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Microbiology
Cardiovascular
Endocrine
Gastrointestinal
Hematology/Oncology
Musculoskeletal, Skin, and Connective tissue
Neurology
Ophthalmology
Renal
Reproductive
Respiratory

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Microbiology

Disease Histology Gross CT/MRI/XR

Ehrlichiosis (Ehrlichia Monocytes with morulae (mulberry-like

chaffeensis) inclusions in the cyt

oplasm)

1
Gardnerella vaginalis

Clue cell

Histoplasmosis
Macrophage with Histoplasma

Erythema nodosum

Pneumonia with hilar adenopathy

2
 Histoplasma granuloma

Blastomycosis
Patchy alveolar infiltrates “Cannonball” lesions

Broad-based bud

Paracoccidioidomycosis

Captain k Wheel

3
Malassezia furfur

“spaghetti-and-meatball” appearance Hypopigmentation “Christmas Tree”

distribution

4
Taenia Solium

Tapeworm

Neurocysticercosis “swiss cheese” appearance

5
Candida

Germ tubes @ 37 C (true hyphae)

Budding yeast (pseudohyphae) @ 21 C

6
Aspergillus

Septate hyphae branched @ acute angles

Conidiophore

Pneumocystis jiroveci

Crushed Ping-Pong Balls

7
Human Herpesvirus 8
(HHV-8)

lymphocytic inflammation

Kaposi sarcoma

8
HIV / AIDS

Multinucleated giant cells formed by fusion

of macrophages (AIDS Dementia)

Parainfluenza

Giant multinucleated epithelial cells

“Steeple sign”
Croup (laryngotracheobronchitis).

9
Rubeola/ Measles

Koplik spots: small irregular red spots

with central gray, white, or blue specks
on the buccal mucosa

Leishmania Tropica

Cutaneous leishmaniasis (from sandfly)

10
Streptococcus agalactiae
(group B streptococcus)

Gram-positive cocci in pairs and short chains

Actinomyces

Gram positive filamentous bacteria

yellow material in the sinus tract
representing sulfur granules

Trypanosoma cruzi
Trypomastigotes detected on blood
microscopy, in acute phase (8-12 wks) of
Chagas disease

11
Cardiovascular

Disease Histology Gross CT/MRI/XR

Giant Cell (Temporal)

Arteritis

Focal granulomatous inflammation of the

temporal artery

12
Cardiac Myxoma

Extensive glycosaminoglycans - abundant,

loose, myxoid stroma.

Typically in Left Atrium

Aortic Dissection

Widening of aortic valve root

Blood in the false lumen, true lumen labeled

with star

The long arrow indicates the location of the

true lumen, and the short arrow indicates the

13
 false lumen.

Endocrine

Disease Histology Gross CT/MRI/XR

Graves Disease

Scalloping

Pretibial myxedema
Skin thickening and induration

tall cells with follicular hyperplasia

Papillary thyroid cancer

14
 psammoma bodies and Orphan Annie-eye
nuclei

Insulinoma

Uniform cells in nest

Glucagonoma

necrolytic migratory erythema

indurated, bronze-colored areas that are

surrounded by blistering, crusting, and
scaling at the borders

15
Gastrointestinal

Disease Histology Gross CT/MRI/XR

Alcoholic hepatitis

Cirrhosis

Mallory bodies (intracytoplasmic

eosinophilic inclusions of damaged keratin
filaments)

Advanced cirrhosis

Hyperplasia of smooth endoplasmic

reticulum and damaged mitochondria

16
Hepatitis A hepatitis

Councilman Bodies(also seen in Yellow

fever)/Ballooning degeneration/spotty
necrosis

Hepatitis B (Acute
Hepatitis)

Ground glass appearance (HBsAg

inclusion) - “granular, homogenous,
eosinophilic staining of cytoplasm.”

Hepatitis C

Lymphoid aggregates with focal areas of

macrovesicular steatosis/plasma cell and
macrophage infiltrate

17
Reye Syndrome

Liver cells show microvesicular (small fat

globules) fatty change (steatosis)

Fulminant liver failure

Giant cell hepatitis

giant hepatocytes with multiple nuclei

Hypertrophic pyloric
stenosis

“String Sign” and dilated of the stomach

(non-bilious vomiting)

18
small bowel obstruction

multiple dilated loops of bowel and air-fluid

levels.

Ileus

Diffuse bowel dilatation including the colon

19
Boerhaave syndrome

pneumomediastinum, the abnormal presence

of air in the mediastinum

Hernia

chest x-ray with stomach bubble noted above

the diaphragm

Villous adenoma

20
Tubular adenoma

Pedunculated (attached by a stalk)

Tubulovillous adenoma

Leaf-like

Diverticulosis

small pouch formations in the colon wall

21
Esophageal Varices

dilated, thin-walled veins. Thrombus

contained (big pink ovale)

linear-oriented dilated and tortuous veins

wormlike filling density representing dilated left

gastric veins

Diffuse type gastric

carcinoma

Linitis plastica

Signet ring cells

22
Gastric CA

Thickened gastric wall with stenosis

Pseudomembranous
colitis

Massive yellow, partially confluent plaques

form a pseudomembrane on the mucous
membrane. Colonoscopy finding.

23
Nutmeg liver (congestive
hepatopathy)

Here is an example of a "nutmeg" liver seen

with chronic passive congestion of the liver.
Note the dark red congested regions that
represent accumulation of RBCs in
centrilobular regions.

Jejunal atresia

‘Triple Bubble Sign’

S = stomach, D=duodenum, J=jejunum

24
Duodenal Atresia

‘Double bubble sign’

D=duodenum, S = stomach

Hematology/Oncology

Disease Histology Gross CT/MRI/XR

Iron Deficiency Anemia

Enlarged area of central pallor Koilonychia “Spoon shaped nails”

25
G6PD Deficiency

Degmacyte / Bite Cell

Heinz Body

Sickle Cell

dactylitis

26
Langerhans Cell
Histiocytosis

multiple granules that are striated and

rod-like with single-sided outpouchings.
Tennis-Racket appearance

Diffuse large b cell

lymphoma

highly atypical lymphoma cells with open

vesicular chromatin, prominent nucleoli, and
variable amounts of cytoplasm.

27
Multiple Myeloma

Nodular sclerosis
Hodgkin’s
lymphoma

Lacunar Reed Sternberg cells

P. falciparum

Aplastic Anemia

28
Musculoskeletal, Skin, and Connective tissue

Disease Histology Gross CT/MRI/XR

Sarcoptes Scarbi

Scabies

Itching between fingers

can be a buzzword

Basal Cell Carcinoma

(upper lip)

Palisading nuclei

Central crusting, ulcerations, telangiectasias,

rolled borders

29
Squamous Cell
Carcinoma

Keratin pearls

Hodgkin's lymphoma )

Reed-Sternberg cells: bilobed nucleus with

eosinophilic inclusions of nucleoli, termed
“owl eyes.”

30
seborrheic keratosis Check for underlying GI malignancies (eg.
signet ring cell carcinoma - diffuse)

"stuck on" appearance. Leser-Trélat

syndrome(multiple SK)

Leukocyte adhesion Involving CD18

deficiency type 1 (LAD-1)

Lack of pus, limited acute inflammation

31
Keloid

irregular scar that grows beyond the border

of the original
wound

Acute contact dermatitis Involving CD4+ lymphocytes

intradermal vesicle filled with fluid

Linear streaks

32
Sturge-Weber syndrome

Port Wine Stain

Granuloma annulare

annular lesions with ropy borders and

central clearings that grow slowly.

33
Ewing sarcoma

Neuroectodermal in origin(NOT neural crest

derived) Onion skin appearance

Osteosarcoma

34
Giant cell tumor

Soap bubble appearance

Lipoma

mature univacuolated adipocytes with small

nuclei

35
osteomyelitis if

osteomyelitis of the tibia

Pott disease

caseating granulomas

tuberculous osteomyelitis

36
Scapholunate ligament
tear

Rheumatoid Arthritis

Boutonniere deformity, Swan neck deformity,

Ulnar deviation

37
Osteoarthritis

Bony outgrowths of the proximal

interphalangeal (PIP) joints (Bouchard
nodes) and the distal interphalangeal joints
(Heberden nodes)

Dupuytren contracture Characterized by fibrosis (appears initially as

this)

fixed flexion contracture of the hand where

fingers bend forward and cannot fully extend

38
Neurology

Disease Histology Gross CT/MRI/XR

Parkinson’s
Disease

Depigmentation of substantia nigra

pars compacta (Left)
Lewy bodies made of
alpha-synuclein (intracellular
eosinophilic inclusions) (Left)

39
Alzheimer’s
Disease

Cortical atrophy, narrow gyri, wide

Senile plaques made of sulci
amyloid-beta (extracellular)

Cortical atrophy, narrow gyri, wide

Intracellular hyperphosphorylated
sulci
tau protein (tangles)

Frontotemporal
Dementia

Intracellular hyperphosphorylated
tau protein (round) (ubiquitinated
TDP-43)
Frontotemporal degeneration Frontotemporal degeneration

40
Vascular Dementia

Multiple cortical/subcortical infarcts

Creutzfeld-Jakob
Disease

Spongiform cortex (vacuolization

without inflammation)
Prions (Beta-pleated sheets)
Spongiform cortex (vacuolization
Spongy white areas
without inflammation)

41
Glioblastoma
multiforme

Pseudopalisading pleomorphic
tumor cells with central necrosis
Necrosis, hemorrhage,
microvascular proliferation,
butterfly glioma

Necrosis, hemorrhage,
microvascular proliferation,
butterfly glioma, crosses sagittal
plane

Pilocytic
astrocytoma

Rosenthal fibers (eosinophilic) Cerebellar invasion

Posterior fossa tumor with mixed

areas of cystic areas/solid tumor;
cystic lesion w/ mural nodule
“pilocystic” astrocytoma

42
Oligodendroglioma

“Fried egg” cells + “Chicken wire”

capillary pattern in frontal lobes

Typically in frontal lobes

Schwannoma

"fish flesh" soft tan appearance.

Biphasic, dense, hypercellular
spindle cells with alternating
hypocellular myxoid cells
Usually at the cerebellopontine
angle

43
Meningioma

Compressing parenchyma

Psammoma bodies
Known to have dural attachments
(Concentrically-arranged spindle
(tails)
cells in a whorled pattern)
Men have PSA: psammoma, AFP,
spindle cells

Craniopharyngiom
a

Supratentorial tumor

Ectoderm from Rathke’s pouch

(roof of mouth derived) with
calcifications with keratin deposits

44
Medulloblastoma

Compression of 4th ventricle

(hydrocephalus)
Tumor of cerebellum
Homer-Wright rosettes, small blue
cells (NSE+)

Ependymoma

Found near 4th ventricle

Perivascular pseudorosettes,
rod-shaped blepharoplasts (basal
ciliary bodies near nucleus) Found near 4th ventricle

Hemangioblastom
a

bubbly cytoplasm (Foamy cells) Red mass in the vermis of

Involved with VHL disease cerebellum bulging into the fourth
ventricle

45
Epidural Rupture of middle meningeal
hematoma (EDH) artery

Lenticular-shaped or
biconvex-shaped (Middle
meningeal artery)

Subdural Rupture of bridging veins

hematoma (SDH)

Crescent-shaped
that crosses suture lines (Bridging
vein)
Blood covers surface of the brain-
collection of blood underneath the
dura

Subarachnoid “Worst headache of my life”

Hemorrhage Ehlers Danos and Marfans =
predisposing

Subarachnoid blood filling sulci

(Berry / Saccular)

46
Syringomyelia Affecting dorsal horn of spinal cord
- spinothalamic tracts affected

A collection of fluid within the

central canal of the spinal cord

Ophthalmology

Disease Histology Gross CT/MRI/XR

Acute Angle Closure

Glaucoma

47
Central Retinal Artery
Occlusion

Cherry-red spot with central pallor

Central Retinal Vein Due to hypertension

Occlusion

“Blood and thunder” retina with venous engorgement

CMV Retinitis Perivascular & Painless

Hemorrhage and cotton wool spots

48
Dry Macular
Degeneration

Fovea degeneration; yellow drusen buildup between

Bruch's membrane and retinal pigment epithelium

Glaucomatous Cupping Closed angle

49
Hypertensive Flame hemorrhage is classic
Retinopathy

Papilledema

Elevation of optic disk with pronounced disc margins

and hemorrhage

50
Retinal Detachment

Retinitis Pigmentosa “Bone spicule” like lesions

Roth Spots

Red spots, often with central pallor

51
Tay-Sachs/Niemann-Pick
Disease

Cherry-red spot

Renal

Disease Histology Gross CT/MRI/XR

52
Horseshoe Kidney

Stuck usually under IMA (failure to

ascend)

Autosomal dominant
polycystic kidney
disease (ADPKD)

53
 CT image of the abdomen shows bilateral
advanced PKD

Potter sequence Oligohydramnios - flat facies, lung

hypoplasia, clubbed feat, deformed
extremities

Due to Oligohydramnios

CASTS
1. RBC cast

54
 2. WBC cast

3. Granular
(Muddy Brown)
Cast

IgA nephropathy (Berger

Disease)

mesangial "tree" deposition of IgA (left),

expansion of the mesangial regions of the
glomerulus (middle)

Focal segmental No immune complex deposition

glomerulosclerosis
(FSGS)

sclerosis and hyalinosis in some, but not all,

glomeruli.

55
Rapidly progressive
glomerulosclerosis(
RPGN)

active segmental necrotizing destructive

crescent (asterisk) with destruction of
Bowman’s capsule (arrow)

PSGN

(electron microscopy)- subepithelial

humps

Subepithelial deposits (humps)

DPGN Wire-looping (glomerular capillary loops)

with endothelial+neutrophils+mesangial cells

56
 Epimembranous spikes

MPGN (type I+II) Mesangial cell ingrowth leading to tram-track

appearance

57
Reproductive

Disease Histology Gross CT/MRI/XR

Choriocarcinoma

No chorionic villi present

cytotrophoblast/syncytiotrophoblast
Often spreads to lungs (cannonball

58
 appearance)

Hydatidiform mole

“Snowstorm” appearance
46XX or 46XY
Paternally imprinted

placental villi are transformed into grape like

vesicles

Leiomyoma

Heterogeneous hypoechoic uterine wall

mass

Irregularly formed uterus

Predisposing factor = african american race

59
 Cigar-shaped nuclei

calcified pelvic mass

Paget Disease of the

Breast

patchy erythema, purpura, and nipple

abnormalities
High-grade invasive ductal carcinoma with
infiltration of the dermis and mitotic figures

large, atypical adenocarcinoma cells with

pale to clear cytoplasm that infiltrate through
the epidermis

60
Struma ovarii (Dermoid Hyperthyroidism side effects
cyst) Mature cystic teratoma (benign)

ovarian tissue that is disrupted by dense

proliferations of thyroid follicles

Endometriosis.

Biopsy reveals endometrial glands (black superficial implants or pelvic masses

arrow) and stroma comprised of cyst-like structures
(endometriomas or chocolate cysts)
containing fluid and menstrual debris

61
Respiratory

Disease Histology Gross CT/MRI/XR

Chronic Bronchitis

Asthma Will also see Cushman spirals

obstruction of the bronchial lumen with

62
 mucoid exudate, goblet cell metaplasia, and
smooth muscle hypertrophy (upper right
corner).

Eosinophilic Charcot leyden crystals

Silicosis

“Eggshell” calcifications of hilar lymph

Central areas with whorled collagen fibers nodes

Asbestos

scalloped whitish-gray plaques

golden-brown, beaded asbestos body
(Ferruginous bodies)
Often see calcified bodies in lung pleura extensive calcified pleural plaques
(“candle wax appearance”)

63
Sarcoidosis

Non-caseating granulomas (vs. TB,

caseating)

Bilateral hilar adenopathy (vs. TB, usually

unilateral)
Paratracheal and hilar enlargement

asteroid body

Bronchiectasis

dilated airways filled with pus

Clusters of Grapes

64
Cystic Fibrosis

plugs of viscid mucus distending bronchial

gland ducts

pus-filled bronchiectatic cavities and

abscesses

macronodular biliary cirrhosis caused by

thickened bile secretions

65