30 June 2021: Pathology Images of the Week

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

Muscle & peripheral nerve nontumor > Antisynthetase syndrome associated myositis

57 year old man with positive Jo1 antibody and interstitial lung disease. H&E shows necrotic fibers and myophagocytosis predominantly involving perifascicular fibers. The perimyisial connective tissue appears edematous and fragmented.

Contributed by Chunyu “Hunter” Cai, M.D., Ph.D.

Ovary > Clear cell carcinoma

Clear cell carcinoma with a predominant tubulocystic growth pattern.

Contributed by Gulisa Turashvili, M.D., Ph.D.

Prostate gland & seminal vesicles > Sarcomatoid carcinoma

A monophasic sarcomatoid carcinoma shows only a spindle cell component with mesenchymal appearance, without admixed carcinoma. Extensive sampling and history of prostatic adenocarcinoma, preferably with immunohistochemical (keratins, rarely PSA or other prostatic markers) evidence of epithelial differentiation, helps establish the diagnosis.

Contributed by Steven Christopher Smith, M.D., Ph.D.

Stains & molecular markers > PRAME

Positive nuclear staining for PRAME in seminiferous tubules.

Contributed by Cecilia Lezcano, M.D.

26 May 2021: Pathology Images of the Week

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

Salivary glands > Intraductal carcinoma

Cuboidal cells with eosinophilic cytoplasm and small, oval nuclei and inconspicuous nucleoli (H&E, 40x).

Contributed by Kim A. Ely, M.D.

Soft tissue > Perineurioma

Soft tissue perineurioma showing hemangiopericytoma-like growth pattern (H&E, 12.5x).

Contributed by Andrea Saggini, M.D.

Stains & molecular markers > Microphthalmia associated transcription factor (MITF)

MITF highlights the nuclei of the pigmented spindle cells forming nests and fascicles.

Contributed by Ata Moshiri, M.D., M.P.H.

Stains & molecular markers > MCPyV (CM2B4)

The nuclear pattern of CM2B4 immunoreactivity in MCC tumor cells indicates MCPyV positivity. There is an absence of staining in the background nontumoral cells, including inflammatory, endothelial and stromal cells.

Contributed by Thai Yen Ly, M.D.

Ovary > Brenner tumor

This benign Brenner tumor features bland nuclei with conspicuous nuclear grooves in some tumor cells.

Contributed by Jutta Huvila, M.D. and C. Blake Gilks, M.D.

Lymphoma & related disorders > Lymphomatoid granulomatosis

Case 1: lung; H&E staining, Fig 2A: polymorphous infiltrate in scanner view (40x). Fig 2B: lymphocytic vasculitis with infiltration of the vessel wall is seen (100x). Fig 2C: lymphocytic vasculitis with infiltration of the vessel wall is seen (200x). Fig 2D: angioinvasion by lymphoid cells in lymphomatoid granulomatosis (400x).

Contributed by Nicholas Joseph Dcunha, M.B.B.S., M.D. and Elanthenral Sigamani, M.B.B.S., M.D.

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.

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.

20 January 2021: Images of the Week

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

Acute mastitis / abscess

Core needle biopsy from a 28 year old lactating woman. A dense inflammatory infiltrate is shown on the left, obscuring underlying breast parenchyma.

Contributed by Kristen E. Muller, D.O.

Prostate specific antigen (PSA)

PSA is focally positive, which is common in more poorly differentiated prostatic adenocarcinoma. Lung adenocarcinoma will not be positive for PSA, so this confirms metastatic prostatic adenocarcinoma. Of note, this patient had a clinical history of a prostatic adenocarcinoma.

Contributed by Heather I-Hsuan Chen-Yost, M.D.

Fibromatosis / fasciitis-like

Papillary thyroid carcinoma with fibromatosis / fasciitis-like stroma: myofibroblastic proliferation within collagenous stromal tissue.

Contributed by Ayana Suzuki, C.T.

Gunshot wounds

Soot deposition, searing of the skin and contusion surrounding the central defect.

Contributed by Lorenzo Gitto, M.D. and Robert Stoppacher, 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.