Last Minute Pathology: Image-Based Revision for INI-CET Toppers

Caseous Necrosis

Associated with the high lipid content in the cell walls. There is a cheese-like appearance of the organs. It is the combination of coagulative necrosis (m/c) and liquefactive necrosis. Most common examples include tuberculosis and fungal infections (histoplasmosis and coccidioidomycosis)syphilis, etc.

Barrett's Esophagus

Precancerous adenocarcinoma of the esophagus (cancer)

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Melanin Stain

In the skin, there is a brownish stain around the basal layer (stratum basale) which shows the presence of melanin brown-black pigment.

Hemosiderin

It consists of any existence of hemorrhage or hematoma. Yellow, Brown, Refractile (Shiny). Perl's stain or Prussian Blue stain can be used. It will stain Fe3+. Hemosiderin appears in cases of iron overdose

Stains for Lipids

• The red color stain is called the oil red O.
• The black color stain is called Sudan Black B
• The orange color stain is called Sudan IV.

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Modified macrophage or epithelioid cell.

The most important cell of granuloma

Herpes Simplex Virus (HSV)

Three M technique of HSV giant cell

• Multinucleated
• Moulding of nuclei
• Margination of the nucleus

Tay Sachs Disease

• Cherry red spots are seen in the Macula of the eye.
• Ballooned neurons(oil red positive as they contain fat)
• On Electron microscopy onion skinning of Lysosome.

Niemann Pick Disease

• Light microscope: Foamy cells
• Electron microscope: Zebra bodies

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Gaucher's Disease

Crumpled tissue paper appearance of macrophages.

It has two types:

1. Type 1 (no CNS involvement)

2. Type 2 (CNS involvement—most severe type).

Teratoma

Tuft of hair present, hollow cavity, and Rokitansky protuberance present. Cutting through the Rokitansky protuberance shows whether cancerous cells are present or not, indicating whether the teratoma has malignant tendencies.

Hamartoma

Benign Tumor caused due to abnormality in Chromosome 6. Haphazard Proliferation of native/indigenous tissue. E.g., Pulmonary Hamartoma aka Chondroma

Human papillomavirus

• It causes cervical cancer.
• HPV consists of 2 proteins, E6 and E7.
• The protein E6 will turn off the p53, and the E7 will affect the RB gene.
• Koilocytes are the characteristic cells of HPV.

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Human T Cell Leukemia lymphoma virus

• ATLL- Adult T cell Leukemia/Lymphoma
• Tropical spastic paraperesis
• Via TAX gene cause cancer
• Clover leaf cells

Epstein Barr Virus

EBV surrounds B cell activates CD T cell (forms a cape)—known as ballerina skirt 8

appearance (Downey cell). Infections: Infectious mononucleosis/kissing disease/glandular fever → enlarged salivary glands, lymph nodes, and hepatosplenomegaly.

• Kissing disease - caused by close contacts
• Diagnosis: Paul Bunnell test, monospot test

Perifascicular atrophy

Atrophy of the muscle fibers which are located at the periphery : peri-fascicular atrophy

Buerger's Disease

It is also called Thromboangiitis obliterans, Associated with Smoking. Involvement: Artery, veins and nerves. Clinical Presentation: Intermittent Claudication-Pain on exertion (arteries & vein involved) and pain at rest (gradual nerve involvement)

CMV Pneumonia

Owl eye appearance - CMV Pneumonia

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Squamous cell carcinoma

M/E findings:

• Keratin pearls
• Intercellular bridges between sq cells - desmosomes
• IHC
  • p40: Best marker
  • p63

Small Cell Carcinoma

• Has maximum markers
• Neuroendocrine tumors
• Salt and pepper appearance of chromatin
• Azzopardi Effect: Blue walled blood vessel

Chicken Wire Fibrosis

• ALD shows chicken wire fibrosis.
• Masson Trichrome is used.
• It is seen in Steatohepatitis

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