bone marrow, IHC, 200x).

Contributed by Marie Therese Manipadam, M.B.B.S., M.D.

Molecular aspects of pancreatic cancer

Site: pancreatic head. Procedure: Whipple resection. Diagnosis: medullary pancreatic ductal adenocarcinoma. Histologic finding: neoplastic cells with syncytial growth and without gland formation (hematoxylin eosin, original magnification 10x). Molecular findings: microsatellite instability is very common in the case of medullary histology.

Contributed by Claudio Luchini, M.D., Ph.D.

Chronic sialadenitis / sialolithiasis

40 year old man with submandibular pain; chronic inflammation with acinar atrophy and fibrosis (10x).

Contributed by James S. Lewis, 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 61 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.

9 December 2020: Images of the Week

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

Adenomyoepithelial adenosis

Haphazardly arranged glands with bland epithelium and prominent myoepithelium with clear cytoplasm (H&E, 20x).

Contributed by Julie M. Jorns, M.D.

CD70

Immunohistochemical double staining demonstrating expression of CD34 (brown) by myeloid blasts and CD70 (red) by interstitial immune cells.

Contributed by Christian Schürch, M.D., Ph.D.

Indeterminate cell histiocytosis

Skin biopsy showing histiocytoid cells with eosinophilic cytoplasm and grooved, reniform nuclei in the dermis in indeterminate cell histiocytosis, 400x.

Contributed by Ryanne A. Brown, M.D., M.B.A.

Atypical carcinoid

Pulmonary atypical carcinoid tumor showing salt and pepper chromatin with inconspicuous nucleoli (400x).

Contributed by Philippe Joubert, M.D., Ph.D.

Buschke-Löwenstein tumor

Low magnification view of resection sample shows arborizing papillary architecture and maturing squamous surface epithelium.

Contributed by Lewis A. Hassell, M.D. (source: Juan Rosai Slide Collection)

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 61 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.