tongue: herpes simplex glossitis lab 8, case 1. cross section of the tongue there is an area along...
TRANSCRIPT
![Page 1: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/1.jpg)
Tongue: Herpes Simplex Glossitis
Lab 8, Case 1
![Page 2: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/2.jpg)
Cross section of the tongue
There is an area along the surface of the tongue where the normal epithelium has been lost and there are areas of ulceration (arrows).
![Page 3: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/3.jpg)
1: Epithelium
2: Edge of the ulcer
3: Ulcerated epithelium
There is an inflammatory exudate at the base of the ulcer and some necrotic cells where the epithelium once was present.
![Page 4: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/4.jpg)
Edge of the ulcer
Even at this power, amphophilic (dark, blue-purple-staining) intranuclear inclusion bodies can be seen in the epithelial cells. Note the inflammatory infiltrate in the subepithelium.
![Page 5: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/5.jpg)
Epithelium at the edge of the ulcer
Amphophilic intranuclear inclusion bodies can be seen in almost all of the epithelial cells in this section.
![Page 6: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/6.jpg)
Epithelium at the edge of the ulcer
The cells that have been invaded by the herpes virus contain intracellular accumulations of amphophilic viral inclusions (arrows).
![Page 7: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/7.jpg)
Brain: Herpes Encephalitis
Lab 8, Case 2
![Page 8: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/8.jpg)
Multiple small, punctate hemorrhages throughout the brain parenchyma (arrows)
![Page 9: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/9.jpg)
Section of brain with numerous perivascular hemorrhages (arrows) and some areas that appear hypercellular
![Page 10: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/10.jpg)
Blood vessel with perivascular hemorrhage (1), areas with loss of brain parenchyma, and edema (2)
Even at this power, it can be seen that many of the cells are shrunken and dark red, suggesting that they are necrotic.
![Page 11: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/11.jpg)
Higher power of previous section
At this power it is easier to see the blood vessel with the perivascular hemorrhage and lymphocytic cuffing (1). In addition, the areas of edema and loss of neutrophil (2) can be better appreciated. Red shrunken neurons and glia with pyknotic nuclei (3) are also evident.
![Page 12: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/12.jpg)
Blood vessel with perivascular hemorrhage and mild perivascular lumphocytic cuffing (arrow)
In addition, there are numerous red shrunken neurons and glia with pyknotic nuclei throughout this section.
![Page 13: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/13.jpg)
Clear areas indicate edema
1: Numerous shrunken red necrotic cells
At this power, it can be seen that eosinophilic intranuclear inclusion bodies have displaced chromatin to the periphery of the nucleus in some cells (2).
![Page 14: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/14.jpg)
Arrows: Necrotic Cells
![Page 15: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/15.jpg)
Cells containing intranuclear inclusion bodies (arrows)
![Page 16: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/16.jpg)
Cell containing an intranuclear inclusion body (arrows)
Note that the chromatin has been pushed to the outer edges of the nucleus.
![Page 17: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/17.jpg)
Cell containing an intranuclear inclusion body (arrows)
![Page 18: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/18.jpg)
Brain section stained with antibody against herpes simplex
Even at this magnification, it is easy to pick out cells that are positive for the virus (arrows).
![Page 19: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/19.jpg)
Brain: Rabies
Lab 8, Case 3
![Page 20: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/20.jpg)
Hippocampus from this case, low power
![Page 21: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/21.jpg)
Brain tissue exhibiting edema and evidence of shrunken, necrotic neurons (arrows)
![Page 22: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/22.jpg)
Shrunken neurons, higher power
One neuron appears to have an eosinophilic intracytoplasmic inclusion body (arrow).
![Page 23: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/23.jpg)
Neurons containing variably-sized intracytoplasmic eosinophilic inclusion bodies (arrows)
![Page 24: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/24.jpg)
Neuron surrounded by inflammatory cells (lymphocytes and microglia)
This neuron has two intracytoplasmic eosinophilic inclusion bodies (arrows).
![Page 25: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/25.jpg)
Spinal Cord: Poliomyelitis
Lab 8, Case 4
![Page 26: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/26.jpg)
Spinal cord from this case
Note that the anterior horns (arrows) are almost completely devoid of neurons.
![Page 27: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/27.jpg)
Spinal cord
Note the absence of motor neurons in the anterior horns and the gliosis (arrows).
![Page 28: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/28.jpg)
Anterior Horn of Spinal Cord
Note the absence of motor neurons in the anterior horns and the diffuse gliosis.
![Page 29: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/29.jpg)
Junction of white and grey matter
Note the inflammatory cellular infiltrate and tissue breakdown. There is significant loss of neurons and myelin in this area.
![Page 30: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/30.jpg)
Anterior horn with inflammatory cell infiltrate and total loss of neurons
![Page 31: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/31.jpg)
Liver: Hepatitis B
Lab 8, Case 5
![Page 32: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/32.jpg)
Liver from this case
This section was stained with a modified aldehyde fuchsin stain and counterstained with H & E. Modified aldehyde fuchsin colors cystine-rich proteins, such as HBsAg and elastic fibers, deep purple. The cytoplasm of most liver cells (and RBCs) stain red due to eosin and have dark blue nuclei.
![Page 33: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/33.jpg)
Note the severe congestion (RBCs in sinusoids) and the presence of occasional hepatocytes with dark red/magenta-stained cytoplasm (arrows).
![Page 34: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/34.jpg)
Periportal region exhibiting some inflammation and bile duct hyperplasia
There is also congestion and some loss of hepatocytes with disruption of the hepatic cords.
![Page 35: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/35.jpg)
Numerous hepatocytes containing acumulations of magenta-staining material in the cytoplasm (arrows).
![Page 36: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/36.jpg)
Hepatocytes, the cytoplasm of which contain intracytoplasmic accumulations (arrows) of hepatitis B surface antigen
![Page 37: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/37.jpg)
Liver section from another case of Hepatitis B
In this H & E stained section, the typical “ground glass” appearance of the hepatocytes can be appreciated (arrows).
![Page 38: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/38.jpg)
Liver from previous image
Reacted with antibody to HBsAg
The hepatocytes that contain HBsAg stain brown.
![Page 39: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/39.jpg)
Higher power of previous section that shows more clearly the HBsAg positive cells
Upon staining with H & E, these same cells exhibit a “ground glass” appearance, which is due to the accumulation of HBsAg in the hepatocyte cytoplasm.
![Page 40: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/40.jpg)
Low power of the same liver reacted with antigen for Hepatitis B core antigen (HBcAg)
The hepatocytes that contain HBcAg stain brown. Note that even at this magnification, many brown-staining nuclei can be seen.
![Page 41: Tongue: Herpes Simplex Glossitis Lab 8, Case 1. Cross section of the tongue There is an area along the surface of the tongue where the normal epithelium](https://reader034.vdocument.in/reader034/viewer/2022051401/56649f215503460f94c39877/html5/thumbnails/41.jpg)
High power of previous section showing HBcAg positive nuclei (arrows)