-Present

>102 Knuckles, increased MMA,

<80 MCV
homocystienemia
M a c ro c y t i c
Microcytic 80-102
N o F r u i t s / Ve g e t a b l e s , A l c o h o l i c s ,
✓ Vitamin B12
C h a l l e n g e o r a l i r o n f o r/ 1 w e e k Nor mocytic Hypersegmented- m a l i g n deficiency
a n c y, i n f l a m m a t i o n ,
p r e g n a n c y, c e l i a c & t r o p i c a l s p r u e ,
Re t i c c o u n t neutrophils Absent
increased FIGLU
<3% Retic Count Neurological manifestations, Ileal
Increases
>3% disease, gastrectomy, Vegetarian
Doesn't increase RC1-3%, no Pan cytopenia Hyperproliferative diet, autoimmunity association
Hypoproliferative R C < 1 % , Pa n c y t o p e n i a T hyd
r oi si d
e /aLsiev e r Folic acid deficiency
I DA Present (pernicious), hyperpigmented
>102 Knuckles, increased MMA,
<80 AMCV
nemia of hemodilution BMA Dry tap Aplastic
homocystienemia
BM transplant
I ro n P ro f i l e
Continue oral iron for
Anemia of CRF Macrocytic
B M B x : o n l y Fa t anemia
Microcytic 80-102 No Fruits/ Vegetables, Alcoholics,
6-12 months
Challenge oral iron for 1 week I n c r e a s e dNormocytic
Serum TFR-1 Hypersegmented malignancy, inflammation,
IDA (malabsorption) I ro n i n j e cceliac&
pregnancy, t i o n s tropical sprue,
All Decreased except TIBC-+
Retic count & protoporphyrins neutrophils Absent
increased FIGLU
Anemia of Chronic Tr e a t t h e c a u s e
All decreased except S. Ferritin
Doesn’t increase Increases ESR
I n c r e a s e d C R P, T L C ,
RC1-3%, no Pan cytopenia
RC<1%, Pancytopenia
disease
D iThyroid/Liver
sease
✓i n Folic
All increased except TIBC BMA sideroblasts
Sideroblastic anemia vitam B 6 , acid
t r e adeficiency
t the cause
✓ IDA
✓ Anemia of hemodilution BMA Dry tap ✓ Aplastic BM transplant
Iron ProfA
ilel l n o Continue
rmal H P LC i n c re a s ✓
oral iron for
e d Anemia
H bA 2 ( 3.5 -9%)
of CRF T hBMBx:
a l a s sonly
e m i FatM i n o r
a anemia G e n e t i c c o u n s e l l i n g
6-12 months
Increased Serum TFR-1 ✓ IDA (malabsorption)
All Decreased except TIBC Iron injections
& protoporphyrins

ra/ 4
MOA2
All decreased qHoF
except Curthuria
S. Ferritin
✓ Anemia of Chronic
Increased CRP, TLC,H y p e r p ro l i fe r a t i v Disease Treat the cause
CSAL
All increased exceptDUA
TIBC ESLDNI
ESR
BMA sideroblasts
e Anemia
✓ ( Sideroblastic
RC>3%) anemia vitamin B6, treat the cause
Child Adult

All normal HPLC increasedI nHbA2

h e r i t e(3.5-9%)
d
ww
✓ Thalassemia Minor
Acquired
Genetic counselling
? IV
(Clinical features Hemoglobinuria,
Oxidative stress
Splenomegaly Splenomegaly Splenomegaly+ Autoimmune Clinical
Onset @ birth Hemolytic faces Vascular crisis A n y Hyperproliferativ
age (child and fe atu re Jle mog lobin u ria,
e Anemia D u g h i s to r y t h ro m b o s i s ,
+ ewnt >6m adult)
(RC>3%) Adult thrombocytopenia
Child
Spherocytes Target, tear drop cells Target, Sickle cells
Clumping of RBC, Pancytopenia+
Osmotic Inherited Spherocytes
HPLC: inc.HbF, HPLC: inc.Hbs, Bite cells, Heinz Acquired
fragility test decreased HbA decreased HbA bodies
Combs test +ve Flow cytometry
Clinical features
Hemoglobinuria,
Hereditary G6PD
Sickle cell
Splenomegaly T h a l a ss e m i a®
Splenomegaly Splenomegaly+ Autoimmun
Oxidative stress Autoimmune Clinical Paroxysmal
spherocytosis major deficiency
disease
features nocturnal
Vascular crisis Any age (child and e hemolytic Hemoglobinuria,
Onset @ birth Hemolytic faces
, 000A
Anemia
adult)
history
anemia thrombosis,
hemoglobinuria
thrombocytopenia
Spherocytes Target, tear drop cells Target, Sickle cells Clumping of RBC,
•
Splenec tomy Intermittent BT Hydroxyurea Pancytopenia+
Osmotic S te ro i d s
Spherocytes
HPLC: inc.HbF, HPLC: inc.HbS, Bite
L-Glutamine cells,oxidative
Avoid Heinz Eculizumab
fragility test ind: Hb 410
decreased HbA bodies Tr e a t t h e c a u s e Flow cytometry
decreased
I n te r m i tHbA
te n t st re ss Combs test +ve

✓ Hereditary ✓ Thalassemia ✓ Sickle cell ✓ G6PD

✓ Autoimmun ✓ Paroxysmal
spherocytosis major disease deficiency
e hemolytic nocturnal
 Diagnosis?

Sidimo blanfe
e or s i ro ti
anem,
nemia l on in
not res
to ora iorn B i en
n ee r g r e e
Iron granules
(Blue)
Dia nosis

Sanjeey Chitragar MD AIIMS New Delhi

ron ranu es
B ue

Ke y Wo r d s : Pa n c y t o p e n i a , n o h e p a t o s p l e n o m e g a l y B M b i o p s y
n ee r g r e e
C
eMedicoz

only
Sanjèex Chitragar MD AIIMS NewDelhi Fat
Diagnosis?

e or s Pan to enia no e atos enome a B io s

Aplushe
Anea n ee r g r e e

Dia nosis

Sanjety Chitragar MD AIIMS NewDelhi

 A
RBC
Tear proP mF
Hypersegmented
Diagnosis? myalo N e u t ro p h i l
e or s
i ee tom
B12 dul

CA
anemia
n ee r g r e e

erseg en e
Dia nosis e r

Sanjeev Chitranet MD AIIMS NewDelhi

Ke y Wo r d s : CKMX
DA M S
N e w- B o r n ,
eMedicoz

n ee r g r e e
jaundice,
splenomegaly Sanjeev Chitragar MD AlIMS NewDelhi

Diagnosis?

Hurdittu
e or s
e Born
aunSphrroulupd
i e
s enome a n ee r g r e e

Dia nosis

Sanjeev Chitragar MD AIIMS NewDelhi

 Diagnosis?

e or s emo o inuria a ter startin nti ioti s

Bite cells

n ee r g r e e

Dia nosis

Bite e s

Sanjeev Chitragar Mp AIIMS NewDelhi

Diagnosis: G-6-PD deficiency anemia

B0
n ee r g r e e
Dia nosis PD e i ien anemia DA M S C I N Y
eMedicoz

Sanjeev Chitragar MD AllMS NewDelhi

2
n ee
Pormina
r g r
Taregk
e e
Tear dnop

malocelumr

Sanjeev Chitragar MD AIIMS NewDelhi

Diagnosis?
Thal
 Diagnosis?

c
SoA Srckl
Ceu

n ee r g r e e
2

Dia nosis

000
5000.

Key Wo rd s :
DAMS
CX
Mycoplasma eMedicoz

pneumonia
patient
S an je ev C h i t r ag a M D A l IIM S N e w De l h i

kM Anahvn
Hemagguch LHA

e or s
Cod
o asma
neumonia
atient n ee r g r e e

Sanjeev Chitragar MD AIIMS NewDelhi

Disean
Cold agghuhmn
Diagnosis?

n ee r g r e e
 1 O 1 U N I T S

WBC PIPETTE

C A L I B R A T E O S T E M

W2
RBCI
1 1 U N I T S

Drlwhren 20X

4b0
l ye n e
Hb Electrophoresis and HPLC BsG slys H6Ees,b 26
Chue

HPLC
Stdole Bthy
1 Pt o huchowyw Az windouo

SC Hb sc disom L 46E Conedred

KbA2
>qh
AS S CT

AFSC standards

Wb2 SS
CCA miY
iD aF thal
%Philadelphia

SER
DnW HbA © AA

AFSC standards
*
CA2 S F A retention time
 biopsy
Infiltrative
Hyper cellular withDry tap, fibrosis on H y p e r c e l l u l a r w i t h H y p o c e l l u l a r/ D r y t a p. Hypercellular &
diseases " H e m o g l o b i n u r i a ,"
normal hematopoiesis Biopsy abnormal cells +
Dysplasia
t h ro m b o s i s
V Myelofibrosis Metastasis M o r p h o Pancytopenia
logy
Aplastic Anemia PNH Cytogenetics (FISH)

Hypersplenism Clinical examination

use Flow to differentiate if Mature
Myelodysplastic
I m Hepatosplenomegaly
m a t u re / b l a s t s No heatosplenomegaly
morphology is equivocal syndromes
Bone marrow Aspirate/ Bone marrow Aspirate/ biopsy
Morphology of cells (Morphology
biopsy
Abundant granular cytoplasm, Auer rods
Infiltrative
Scant cytoplasm, no Granules Auer rods
Ly m p h o itap
d Myeloid
Hyper cellular
S p e c i a l with Dry
P Otap,
S B fibrosis on Hyper cellular with Hypocellular/ Dry
Hemoglobinuria,Hypercellular &
Stain : M
normal hematopoiesis diseases S p e c i a l s t a i n PA S
Biopsy abnormal cells Dysplasia
Cytogenetics (FISH)
thrombosis
FISH/PCR
Flow cytometry
F l o w cMorphology
ytometry ✓ Aplastic Anemia ( P h i l a d e l p h i a , J ACytogenetics
✓ Myelofibrosis ✓ Metastasis (FISH)
+ve -ve
CLL ✓ PNH K2)

AML with
✓ Hypersplenism PCR/ Sequencing
C D 3 , Tduse Flow
T, C D toDdifferentiate
1 0, C 3 4 C D 1 9,C D 2 if0 , C D Mature
1 0 , 1 aT, C D 3 4 ✓ Myelodysplastic
Cytogenetic Immature/ blasts morphology is equivocal CML
No syndromes
abnormalities Mutations (CEBPA, PCV
Morphology m ofucells
tations V T-ALL B - A L L Morphology ET
R U N X 1, n m p - 1 )
Abundant granular cytoplasm, Auer rods Scant cytoplasm, no Granules Auer rods
Lymphoid Myeloid
v
Special Stain : MPO SB AML NOS
+

Special stain PAS

AML with mutations
Cytogenetics (FISH) Flow cytometry Flow cytometry FISH/PCR
+ve -ve (Philadelphia, JAK2)
✓ CLL
✓ AML with PCR/ Sequencing CD3, TdT,CD10, CD34 CD19,CD20, CD10, TdT, CD34
1) CD3, CD20
Cytogenetic
4B-? CDS, 10, 23No
abnormalities Mutations (CEBPA,
Ly m p h a d e n o p a t h y ✓ CML
✓ PCV
T RUNX1, nmp-1) mutations
Generalised LN, extranodal +ve
✓ T-ALL Clinical examination/ ✓ B-ALL ✓ ET
Regional LN, extranodal -ve
s t i cAML
N u m e r o u s n e o p l a✓ c e l l sNOS microscopy
Occasional Neoplastic cells
✓ AML with mutations
Non-Hodgkin Hodgkin
1 C D 3, 1 9, 2 0
Immunohistochemistry
CD 3 + C D 1 5, 3 0, 2 0, 4 5
C D 1 9, C D 2 0 +
C D 2 0, C D 4 5 + CD15, CD30 +
B-NHL Lymphadenopathy
T- N H L Popcorn cells Rreed Sternberg
CD 5 Clinical examination/ cells
-ve
Generalised LN, extranodal +ve Regional LN, extranodal –ve
Numerous neoplastic cells microscopy Nodular Classical
Occasional Neoplastic cells
+ve CD 23 -ve
C D 1 0, 2 3 lymphocyte HL
✓ Non-Hodgkin
Cd10+,23+ Cd10-,23- ✓ Hodgkin
CD 10+, cd23- B - C L L- S L L Cyclin D1 predominant HL
CD 3, 19,20
B sy m p tImmunohistochemistry
oms
Td T+ M a rg i n a l zo n e CD 3 + CD15, 30, 20, 45
CD19, CD20 l y m+p h o m a M A LTo m a -ve + CD15, CD30 +
CD20, CD45
B-ALL ✓ B-NHL
+ v e
Sox 11 tve
Present ✓ T-NHL Popcorn cells Rreed Sternberg
Absent Mantle cell
CD 5 +ve lymphoma Cyclin D1-ve cells
-ve Ki 67
Mantle cell
BCI-2+, Low Ki 67 ✓ Nodular ✓ Classical
index® i g h b uCD
H+ve t < 923
5% -ve lymphoma
CD 10, 23 >95% lymphocyte HL
Follicular
CD 10+, cd23- Cd10+,23+ Cd10-,23- ✓ B-CLL-SLL Cyclin D1 predominant HL
lymphoma B symptoms Diffuse large B
TdT+ B u r k i t t l y mMarginal
p h o m a zone
cell lymphoma
lymphoma MALToma -ve
+ve
✓ B-ALL
 . -

A. Stylet

B. Needle C. Aspiration holes

D. C e n t i m e te r m a r ks

BM biopsy needle
BM Aspirate needle
 CD2ot 8 :22
CD S-
0D1O+
e or s c-myC
CD 2 3 7 mass
omina
BC16+
e er i t
S eats
K4b71001.
n ee r g r e e

S torw
Sa
Sanjeev Chitragari
Diagnosis?
mutation

n ee r g r e e
Dia nosis
mutation
CAMX
Ke y Wo rd s : C e r v i c a l l y m p h n o d e DAMS
eMedicoz

A
Sanjeev Chitragar MD AIIMS WewDelhi

Dudl ae

S
e or s Cer i a m no e
RS Cell

n ee r g r e e

Diagnosis?
Etiology
S a n j e ev C h i t r a g a r M D A I I M S N e w D e l h i

(BV
 pan5vem lagar Mu raiMs NewDelhi

e or s er Smudoe
nemia re urrent
lumprstut CUU
in e tion

n ee r g r e e

Sanjeev Chitragar MD' ANMS NewDelhi

Diagnosis?

cu

n ee r g r e e
Key Words : 4-year, fever DA M S

l
Dia nosis eMedicoz

sanjeer hitragar MD AIIMS NewDelhi

lumano Blart

Au
e or s ear e er

n ee r g r e e

S a n j e ev C h i t r a g a r M D A I I M S N e w D e l h i

Diagnosis?
 mott
e or s ear
Ba a e

Sanjeev Chitragar MD AIIMS NewDelhi

Diagnosis?
muthr Muelomor

n ee r g r e e
Key Words : 35-year, DAMS
eMedicoz
Pa n c y t o p e n i a , D I C
Dia nosis AISH

+ (IS. n) (PML: BARA) ;Sanleey Chitragar MD AIIMS NewDelhi

Aml- M3
D= APML
e or s ear
Pan to enia D C
n ee r g r e e

Faggot
CulA

Al Rehinty
fans
OUM
D i a g n o s i sy C h i t r a g a r M I D A I I M S N e w D e
Treatment?
 o
L0
CW
e
GN
or s Pan to enia
§
n ee r g r e e

S a n j e ev C h i t r a g a r M D A I I M S N e w D e l h i

Genetics?

n ee r g r e e

Key Words : 2-yr, DAMS

eMedicoz

lytic lesion in
eneti
Skull
s
Sanjeev Chitragar MD ANMS-NewDelhi

Aw)
e or s r
Bir biok
ti esion in granuli,
S u n ee r g r e e
LCH

Diagnosis?
M a r ke r ?
Sanjeev Chitras NewDelar

StoD
cpla
CD207

langrl
 Neutrophils 7 cpAa
rate

1
103

150

Monocytes 104

100
nawt CDID 9 O d f E I

J31eos apis

2 motvo
ANO g
-ymphocytes
99% 7.71% 26 56%

&e
10° 100

100 200 bout 10° 10 3 104

10° 10 103

PE
50

Forward Scatter (PSC)

Sr d Cuf Nerwunl
9
CDSS

CD SO

Bleeding
Petechiae Purpura, increased BT Ecchymosis, hemarthrosis, increased CT

Secondary plug disorders

Primary plug disorders

Platelet count
Nor mal
Decreased
Associated with glomerulonephritis, pneumonitis?
No Ye s
I m m a t u re p l a t e l e t Bleeding
<6% fraction >6% Platelet func tion disorders Small vessel vasculitis
Petechiae Purpura, increased BT Ecchymosis, hemarthrosis, increased CT
Amegakaryocytic Megakaryocytic Age
g r eSecondary
P l a t e l e t a g✓ gation plug disorders Child
o mPrimary
t h r o m b o c y t o p e n i a t h r✓ b o c y t oplug
p e n disorders
ia Absent ADP &
Ad u l t
Absent Ristocetin t e s t Arthritis,
Aggregation Collagen Aggregation Abd
Platelet count
Normal Cramps,
Decreased VWD Glanzman
Associated with glomerulonephritis, pneumonitis?
Renal failure, Viral Females, increased
diarrhoea Ber nard
No T h r o m b a s t h e nYes
ia Henoch Schonlein
Immatureinfection
platelet Autoimmunity CT Soullier Purpura
V Aspirin Small vessel vasculitis
<6% Acu te ITP >6%Chronic
V fraction Platelet function disorders
Schistocyte
ITP
Amegakaryocytic Megakaryocytic DIC P-ANCA
Age Saddle Nose,
thrombocytopenia
Wait and Watch Platelet aggregation Child
thrombocytopenia
V TTP Malar Rash, Adult
Steroids IVIgAbsent Ristocetin
ANA+
test Absent ADP & Granulomas, C-ANCA
Arthritis,
Splenec tomy Aggregation Collagen Aggregation Abd
Asthma, Eosinophilia, v M-PAN Wegner
Plasmapheresis-Steroids IVIg> Splenectomy C a r d i o m✓
yop athy
Cramps,
Lupus Glanzman
Renal
FFP failure, Viral Females, increased ✓ VWD
infection Autoimmunity CT ✓ Bernard Thrombasthenia ✓ Henoch Schonlein
A sdiarrhoea
pirin Churg Strauss
Soullier ✓ Aspirin Purpura
 Only increased
Both Increased
224 l0 Both Normal
Only APTT increased
Fac tor 7 (Vitamin Thrombin time
K) deficiency F-13 deficiency I n cre a s e d (TT) Nor mal
Age

Child Secondary plug Disorders

Adult
Recombinant F-13 or Platelet Count, D Dimers Factor 10
Vitamin K IV
Sex CPT,
r y o pAPTT
recipitate deficiency
2mg
B oy Girl
FFP Low platelets, D
Only PT increased VWD Symptomatic No Bleeding, Thrombosis Normal
Dimers
Both high
Increased
Mixing
Studies H e m o p hOnly
ilia C Mixing
APTT increased
Both Normal Afibrinogenemia
✓ Factor 7 (Vitamin Studies
Factor 12 Re c u r re n t DIC time
Thrombin
K) deficiency Def abor tion
✓ F-13 deficiency Cryoprecipitate
(TT) Normal
Age Factor Increased
Hemophilia. Hemophilia C inhibitors Dilute Russel Platelets 6units, FFP 1-3 units,
Child Adult Platelet
Recombinant
V i p e r F-13
Ve n oor
m N oCount,
t r e s pD
o nDimers
ding ✓ Factor 10
Vitamin K IV H e p a rCryoprecipitate
in
Christmas
Sex test deficiency
2mg Steroids Ad d H e p a r i n
Boy Girl F F P Low platelets, D
FFP Symptomatic No Bleeding, Thrombosis Normal
Anti Phospholipid Dimers high
R e c o F - 8 o r C Mixing
P ✓ VWD Antibody
Mixing ✓ SAfibrinogenemia
yndrome
R e c o F -✓
Studies 9 oHemophilia
r FFP C
Studies ✓ Factor 12 Recurrent ✓ DIC
Def abortion
H e p a r i Cryoprecipitate
n
✓ Factor Platelets 6units, FFP 1-3 units,
✓ Hemophilia A ✓ Hemophilia C Dilute Russel
inhibitors
Viper Venom Not responding
Heparin test
✓ Christmas FFP Steroids Add Heparin

TEG 5,9 , wyer ✓ Anti Phospholipid

Reco F-8 or CP Antibody Syndrome
Reco Clot Formation
F-9 or FFP
Fibrinolysis
Heparin
Clot Strength
(Platelets/Fibrin)
LY30 Wyx afi
30 min

(MA) max Ampliude

U mx Huilima 6 cdl
2omm Plt , oayulalioo
Coazulatren fachor
OAWO L M

Enzymatic Polymerization Th rombolys is

Clotting Time Clot Kinetics Clot Stability

( C o a g u l a t i o n Fa c to rs ) C l o t B re a kd ow n
 K = Prolonged:
MA;Angle = Decreased
RON
Platelet Blockers
Thrombocytopenial
MAL
Thrombocytopathy
R~ Normal; K Prolonged;
MA = Decreased
Lu 30 ^
Fibrinolysis (UK, SK, or t-PA)

Hypercoagulation
R;K = Decreased;
MA;Angle Increased

Stage D.I.C Hypercoagulable state with

secondary fibrinolysis
D.I.C Stage 2
Hypocoagulable state

Order Va c u t a i n e r Uses

1 C u l t u re b o t t l e Aerobic followed by anaerobic

blagly
2 Citrate Coagulation profile (citrate: blood=1;9), ESR (C;B = 1 4)

Serum (powdered glass) S e r o l o g y, i n d i r e c t C o m b s , C r o s s m a t c h

r er a utainer ses
Serum (Powdered glass Immunology, Chemistr y, iron/ B12 /Folate, bac terial/viral
with reo l y m e re g e l )
p er
serology e n er
Heparin Arterial blood gas , OFT
r e g n r e r e
E D TA CBC, Blood grouping, Rh typing, Flow cytometry (blood)
er ere g ss er g n re s r ss
Acid Citrate Dextrose HLA typing, DNA studies, Pternity testing
er ere g ss n g e sr r n e er r
er ge ser g
Ox a l a te w i t h F l u r i d e Blood GIcose, Alcohol, Lactate
e rn r er g s
Aucolnd
gr ng ng er
 2

Drops
Incubate Add Anti Human
A > 4 7
otClumping
37°C, 1 hi Globulin (Combs
Patient’s Serum Com ati e
Serum)
3 Washes

Dro s
n u ate No
Drop nti uman
© S a n j e ev C h i t r a g a r, M D A I I M S , N e w D e l h i , fa c u l t y DA M S
℃ r CClumping
um in
o u in Com s
Serum Compatible
Donor's RBC as es

Dro San ee C itra ar D S e De i a u t D S o

C um in
B l o o d Wa r m e rs

Com ati e
Donor’s RBC
Barkey

Blood Warmers S-line

73
AMPIR-01

96.6
STOp
ES TAR T

. / Ta H a r .
Barkey
 Pink hyaline material in vessel wall Onion skin appearance

e or s atient ie o asa an ia emorr a e an on auto s

n ee r g r e e

Pin a ine materia in esse a nion s in a earan e

Sanjeev Chitragal MD AMMS New Delhi

H ya l i n e a r te r i o s c l e ro s i s ( B e n i g n hyper plastic ar teriosclerosis ( Malignant

Hypertension) Hypertension)

DA M S CA M X
Small n
hemor
ee rhage
r gonr sur face of e e eMedicoz

kidney = Flea Bitten Kidney

a ine arterios erosis Beni n er asti arterios erosis a i nant
S an je ay C h i t r ag ar M ID A IIM S
ertension N e w De l h i ertension

Sma emorr a e on sur a e o

i ne ea Bitten i ne
Key Words : patient died of basal ganglia hemor rhage and LVH on
autopsy? n ee r g r e e

Caus es :
e or s atient ie o hypertension
1. malignant asa an ia emorr a e an on
auto s 2. Infec tive endocarditis
S an je ev C h i t r ag ar M D A IIM S N e w De l h i
3. PA N
4. All RPGN
5. Leptospirosis
6. S L E

Causes
 F i b ro s i s

e or s ear i o ia esse io s

n ee r g r e e
Giant cells
i rosis

Causes: iant e s
1. Giant cell arteritis(>50yr)
2. Ta kaya s u a r te r i t i s ( < 5 0 y r )

Key Words : Chronic HBV, hypertension, vessel biopsy DAMS

eMedicoz

Causes
Sanjeeviant
Chitrager Ml
e arteritis r Delh n ee r g r e e
a a asu arteritis r

Inflammation

e or s C roni B ertension esse io s

n ee r g r e e

n ammation
Fibrinoid
N e c ro s i s

Diagnosis: Sahjeey Chitragar MD AIIMS New Delhi

1. Polyarteritis Nodosa
i rinoi
 S ad d l e N o s e (
Cartilage
e or s ear ematuria emo t sis destruction

n ee r g r e e

Fibro cavitary lung

lesions
Sa e ose
Carti a e
estru tion

i ro a itar un Sanjeev Chitragar MD AIIMS New Delhi

esions D i a g n o s i s
1. G r a n u l o m a t o s i s w i t h p o l y a n g i i t i s
( We g n e r ' s G r a n u l o m a to s i s )

CHEY
Key Words : identify infarc t in the image Viable myocardium red DAMS
eMedicoz

a re a s )
n ee r g r e e
Dia nosis
ranu omatosis it o an iitis
e ner’s ranu omatosis
S a n j e ev C h i t r a g a r M D A I I M S N e b l l

e or s i enti in ar t in t e ima e ia e m o ar ium re

areas

I n fa rc t
n ee r g r e e unstained
areas

Triphenyl tetrazolium Chloride stain of infarc t

n ar t
Sanjeev Chitragar MD AIIMS New Delhi
unstaine
areas
 Ninja Star Nuclei
e or s re u e C m o ar ia io s
earan e Dia nosis tio o i ai ure S so i or Diasto i

in a Star u ei

X
Diagnosis: DCMP
E t i o l o g y : I d i o p a t h i c , Ti t i n M u t a t i o n , D r u g s
A l c o h o l , C o b a l t , H e m o c h ro m a t o s i s
Systolic failure

Key Words : reduced CO, myocardial biopsy

Dia nosis DCDiagnosis?
Appearance? P Etiology? Which Failure Sysolic or Diastolic?
tio o io at i itin utation Dru s
o o Co a t emo romatosis
BOX car Nuclei
S sto i ai ure

e or s re u e C m o ar ia io s
earan e Dia nosis tio o i ai ure S so i or Diasto i

B ar u ei

UP
D
Diagnosis: 35 49 69
1. HOCM -,L:
Etiology: MY¢ 7 mutation
D i a s t o l i c fa i l u re
 Name lesion?
Diagnosis?
e or s itra stenosis

Anitschlow
n ee r g Wf
r & e e
Lympho plan
Cuant luf
ame esion
Dia C Aschott Cu)
nosis
As c h o f f N o d u l e

As c h o f f B o d y
R h e u m a t i c c a rd i t i s

Sanjeev Chitragar MD AIIMS New Delhi

s o o ue
DAMS
CHM
Ke y Wo rd s : N e w b o r n w i t h re s p i r a t o r y d i s t re s s
eMedicoz
s o Bo
R eumati ar itis
S a n j e ev
R i s k Fa c t o r s ?
n ee r g r e e
L
nk pm
e or s e orn it res irator istress
Premahunlt
Hyaline membrane
n ee r g r e e
Ris a tors

X
a ine mem rane

Causes
1. R D S o f N e w b o r n
2. ARDS eo Sanjeev Chitragar N
 e or s Smo er C roni e atitis rom i oo

n ee r g r e e

Thinned out and dilated air

spaces

Emphysema

inne out an i ate air

Key Words : smoker, cough sputum for 2 years s a es DAMS
CKHY

eMedicoz

m sema
Sanjeev Chitragar MD AIIMS New Delhi n ee r g r e e

e or s smo er ou s utum or ears

n ee r g r e e

Hyperplasia of sub mucosal

glands

C h ro n i c b ro n c h i t i s

er asia o su mu osa
an s Sanjeev Chitragar MO AIIMS New Delhi
 n ee r g r e e

C u rs c h m a n n S p i r a l s

Charcot leyden Crystals

Bronchial Asthma

Curs mann S ira s Sanjeev Chitragar MD AIIMS New Delhi

C i nar
Key Wo rd s : s p u t u m ex a m a t iot
o n ei n 1en Cra rsta
2 -ye s with episodic
b oy
breathlessness
C re o l a b o d y

Bron ia st ma
Ke y Wo rd s : p o s t p n e u m o n i a DA M S
CAM
n ee r g r e e eMedicoz

e or s s utum e amination in ear o it e iso i

S a n j e e v C h i t r a g a r M D reat
AUN essness
Creo a o

e or s ost neumonia

n ee r g r e e
Dilated and fibrotic bronchi

Di ate an i rotiS a n ron

jenl Chitragar
i MD AIIMS New Delhi

Bronchiectasis
 e or s reat essness m i roti at in un

n ee r g r e e

Carbon black) layden

macrophages

Compacalio
C o a l Wo r k e r
Sanigey Chifrager MD AIIMS New Delhi
Pneumoconiosis

Car on a a en
ma ro a es
Key Words : breathlessness, fibrotic patch in lung, manu factures roof sheets DAMS
eMedicoz

Coa or er n ee r g r e e
Pneumo oniosis
Sanjeev Chitragar MD AIIMS New Delhi

e or s reat essness i roti at As,rook,s eets

in un manu a tures Ca, Potun

n ee r g r e e

B e a d e d g o l d e n b row n b o d y
(asbestos body)

S a n j e ev C h i t r a g a r M D A I I M S N e w D e l h i

As b e s to s i s

Bea e o en ro n o
as estos o
 e or s ear ema e er a emia ei t oss
un esions
n ee r g r e e
Asteroid body

Schawmann body calcification)

Sarcoidosis

steroi o
S a mann o a i i ation

Sanjeev Chitragar MD AIIMS New Delhi

Sar oi osis

Key Words : Farmer, breathlessness, fibrotic patches in lungs DA M S C H

eMedicoz

n ee r g r e e
S a n j e e v. G h i t r a g a r M D A I I M S N e w D e l h i

e or s armer reat essness i roti at es in un s

n ee r g r e e

Giant cell, Granuloma

Hypersensitivity Pneumonitis ( anjeey Chitragar MD ATIMS New Delhi

fa r m e r s L u n g )
 e or s nonsmo er ema e ei t oss
eri era un esion
Dia nosis ar ers eneti s

n ee r g r e e

G l a n d fo r m a t i o n

M a r ke r : N a p s i n A , T T F - 1
Adenocarcinma Genetics: EGFR, ALK, KRAS

an ormation

Key Words : smoker, weight loss, confusion, DAMS

eMedicoz

delerium ar er a sin
D i a g n oseno ar ke
i s , Mar inma
rs , Ge n e t i c s eneti s R R S
n ee r g r e e
Sanjeev ahitragar MD

e or s smo er ei t oss on usion

e erium
Dia nosis ar ers eneti s

n ee r g r e e

S m a l l c e l l s w i t h hy p e rc h ro m a t i c
nucleus

sámjeey Chiacar MD AIIMS New Delhi

Marker: Chromogranin,
Small cell S y n a p to p hys i n , T T F - 1
carcinoma G e n e t i c s : P 5 3, R B , M yc
 e or s smo er ei t oss
er a emia
Dia nosis ar ers eneti s

n ee r g r e e

Ke r a t i n p e a r l s

Marker: P40, P63

Squamous cell Genetics: P53, EGFR
carcinoma Sanjeev Chitragar MD AIIMS New pell

eratin ear s
Key Words : smoker, weight loss, industrial
CAH
wo r ke r wo r ke d i n f i re p ro o f i n g DAMS
eMedicoz

Diagnosis, Markers, EM finding

ar er P P
S uamous
Sanjeev e
Chitragar eneti s P R
n ee r g r e e
ar inoma

e or s smo er ei t oss in ustria

or er or e in ire roo in glands
Dia nosis ar ers in in

n ee r g r e e

an s Spindle
cells

M a r ke r : c a l re t i n i n
Mesothelioma E M : Lo n g m i c rov i l l i
agar MD AlIMS New Delhi
S in e
 war-busn
e or s s e sia
s tor
Dia nosis ma i nan arisin Comma
shaped
organisms
n ee r g r e e

Diagnosis: H.
py l o r i
Comma
s a e
or anisms

Maltoma (100% association)

Gastric carcinoma

Dia nosis Sanjeev Chitrapar MD AIIMS New Delhi

ori

Key Words : Diar rhoea, weight loss

D i a g n o s i s , Pa t h o g e n e s i s DAMS
eMedicoz

a toma asso iation

astri ar inoma
S a n j e ev C h i t r a g a r M D A I I M S N e w D e
n ee r g r e e

e or s Diarr oea ei t oss

Dia nosis Pat o enesis

n ee r g r e e

Diagnosis: H y p e r p l ast i c
Men etrier's gastric folds
Disease

E xc e ss i ve TG F - a

Dia nosis er asti

Sanjeev Chitragar MD AIIMS New Delhi
enetrier’s astri o s
Disease
 e or s Diarr oea Duo ena tumor
isto o in rease astri o s
Dia nosis

n ee r g r e e

Diagnosis: Salt and

Neuroendocrine tumor pepper
chromatin

Zollin ger Ellis on

Syndrome
Dia nosis Sa t an
itragar MD AIIMS New Delhi
euroen o rine tumor e er
romatin

Key Wo rd s : D i a r r h o e a , d u o d e n a l b i o p sy
CAMN
Diagnosis, treatment, malignancy arising? DAMS
o in er ison eMedicoz

S n rome
Sanjeev Chitragar MD A MS New Dathi
n ee r g r e e

Villous
e or s Diarr oea uo ena atrophy
io s
Dia nosis treatment ma i nan arisin

n ee r g r e e

Diagnosis: Celiac i ous

Disease atro
Crypt
hy p e r p l a s i a

G lu te n F re e d i e t
T cell lymphoma
Dia nosis Ce ia
Sanjeev Chitragar MD AIIMS New Delhi
Disease
 e or s steatorr oea uo ena io s
i i a uo es in
Dia nosis etio o
e it e ia e s
Ac a n t h o c y t e s
n ee r g r e e
'000•D

Diagnosis:
A b e t a l i p o p ro te i n e m i a

ant o tes

MTP mutation
Autosomal
recessive
Dia nosis
eta i o roteinemia

Key Word s : J oi n t p ai n ste ato r r h o e a ,

duodenal biopsy DAMS CK
eMedicoz

P mutation
Diagnosis, etiology
utosoma
S re
a n j eessi
e v Ce
hitrages AIIMS New Delhi
n ee r g r e e

e or s oint ain steatorr oea

uo ena io s
Dia nosis etio o

n ee r g r e e

Diagnosis: Whipple
Disease
F o a my M a c ro p h a g e s i n
lamina propria (PAS +)

T. w h i p p e l i

Dia nosis i e
Disease oam a ro a es in
amina ro ria P S
 e or s omina ain ee in PR
Dia nosis

n ee r g r e e

Diagnosis: Ulcerative
colitis

Pseudopolyps

Dia nosis erati e

Sanjeev Chitragar MD AIIMS New Delhi
o itis
Pseu o o s
Key Wo rd s : m e g a l o b l a s t i c a n e m i a ,
abdominal pain, lleal biopsy DAMS
eMedicoz

Diagnosis

Sanjeev Chitragar N

n ee r g r e e

e or s me a o asti anemia
a omina ain ea io s
Dia nosis

n ee r g r e e

Diagnosis: Crohn
Disease Submucosal granulomas
B12 deficiency

Dia nosis Cro n

Sanjeev Chitragar MD AIIMS New Delhi
Disease Su mu osa ranu omas
B e i ien
 e or s earpoup
i ee in PR
Dia nosis
JP
n ee r g r e e
(Relunlion pdup)
D i a g n o s i s : J u ve n i l e
Polyp
Dilated glands within polyp

Dia nosis u eni e

Chitragar MD AIIMS New Delhi
Po
Di ate an s it in o

Key Wo rd s : 1 1 -ye a r c h i l d , g u m
hy p e r p i g m e n t a t i o n b l e e d i n g P R DAMS
•Medicoz

Diagnosis

Sanjeev Chitragar MD AIIMS Nev

n ee r g r e e

e or s ear i um
er i mentation ee in PR
Dia nosis

n ee r g r e e

Diagnosis:
Hamar tomatous Peutz
A r b o r i s o n g p a t te r n o f
J a g h e rs ) p o l y p
s m o o t h m u s c l e d i ss e c t i n g
the glands

Dia nosis
amartomatous Peut
a ers o r orison attern o
 e or s ear ee in PR Bran in an s it sta
Dia nosis

n ee r g r e e

D i a g n o s i s : Tu b u l a r a d e n o m a

Dia nosis u u ar a enoma New Delhi

Key Words : 50-year, bleeding PR

Ta l l f i n g e r l i ke p ro je c t i o n
Diagnosis DAMS
(no stalk) •Medicoz

Sanjeev Chitragar AD AIIMS New

n ee r g r e e

e or s ear ee in PR
a in er i e ro e tion
Dia nosis
no sta

n ee r g r e e

Diagnosis: Villous adenoma

Dia nosis i ous a enoma

Sanjeev Chitragar MD AIIMS New Delhi
 e or s ear ee in PR
a in er i e ro e tion
Dia nosis
no sta i ous
Bran in an s tu u ar
n ee r g r e e

D i a g n o s i s : Tu b u l o V i l l o u s
adenoma

Sanjeew Chitragar MOLA

Key Words : Alcoholic patient

Dia nosis
Identify u ustruc
pointed o itures,
ous Content DAMS
eMedicoz

a enoma

Sanjeev Chitragar MD AlfMne New Delhi n ee r g r e e

e or s o o i atient
enti ointe stru tures Content

n ee r g r e Mae
llory Bodies

a or Bo ies
Mallory Hyaline
C y t o ke r a t i n i n t e r m e d i a t e F i l a m e n t s

Sanjeev Chitragar MD AIIMS New Delhi

 hepatocytes

e or s res irator i i ut it
e atitis
Dia nosis un esion

n ee r g r e e
P S o u es in
e ato tes

D i a g n o s i s a1 A n t i t r y p s i n
Deficiency

L u n g l e s i o n : Pa n a c i n a r
Emphysema

Sanjeev Chitragar MD AIIMS New Delhi

Dia nosis nti tr sin

Key Words : Ulcerative colitis patient with
De i ien
Jaundice DA M S C H E X
eMedicoz

Dun
i a g n oesion
sis Pan a inar
m sema
S a n j e ev C h i t r a g a r M D A I l M S
n ee r g r e e
Onion skin fibrosis

e or s erati e o itis atient it

aun i e
Dia nosis

n ee r g r e e

nion s in i rosis

Diagnosis Primar y Sclerosing

cholangitis

Dia nosis Primar S erosin

 e or s ematuria s a ter
Res irator in e tion
Dia nosis
Sub epithelial Humps

n ee r g r e e

Diagnosis Post streptococcal GN

Su e it e ia um s
CL

A1
Sanjeey Chitragar MD AIIMS New Delhi

Dia nosis Post stre to o a

Key Wo rd s H e m a t u r i a , Azo t e m i a A n u r i a
D/ D ?
Cresents
DAMS
CK
eMedicoz

Sanjeev Chitragar MD AIIMS New Dethf

n ee r g r e e

e or s ematuria otemia nuria Cresents

D D
Diagnosis Cresentic GN (RPGN)

n ee r g r e e

Dia nosis
Ty pCresenti
e I (Anti G B MRP
) Ty p e I l ( I m m u n e c o m p l e x ) Ty p e I I I ( P a u c i I m m u n e )

G o o d p a s t u re ( u re L i H 6 4 - SLE Tur IL HSR Wegner's

HSP M-PAN
Rarely IgA, PSGN Churg strauss

(F Linear patter n Granular pattern

No depgsitseev Chitragar MD AIIMS New Delhi
 e or s emo t sis
Dia nosis
AN
ES
ematuria

n ee r g r e e
inear atter

Diagnosis Goodpasture
Syndrome

S an je ev C h i t r ag ar M D A IIM S N e w De l h i

Dia nosis oo asture

Key
S n Wo rd s 1 5 -ye a r a r t h r a l g i a H e m a t u r i a a n u r i a a f te r p h a r y n g i t i s
rome
I F fo r I g A & L M a re g i ve n DAMS
eMedicoz

Diagnosis Sanjeev Chitragar MD AIIMS New Delhi

n ee r g r e e

e or s ear art ra ia ematuria anuria a ter ar n itis

or are i en
Dia nosis n ee r g r e e

Cresents Granular patter n . Type II RPGN

Sanjeev Chitrager MD AIIMS New Dehi

Diagnosis Henoch Schonlein Pur pura

Cresents ranu ar attern e RP

n ee r g r e e
 Tr a m t r a c k a p p e a r a n c e

e or s ematuria
Dia nosis
D D ase on
n ee r g r e e

ram tra a earan e

Diagnosis MPGN membranoproliferative GN

IF : d e p os i ts of Ig G, C1, C3, C4= M P GN t yp e |

IF : deposits of C3 only = MPGN type II
AIIMS Néw Dell

Dia nosis P mem rano ro i erati e

Ke y Wo r d s H e m a t u r i a
L M s h ows Tr a m t r a c k E M i s b e l ow DA M S
C
eMedicoz

e osits
Diagnosis, o
Etiology C C C P t e
e osits o C on P t e
n ee r g r e e
S a n j e ev C h i t r a g a N

Dense deposits along BM

e or s ematuria
s o s ram tra is e o
Dia nosis tio o

n ee r g r e e

Dense e osits a on B

D i ag n os i s De n s e De p o s i t D i s e a s e / t y p e II M P G N )

C3NeF is etiology
 Spike BM appearance

e or s e roti e er ma e
Dia nosis

n ee r g r e e

S i eB a earan e

Diagnosis Membranous GN

Sanjeev Chitragar MD AIIMS New Delhi

Key
Dia Words
nosis Nephrotic,
Diagnosis
em ranous 4 year, no change in LM
DAMS
CA
e M e d i c o z

Sanjeev Chitral Dell

n ee r g r e e
E f fa c e m e n t o f F o o t

e or psro cee s sroti

es
ear no an e in
Dia nosis

n ee r g r e e

a ement o oot
ro esses

Diagnosis Minimal change Disease

Sanjeev Chitragar MD

Dia nosis inima an e Disease

Dia nosis

S eroti no u es
n ee r g r e e

Kiemmelsteil Wilson lesion

Diabetic Nephropathy

Sanjeev Chitragar MD AIIMS New Delhi

Key
iemme Wordstei
s : Ch i ld w i t hesion
i son d e af n e ss a n d re n a l
fDia
a i l u reti
e e ro at DA M S C A N Y
eMedicoz

Diagnosis

Spliting of lamina Densa

Sanjeev Chitragar MD AñME New Delhi

n ee r g r e e

e
ai ure
or s C i

Dia nosis
it ea ness an rena
EP
S itin o amina Densa
n ee r g r e e
Alternate thinning of BM

Basket
wcave CL
Diagnosis Alport Syndrome

ternate t innin o B

Sanjeev Chitragar MD AMMS New Delhi

Dia nosis ort S n rome

 Blood vessels

e or s s m tomati Rena tumor

Dia nosis sso iation

Adipose Tissue
n ee r g r e e

Diagnosis Angiomyolipoma

Smooth
Tuberous sclerosis m u s c l e f i b re
close to the
vessel wall
S a n j e ev c h i t r a g a r M l A I I M S N e w D e l h i

Dia nosis n iom o i oma

Key Wo rd s H e m a t u r i a w i t h re n a l m a ss
Diagnosis, Cell of origin, inherited cancer DAMS
•Medicoz

syndrome?
u erous s erosis

Sanjeev Chitragar MD AllMS New Dethi n ee r g r e e

Clear cells

e or s ematuria it rena mass

Dia nosis Ce o ori in in erite an er
s n rome

n ee r g r e e
C ear e s

Diagnosis Clear cell RCC

PCT, Von Hippel Lindau Syndrome

Sanjeev Chitragar MD AIIMS New Delhi

 Perinuclear halo

e or s ematuria it rena mass

Dia nosis e o ori in
Thick cell membrane
(Plant cell appearance
n ee r g r e e

Perinu ear a o

Diagnosis Chromophobe
i e mem rane
RCC
P ant e a earan e

Intercalleted cells of collecting duct

Sanjeev Chitragar MD AIIMS New Delhi

Key
Dia Wo rd sC5 -ye
nosis romoa r, H e
omea t u r i a w i t h re n a l m a ss
CKHX
D iagnosis, Inherited conditions?
RCC DAMS
eMedicoz

nter a eteChitragar
Sanjeev e s o MDLARIS
o e tin u t B l a s te m a ( S m a l l
Spindle cells
round blue cells)
n ee r g r e e

e or s ear ematuria it rena mass

Dia nosis n erite on itions

Tu b u l e f o r m a t i o n
n ee r g r e e B astema Sma
S in e e s
roun ue e s

D i a g n o s i s N e p h ro b l a sto m a (
Wilms' tumor)
u u e ormation
1. WAG R ( W T, A n i r i d i a , G e n i t o u r i n a r y a b n , M e n t a l R e t a r d a t i o n , W T 1 m u t a t i o n
2. D e nys D r a s h sy n d ro m e ( D o m i n a n t n e g a t i ve M i s s e n s e m u t a t i o n o f W T 1,
Gonadoblastoma, WT, Nephropathy (mesangial sclerosis) Sanjeev Chitragar MD AIIMS New Delhi
3.
B e c k w i t h w i d e m a n n sy n d ro m e ( l o ss o f m a te r n a l i m p r i n t i n g o f W T 2 o r p a te r n a l
d i s o my o f c h r 1 1 = h e m i hy p e r t ro p hy, W T
Dia nosis e ro astoma
i ms’ tumor
M a r ke rs : Po d o p l a n i n , N a n o g , O CT3 /4,
CeD 1 1 7 or s ear testi u ar tumor
Dia nosis ar ers
omo enous ra ite no e rosis emorr a e
DAMS
Dia nosis Seminoma e M e d i c o z

n ee r g r e e 1 c

ar ers Po o anin ano C

CD
r mphocytic infiltrate

Clear cytoplasm Sanjeev Chitragar MD AIIMS New Delhi

m o ti in i trate
Key Words 25-year, testicular tumor
Di a g n o s i s , Marke rs ?
Tu m o r w i t h l a rg e a re a s o f h e m o r r h a g e a n d n e c ro s i s
C ear to asm n ee r g r e e
Diagnosis Embryonal
C a rc i n o m a S a n j e ev C h i t r a g a r M D A l l s N eve

M a r ke rs : C y t o ke r a t i n , O CT3 /4, N A N O G
e or s ear testi u ar tumor
Dia nosis ar ers
umor it ar e areas o emorr a e an ne rosis
DAMS
Dia nosis m r ona eMedicoz

Car inoma n ee r g r e e
Gland like struc tures

ar ers C to eratin C 1 cm

an i e stru tures
pleomorphism
MD AIIMS New Delhi
 e or s ear testi u ar tumor
Dia nosis ar ers

n ee r g r e e
S i er Du a Bo

Diagnosis Endodermal Sinus

( yolk Sac) tumor

Markers: Alphafetoprotein

MD AIIMS New Delhi

Dia nosis n o erma Sinus

o Sa tumor
Key Words 10-year, testicular tumor, Precautious puber ty
Diagnosis, Familial for ms? DAMS
aMedicoz

ar ers a eto rotein

Sanjeev Chitragar MD ANIMS New Del
n ee r g r e e

C r yst a l s o f R i n ke
e or s ear testi u ar tumor Pre autious u ert
Dia nosis ami ia orms

n ee r g r e e

Cr sta s o Rin e

Diagnosis Leydig Cell tumor

Fa m i l i a l : F D H m u t a t i o n R C C ,
Le i o myo m a , Le yd i g c e l l t u m o r

Sanjeev Chitragar MD AIIMS New Delhi

Dia nosis e i Ce tumor

 e or s Breast tumors

Du t ormation
n ee r g r e e
Singly ar ranged cells ( Indian
Diagnosis Duc tal carcinoma
F i l e Pa t t e r n )

Sin arran e e s n ian

Dia nosis Du ta ar inoma
i e Pattern Sanjeev Chitragar MD AIIMS New Delhi

D i a g n o s i s Lo b u l a r
carcinoma

Key Words 5-year, testicular tumor,

D i a g n o s i s , m a r ke r s ? DAMS
M e d i c oz

n ee r g r e e
Sanjeev Chitragar MD AIIMS New Delhi
Dia nosis oSpindle
u ar cells with Striations
ar inoma

e or s ear testi u ar tumor

Dia nosis mar ers

n ee r g r e e
S in e e s it Striations

D i a g n o s i s R h a b d o myo s a rc o m a

Markers: Desmin, Myogenin,

Myo D1

Sanjeev Chitragar MD AIIMS New Delhi

Dia nosis R a om osar oma

Dei a g n or
o s i ss S c h w
ear
a n ntinnitus
oma CP an e tumor
Dia nosis mar ers in erite an erCentral Nuclei
s n rome Free areas ( Verocay Bodies)

M a r ke rs : S - 1 0 0
N F - 2 : S c hwa n n o m a , M e n i n g i o m a
n ee r g r e e

Dia nosis S annoma Centra u ei ree areas ero a Bo ies

Nuclei pallisading
ar ers S
S annoma enin ioma

Chthagar MD ANMS New Delhi

Key Words 10-year, bone tumor, Codman triangle u ei a isa in

Diagnosis? DAMS
eMedicoz

Sanjeev Chitragar MD AlIViS New Osteoid

n ee r g r e e

De
i a g n oor
s i ssO s te o
ear one
s a rc o m a tumor Co man trian e
Dia nosis

n ee r g r e e steoi

Dia nosis steosar oma

Pleomor phic cells

Sanjeev Chitragar MD AIIMS New Delhi

P eomor i e s
 e or s ear one tumor Co man trian e
Diagnosis Ewings Sarcoma /
Dia
P N E nosis
T ar ers eneti s t er auses
Sma roun e s
Markers:
n ee CD99r g r e e
Genetics: t(11;22)

O t h e r C a u s e s : N e u ro b l a s t o m a ,
MDia
e d unosis
l l o b l a s t oinm as,Sar oma
PPi n e o b l a s t o m a

ar ers CD Rosette with cytoplasmic process in lumen

eneti s t H o m e r Wr i g h t R o s e t t e

t er Causes euro astoma

e u o astoma
Pineo astoma
Ke y Wo r d s , b o n e t u m o r
Diagnosis? Cell of Origin?
Rosette it to asmi ro ess in umen DA M S C M
omer ri t Rosette eMledicoz

M u l t i n u c l e a te d g i a n t c e l l s
Sanjeey dht
n ee r g r e e

e or s one tumor
Dia nosis Ce o ri in

u tinu eate iant e s

n ee r g r e e

Diagnosis Giant cell tumor |

Osteoclastoma)
Mononuclear cells

Cell of origin: Osteoblast precursor ( very less seen in tumor)

Dia nosis iant e tumor

 e or s i it or ita tumor
Dia nosis ame t e stru tures t er auses
Rosette (With empty lumen

n ee r g r e e

D i a g n o s i s Re t i n o b l a sto m a
Rosette it em t umen
F l ex n e r W i n te s t i n e r Ro s e t te

O t h e r c a u s e s P i n e o b l a sto m a , m e d u l l o e p i t h e l i o m a

sanjéev Chitragar MID AnMS New Delhi

Dia nosis Retino astoma

Key Wo rd s 8 -ye a r, re t ro o r b i t a l t u m o r
D i a g n o s i s , M a r ke r ? M a ke u p o f w h a t e ner intestiner Rosette DA M S C A N Y
eMedicoz

t er auses Pineo astoma me u oe it e ioma

Sanjeev Chitragar MD AIIMS New Delhi

n ee r g r e e

e
Diagnosis or sPilocytic
ear retro or ita tumor
Dia
A s t r o c y t o m a er
nosis ar a eu o at

M a r kn
e ree
: G FA P r g r e e H a i r l i ke p ro j e c t i o n ( p i l o c y t e s )
Ro s e n t h a l f i b re s a re G FA P
intermediate Filaments
Ro s e n t h a l f i b re s

Dia nosis Pi o ti
stro toma

ar er P air i e ro e tion i o tes

Rosent a i res are P
interme iate i aments
Rosent a i res
Sanjeev Chitragar MD AIIMS New Delhi
 Large areas of necrosis
e or s ear rain tumor
Dia nosis

n ee r g r e e

ar e areas o ne rosis

Peripherally ar ranged Nuclei ( Pseudo Pallisading)

Glioblastoma

Jaitragar MD AJIMS ew Delbi

Ke y Wo r d s B r a i n t u m o r
Diagnosis, genetics? DA M S C H Y
eMedicoz

Peri era arran e u ei Pseu o Pa isa in

Sanjeev Chitragar MDP ANMS
io astoma
n ee r g r e e

Fried egg appearance

Dei a g n oor
s i ss O
Brain
l i g o dtumor
endroglioma
Dia nosis eneti s

G e n en
tic
ees: 1p/19
r qgcro - d e l e t i o n e e

rie e a earan e
Dia nosis i o en ro ioma

C h i c ke n w i re c a p i l l a r y
eneti s o e etion

Sanjeev Chitragar MD AIIMS New Delhi

C i en ire a i ar
 e or s Brain tumor
Diagnosis ependymoma
Dia nosis

Perivascular ( Pseudo) rosette

n ee r g r e e

Dia nosis e en moma

Peri as u ar Pseu o rosette

Delhi

hey Words 40-year female tumor in Falx

Diagnosis? DAMS
eMedicoz

Whorling with
Psammoma bodies n ee r g r e e

De
i a g n oor
s i ss M e n iear
n g i oema
ma e tumor in a
Dia nosis

or in it
Psammoma o ies

Dia nosis enin ioma

 e or s ear t roi tumor
Dia nosis ti a ear or an
nnie e e nu ei

D i a g n o s i s Pa p i l l a r y c a rc i n o m a

K e y Wo r d s 5 - y e a r t h y r o i d t u m o r, h y p e r t e n s i o n , F a m i l y h i s t o r y +
Diagnosis? Other tumors associated. Genetics DAMS
A
eMedicoz

Dia nosis Pa i ar ar inoma Tu m o r A m y l o i d

e or s ear t roi tumor ertension ami istor

Dia nosis t er tumors asso iate eneti s

umor m oi

Diagnosis Medullary carcinoma

MEN 2: RET mutation,

Pheochromocytoma