SYSTEMIC

PATHOLOGY
Mock Practicals
A. Identify the slide
B. True about this slide:
1- Nucleus appear at the basal
2- Cells have a non vacuolated cytoplasm
3- Both
4- Neither
A. Lactational/Lactating Adenoma
B. 4
***In this slide, nucleus appear at the apex and cells
have a vacuolated cytoplasm.
A. Identify the slide
B. True about the slide:
1- Protrusion of the luminal cells with fibrovascular core
2- Seen in dilated ducts
3- Both
4- Neither
A. DCIS: Papillary
B. 3
A. Identify the pointed structure.
B. Cells seen here will include the ff. except:
1- Macrophage
2- Monocytes
3- Lymphocytes
4- Neutrophils
A. Foreign body type giant cell
B. 2
***In Granulomatous Mastitis, cells here are
epithelioid macrophages, multinucleated giant
cells, lymphocytes, neutrophils and plasma cells.
A. Identify the slide
B. True about the slide except:
1- Cells are flattened
2- Seen in dilated duct
3- Large round nuclei
4- Eosinophilic, granular cytoplasm
A. Apocrine metaplasia
B. 1
***In Apocrine metaplasia, cells are not flattened.
A. Identify the pointed structure.
B. True about this slide except:
1- Regression after menopause
2- Delicate stroma
3- Arise in the intralobular stroma
4- Dilated glands are noted
A. Intralobular stroma
B. 4
***In Fibroadenoma, compressed glands are noted
A. T/F: The pattern of this slide is Triple Negative/Basal-like.
B. True about the slide:
1- Tumor cells are noted
2- Nuclei are vesicular and has prominent nucleoli
3- Lymphoplasmacytic infiltrates are seen
4- 1 and 3
5- AOTA
A. True
B. 5
A. True about the slide:
1- Fibroadenomatous changes
2- No Calcification
3- Fibrosis
4- 1 and 3
5- AOTA
B. True about the pointed structure.
1- Formed by dilatation and folding of lobules
2- Lined by flattened epithelium
3- Both
4- Neither
A. 4
***In Fibrocystic changes, there are fibroadenomatous changes,
chronic inflammation, fibrosis, and calcification.
B. 2
***Cyst formation is formed by the dilation and unfolding of
lobules.
A. T/F: This slide (left) has intraluminal space.
B. T/F: This slide (right) is associated with
microinvasion.
A. False
***In DCIS Solid type, there is no intraluminal
space.
B. True
***DCIS Comedo type is associated with
microinvasion
A. Identify the pointed structure and its location.
B. True about this slide:
1- Increase number of acini to at least twice the normal
number
2- Acini/ducts in the center are dilated
3- Both
4- Neither
A. Dilated acini/ducts in the periphery
B. 1
***In Sclerosing Adenosis, acini are compressed and
distorted in the center but dilated at the periphery
A. Identify the pattern which is positive for ER/PR only?
B. True about the pattern:
1- Respond well to hormonal therapy
2- Positive lymph node metastasis
3- Respond to chemotherapy
4- High grade tumor grade
5- BRCA 1 mutation
A. Luminal A
***ER: positive, HER2/neu: negative
B. 1
A. T/F: This slide is proliferative.
B. T/F: Monomorphic proliferation of irregularly
spaced cells filling up the lumen.
A. True
***Atypical Ductal Hyperplasia is a proliferative breast
disease with Atypia
B. False
***In Atypical Ductal Hyperplasia, there is
monomorphic proliferation of regularly spaced cells
filling up the lumen.
A. Identify the slide
B. T/F: This slide is well-differentiated.
A. Mucinous/Colloid Carcinoma
B. True
***Well-differentiated because there is tubule
formation.
A. Identify the slide.
B. True about the slide except:
1- Small duct: multiple, deeper within ductal system
2- Large duct: solitary, lactiferous sinuses
3- Single branching fibrovascular cores
4- 1 and 2
5- AOTA
A. Intraductal Papilloma
B. 3
***In Intraductal Papilloma, there are multiple
branching fibrovascular cores
A. T/F: Tubule formation is seen.
B. True about the slide:
1- Indian file pattern
2- Discohesive infiltrating tumor cells
3- Signet rings may be present
4- 1 and 2
5- AOTA
A. False
***In Invasive Lobular Carcinoma, there is no tubule
formation.
B. 5
A. Identify the slide
B. All are true about this slide:
1- Two ducts are involved
2- Usually occurs during lactation esp. in 1st month of nursing
3- Chronic form will include lymphocytes only
4- Staphylococcus aureus: diffuse lesion
A. Acute mastitis AND/OR Chronic Mastitis depending
on the cells seen in the slide
B. 2
***Usually only one duct is involved; Chronic form will
include lymphocytes and plasma cells; Staphylococcus
aureus: localized lesion Streptococcus: diffuse lesion
A. True about the pattern:
1- 15-20 %
2- 7-12 %
3- 13-35 %
4- 40-55 %
B. True about the Alfred Scoring system
1- 3+ (linear, defined staining)
2- 2+ (granular, equivocal)
3- 1+ (negative)
4- 4+ (confirmation using FISH)
5- 1, 2, and 3
6- AOTA
A. 2
***HER2 positive- 7-12 %
B. 5
***0 or 1+ (negative) ; 2+ (granular, equivocal,
confirmation using FISH); 3+ (linear, defined
staining)
A. Identify the slide
B. True about the slide except:
1- Tubule formation is noted
2- Benign counterpart is medial scar
3- A well-differentiated has occasional mitotic figures
4- 1 and 2
5- 2 and 3
A. Invasive Ductal Carcinoma
B. 2
***In this slide, the benign counterpart is your
radial scar (gross).
A. Identify the pointed structure
B. This slide is associated with the ff. except:
1- Alcohol
2- Marijuana
3- Cirrhosis
4- Anabolic steroids
5- Opioids
A. Dense Collagenous Connective Tissue
B. 5
***Gynecomastia is associated with use of
marijuana, alcohol intake, anabolic steroids or
sometimes liver cirrhosis