2005 Anatomic Pathology Exam Microscopic Slide Review

2005 Anatomic Pathology ExamMicroscopic Slide Review

Presented at the57th Annual Meeting of the ACVP

December 3, 2006Tucson, AZ

2005 Microscopic Slide Exam Reviewpreparing the microscopic exam

1. Nov/Dec- initial committee meeting @ annual ACVP

2005 Microscopic Slide Exam Reviewpreparing the microscopic exam

1. Nov/Dec- initial committee meeting @ annual ACVP

2. Mid-Apr- contributions to section leader

2005 Microscopic Slide Exam Reviewpreparing the microscopic exam

1. Nov/Dec- initial committee meeting @ annual ACVP

2. Mid-Apr- contributions to section leader

3. Section leader prepares draft exam-matrix: process/tissue/species

2005 Microscopic Slide Exam Reviewpreparing the microscopic exam

4. May/Jun- 2nd committee meeting, review of draft exam, keys prepared

2005 Microscopic Slide Exam Reviewpreparing the microscopic exam

4. May/Jun- 2nd committee meeting, review of draft exam, keys prepared

5. Mid-Aug- slides, exam questions completed

2005 Microscopic Slide Exam Reviewpreparing the microscopic exam

4. May/Jun- 2nd committee meeting, review of draft exam

5. Mid-Aug- slides, exam questions completed

6. Sep- exam time

2005 Microscopic Slide Exam Reviewpreparing the microscopic exam

1. rat, brain, astrocytoma

2. horse, artery, strongylosis

3. dog, skin, ceruminous gland carcinoma & dirofilariasis

4. dove, liver, amyloidosis

5. sea lion, kidney, leptospirosis

2005 Microscopic Slide Exam Review

6. ox, lung, atypical interstitial pneumonia

7. cat, intestine, panleukopenia & FIP

8. marmoset, bone, fibrous osteodystrophy

9. dog, salivary gland, infarct

10.ox, spinal cord, fibrocartilaginous embolus

2005 Microscopic Slide Exam Review

11. cat, kidney, lily toxicosis

12. dog, eye, phthisis bulbi

13. rhesus, lung, SIV & CMV

14. walleye, skin, fibrosarcoma

15. ox, heart, ionophore toxicosis

2005 Microscopic Slide Exam Review

16. dog, bone, metastatic carcinoma

17. horse, placenta, aspergillosis

18. dog, liver, autoimmune hemolytic anemia

19. rat (panel), thoracic mass, hibernoma

20. ox (TEM), oral mucosa, MCF

2005 Microscopic Slide Exam Review

Case 7: Tissue from a cat.

• Histopathologic description (12 points)

• Morphologic diagnosis(es) (4 points)

• Cause(s) (4 points)

Case 7: Tissue from a cat.

• Histopathologic description (12 points)– Intestine

• Mucosa– Blunting of villi– Collapse of lamina propria– Dilated crypts with necrotic debris

• Muscularis, serosa, mesentery– Perivascular accumulations of PMNs, macrophages

and fibrin

– O/C• Logical and clear presentation of features

Case 7: Tissue from a cat.

• Morphologic diagnosis(es) (4 points)– Necrotizing enteritis– Pyogranulomatous perivasculitis/peritonitis

• Cause(s) (4 points)– Feline parvovirus (Feline panleukopenia virus)– Feline infectious peritonitis virus

Case 9: Tissue from a dog.

• Histopathologic description (14 points)

• Morphologic diagnosis(es) (6 points)

Case 9: Tissue from a dog.

• Histopathologic description (14 points)– Salivary gland (ID)

• Vasculature– Thrombosis

• Acini– Coagulative necrosis– Inflammation– Granulation tissue

Case 9: Tissue from a dog.• Histopathologic description (14 points)

– Salivary gland (ID)• Septa

– Inflammation– Hemorrhage– Fibrosis

• Ducts– Inflammation– Necrosis– Squamous metaplasia

– O/C• No points allotted

Case 9: Tissue from a dog.

• Morphologic diagnosis(es) (6 points)

– Necrotizing sialoadenitis with thrombosis (infarction) and squamous metaplasia

Case 11: Tissue from a cat.

• Histopathologic description (13 points)

• Morphologic diagnosis(es) (4 points)

• Most likely cause (3 points)

Case 11: Tissue from a cat.

• Histopathologic description (13 points)– Distribution

– Tubular epithelium• Degeneration • Necrosis• Regeneration

Case 11: Tissue from a cat.

• Histopathologic description (13 points)– Casts

• Granular• Protein

– Mineralization

– O/C • Logical and clear presentation of features

Case 11: Tissue from a cat.

• Morphologic diagnosis(es) (4 points)– Diffuse tubular necrosis with casts

• Most likely cause (3 points)– Lily toxicosis– Aminoglycoside antibiotic toxicosis

Case 16: Tissue from a dog.

• Histopathologic description (14 points)

• Morphologic diagnosis(es) (6 points)

Case 16: Tissue from a dog.

• Histopathologic description (14 points)– Bone

• Neoplasm: location, pattern, cell morphology, cell borders, cytoplasm, nuclear morphology, nucleoli, mitoses, anisokaryosis, necrosis

• Proliferation of new bone • Resorption of trabecular bone

Case 16: Tissue from a dog.

• Histopathologic description (14 points)– Muscle degeneration and atrophy

– O/C• Logical and clear presentation of features• Primary vs. secondary processes

Case 16: Tissue from a dog.

• Morphologic diagnosis(es) (6 points)– Metastatic transitional cell carcinoma in bone– Hyperostosis– Muscular atrophy and degeneration

Case 19: Tissue from a rat.

• Microscopic description (16 points)

• Morphologic diagnosis (4 points)

Case 19 (panel): Tissue from a rat.

• Microscopic description (16 points)– A. H&E

• Description: pattern, cell morphology, cell borders, cytoplasmic vacuoles (fat), nuclear morphology, multinucleated cells, nucleoli, no mitotic figures

– B. Oil-Red-O• Positive cytoplasmic staining = lipid

Case 19 (panel): Tissue from a rat.

• Microscopic description (16 points)

– C. Mitochondrial uncoupling protein-1 immunohistochemistry

• Reactivity indicates presence of numerous mitochondria

Case 19 (panel): Tissue from a rat.

• Microscopic description (16 points)– D. TEM

• Many mitochondria• Some mitochondrial swelling• Fat droplets• Morphology consistent with brown fat

Case 19 (panel): Tissue from a rat.

• Morphologic diagnosis (4 points)– Hibernoma

2005 Microscopic Slide Exam Reviewscoring

Proportion (%) Passed Mean Score Range of Scores

2003 2004 2005 2006 2003 2004 2005 2006 2003 2004 2005 2006

45 72 47 61 57 63 57 62 71-37 82-11 75-31 83-7