dias nummer 1 - mans · hematocele • specimen ... pelvis. the renal tissue in between and...

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Museium jars

Pathology Team

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• Gross description of Pathology Jars • NE: any mass 3S 3C • Size, Shape, Surface • Color, Consistency, C/S • Border (or capsule), Number • Cavity or Cyst • Size, Shape, Surface • Wall, Lining, Content

1- Cell injury

• Fatty change liver

• Amyloid spleen and kidney

• Brown atrophy of the heart

Fatty change of liver

Specimen: A triangular-shaped slice of liver: Surface: The liver has shreddy peritoneal

covering and smooth outer surface. Color: Yellow. Consistency: Soft. Cut section: Shows rounded edges (sharp

due to preservative) with yellow surface and greasy to touch.

Fatty liver

Amyloid spleen (sago spleen) and kidney

Specimen: Spleen and Kidney: Kidney Size: Enlarged. Surface: Smooth. Cut surface: Shows thickening of the cortex, with waxy

appearance. Consistency: Firm rubbery. Spleen Size: Enlarged. Surface: Smooth. Cut surface: Shows small numerous brownish semi-translucent

nodules throughout the white pulp (Amyloidosis affecting the lymphoid follicles = Sago spleen)

Brown atrophy of the heart

• Specimen: heart & part of ascending aorta • Size: small sized heart (atrophied) • Surface: shows tortuous coronaries

(indicating that the decrease in heart size is acquired)

• C/S: left ventricle has small cavity & thin wall (atrophy)

• Color: brownish (due to excess accumulation of lipochrome pigment)

2- Inflammation

• Acute suppurative appendicitis

• Fibrinous pleurisy

• Chronic suppurative lung abscess, pleural adhesions

Acute diffuse suppurative appendicitis

• Specimen: appendix

• Size: increased (swollen by edema)

• Surface: peritoneal covering is dull opaque, lost normal luster (due to peritonitis)

• Color: yellowish red (pus+hyperaemia) with bluish brown dots of hemorrhage

• Conisitancy: soft

Acute diffuse suppurative appendicitis

Fibrinous pleurisy

• Specimen: left lung • Shape: longitudinal section of lung • Surface: pleura is dull opaque, thickened,

adherent to underlying lung tissue (due to fibrin)

• pleural membrane thickness about 2mm, red threads of hyperaemia on outer surface of visceral pleura and inner surface of parietal pleura

• C\S: lung parenchyma normal appearing,

Chronic suppurative lung abscess, Plueral adhesions

• Specimen: right lung • Shape: wedge shaped • Surface: pleura is thickened, adherent (fibrosis) • Consistency: firm • C/S: shows a Cavity • *Number: solitary cavity • *Site: middle &lower parts of lung • *Shape: oval • *Size: 12x3cm • *Wall: thickened, grayish white (fibrosed as evidenced by

the patent cavity) • *Lining: smooth, covered by yellowish exudate

(suppurative inflammation), traversed by thick cords (remnants of bronchi & vessels)

• Surrounding lung tissue: anthracotic, collapsed

3- Repair

• Skin scar

• Malunion of fracture femur

Malunion of fracture femur

Specimen: part of femur Femur shows fracturesite: shaft Shape: oblique Fracture ends: distal end displaced medially& fracture ends impacted (improper repositioning of fracture ends, faulty immobilization) Recent callus seen around fracture ends and in medullary cavity

4- Circulatory disorders

• Massive pulmonary embolism

• Dry gangrene of lower limb

• Moist gangrene of upper limb

• Strangulated hernia

• Cerebral hemorrhage

• Hematocele

Massive pulmonary embolism • Multiple emboli:

Site: within the main pulmonary branches

Shape: does not fit the shape of the artery in which they exist, one of these emboli has curved appearance.

Color: brown

Consistency: firm

Adjacent lung tissue appears normal, because of sudden death with such massive emboli.

Dry gangrene of foot • Specimen: foot & leg • Size: limb is shrunken & shriveled (due to gradual arterial

occlusion with persistant venous and lymphatic drainage + surface evaporation)

• Surface: skin is wrinkled (due to tissue shrinkage) • Color: blackened foot up to ankle (due to ischemic necrosis

followed by putrefaction with production of hydrogen sulphide)

• Line of demarcationreddish white line near ankle, separating proximal healthy part from distal gangrenous one. (zone of acute inflammation in the neighboring healthy part due to irritation by toxic products of putrefaction)

• Autoamputation of little toe (separation of gangrenous toe)

Moist gangrene of forearm

• Specimen: forearm and hand of a child • Size: Limb is swollen (evidenced by increased

depth of finger creases & obliteration of palm concavity)

• (due to sudden arterial and venous occlusion following severe crushing injury)

• Surface: skin is macerated (due to ischemic necrosis followed by putrefaction)

• Color: bluish (congestion) • No line of demarcation (due to rapid spread of

gangrene)

Hematocele

• Specimen: Testicle & tunica vaginalis

• Tunica vaginalis:

-Tunical space widened &contains remnants of clotted blood

-Wall is thickened (about 3mms), grayish white (due to fibrosis)

• Testis: Atrophied (due to compression by blood in tunica)

Strangulated hernia & moist gangrene

• Specimen: U-shaped loop of small intestine

• Size: markedly swollen (due to sudden arterial and venous occlusion)

• Surface (wall): a depression appears at middle zone of the specimen (site of constriction of the loop, strangulation)

• Color: lower half shows deep bluish areas (congestion) + blackish zones (gangrene)

• Peritoneal covering: dull, opaque (due to peritonitis)

Massive spontaneous Cerebral hemorrhage

• Specimen: brain (coronal section)

• Specimen shows hematoma

• site: region of right basal ganglia with extension into the ventricular system (blood clots)

• shape: oval

• size: 4x3cm

• color: dark red (old hemolysed blood)

5-Tuberculosis

• Tuberculoma

• Chronic fibrocaseous pulmonary tuberculosis, confluent bronchopneumonia and fibrinous pleurisy

• Tuberculous epididymitis.Tuberculoma of the spermatic cord.

• Tuberculous lymphadenitis

• Tuberculous pyonephrosis

Tubercloma Specimen: Upper lobe of a lung

The lung lobe is bisected to show a mass

Site: in the upper part of the lobe with its lower pole tapered towards a bronchus

Size: 6X3 cm

Shape: oval

Colour: grayish yellow with brown hemorrahage

Consistency: friable, surrounded by fibrous wall compressing the surrounding parenchyma

The lining of the related bronchus is yellow caseous as an evidence of tuberculous process.

Chronic fibrocaseous pulmonary tuberculosis, confluent tuberculous bronchopneumonia. Fibrnous pleurisy

Specimen: longitudinal section of the lung

Showing a cavity

Site: in the upper part of the lung

Size:4X8 cm Shape: oval

Wall: white fibrous

Lining: smooth with several ridges run in the wall in various directions representing remnant of bronchi blood vessels that resist destruction.

Content: grayish yellow caseous material

Chronic fibrocaseous pulmonary tuberculosis, confluent tuberculous bronchopneumonia. Fibrnous pleurisy

The rest of the lung tissue appears: consolidated grayish yellow in colour with black anthracotic foci.

Hilar lymph nodes: Enlarged, with anthracotic pigmentation and grayish yellow caseous foci.

Pleura: thick, dull, opaque& lost its normal luster

Tuberculous pyonephrosis

Specimen: Half of a kidney

Size: enlarged

Capsule: thickened with subcapsular hemorrhage

Cut section: shows dilated calyces to form cavites

Size: variable

Shape: irregular

Lining: grayish yellow caseous material

Some of them appear to be communicating with the dilated pelvis.

The renal tissue in between and surrounding the cavites show numerous caseous foci, variable in size and shape& not surrounded by hyperemia.

Tuberculous epididymitis, tubercloma of the spermatic cord

Specimen: Testis, Epididymis and spermatic cord

The body and head of epididymis are seat of:

Multiple, variable size foci of friable grayish yellow caseation, not surrounded by congestion.

The spermatic cord shows a nodule:

Site: on one side of the cord

Size: 1X1 cm.

Shape: oval

Cut section: shows grey yellow friable picture of caseation, surrounded by thick fibrous wall

Tuberculous lymphadenitis

• Specimen: Mass of lymph nodes

• Number: multiple, matted together and adherent to the surrounding

• Size: enlarged

• Cut section: grey yellow friable cheese like foci (caseation), not surrounded by red zone of hyperemia.

6- Parasites

• Hydatid cyst

• Coarse bilharzial periportal fibrosis (liver)

• Bilharzial splenomegaly

• Bilharzial colonic polypi

• Ureteritis cystica

Hydatid cyst

• Specimen: lung lobe is opened to show a cavity

• Site: upper part of the lobe

• Size:8X8cm

• Shape: rounded

• Wall: fibrous compressing the surrounding lung tissue

• Lining: Cyst with opaque whitish thick (chitinous) wall

Coarse Bilharzial fibrosis of the liver

• Specimen: Slice of the liver • Size: Enlarged • Shape: Wedge shaped • Surface: Low hills separated by shallow

depressions • Color: Liver parenchyma is brown in color • Consistency: Firm • C/S: Grayish white fibrous thickening of large

portal tracts appearing as rounded or oval areas. No evidence of regenerating nodules

• Capsule: Capsule is thick

Bilharzial (coarse) periportal fibrosis

Bilharzial spleenomegally

• Specimen: Whole or half of the spleen • Size: Markedly increased, uniform • Shape: Preserved • Border: Rounded, thick • Notches: Prominent, accentuated • Capsule: Thick, grayish white • Hilum: Fibrosis, adhesions • Consistency: Firm • C/S: Splenic tissue is dark red with hardly

visible white pulp, & grayish white trabeculae

Bilharzial colonic polypi

• Specimen: Longitudinal section of large intestine

• Lumen: Polypi Number: multiple Size: variable in size Shape: sessile or pedunculated,

simple or branched Color: dirty yellow, the top are

necrotic & deep brown to black • Mucosa: Thick granular, dull yellow

Multiple Ureteritis cystica with stricture of the ureter (mostly

bilharzial)

• Specimen: Part of the ureter, 12cm in length

• Lower part: Narrow, 3 cm

• Upper part: dilated, cysts (multiple, elevated, variable in size, pale blue, contain watery fluid)

7-Growth disorders/benign tumors

• Senile prostatic hyperplasia

• Lipoma

• Uterine leiomyoma a. Submucous b. Subserous

• Dermoid cyst, ovary

Senile prostatic hyperplasia

• Specimen: Enlarged prostate.

• Size: about 7.5x5 cm.

• Shape: Oval.

• Outer surface: Nodular.

• Color: Grayish white.

• Consistency: Firm

Lipoma (2 Jars) • Specimen: Mass of Fatty Tissue. • Size: about 11 cm (the mass of the other jar is

about 15x10 cm). • Shape: One half of a more or less round mass. • Surface: Bossy and well demarcated. • Color: Yellow. • Consistency: Soft with greasy sensation. • Capsule: appear as a thin grayish fibrous tissue. • Cut section: Shows areas of dystrophic

calcification (chalky white) and areas of myxomatous degeneration (pale blue).

Uterine leiomyoma

Submucous leiomyoma • Specimen: Uterus, Fallopian tubes and Ovaries

• Size of the uterus: is enlarged due to hypertrophy of the uterine musculature.

• Two masses are seen: arising from the the posterior wall of the uterus (the cervix and anterior wall of uterus are opened to show the two masses).

• Consistency: Firm.

• Cut section: Whorly appearance (combination of brown color “muscle bundles” and grayish white color “fibrous tissue”)

• Surface: smooth and covered by intact mucous membrane.

The lower mass:

Size: 5x3 cm. Shape: Pyriform.

Site: arising immediately above the cervical canal.

It has a short pedicle.

The other mass: Size: 2x1 cm. Shape: Oval. Site: arising immediately above the first one.

- This mass is protruding towards the uterine cavity without pedicle

Subserous leiomyoma Specimen: One Half of Uterus and Cervix Size of the uterus: Normal size. A mass is seen on the outer side of the uterus: • Size: about 6x8 cm. • Shape: oval. • Outer surface: Smooth. • Consistency: Firm. • Cut section: Whorly appearance (combination of brown

color “muscle bundles” and grayish white color “fibrous tissue”)

The cervix: shows the presence of a small cyst (Nabothian cyst),

• Size: about 6x3 mm. • Shape: Oval

Dermoid cyst of the ovary Specimen: Ovary containing a cyst • Size: 15 cm. • Shape: Spherical. • Outer surface: Smooth and shows remnants of ovarian

tissue. • The wall thickness is about 5 mm. • The lining: Smooth. • Content: Pale yellow greasy materiel with tufts of hair. Dermoid ridge (nipple, papilla): • Site: projecting from the wall into the cyst cavity. • Size: about 2 cm • Shape: Globular. • Color: Yellow • Consistency: firm with hard gritty foci.

8- Malignant tumors • Urinary bladder carcinoma a. Polypoid b. Diffuse infiltrating c. Ulcerating

• Infiltrating carcinoma large intestine (annular)

• Ulcerative carcinoma large intestine

• Malignant skin ulcer

• Malignant melanoma of the hand

Urinary bladder carcinoma

Polypoid carcinoma of the urinary bladder

Specimen: Urinary Bladder, Prostate, Seminal Vesicles and Lower Part of Ureters.

The urinary bladder is opened to show a polypoid mass: • Site: arising from the left side of the posterior wall. • Size: 8x5 cm • Shape: Oval. • Surface: Rough. • Color: Grayish white with yellowish necrotic areas.

Hyperemic and brown area in center are seen (hemorrhage).

• Consistency: Firm with fixed indurated base. The urinary bladder: Shows dilated lumen and

hypertrophied wall with dirty yellow mucosa. The prostate: Enlarged with nodular surface

Diffuse infiltrating carcinoma of the urinary bladder

Specimen: Urinary Bladder, Lower ends of ureters (Blue Rod Inside) & Prostate

The anterior wall of the bladder is resected to show that the bladder wall is diffusely thickened and indurated.

It is infiltrated by an abnormal growth: • Surface: necrotic irregular surface. • Consistency: Firm and friable. • Color: Grey yellow. The bladder: is nearly obliterated. The prostate: is enlarged due to malignant infiltration. The ureters: are dilated and enlarged (hydroureter).

Ulcerative carcinoma of the urinary bladder:

Specimen: Urinary Bladder, Lower ends of ureters (Blue Rod Inside)

The anterior wall of the bladder shows an ulcer: • Size: about 6x5 cm. • Shape: Oval. • Margin: Irregular. • Edge: Raised and everted. • Floor: necrotic with black areas of hemorrhage. • Base: Indurated. Adjacent bladder mucosa: shows white patches

(leukoplakia).

Infiltrating (annular) carcinoma of the large intestine

Specimen: Part of large intestine is opened longitudinally to show

An abnormal growth: • Site: infiltrating all the layers of the wall along the

whole circumference. • Size: affecting a segment about 4 cm in length. • Color: Grayish white. • Consistency: Hard. • Covering mucosa: Rough. The lumen distal to the growth: Narrow. The lumen proximal to the growth: Dilated and the

wall is hypertrophied

Ulcerative carcinoma of the large intestine

Specimen: The cecum and ascending colon are opened longitudinally to show

Two ulcers: • Size: Each is about 7x8 cm. • Shape: Oval and situated transversely across

the intestinal mucosa. • Margin: Irregular. • Edge: Raised and everted. • Floor: necrotic with dark brown areas of

hemorrhage. • Base: Indurated

Malignant ulcer of the skin

Specimen: A Part of Skin The skin shows an ulcer: • Size: 2 cm. • Shape: Rounded. • Margin: Irregular. • Edge: Raised and everted. • Floor: necrotic with dark brown areas of

hemorrhage. • Base: Indurated.

Malignant melanoma of the hand

Specimen: Hand & distal forearm The little finger and the adjacent palm show a

mass: • Size: about 7x5 cm. • Shape: Oval. • The surface: Irregular and rough. • Color: Mottled dark brown to black with

necrotic yellow foci. Skin on the dorsum of the wrist joint: Shows

another dark nodule completely separated from the main mass.

9- Cardiovascular system

• Left ventricular hypertrophy

• Atherosclerosis

Left ventricular hypertrophy (Mostly hypertensive heart)

• Specimen: Whole Heart

• Weight: 420 gm.

• The left ventricular myocardium: Thickened.

• The columnae (trabeculae) carnease: Hypertrophied.

• Both coronary arteries: Show moderate atheroma.

• The aortic valve: Normal.

Atherosclerosis with ulceration & calcification

• Specimen: A strip of the aorta • The strip is opened longitudinally. • The intima : patches Number: numerous Site: around the openings of the branches of the aorta. Size: variable sizes, vary in size from 2-5 mm in diameter Shape: variable shapes, round, oval or irregular. slightly raised over the surface of intima. some patches are ulcerated. Color: predominant yellow grayish white color is seen due to fibrosis. dull white color appears with calcification.

10- Respiratory system

• Lobar pneumonia

• Bronchiectasis

• Bronchogenic carcinoma

Lobar pneumonia of lower lung lobe (grey heptization stage)& fibrnous pleurisy

• Specimen: longitudinal section of the lung

• The upper lobe is normal, the lower lobe is

• Enlarged in size

• Colour: dull grayish yellow with scattered anthracotic foci

• Consistency: firm, the normal spongy texture is lost due to filling of the alveoli with inflammatory exudates

• Hilar lymph nodes: enlarged and anthracotic

• Pleura: thick, dull, opaque and lost its normal luster.

Bronchiactasis:

• Specimen: part of the lung

• The cut surface shows cross section of dilated medium- sized bronchi:

• Size: variable from 5-10 mm

• Shape: mostly oval

• Wall: thick fibrous

• Lining: rough mucosa with yellowish bands of pus,

• The lung tissue in-between the bronchi, is the seat of fibrosis.

• Pleura: opaque and thickened by grayish white fibrous tissue.

•

Bronchogenic carcinoma

• Specimen: part of the lung

• The cut section shows a mass

• Site: arising from the wall of the bronchus, infiltrating the bronchial wall and destroying the surrounding lung tissue.

• Colour: grayish white

• Consistency: hard with shreddy necrotic areas

• Mediastinal pleura: shows multiple small nodules of few mm in size (infiltration)

• The covering pleura: is thickened by fibrosis

11- Gastro-intestinal tract-1

• Post corrosive stricture esophagus

• Malignant ulcer lower third esophagus

• Congenital megacolon

• Acquired diverticulum

Post corrosive stricture esophagus

• Specimen: Child esophagus. • Size: 12 cms in length. • Lower part: * Wall → fibrous. * Lumen → narrow (due to stricture). * Lining → irregular, rough, fissured & puckered

"due to corrosion followed by fibrosis". • Upper part (above the stricture) → dilated &

hypertrophied "to overcome stricture".

Postcorrosicve stricture of oesophagus

Malignant ulcer lower third esophagus

• Specimen: esophagus. • Size: 15 cms in length. • Lower part shows ulcer: * Site: lower part with its longitudinal axis

parallel to that of the esophagus. * Size: 5x3 cms. * Shape: oval. * Edge: elevated everted. * Floor: necrotic. * Base: hard fixed.

Malignant ulcer of osesophagus

Congenital megacolon (Hurschsbrung disease)

• Specimen: part of the colon of a child (Few small appendices epiploicae).

• The lower part of the specimen:

* Long narrow collapsed part 22 cms in length without gross lesions.

• Above the lesion:

* Wide short with thick brownish muscle layer (compensatory hypertrophy).

Acquired diverticulosis of small intestine

• Specimen: Segment of small intestine. • Lesion: Shows 2 globular blind pouches cc by: * Site: near the attachment of mesentery. * Size: the upper one → 5 cms. The lower one → 3 cms. * Wall → thinner than that of intestine "due to

absent muscle layer". * The cavity of each pouch is communicating

with the intestinal lumen by an orifice.

Acquired diverticula SI

12- Gastro-intestinal tract-2

• Typhoid entritis

• Intussusception (ilio-ilial)

• Crohn’s disease

• Ulcerative colitis

• Multiple familial polyposis colon

- Typhoid enteritis

Specimen: Mucosa of small intestine shows elevated lesions:

Number: Multiple. Size: Variable (few mms, up to 2 cms in length

and 1 cm in breadth). Shape: Oval being present in the anti-mesenteric

border with their long axis parallel to that of the intestine.

The largest lesions have ulcerated surface. The floor shows grayish yellow necrotic material. The mucosa in between: Is slightly hyperemic.

Typhoid enteritis (SI)

Crohn's disease (Regional enteritis)

• Specimen: Ileum and Caecum.

• Size: Ileum → 20 cms & Caecum → 10 cms.

• Wall → Diffuse thickening reaching about 1/2-1 cm.

• Lumen → extensive narrowing in some parts "due to wall thickening".

• Lining: at the ileal end → characteristic cobble stone appearance with longitudinal fissuring.

Crohn’s disease of small intestine

Intussusception and moist gangrene of small intestine

• Specimen: Part of small intestine of child.

• The outer covering part "intessuscepien" is opened to show the invaginated or entering part "intessuscptum".

• The tip of intessuscptum is called the apex (head).

• The wall of the intessuscptum is dark black, soft, thin-walled & hemorrhagic (gangrenous).

• Its peritoneal covering is dull & opaque "due to peritonitis".

Ulcerative colitis

• Specimen: Segment of colon.

• Lesion: ulcers:

* Multiple, irregular, superficial & diffuse.

* Floor: covered by granulation tissue.

• Mucosa between ulcers: multiple pseudopolyps & scattered hemorrhagic spots

Familial polyposis coli

• Specimen: one is segment of colon & the other one include terminal ileum, caecum & ascending colon.

• Size: Each segment measures about 30 cms. • Lesion: Both colonic segments show polypi cc by: * Innumerable & condensed on each other. * Size: ranging from few mms → 1.5 cm. * Tips → of some are dark red (hemorrhagic). • Mucosa in between polyps →no apparent healthy

mucosa. • The lower part of ileum → free of polyposis.

13- Liver/Gall bladder

• Secondary infected ameobic liver abscess

• Liver cirrhosis

• Hepatoma

• Chronic cholecystitis+mixed gall stone

• Gall bladder-cholesterol stone

• Multiple secondaries, liver

Solitary secondary infected amoebic liver Abscess

• Specimen: Slice of the liver • Shape: Wedge shaped • Border: Thick capsule • Consistency: firm • C/S: Cavity Number: solitary cavity Size: 16X7cm Shape: oval Site: extending toward the surface of the liver Lining: yellow shreddy necrotic tissue

surrounded by red zone of hyperemia due to associated secondary infection

Secondary infected amebi liver abscess

Multiple secondaries in liver Specimen: Slice of the liver, the seat of multiple masses

Masses Number: multiple Size: variable Shape: variable Border: well demarcated from adjacent liver

parenchyma, discrete but not capsulated Color: grayish white, with reddish tinge of

hemorrhage & yellow areas of necrosis C/S: Large subcapsular nodules may demonstrate

central necrosis and fibrosis that produces umbilication

Multiple liver metstasis

Liver Cirrhosis • Specimen: Slice of the liver • Size: Variable in size, is usually smaller than normal • Shape: Slice of liver • Surface: Diffusely nodular • Color: Nodules yellow in color due to fatty change

separated by grayish white fibrous tissue • Consistency: Firm • C/S: Mixture of nodule, classified as micronodular

(nodules <3 mm) and macronodular (nodules >3 mm). Nodules are separated from each other by fibrous tissue

Liver cirrhosis

Hepatocellular Carcinoma • Specimen: Slice of the liver, mostly occupied by a mass

• Border: well defined but no capsule • Mass Number: single Size: large mass, 12X8 cm Shape: oval Surface: show infiltration by the mass Color: grayish pink, bile stained, or yellow to tan Consistency: soft C/S: variegated as a result of foci of hemorrhage

and necrosis forming multiple small cavities. • Remaining liver parenchyma: non cirrhotic

Hepatoma (liver cell carcinoma)

Chronic cholecystitis & mixed gall stones

• Specimen: Opened gall bladder • Size: Enlarged • Outer surface: Serosal fibrovascular adhesions • Wall: Thickened, fibrotic wall, grayish white • Lumen: Dilated • Lining: Smooth reddish tinge • Content: Stones Number: multiple Size: small Shape: irregular C/S: inner deep brown center & outer

grayish yellow covering)

Chronic cholecytitis (mixed Stones)

Pure Cholesterol stone

• Specimen: Opened gall bladder • Stone: Number: single Size: 2x1.5 cm Shape: oval Surface: mammillated mulberry Color: yellow white Consistency: soft & light weight

Cholesterol stone (gall bladder)

14-Urinary system

• Polycyctic kidney

• Solitary cyst of the kidney

• Pyonephrosis

• Hydronephrosis

• Solitary urate stone+pyonephrosis

• Chronic diffuse glomerulonephritis

• Hypernephroma

• Wilm’s tumor

Polycystic kidney

Specimen: longitudenal section of kidney Description: - Size : enlarged (10x4cm) - Shape : normal - Surface: bossy - C\S shows : cysts and renal parenchma

Cysts are - Thin walled - Variable in size and shape - Color is grayish to dark blue - Content… either empty, contain blood clots or gelatinous material -**They do not communicates with each other or renal pelvis

Renal tissue in between the cysts is compressed Diagnosis: polycystic kidney

Solitary cyst of the kidney Specimen : Half of a kidney Description: Kidney is of normal size, its outer surface: shows a sub capsular cyst C\S shows a solitary cyst and renal tissue *Cyst characterized by: - Shape : rounded - Size :2cm in diameter - Wall is grayish and fibrous - Lining is smooth - Cyst does not communicate with renal pelvis *Renal tissue appears normal Diagnosis :Solitary cyst of kidney

Hydronephrosis Specimen : section of kidney

Description: Kidney is - Enlarged in size - Lobulated outer surface -C\S reveals calyces and renal tissue

are dilated to produce sacs which Calyces characterized by: Thin walls Variable in size and shape **Communicate with each other and renal pelvis

Renal tissue: Mainly atrophied The remaining part appears as peripheral rim Diagnosis: hydronephrosis

Pyonephrosis & pyoureter Specimen : section of kidney and ureter Description: kidney shows

- Enlarged size - Lobulated outr surface - Capsule is thick, fibrous with peri-nephric adhesion - C\S reveals calyces and renal tissue

:Calyces Dilated to produce sacs which are: - Variable in size and shape - ** Communicate with renal pelvis & ureter

Renal tissue: Mainly atrophic and appears as peripheral rim

:Ureter Dilated, with thick fibrous wall The mucosa is deep red covered by yellow exudates Diagnosis: pyonephrosis & pyoureter

Solitary urate stone+Pyonephrosis Specimen Half of a kidney

Description: Kidney is enlarged , the renal pelvis is occupied by a stone Stone: - Occupying most of dilated pelvis - Size : 5x2cm - Shape : triangular - Outer surface: smooth - Color : yellowish with brownish tinge - Consistency : firm Kidney : Shows the picture of pyonephrosis…..(describe) Diagnosis: solitary urate stone & pyonephrosis

Chronic diffuse glomerulonephritis Specimen : half of kidney

Description: - Size : Smaller than normal (shrunken) - Outer surface: finely granular - Capsule : thick, fibrous and adherent - C\S shows *Narrow cortex (2-3mm in some areas) * No demarcation between cortex &medulla * Increase peri- pelvic fat * Thick walled renal arteries with patent lumen Diagnosis: chronic diffuse glomerulonephritis

Wilm’s tumor Specimen :half of child kidney

Description: Renal tissue is compressed by mass characterized by: - Shape: Oval, well circumscribed - Size :12x8cm in diameter - Color: Grayish white with brownish areas of hemorrhage - Consistency: Soft - C\S : Small cavities of necrosis and liquefaction Diagnosis: Wilm’s tumor of kidney (nephroblastoma)

Hypernephroma Specimen :Half of kidney

Description: - Kidney tissue is compressed at one pole - The other pole of the kidney is replaced by a mass which is characterized by: - Shape: Rounded, does not infiltrate the renal capsule - Size : 15 cm in diameter - Color: Grayish white with a yellow tinge and brownish areas of hemorrhage - C\S : Shows variegated appearance (necrosis, cysts, hemorrhage..etc) Diagnosis: Hypernephroma

15-Bone and joints

• Adamantinoma of the mandible

• Chondrosarcoma

• Osteo-chondroma

• Giant cell tumor of tendon sheath

• Pigmented villonodular synovitis

• Rickety chest

Adamantinoma mandible Specimen : Parts of the mandible Description : * The molar region of the mandible is the seat of a swelling . ( Oval, 8x6 cm in size & project outwards ) * On bisection, multiple cystic cavities appear, Cysts are…. - Variable in size & shape - Contain fluid of motor oil appearance ( during life ) - Some of fluid still persisting as brown coagulated

material. * Most of the mandible is destroyed & replaced by the lesion Diagnosis : ( Adamantinoma mandible )

Chondrosarcoma of ribs

Specimen Mass on the chest wall

( Parts of ribs seen in the back of the specimen ) Description :

- The site (ribs - Size : 8x6 cms.

- Shape : ovoid (partially defined) - Consistency: firm - Color : faint blue shredy with necrosis and hemorrage. - The bluish colour indicates the cartilaginous origin . Hemorrage and necrosis are in favor of malignancy . Diagnosis : ( Chondrosarcoma of ribs )

Osteochondroma • Specimen: A Bony Swelling:

• Shape: Oval, polypoidal (wide from below and narrow from the upper part of the specimen).

• The narrow part (pedicle) was the site of attachment to the original bone.

• Surface: Smooth and lobulated. • Color: Bluish gray. • Consistency: Hard. • Cut surface: Shows a core of cancellous bone

(porous yellow) covered by a bluish cartilagenous cap.

Giant cell Tumor ( tendon sheath) Specimen : Parts of the hand Description : * The base of the mounted fingers shows a swelling which

is…. - Oval in shape. - 10x6 cm in size - Firm in consistency but circumscribed - C/S shows : grayish white tissue, black

hemorrhagic areas admixed with yellow necrotic areas. * The neighboring tendon is free. Diagnosis : ( Giant cell Tumour ( tendon sheath )

Pigmented villo-nodular synovitis

Specimen : Parts of synovium of a joint. Description : - The synovium is thickened. - The inner surface shows many outgrowths. ( thin, delicate, from 3- 10 mms in length ( - The middle part of the specimen shows old thin villous Structures which are enlarged into pedunclated, bulbous structures (15 mm in length , 5 mm in width) - All the structures have a rusty browns discoloration Diagnosis : ( Pigmented villo-nodular synovitis )

Rickety chest Specimen : Thoracic cage of a child. Description : -The sternum projects forwards increasing the antero-

posterior diameter of the thoracic cage (pigeon chest) - The costochondral junction is enlarged & prominent ( rickety rosary ) - The vertebral column shows lateral bending (Scoliosis)

Diagnosis : ( Rickety chest )

16- Female genital-1

• Simple serous cyst of the ovary

• Papillary serous cystadenoma-ovary

• Mucinous cystadenoma-ovary

• Serous cystadenocarcinoma

Simple serous ovarian cyst

Specimen : Ovary containing cyst. Description : * Unilocular ovarian cyst: 1- Shape : oval 2- Size : 6x4 cm in diameter 3- Outer surface : smooth. 4- Wall : very thin, grayish white

& transparent. 5- content : serous watery fluid.

(evacuated) Diagnosis : ( Simple serous ovarian cyst )

Papillary serous cyst adenoma of Ovary

Specimen : Ovary containing cyst. Description : *A half of a unilocular ovarian cyst: 1- Shape : oval 2- Size : 13x10 cm in dimeter. 3- Wall : 2 mms in thickness with no

evidence of infiltration 4- Outer surface : not lobulated, grayish white Slightly transparent. 5- The lower part shows papillomatous structure: - Size : 5x4 cm. - colour: grayish white, crowded with short pedicle - Other dispersed ones of few mms project from the rest of the

wall.The lining in-between these papillomata are smooth Diagnosis : ( Papillary serous cyst adenoma of Ovary

Mucinous cystadenoma ovary Specimen : Pathological ovary containing cyst . Description : * A part of ovary is mounted with cystic structure

15x10x19 cms with a smooth, lobulated outer surface and thin fibrous wall 2mms in thickness

The C/S shows multiple loculi: 1- Shape : variable rounded,

oval or irregular 2- Size : variable 3- lining : smooth 4- Contents : Coagulated pale blue

gelatinous material - The bigger locus evacuated from its contents. Diagnosis : (Mucinous cystadenoma ovary)

Serous cyst adenocarcinoma

Specimen : Ovary cyst. Description : 1- Shape : rounded 2- Size : 20 cm in dimeter 3- Wall : bluish white 4- Outer surface : smooth with some infiltrated nodules. 5- Content : solid fleshy necrotic part opposite the surface nodule, the remaining part contains fluid. Diagnosis : ( Serous cyst adenocarcinoma )

17- Female/Endocrine

• Vesicular mole

• Subinvoluted secondary infected uterus

• Thyroid adenoma

• Nodular goiter

Vesicular ( hydatiform ) mole

Specimen : Pathological placenta. Description : Grape like vesicles . -Shape : rounded or oval - Size : few mms to 1 cm in diameter . - Wall : thin, transparent & grayish white. * Such vesicles are connected to each other by

thin fibrous tissue strands. Diagnosis : (Vesicular ( hydatiform ) mole)

Subinvoluted uterus. & puerperal sepsis

Specimen : Uterus & its adenxia and upper part of vagina Description : 1- The size : 23x12 cm It is excess than normal, but is below that of the full term

gravis uterus (subinvoluted) 2- The anterior wall is removed to show: the uterine cavity

which is irregular and lined by necrotic shredy layer. 3- The uterine wall : 3 cm in thickness shows dilated veins containing greenish yellow thrombi (infected ) 4- The peritoneum : thick, dull and opaque. Diagnosis : ( Subinvoluted uterus. & puerperal sepsis )

Thyroid adenoma Specimen : Part of thyroid

Description: mass surrounded by thyroid capsulatedS reveals a \C

tissue The mass characterized by: Shape : Oval Size : 5x3 cm Color : Grayish Consistency: Firm C\S : Grayish yellow in color with blackish areas of hemorrhage as 2ry changes

The normal thyroid tissue is compressed in the lower part Diagnosis: Thyroid adenoma

Nodular goiter

Specimen : Thyroid gland Description: Size : Enlarged 12x7 cm Capsule : Thick with dilated vessels Outer surface: Irregular (many nodular elevations &depressions) Consistency : Firm C\S : Shows nodules characterized by Shape : rounded or oval Size : from 3mm to one cm in diameter Content: glistening, reddish brown substance (colloid) The nodules are separated by fibrous trabeculae Diagnosis: nodular goiter

18-Breast/CNS

• Fibrocystic disease of the breast

• Giant fibro-adenoma

• Scirrhous carcinoma of the breast

• Adult hydrocephalic skull

• Cerebellar astrocytoma

Fibrocystic changes (disease) of breast (Cystic mammary

hyperplasia=fibroadenosis) • Specimen: dome shaped part of the breast

with irregular outline with yellowish colour.

• Lesion: Cysts:

* Size: variable from few mms to 2 cms.

* Lining: smooth.

• In between the cysts:

* The mass is solid.

* Mixed with grey white fibrous tissue

Giant fibroadenoma of breast Benign phylloides tumor

• Specimen: Whole female breast (Nipple on the back).

• Lesion: the breast substance is replaced by well defined huge mass:

* Size: 25x13 cms. * Shape: ovoid. * Colour: bluish (myxoid). * Consistency: soft (before preservation). * Cut surface: multiple variable sized cysts & slit-like

spaces. * Covering skin: free (No nipple retraction, no peau

d'orange appearance).

Scirrhous carcinoma of the breast

• Specimen: part of female breast. • Lesion: mass: * Size: 6x4 cms. * Shape: oval. * Capsule: not capsulated & infiltrates the surrounding

fibrofatty breast tissue. * Colour: grayish white with reddish tinge. * Consistency: hard with gritty sensation on cutting. * Cut surface: not homogenous "it shows white strands of

fibrous tissue running in various directions". • Nipple: retracted. • Surrounding skin: dimpling (cc peau d'orange appearance".

Adult hydrocephalic skull

Specimen : Vault of the skull Description : 1- The skull sutures : fused (adult skull) 2- The outer surface : smooth. 3- The inner surface : shows excess pits, Thinning of the inner table due to

pressure atrophy caused by distended meninges.

Diagnosis : ( Adult hydrocephalic skull )

Cerebellar astrocytoma

Specimen :brain stem &cerebellum Description:

The cerebellum is the seat of a cystic cavity characterized by:

Shape : oval

Size :5x4 cm

Surrounded by: compressed cerebellar tissue

Lining : smooth with mural nodules

(characteristic of cerebellar astrocytoma)

19- Lymphoid system

• Hodgkin’s lymphoma-L.N

• Malignant lymphoma-spleen

• Malignant lymphoma-small intestine

Hodgekin’s lymphoma of L N

• Specimen: Lymph Nodes • Size: enlarged. • Size: Each is about 2x1 cms in diameter • Shape: oval • The nodes are discrete and not matted to

each other or to the surrounding structures.

• Colour: pale gray • Consistency : firm rubbery. • C/S: homogenous

Malignant lymphoma, spleen (NHL) • Specimen: whole spleen or half of spleen • Size: Markedly increased, 20x30 cm • Shape & Notches: lost • Surface: Nodular • Border: Rounded, thick • Capsule: Stretched & adherent • Consistency: Firm • C/S: Sub capsular haemorrhagic spots & grayish white foci • Mass or Masses Number: single multiple Size: large mass, 25 cm variable Shape: oval, rosette like, plugging variable Border: well demarcated with peripheral lobulation separated from

each other by thin remnant

of splenic tissue Color: grayish white with brownish tinge grayish brown Consistency: Firm Firm

Malignant lymphoma, small intestine (NHL)

• Specimen: Ileo-Cecal Junction • Lumen: Narrow, obliterated, contain

hemorrhagic content • Mass: Site: infilterate the ileum & extend

to the cecum Size: Huge Consistancy: Fleshy C/S: Homogenous • LN: enlarged, fleshy, on the right side