The Beauty of Histopathology: 3 Year

The beauty of
Histopathology
3rd year
Courtesy:
All students from class of 2023
and seniors.
Summarized by Y.S.
Checked by W.M, A.K, A.Y
Slide lists of 1st semester
1. Myocardial infarction (Coagulative necrosis)
2. Gangrene in the lower the extremity
3. Fat necrosis in the pancreas
4. Caseous necrosis in a mediastinal lymph node
5. Fatty change in the liver (H&E)
6. Fatty change in the liver (Oil-red O)
7. Atheromatous plaque
8. Cholesterolosis in the gallbladder mucosa
9. Atrophia brunea cordis (brown atrophy of the heart)
10. Simple endometrial hyperplasia
11. Atrophy of the endometrium and myometrium
12. Nodular hyperplasia of the prostate gland (BPH)
13. Bile stasis in the liver due to extrahepatic bile duct obstruction.
14. Amyloidosis in the kidney with Congo-red staining
15. Arterial thrombus
16. Necrosis of the small bowel due to incarceration
17. Hemorrhagic infarct in the lung
18. Pulmonary edema
19. Nutmeg liver (hepar moschatum (adiposum))
20. Acute suppurative appendicitis
21. Purulent meningitis
22. Bronchopneumonia complicated with lung abscesses
23. Septic abscesses in the myocardium due to systemic fungal infection (PAS)
24. Chronic non-specific salpingitis
25. Foreign body granuloma
26. Keratoacanthoma
27. Condyloma (accuminatum)
28. Bowen’s disease of the vulva (intraepithelial- in situ – cancer)
29. Invasive cervical cancer
30. Signet ring cell carcinoma in the stomach (PAS)
31. Krukenberg type of metastatic ovarian carcinoma (PAS)
32. Liver metastasis
33. Teratoma adultum (cysticum) ovarii (ovarian teratoma)
34. Leiomyoma
Slide lists of 1st semester
35. Allergic (hypersensitivity or leukocytoclastic) vasculitis (in the skin)
36. Polyarteritis nodosa in the skin
37. End stage lesion in Buerger disease
38. Tophus uraticus (gouty tophus)
39. Polymyositis
40. SLE lymphadenopathy
41. Chronic synovitis (RA)
42. Rheumatoid nodule (RA)
43. Gaucher’s disease in a lymph node (PAS)
44. Toxoplasma lymphadenitis
45. Chronic lymphocytic leukemia
46. Follicular lymphoma
47. Diffuse large B cell lymphoma (DLBCL)
48. MALT lymphoma of the stomach
49. Hodgkin lymphoma
50. Primary myelofibrosis
Dear 3rd year students
◆ As you may know, in histopathology exam, you will see 4 or 5 pictures of the same
specimen with different magnification. (lowest to highest)
◆ In most case, we should (“can”) differentiate which slides we are dealing with,
therefore I only put one lowest magnification slide.
◆ In addition to the answer, in the last column I added some explanation or more
general facts of underlying pathology. (Not included in this pdf)
One point advice from writer:
◆ Histopathology is one of the very hyper super ultra important aspects of pathology.
◆ Accordingly, in your final exam, examiners often ask questions regarding the slides
that you pick , especially, if related.
◆ I highly recommend not only just memorizing answers but also understand
what/how/why/where the lesion is present in the background of pathology.
Good luck!!
The Beauty of Histopathology 1st semester
Name of slide Slide picture Questions

What basic change can be seen in the
preparation?
Coagulative necrosis
Which are the main histological features?
Hypereosinopphilia, lack of nuclear staining, intact
Myocardial cell contours
infarction Which tissue is involved in the presented case?
1
(coagulative Myocardium
necrosis) What is the basic cause of the lesion?
Loss of tissue perfusion
What anatomical change is responsible for it?
Occlusion or severe narrowing of the coronary artery
Healing of the change is follwed by
Scar formation
What cause the gangrene?
Bacterial infection
Which tissue is undergoing necrosis?
Gangrene in the Skeletal muscle
2
lower extremity What surrounds the necrotic tissue?
Granulation tissue --> scar formation
What cells are present?
Neutrophils (Acute inflammation)
What is the condition on the slide ?
Fat necrosis
The result of which disease is it ?
Acute pancreatitis
Which anatomical localisation is mostly
exposed?
Fat necrosis in the Peri-pancreatic fat
3
pancreas Why does it happen ?
Fat cells digested by pancreatic lipase
What is the chemistry of the free fatty acids
during the process?
Saponification with ionic calcium
How does healing proceed ?
Scar formation
What tissue is presented ?
Lymph node
What is the condition ?
Tuberclosis
What type of tissue damage is it ?
Caseous necrosis
What is the key histological feasture of tha
change ?
Caseous necrosis
Granuloma formaiton with central necrosis
4 in a mediastinal
What are granulomas consisted of ?
lymph node Epitheloid macrophages, Langhans-type giant cells.
lymphocytes...(fibroblasts at periphery)
Which microbial agent is reponsible for the
change ?
Mycobacterium tuberclosis
Which special staining can demonstrate the
agent ?
Ziehl-Neelsen
Summarized by Y.S. 1

How is the presented change called ?
Fatty change of the liver
Fatty change Which process does it belong to ?
5 in the liver Adaptive degeneration
(H&E) What happens at the cellular level ?
Accumulation of fatty acids in teh hepatocytes
How stain can be specifically used to highlight
fat in histology ?
Oil-red O
Is this a reversible process ?
Fatty change YES (there are multiple "yes" with some condition but
6 in the liver chosse "pure yes")
(Oil-red O) What is the most common frequent etiology
here?
Chronic alcohol abuse
What is the presented change ?
Atherosclerosis
Where does it occur most frequently ?
Large and medium size arteries
Atheromatous Which components can be recognised here?
7
plaque Necrotic core, fibrous cap
Which cell type dominates the early lesions?
Foamy macrophage
What complications may occur ?
Calcification, exulceration, rupture
Which organ is represented here ?
Gallbladder
What tissue change can be recognised ?
Cholsterolosis
Cholesterolosis in The accumulation of what material is
8 the gallbladder responsible for that ?
mucosa Cholesterin
Which cells acuumulate the excess material?
Macrophages
Where is the accumulation located ?
In the lamina propria of the mucosa
What tissue is presented here ?
Myocardium (Cardiomyocytes)
What material is accumulated in the cells ?
Atrophia brunea Lipofuscin
cordis (brown Where is the deposition located ?
9
atrophy of the Cytoplasm close to the nucleus (perinuclear)
heart) What age is most frequently affected ?
Elderly patients
What does it cause ?
Atrophy of the heart

The change of which tissue is presented here ?
Endometrium
Which adaptive change can be observed ?
Simple Hyperplasia
10 endometrial What are the characteristic changes ?
hyperplasia Enlargement of the endometrium, proliferating,
cystically dilated glands
What level of atypia can be usually seen ?
None
Which histopathological changes can be seen in
the image ?
Atrophy of the endometrium and myometrium
What are the key histological features ?
Narrow tubular endometrial glands, scaant cytoplasm
Atrophy of the
in stromal cells, dense appearnace
11 endometrium and
What is the biological background of the
myometrium changes?
Shrinkage in size due to the loss of cellular function
and metabolism
Cause of the phenomenon in this case ?
Reduced hormonal stimuli
What pathological change is presented here?

Nodular hyperplasia of the prostate gland
Features characteristic for the glandular
component ?
Enlarged, cystic dilatation of glands with irregular
shape and pseudopapillary projection into the lumen
Nodular Characteristic features of the epithelial cells in
hyperplasia of the the glands ?
12
prostate gland The epithelial cells show no atypia, they are tall with
(BPH) abundant cytoplasm and basally located nucleus
Characteristic features of the stromal
component ?
Thick smooth muscle fibers
Definition of the phenomenon ?
Increase in the number of the cells resulting in th
increase of the organ volume
What changes can be seen in the images ?
Bile stasis in the iver
Where exactly is the change localized ?
Bile stasis in the Intra- and extracellular bile accumulation
liver How would you describe the histologic change ?
13
(due to extrahepatic Yellowish-brown pigment deposition in the
bile obstruction) hepatocytes and in the enlarged bile ducts.
What kind of ?inflmmation surrounding the bile
ducts ?
Acute inflammatory infilterate consists of neutrophils

Which tissue can be seen in the images ?
Kidney
What is the name of the change ?
Amyloidosis
What is teh exact localization of the deposition ?
The mesangium of the gromeruli and the wall of the
Amyloidosis in the
14 small arteries
kidey (Congo-red) Special staining used to highlight the
acuumulated substance ?
Kongo red (Congo red)
Another specific way to demonstrate the tissue
change ?
Apple green birefringence in polarised microscope
What pathological changes can be seen in the

image?
Arterial occlusion due to a blood clot
What is the etiology of the lesion ?
Thrombus vagy (=or) thromboembolus
What is the morphological appearnace of the
lesion that fills the lumen of the vessel?
15 Arterial thrombus
Formation of Zahn lines (red and white lines)
What is the reason for this morphological
formation ?
From stratification of erythrocytes, fibrin, and
plateets.
What are the predisposing factors ?
Endothelial injury, stasis turbulence,
What is pathological phenomenon ?
Hemorrhagic infarction of small intestine
Necrosis of the What is the main cause of change ?
Incarceration
small intestine
16 Types of phenomenon by severity ?
due to mucosal, intramural, transmural (if not, choose
incarceration hyperacute, acute, chronic)
Histologic appeance of this condition ?
necrosis, congestion adn intestinal hemorrhage
What is the pathological change ?
Hemorrhagic infaction in the lung
What is the main cause of the condition ?
Pulmonary artery embolism
Where do the clots come from ?
Deep veins of the lower extremity or the pelvic venous
Hemorrhagic
17 plexus
infarct in the lung What are the main histological features of the
changes ?
Aleveolar septal necrosis, aleveoli filled up with blood
What signs indicate to the contiunuance of the
presented condition ?
Recanalization of the artery

What is this pathologic change ?
Pulmonary edema
How do we call this type of fluid accumulation ?
transudate
Pathophysiology of the condition ? What is the
most exact cause ?
18 Pulmonary edema Increased hydrostatic pressure
What is the most common cause of the change ?
left sided heart failure
Which special cell indicate to the chronic nature
of the condition and what is the cell origin of
that ?
Heartfailure cell, which is an alveolar macrophage cell
Which pathological change can be seen in the

images ?
Nutmeg liver
How would you desccribe the change ?
Alternating darked and light areas in the parenchyma
What is the explanation for the characteristic
macro- and microscopic appearance ?
19 Nutmeg liver
Venous congestion in the darked areas, the rest
remaining unaffected
What is the etiology of this condition ?
Heart failure
What secondary condition can you see in the
slide ?
Fat accumulation in the hepatocytes
Which organ can be seen in the images ?
Appendix
What is the pathological condition ?
Acute appendicitis
Which cell type dominates teh process ?
Acute suppurative
20 Neutrophil granulocytes
appendicitis What cell can you seen on Figure No. 3 ?
Pus formation, suppuration
What can you see on teh serosal surface of the
organ ?
Fibrino-purulent inflammation (exudation)
What do we see in this slide ?
Acute meningitis
What kind of cells can we see ?
neutrophils, macrophages/leukocytes
Which are the most frequent bacteria causing
Purulent
21 it?
meningitis E.coli for neonates, H.influenza in children,
N.meningitis for epidemic (adults)
What kind of inflammation is present and
where?
Purulent meningitis

What is this organ ?
Lung
What is the disease ?
Broncho- Bronchopneumonia
pneumonia What type of inflammation is this ?
22
complicated with Acute purulent inflmaation
lung abscesses. What can we found in aleveolar space ?
Pus (Bronchioli and aleveoli are filled with pus)
What is the complication ?
Abscess formation
Which organ is represented in the images ?
Heart muscle
What pathological change can you recognize ?
Septic abscess in Septic abscesses
the myocardium What kind of infection is it ?
23 due to systemic Opportunistic infection
fungal infection How is the agent presented in the slide ?
(PAS) PAS staining
What is the architecture of the affected foci?
Fungal hyphae in the center, surrounded with
necrotic tissue and limited amount of neutrophils.
Which anatomical site is represented in the

images ?
Fallopian tube and proximal structures
What pathological change can be recognized ?
Chronic non-specific salpingitis
Chronic non- Which are the characteristic cells of this
24 specific condition ?
salpingitis Plasma cells, lymphocytes
What other inflmmatory type cell can be found
in the slides ?
Neutophil granulocytes
What part/parts of the wall is affected ?
Mucos and muscular propria
What is this pathological change ?

Foreign body granuloma
What are the histological features of this
inflammatory condition ?
Non-necrotizing granuloma
Foreign body Which is the characteristic cell type of this
25
granuloma reaction ?
Foreign body type giant cells
What do these giant cells derived from ?
Tissue macrophage
What cause this reaction in this slide ?
Surgical suture strings

What is the name of this condition ?
Keratoacanthoma
Which organ is involved ?
Epidermis
What is the characteristic intraepidermal
change in the condition ?
Acanthosis/widening
What is collected in the invagination of the
26 Keratoacanthoma epidermis ?
Layered keratin
Why is the leasion frequently called
pseudomalignant ?
Grows fast
Which age group is frequently affected ?
Elderly people
What cause this contion ?
Exposure to sunlight
Which typical sites this is seen ?

Anogenital area
What are the the atypical epithelial cells
characteristic fot this lesion ?
Koilocytes
Condyloma What is the histologic growth ?
27
(acuminatum) Papillary projection
What type of virus cause this ?
HPV
Acanthosis, finger like CT projections growing to the
epidermis, is diffuse epidermal hyperplasia
Name the condition !

Bowen disease
Where might the biopsy originate from ?
Skin of the penis, vulva
Bowen's disease of What morphology is typical in the epidermis?
the vulva Atypical keratinocytes through the whole thickness of
28
(Intraepithelial in the epidermis
situ cancer) How we call these kind of superficial lesions?
In situ cancer
What is the key feature for the named
condition?
non-invasive, the basement membrane is unaffected.

Invasive cervical carcinoma
What is the histological type of the lesion ?
Squamous cell carcinoma
What is the major etiology in this disease ?
Invasive cervical HPV infection
29
cancer What does CIN mean ?
cervical intraepithelial neoplasia
What is the difference between CIN3 (CIS) and
the presented condition ?
the tumor breakes through the basememnt
membrane.
What is the morphological basis of this name?
The tumor cells have signet ring shape appearance
Why does it occur ?
Signet ring cell Mucus secretion
30 carcinoma in the Which anatomical site is typically involved?
stomach (PAS) Stomach
What is the special name of metastases occuring
in this condition ?
Krukenberg tumor
Which organ is presented in the image ?
Ovary
What is the special name of this tumor ?
Krukenberg tumor
Krukenberg type In which organ can the primary tumor be ?
of metastatic Stomach
31
ovarian Wht is a classical clinical features of hte
carcinoma (PAS) change?
Bilateral involvement of the ovaries
How can the tumor cells be hilighted in this
specific condition ?
PAS staining
Name the change on the slide!

Metastasis in the liver
What is the histological type of the tumor ?
Adenocarcinoma
What can be teh primary tumor ?
32 Liver metastasis Colorectal adenocarcinoma
What is in th center of the mass ?
Necrosis
What is the way of metastasis formation in this
case ?
Hematogeneous spread

Teratoma in the ovary
Definition of teratoma
A tumor with tissue to organ components resembling
normal derivatives of more than one germ layer.
What does adult type teratoma mean ?
Teratoma Benign cystic tumor/tumor contains well
33 adultum differentiated functionally mature cells
(cysticum) ovarii What type of mesodermal tissue could be seen?
Cartilage
What organ the teratoma was in ?
an ovary
What is the lining inner layer of the cyst
presented ?
Stratified squamous keratinizing epithelium
Name the condition on the slide !

Leiomyoma
What is the histological type of tumor ?
Benign tumor, which arise from smooth muscle.
Where is the most common localisation of the
tumor?
34 Leiomyoma
Myometrium
Whern do symptoms occur ?
when the size is big
How about the proliferative activity of this
neoplasia?
0-1 mitosis per 10 high-powerfield
The lesion of which tissue can be senn in the

images ?
Skin
What can you see in the dermis ?
Inflmattion surrounding the capillaries
How do we call the change in this localization ?
Vasculitis
What is teh pathogenesis of this disease ?
Hypersensitivity
Antigen-Antibody binding, immuncomplex deposition
35 (leukocytoclastic)
in the vessel wall
vasculitis in skin Which type hypersensitivity reaction is this?
Type III
Wht happens in the proximity of the capilalry
wall ?
Fibrin precipitation
How do you call the fragmentation of the
neurophils (neutrophils) also presented here ?
Leukocytoclasia

What tissue is this slide portraying ?
Skin
Polyarteritis nodosa
What type of arteries are affected ?
Polyarteritis Muscular arteries (small- or medium sized)
36
nodosa in the skin What happened in the wall of artery ?
Transmural necrosis
Type of necrosis in wall of artery ?
Fibrinoid necrosis
What type of lesion can be seen ?
Vasculitis

Buerger's disease
At what age do the symptoms usually start?
30-35 years
What etiology is severely associated with the
disease?
Smoking
What can you see in the lumen of the affected
artery?
Organised thrombus (granulation tissue, attached to
End stage lesion
the wall)
37 in the Buerger's
What leads to the formation of the
disease microscopically characteristic "spanish collar" ?
Wavy degeneration of the fibers of the internal elastic
membrane.
What secondary change can you see in the
lumen of the occluded artery ?
Recanalisation
What complication may occur as a consequence
of progression ?
Local pain as inflammation may spread along the
nerves.
Name the slide !

Gouty tophus
Where is the common locaton of crystal
deposition?
Proximal joint of the hallux
Tophus uraticus
38 What is pathogenesis of disease ?
(Gouty tophus) Purine metabolism is disabled
What acuumulates ?
Uric acid (Crystals)
What types of cell can you see around crystals ?
Foreign body type giant cells (WBCs)

The morphology is characteristic for what
disease ?
Polymyositis
What is the pathomechanism of the disorder ?
Autoimmune inflammation in the striated muscles
Muscle fragmentation, necrosis, lymphocytic
39 Polymyositis
infilteration
What will happen in the damaged areas ?
Fibrosis, scar formation
Which muscle groups are initially affected by
the disease ?
The proximal muscles of the extrimities in a
symmetric fashion.
Name the morphological change on the slide ?

Systemic lupus erythematous lymphadenopathy
Which pathomechanism fits to the changes ?
Multisystemic autoimmune inflammation
What type of antibodies are characteristic for
the disease ?
SLE
40 Anti-nuclear antibodies
lymphadenopathy Which hypersensitivity reaction cause the tissue
damage in this disease ?
Type II. and III.
How do we call the characteristic deposits in
the necrotic areas ?
Hematoxylin bodies
Name the histological chagne!
Chronic synovitis
When does it typically occur ?
Rheumatoid arthritis
Which inflammatory cell type act as effectors in
Chronic synovitis this disease ?
41 (Rheumatoid CD4+ T helper cells
arthritis) What is the result of the inflammation ?
Progression of inflammation from the synovium
toward the cartilage and bone, tissue destruction
How do we call the synovial membrane
proliferation?
Pannus
Name the conditon!
Rheumatoid nodule
In which disorder does it typically occur ?
Rheumatiod arthritis
Rheumatoid What is the pathomechanism of the disease ?
Autoimmue inflammtion of the synovial membrane
nodule
42 Which are the other common localisations of the
(Rheumatoid condition ?
arthritis) Extensor surface of the forearm, subcutaneous
nodules
Granuloma, central fibrinoid necrosis surrounded by
palisading macrophages, rim of granulation tisssue.

Name the disease!
Gaucher's disease
Name the defected enxyme in association with
the changes ?
Glucocerebrosidase
Which special staining helped to characterize
Gaucher's disease
the deposition ?
43 in the lymph node
PAS
(PAS) Which cell types are affected ?
Phagocytic cells (macrophages, RES)
What is accumulating in the affected tissue ?
Glucocerebroside
In which organelle does it accumulate ?
lysosome
Name the condition on the slide!
Toxoplasma lymphadenitis
Name the infectious agent!
Toxoplasma gondii
What is the way of infection ?
Toxoplasma Obligate intracellular parasite
44
lymphadenitis What histological changes are presented in this
slide?
Follicular hyperplasia and epithelioid cell granuloma
Which severe complications may occur in th
ecompromised patient ?
Intrauterine fetopathy
What is the leukemia ?

Peripheral blood involvment by neoplastic WBCs due
to BM infiltrate
What does the chronic in CLL mean ?
Slow progression, No blasts
What tissue is it ?
Chronic Bone marrow
45 lymphocytic Indolent or aggressive prognosis ?
leukemia Indolent (grow slowly)
Main features of the cell ?
Small, monomorphic compact cells similar to normal
lymphocytes.
Difference between leukemia and lymphoma?
Leukemia targets bone marrow and blood while
lymphoma target lymph organs.

Name the disease on the slide!
Follicular lymphoma
What does the term lymphoma mean ?
Lymphoid tumor producing masses in imvolved lymph
nodes or extranodal tissues.
Name the genetic mutation, whihc leads to the
disease!
Follicular t(14;18), bcl2/IgH gene fusion
46
lymphoma What are the key histological features of this
tumor ?
Follicular pattern, missing apoptotic activity in the
germinal centre.
What type of cells form this tumor ?
Centrcytes, centroblasts
What can be the complication in this disease ?
Transformation to aggressive lymphoma (DLBCL)
Which disease can be seen on this slide!
Diffuse large B cell lymphoma
What does the term lymphoma mean ?
Lymphoid tumor producing large masses in lymph
nodes or extranodal tissues
Which are the key histological features ?
Diffuse Large B Polymorphic large lymphoid cells infiltrate the lymph
47 cell Lymphoma node
(DLBCL) Chose the correct description of this tumor
type!
Heterogeneous group, varibale genetic mutations,
common features is the diffuse growing pattern and
the aggressive clinical behavior.
In which patient group is it common ?
Elderl people, immunosuppressed patients
What is the pathology ?

MALT lymphoma
Where do the the cancer cell arise from ?
Marginal zone
48 MALT lymphoma
What may evoke the cancer ?
Helicobacter pylori
What types of cells can be seen ?
Centroblasts and immunoblasts

Name the conditon on the slide!
Hodkins lymphoma
How do we call the characteristic tumor cells?
Reed-Sternberg cell
Choose the correct discription of the these cells?
Large cells, multinucleated nucleus, prominent
nucleoli, abundant eosinophilic cytoplasm.
49 Hodgkin disease Which viral etiology is associated with this
disease ?
EBV
Why this does this condition habe a better
prognosis compared to the other lymphoid
tumors ?
Predictable, slow progression, few tumor cells, lot of
reactive inflammatory cells
What kind of tissue material is presented ?
Bone marrow biopsy
Name the condition in the slide!
Myelofibrosis
Which larger disease category does it belong to?
Primary Chronic myeloproliferative disease
50
Myelofibrosis Which cell line is affected ?
Megakaryocytes and myeloid cells
What can you see in the slide ?
Hypercelllular bone marrow, neoplastic
megakaryocytes, incresing interstitial fibrosis.
Slide lists of 2nd semester
51. Lipoma
52. Embryonal rhabdomyosarcoma (Botryoid type)
53. Acute Osteomyelitis
54. Chondroma
55. Osteosarcoma
56. Diabetic nephropathy
57. Hyalin membrane disease in the neonatal lung (IRDS: infantile respiratory
distress syndrome)
58. Bronchial asthma
59. (Boeck’s) Sarcoidosis
60. Bronchial squamous carcinoma
61. Intrabronchial carcinoid tumor
62. Small cell carcinoma
63. Barret’s esophagus
64. Chronic peptic ulcer in the stomach
65. Crohn’s disease
66. Ulcerative colitis
67. High grade adenoma in the colon
68. Adenocarcinoma of the colon (malignant transformation of adenoma)
69. Adenocarcinoma of the colon (mucinous type)
70. Liver cirrhosis with hepatocellular carcinoma
71. Crescentic glomerulonephritis (RPGN: rapidly progressing glomerulonephritis)
72. Acute pyelonephritis
73. Clear cell kidney carcinoma
74. Transitional cell carcinoma of the urinary bladder
75. Prostate cancer
76. Seminoma
77. Embryonal carcinoma with choriocarcinoma
78. Fibroadenoma of the breast
79. Invasive ductal carcinoma with DCIS
80. Invasive lobular carcinoma
81. Adenocarcinoma of the endometrium
82. Endometriosis
83. Papillary serous cystadenocarcinoma of the ovary
84. Tubal abortion (ectopic pregnancy)
Slide lists of 2nd semester
85. Basal-cell carcinoma (Basalioma)
86. Compound nevus
87. Superficial spreading malignant melanoma
88. Malignant melanoma in the eye
89. Hashimoto thyreoiditis
90. Grave’s disease
91. Papillary carcinoma of the thyroid
92. Follicular carcinoma of the thyroid
93. Retinoblastoma
94. Alzheimer’s disease (H&E and Tau)
95. Parkinson’s disease (H&E and alpha-synuclein)
96. Schwannoma
97. Meningioma
98. Glioblastoma multiforme
Dear 3rd year students
◆ As you may know, in histopathology exam, you will see 4 or 5 pictures of the same
specimen with different magnification. (lowest to highest)
◆ In most case, we should (“can”) differentiate which slides we are dealing with,
therefore I only put one lowest magnification slide.
◆ In addition to the answer, in the last column I added some explanation or more
general facts of underlying pathology. (Not included in this pdf)
One point advice from writer:
◆ Histopathology is one of the very hyper super ultra important aspects of pathology.
◆ Accordingly, in your final exam, examiners often ask questions regarding the slides
that you pick , especially, if related.
◆ I highly recommend not only just memorizing answers but also understand
what/how/why/where the lesion is present in the background of pathology.
Good luck!!
The Beauty of Histopathology 2nd semester

Lipoma
What cells are made up of this lesion ?
Adipocytes
What is this lesion surrounded by ?
Connective tissue capsule
51 Lipoma
What is the most common localisation of this
change ?
Subcutaneous tissue
What is the name of the malignant counterpart
of this condition ?
Liposarcoma
What histopathological condition can be seen in

the pictures ?
Embryonal rhabdomyosarcoma
In which age this disease occurs generally ?
Embryonal Under the age of 20
rhabdomyo- On picture 2: the lesion is covered by ?
52
sarcoma Stratified squamous epithelium
(Botryoid type) Name the type of tumor cell in picture 4!
Rhabdomyoblast
What other subytpe of this disease are you
familiar with ?
Aleveolar, pleomorphic

Acute osteomyelitis
What is the most common microbial agent
causing this condition ?
Staphylococcus aureus
Acute How do we usually treat this conditon ?
53
osteomyelitis Antibiotics
How do we call the necrotic bone parts in this
condition ?
sequestrum
What can you see on the slide no.5 ?
Acute inflammatory cell infiltration
Name the conditon on the slide !

Chondroma
Wchich bone(s) is (are) the most commonly
affected ?
Small bones of the hands and the feet
What special radiological sign is characteristic
54 Chondroma here ?
O-ring sing (sign!!!! )
Choose the correct answer !
This conditon is a benign tumor
Name the cell type which are shown on slide
no.5?
Benign chondrocytes

Name the tissue/organ on the slide !
Ovary
Name the pathological condition on the slide !
Papillary serous cystadenocarcinoma of the ovary
What are the characteristic histological features
of this condition ?
solid and cystic tumor with rich, branching papillas
55 Osteosarcoma
and stromal invasion
Which G46 disease category does this condition
belong to ?
surface epithelium tumors
What specific structure can you see on slide
no.5?
psammoma bodies+K46:T77
Which organ/tissue can be seen in the pictures ?
Kidney
Name the pathological condition ?
Diabetic nephropathy
What kind of process/disease can be in the
Diabetic background ?
56
nephropathy Diabetes mellitus
Within the organ usually where can you see the
changes ?
Glomeruli and arterioles
Name the lesion visible in picture 4!
Kimmelstiel-Wilson nodules
What is the pathological condition in the
pictures ?
IRDS
Which age group is affected ?
newborn
Hyalin membrane What are teh histopathological features of this
disease in the disease ?
57
neonatal lung atelectasis and the appearance of hyalin membrane
(IRDS) What is the pathogenesis of hte disease ?
Immmature newborn with insufficient surfactant
production
What can you see in picture 5 ?
partially collapsed alveoli, congestion in the
capillaries.
Which pathological condition can be seen in the
pictures ?
Bronchial asthma
What are the subtypes of this disease ?
atopic, non atopic
Which inflammatory cell is the most
characteristic for this disease ?
58 Bronchial asthma
eosinophil granulocyte
Wchih layer(s) of the presented structure in
picture 4 is affected by the disease ?
all of them
In picture 5 whic cell type is present in a higher
than usual amount ?
Goblet cell

Which organ/structure can be seen in the
pictures ?
Lung
Boedck's sarcoidosis
What is the most typical localisation of the
(Boeck's) disease ?
59
sarcoidosis lung and hilar lymph nodes
of this lesion ?
non-caseating granulomas wiht Langhans type giant
cells, asteroid and Schaumann bodies
Langhans type giant cells
pictures ?
Bronchial squamous carcinoma
This disease is usually preceded by which
condition ?
Bronchial
squamous metaplasia
60 squamous
Usually, what is the localisation of the disease ?
carcinoma Central, lower of upper lobe, upper of lower lobe
Which of the follwing statements is correct ?
This disease is associated with smoking
lymph node metastasis

Lung
What is the pathological change ?
intrabronchial carcinoid
What is the origin of the tumor cells?
Intrabronchial enterochromaffin (Kulchitsky) cells
61
carcinoid tumor What is the characteristic histological picture of
the disease ?
tumor cell nests, monomorphic tumor cells without
mitosis or necrosis
What is the grade of this disease ?
grade 1

pictures ?
Small cell carcinoma
What is the most common cause of this lesion?
Smoking
What is the typical histopathological
appearance of this disease ?
Small cell
62 tumor cell nests with extensive necrosis and
carcinoma numerous mitotic figures
What is the general appearance of the tumor
cells ?
relatively small tumor cells with scant cytoplasm and
"salt and pepper" like chromatin
What is the grade of this disease ?
grade 3

Which organ can you see on the slide ?
Oesophagus
What is the name of the presented change ?
Barett metaplasia
What is the cause of this condition ?
Barett's Gastro-oesophageal reflux
63
esophagus What special cell type is typical for this
condition ?
Goblet cells
Which special staining can be used to highlight
these cells ?
PAS-AB
H&E PAS-AB
Chronic peptic ulcer of the stomach
Which microbial agent is a risk factor of this
disease ?
Helicobacter pylori
Chronic peptic What can be a typical symptom ?
64 ulcer in the Digested blood in the stool (melena)
stomach Name the layers of this condition from the top
(luminal surface) to the bottom !
Necrosis, inflmmation, granulation tissue, scar tissue
What type of cell is accumulated in high
quantities in picture no.5 ?
Neutrophil granulocytes
Name the tissue.organ on the slide !

Small intestine
Crohn's disease
Which layer of this organ are affected in this
condition ?
65 Crohn's disease
Every layer (transmural)
Which organs can be affected by the disease ?
Any organ of the gastro-intestinal tract
Which inflammatory cells are seen in increased
amount on picture no.5 ?
Lymphocytes, plasma cells, eosinophil granulocytes

Large intestine
Ulcerative colitis
Which layers of this organ are affected in this
condition ?
66 Ulcerative colitis
Mucosa and submucosa
Which organs can be affected by this disease ?
Only large intestine
What characteristic feature can you see on
picture no.5 ?
Cryptitis, crypt abscess

High grade adenoma of the large intestine
What are the characteristic higtologic features
of this condition ?
polypoid mucosal mass, high grade dysplasia within
teh epithelium, no invasive component
High grade
How to classify this condition by the
67 adenoma
macroscopic appearance ?
in the colon pedunculated, sessile
Histological classes of this condition are ?
tubular, villous, tubulovilllosous adenoma
What can you see on picture no.3 ?
the stalk of the polupoid mass, covered by relatively
intact epithelium
Transformation of an adenoma into adenocarcinoma
in the large intestine
What is the histological characteristic feature of
this condition ?
Adenocarcinoma polypoid mucosal mass, with in the epithelium high
of the colon grade dysplasia, with invasive component
68 (malignant Which gene mutation(s) can lead to this
transformation of condition ?
adenoma) APC, p53
Which is the most common symptom in this
disease ?
fresh blood in the stool
What can you see on teh 4th slide ?
Invasive component

Large intestine
Name the condition on the slide!
Mucinous adenocarcinoma
What is the characteristic histological feature of
Adenocarcinoma this condition ?
69 of the colon invasive tumor of the colon with large amounts of
(mucinous type) mucin
What special cells can be seen on picture no.5?
signet ring cells
mucinous adenocarcinoma usually has worse
prognosis compared to conventional colon cancer

Liver cirrosis with hepatocellular carcinoma
What is the most common cause of this change ?
alcohol abuse
Choose correct answer !
Liver cirrhosis liver cirrhosis can transform to hepatocellular
carcinoma
with
70 What can you see on picture no.3 ?
hepatocelllular liver cirrhosis
carcinoma What is the characteristic histological feature of
the condition presented on picture 3 ?
pseudolobular structure, bridging fibrosis, infiltration
of inflammatory cells
What can you see on picture no.4 and 5 ?
liver cirrohosis
Name the pathological condition visible in the
pictures !
Crescentic glomerulonephritis
Crescentic What can be in the background of this disease?
immune mediated glomerular injury
glomerulo-
71 What are the subtypes of this disease ?
nephritis anti-GBM, immune complex mediated, pauci-immune
(RPGN) What can you see in picture 4 and 5 ?
crescent formation
What staining method was used here ?
PAS
Kidney
What is the pathological conditon ?
acute pyelonephritis
What pathological process can be in the
background of this disease ?
Acute ascending/hematogenous infection
72
pyelonephritis What is the characteristic macroscopic
appearance ?
Yellow abscesses protruding from the surface of the
kidney
What kind of inflammatory cells dominate in the
pictures ?
neutrophil granulocytes
Kidney
clear cell kidney carcinoma
What are the general histological features of
this lesion ?
Clear cell kidney solid tumor, tumor cells with sharp border, clear
73
carcinoma (empty) cytoplasm, and rounded nucleus
What anatomical structure can be affected by
the tumor when it spreads ?
Renal vein
What special grading system is used for this
disease ?
Fuhrman nuclear grade

Urinary bladder
carcinoma transitiocellulare vesicae urinariae
Based on the morphology, what subtypes of teh
Transitional cell
tumor you are familiar with ?
74 carcinoma of the
flat and papillary
urinary bladder Which risk factor is the most important in the
pathogenesis of this lesion ?
smoking
Choose teh correct statement !
the tumor most commonly affects older men
Which organ/tissue can be seen in pictures ?

Prostate
Prostate adenocarcinoma
What are teh histological features of this lesion?
closely packed small glands without basal cell layer
75 Prostate cancer
Within the organ what is the frequent
localisation of the lesion ?
peripheral
What special grading system is used for this
disease ?
Gleason

Testis
Seminoma
Which larger disease category does this
condition belong to ?
germ cell tumors
76 Seminoma What are the characteristic histological
features?
solid tumor mass separated by connective tissue
septals, intense lymphocytic infiltration
What are the characteristic cellular feature of
this condition ?
large, monomorphous tumor cells, broad and bright
cytoplasm, sharp cell border

Embryonal carcinoma with choriocarcinoma (mixed
germ cell tumor)
What is the first symptom of this disease ?
painless testicular enlargement
Which tumor marker level does elevate in this
condition ?
Embryonal HCG
77 carcinoma with What can you see in slide no.4 ?
choriocarcinoma the embryonal carcinoma component in the mixed
germ tumor
What can you see in slide no.5 ?
the embryonal carcinoma component in the mixed
germ tumor
(I think the real answer is "choriocarcinoma
component in the mixed germ tumor" but when I chose
this, it was wrong.)

Fibroadenoma of the breast
Who is the affected population ?
Young women
Which is the neoplastic component in this
condition ?
the stromal component
Fibroadenoma of What is that condition that you need to
78
the breast differentiate from this condition ?
phylloid tumor
What is teh most important histological feature
of teh gland/duct(like) component in slide no.5 ?
the presence of the basal/myoepthelial layer
Which are the two histological types of this
condtion ?
intra & pericanalicular

Invasice ductal carcinoma of the breast
Which gene mutation has therapeutic
consequence in this disease ?
Her2
Invasive ductal What is the name of the special grading system
79 carcinoma with that we use in this condition ?
DCIS Nottingham
the invasive component of the tumor
the in situ component of the tumor (no.5 shows
comedo necrosis)

Invasive lobular carcinoma of the breast
of this condition ?
relatively monomorph tumor cells, growing in indian
file pattern
Invasive lobular What extra surgical method should bbe applied
80
carcinoma during the operation of this lesion ?
sentinel lymph node examination
slide no.4 displays only invasive tumor component
Which special type of cell can sometimes be
founded in this condition (see slide no.5) ?
signet ring cell
Name of the oragan on the slide !
Uterus
Endometrial adenocarcinoma
Adenocarcinoma What is the major etiology of this condition ?
81 of the increased oestrogen level
endometrium When does this condition usually occur ?
after menopausa
Which treatment should be performed in this
condition ?
hysterectomy

Skin
Perineal endometriosis
What is the characteristic histological
appearance of this condition ?
82 Endometriosis
endometrial stroma and normal looking glands,
siderophags and bleeding (obviously, siderophages )
What is the complication due to this condition ?
infertility
Name the cell type accumulated in slide no.5 !
siderophags
Ovary
Papillary serous cystadenocarcinoma of the ovary
Papillary serous of this condition ?
cystadeno- solid and cystic tumor with rich, branching papillas
83
carcinoma of the and stromal invasion
oveary Which larger disease category does this
condition belong to ?
surface epithelium tumors
What specific structure can you see on slide
no.5?
psammoma bodies

Fallopian tube
Tubal abortion
Tubal abortion What can be the complication of this disease ?
84 (ectopic rupture and massive bleeding
pregnancy) What can you see on slide no.4 and 5 ?
chorionic villi
What components belong to the diagnostic
features in this condition (see slides 4 and 5) ?
vessels containing red blood cells in their lumen

Skin
What kind of tumor can be seen in the pictures ?
basal cell carcinoma
What is the most typical etiologic factor in this
Basal-cell disease ?
85 carcinoma UV light
(Basalioma) What is the typical appearance of the tumor
cells ?
scant cytoplasm, big, hyperchromatic nucleus
What pattern can be seen on the periphery of
the tumor cell nests ?
palisade
What is the pathological condition in the pictue?

Compound naevus
This lesion is a…
benign lesion
Which layer(s) of the skin is affected ?
epidermis and dermis
86 Compound nevus The tumor cells in the slide are derived from
which cells ?
melanocytes
What is the typical macroscopic appearance of
this lesion ?
sharp border, homogeneous brown color, relatively
smooth surface

Skin
Name the pathological condition !
superficil spreading malignant melanoma
Superficial What is the histopathological appearance of the
tumor cells in this lesion ?
spreading
big cell, abundant cytoplasm, big, eosinophilic
87 malignant
nucleolus in the nucleus
melanoma Which special staging system(s) is used for this
(SSM, skin) disease ?
Clark and Breslow
Which mutation can have therapeutic
significance in this disease ?
BRAF

Which organ/tissue can be seen in the picture?
Eye
melanoma malignum in the eye
What is the histopathological appearance of the
Malignant tumor cells in this lesion ?
88 melanoma big cell, abundant cytoplasm, big, eosinophilic
in the eye nucleolus in the nucleus
What kind of pigment can be seen in the tumor ?
melanin pigment
Which anatomical structure can be seen in
picture 5 ?
optic nerve
Which organ is presented on the slides ?
Thyroid gland
Name the histological condition on the slide !
Hashimoto thyreoiditis
What is the pathogenesis of this condition ?
autoimmune inflmmation
Hashimoto
89 What is the characteristic histological feature of
thyreoiditis this change ?
Hürthle cell (oxyphil) cells, lymphocytic infiltration,
lymphoid follicles with germinal center
What is the main symptom in the advanced
phase of the disease ?
hypothyreosis
Name the pathological condition presented on

the slide !
Graves disease
What is the pathogenesis of this disease ?
Autoimmune inflammation
in this disease ?
90 Graves disease
Follicle hyperplasia and hypertrophy, increased
colloid resorption, slight inflammation
What is the main symptom of this disease ?
Hyperthyreosis
Which measurable serum antibody is
characteristic in this condition ?
anti-TSH

Thyroid gland
Name the pathological condition !
Papillary carcinoma of thyreoid gland
What is the main cause of this disease ?
Papillary ionizing radiation
91 carcinoma of the What is the most important histological feature
thyroid to diagnose this condition ?
special nuclear morphology
What histological features can you identify on
slide no. 5 ?
crowded cell nuclei, longitudinal grooves in the nuclei,
optically clear nuclei

Name an organ on the slide !
Thyroid gland
follicular carcinoma of the thyroid gland
Name the growth pattern of this condition !
Follicular
follicular
92 carcinoma of the
What is the clear sign of malignancy in this
thyroid condition ?
capsule and vascular invasion
What is the etiology/risk factor of this
condition?
ionizing radiation
Eye
retinoblastoma
The mutation of which gene is associated with
the change ?
93 Retinoblastoma RB1
What is the special macroscopic appearance of
the disease ?
cat's eye reflex
What kind of abnormal structure can be seen in
picture 5 ?
Flexner-Wintersteiner rosette
What is the pathological condition in the
pictures ?
Alzheimer's disease
What is accumulated ?
beta-amyloid protein (Ab)
What is seen in the slide stained by
Alzheimer's
immunohistochemistry ?
94 disease
Tau
(H&E) What are the characteristic histological
features?
Neurofibrillary cords and (dystrophic) neurites
(neurofibrillary tangles and neuritic plaques)
What disease is associated with with it ?
Creutzfeldt-Jacob disease
The main histopathological lesions are neuritic
(senile) plaques and neurofibrillary tangles.
Neuritic plaques are extracellular spherical
deposits of dilated, tortuous, neuritic processes
Alzheimer's (dystrophic neurites) which surrounds a central
94 disease amyloid core. The "amyloid core" can be also stained
(Tau) by Congo-red !! (check slide 14, the amyloidosis in the
kidney)
Neurofibrillary tangels (NFTs) are intracellular
collections of polymerized tau filametns. In contrast to
neuritic plaques, 1. NFTs are not unique to AD (can
also be seen in other neurodegenerative disaeases
We didn't have this slide at all last year. So please such as Pick disease, some of Parkinson disease), 2.
understand that these questions and answers are not the distribution of NFTs correlates with the clinical
exactly same. I added some sentences, hope it helps. severity of AD.

Brain
Parkinson's disease
Which special staining was used in picture 3
and 5 ?
Parkinson's
alpha-synuclein
95 disease
Name the characteristic structure visible in
(H&E) picture 4 and 5 !
Lewy-body
Which specific area of the organ is typically
affected by the disease ?
substantia nigra (brain)
Parkinson's
95 disease
(alpha-synuclein)
What is the name of the lesion in the pictures?

Schwannoma
What is the localization of the lesion in general ?
around nerves
What growth pattern is shown in figure 4 ?
96 Schwannoma Antoni B
What growth pattern is shown in figure 5 ?
Antoni A
Name the "body" shown in the growth pattern in
figure 5. ?
verocay test (Verocay bodies)
Dura mater
meningioma
What are the cells of origin of this lesion ?
97 Meningioma meningothelial cells
Characterize the growing pattern of this lesion ?
cell balls with onion-skin structure
Which "body" can be seen in the centre of
picture 5 !
psammoma body

Brain
What is the WHO grading for glioblastoma ?
Glioblastoma Grade IV
multiforme What are the histological features of this lesion?
98
(High-grade General necrosis and pseudopalisading architecture
astrocytoma) around it
What is the special feature of this ?
Abnormal blood vessels and gromeruloid (capillary)
vascular proliferation
END

The Beauty of Histopathology: 3 Year

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The Beauty of Histopathology: 3 Year

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The beauty of

Dear 3rd year students

One point advice from writer:

Name of slide Slide picture Questions

Name of slide Slide picture Questions

Name of slide Slide picture Questions

What pathological change is presented here?

Name of slide Slide picture Questions

What pathological changes can be seen in the

Name of slide Slide picture Questions

Which pathological change can be seen in the

Name of slide Slide picture Questions

Which anatomical site is represented in the

What is this pathological change ?

Name of slide Slide picture Questions

Which typical sites this is seen ?

Name the condition !

Name of slide Slide picture Questions

Name the change on the slide!

Name of slide Slide picture Questions

Name the condition on the slide !

The lesion of which tissue can be senn in the

Name of slide Slide picture Questions

What is the name of the change ?

Name the slide !

Name of slide Slide picture Questions

Name the morphological change on the slide ?

Name of slide Slide picture Questions

What is the leukemia ?

Name of slide Slide picture Questions

What is the pathology ?

Name of slide Slide picture Questions

Dear 3rd year students

One point advice from writer:

Name of slide Slide picture Questions

What histopathological condition can be seen in

Name the condition on the slide !

Name the conditon on the slide !

Name of slide Slide picture Questions

Name of slide Slide picture Questions

Which organ/tissue can be seen in the pictures ?

Which pathological condition can be seen in the

Name of slide Slide picture Questions

Name the tissue.organ on the slide !

Name the tissue/organ on the slide !

Name of slide Slide picture Questions

Name the tissue/organ on the slide !

Name of slide Slide picture Questions

Name of slide Slide picture Questions

Which organ/tissue can be seen in pictures ?

Name the tissue/organ on the slide !

Name of slide Slide picture Questions

Name the condition on the slide !

Name the condition on the slide !

Name of slide Slide picture Questions

Name the tissue/organ on the slide !

Name of slide Slide picture Questions

Which organ/tissue can be seen in the pictures ?

What is the pathological condition in the pictue?

Which organ/tissue can be seen in the pictures ?

Name of slide Slide picture Questions

Name the pathological condition presented on

Name the tissue/organ on the slide !