Pathology Lab 3rd Dec’09

Last practical of 1st SemesterSlides for finals

Ravi A Patel

Leprosy of Skin

Acute Appendicitis

Meningitis (In given slide meningitis is around Cerebellum)

Lung Abscess

Viral Hepatitis

Intestinal amoebiasis

Schistosoma Ova (Schistosoma japonicum)

Wilm’s Tumor

Lobar Pneumonia(bacterial)

Viral Pneumonia

M++

EpidermisDermis

Causative organism- Mycobacterium leprae

Organs affected- Skin and Peripheral nerves--------------------------------------------------------------------------------------------- **** Granulomatous formation – In upper dermis layer ****Foam cells harbouring the organism ****Fibrosis

Observation :---

LPO

Granulomas

LPO

Granuloma

HPO

Foam cells– Modified macrophagesso called because of foamy cytoplasm

HPO

Dark Stained are lymphocytes

Fibrosis

Mucosa

SubmucosaTunica muscularis

Tunica Serosa

Primary casue - 80% Obstruction of lumen producing increased pressure with compression of blood vessels and ischemia.

Secondary cause- bacterial infection and pus formation (suppurative exudates)

Observation ***** PMNs – mainly neutrophil infiltration in muscularis

LPO

Lumen

Mucosal layer

LPO

Tunica muscularis

Wtih infiltrationOf neutrophils

LPO

Blood vessel with clot within

LPO

Lymph nodules

HPO

PMNs ---- Mostly Neutrophils inTunica muscularis layer

Section taken from cerebellum

Molecular layer of cerebellarcortex

Granular layerOf cerebellar cortex Medullary

Layer of cerebellum

Meningeal layer* Site of Meningitis

Causative organism:- Pnemococcus

Observation **** Subarachnoid space filled with suppurative exudates(pus) **** Presence of Neutrophils confirmed in exudates in HPO

LPO

bloodVessels congestedBy the exudatesSurrounding them

Suppurativeexudates

LPO

Congested blood vessel

LPO

Suppurative exudates

LPO

bloodVessels congestedBy the exudatesSurrounding them

Suppurativeexudates

HPO

Blood vessel surrounded byThe exudates

HPO

Predominant NeutrophilsIn exudate

HPOPredominant NeutrophilsIn exudate

HPO Predominant NeutrophilsIn exudate

• Liquefactive type of necrosis• When this necrotic tissue is absorbed from the

organ a cystic space is produced

• Observation ** Total digestion of lung tissue ** Granular debris

** Lymphocyte in filtration

LPO

There is total destruction of lung tissue As observed in these slides the debris of Dead tissue

HPO

Granular debris

Neutrophil infiltrates

HPO

Neutrophil infiltrates

• Morphologic changes in acute and chronic phase of viral hepatitis are the same.

• Slide is in acute phase

• Observation ***Lobular dissray ***Cell necrosis in portal area

***Mononuclear infiltrate in portal areas and sinusoids

Viral Hepatitis

LPOWe might mistake it as lung Abscess if given in low poweras this one

Central vein

illustration of lobular rays in normal liverWhere in the sinusoids(draining to central vein) seems to form rays aroundThe central vein

LPO Lobular dissray- hard to distinguish sinusoids

HPO

HepatocytesSeems to have Undergone cytolysis

Swollen hepatocyte In Viral hepatitis Some cells get swollenAnd some undergo cytolysis

MonnuclearCells infiltrate insinusoids

HPO

Infiltrates inThe sinusoids

HPO

Mononuclear cell infiltrated in the portal area

PV

HA

BD

Lymphatic vessel

Id space : Hepatic sinusoid

Normal Liver

Portal Area

HPO

There is cell necrosis in portal area---

Portal area in normal liver

Portal area in liver with Viral hepatitis showingViral hepatitis

• Causative organism- Entamoeba histolytica• Infective stage of organism- Cyst• Pathologic state of Organism- Trophozoite• Observation *** Cyst

*** Trophozoites *** Mononuclear infiltrates

Intestinal Amoebiasis

LPO

Area where in the mucosa is Ulcerated because of the Proteolytic invasion by trophozoites

HPO

Trophozoites harbouringRBC

Mononuclear infiltrates

HPO

Trophozoites

HPO

Cysts– because it doesnothave RBC within the cytolasm

One pointed is a trophozoite

HPOIdentify Trophozoites and cysts in this slide

HPO

Mononuclear Infiltrates

Schistosoma ova

• Organism- Blood fluke (Schistosoma japonicum)

LPO

HPO

HPO

HPO

HPO

HPO

• Wilm’s tumour is a common primary tumour of childhood.

• Observation *** Area of tumour *** Immature tubules and glomerulus

*** Sphindle shaped cells *** Dark stained cells

Wilm’s Tumour

LPO

Sphindle shaped cells

There are attempts to form tubules and Glomerulus but they are immature

HPO

Blastemal component

Immature glomerulusand tubules surroundingthem

Sphindle shaped cells

HPO

Immature glomerulusand tubules in high power

HPO

Sphindle shaped cells In high power

HPOObservation slide

HPO

Blastemal component

Lobar Pneumonia

Pneumonia- Inflammation of the lung parenchyma when it affects a part of a lobe it is designated ad lobar

Bacterial in origin

Observation *** Lung alveoli filled with fibrino-purulent exudates *** Congested alveolar walls

*** In HPO there is fibroblasts growing into exudates

LPO

Lung Alveoli

Lung alveoli filled with purulentexudates

LPO

Lung alveoli filled with Purulent exudates

HPO

Congested alveolar wall

There is fibrosis in the alveoli Along with purulent exudate (at the pointer)

HPO

Purulent exudate in High power shows presence of neutrophils

HPO

Fibrosis in high power along with neutrophils

HPO Scanty Neutrophils and at the pointeris the congested alveolar wall

Hallmark :- Inflammation in the interstitium and septa but the alveolar spaces are very clear meaning there is no exudate in the space as compared to the bacterial pneumonia.

Viral Pneumonia

LPO Observe clear alveolar spaces withoutExudates, but the alveolar walls are edematous

LPO Patchy Inflammation of the Interstitium and Septa

Mononuclear infiltrates in alveolar wall

LPO

Mononuclear infiltrates inThe alveolar walls

Edematous walls

HPO

Compare the alveolar walls with the normal onesTo appreciate the edema in the viral Pneumonia

Mononuclear infiltrates in alveolar wall

HPO Observation Slide

Differentiating Viral and Bacterial Pneumonia

LPO

Exudates in Alveolar spaces No exudates in the alveolar space, butPatchy inflammtion and edema in The alveolar walls

Thanking to the entire Universe