قسم pathology للدفعة الخامسة
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🤩قناة اللجنة العلمية للدفعة الخامسة لمادة
Pathology
تهتم بنشر المقررات والتسجيلات وكل متعلقات المادة
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#جامعة_٢١_سبتمبر
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#Microscopic

#Diagnosis 👉🏻 Colloid goiter ( simple goiter/diffuse nontoxic goiter)


#The_black_area
Follicle 

#The_features
The follicles enlarged and filled by abundant colloid , with Flattened follicular epithelial lining
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#Gross

#Diagnosis 👉🏻 Graves diseases

#The_features
IN CUT SECTION
- Diffuse enlarged
- symmetrically
- lobulated
- beefy red (lighter) in color
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#Microscopic

#Diagnosis 👉🏻 graves diseases


#The_black_area
 lymphoid follicle

#The_blue_arrows
papillary infoldings

#The_features
- Tall follicular cells (tall columnar epithelium cells) with papillae usually lacking fibrovascular cores
بسبب انه الخلايا حصل لها hyperplasia
- Nuclei are round, often basally located, rarely overlap
- Scalloping of colloid , or vacuoles due to follicular cells eat colloid for the production of hormones
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#Microscopic

#Diagnosis 👉🏻 graves diseases


#The_black_area
 lymphoid follicle

#The_blue_arrows
papillary infoldings

#The_brown_arrows
follicular cells appear columnar

#The_yellow_arrows
Scalloping or vacuoles
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#Gross

#Diagnosis 👉🏻 follicular thyroid neoplasm (follicular adenoma)


#The_white_arrow
Normal thyroid

#The_black_arrow
Capsule

#The_blue_star
Neoplasm (adenoma)

#The_features
- an encapsulated round
neoplasm with a uniform (solitary) nodule.
- bright brown appearance, surrounded by a rim of normal thyroid

NOTES
• Cause pressure symptoms
• Painless
• Cause hyperthyroidism
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#Gross

#Diagnosis 👉🏻 follicular thyroid neoplasm ( follicular adenoma )
9👍2
#Microscopic

#Diagnosis 👉🏻 follicular thyroid neoplasm


#The_black_arrow
Normal follicles

#The_red_area
Capsule

#The_white_arrow
Neoplasm (adenoma)

#The_features
- well differentiation
- an encapsulated round
neoplasm
- The tumor is composed of cloclosely packed follicles
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#Microscopic

#Diagnosis 👉🏻 follicular thyroid neoplasm


#The_black_arrow
Normal follicles

#The_red_area
Capsule

#The_white_arrow
Neoplasm (adenoma)
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#Gross

#Diagnosis 👉🏻  Papillary carcinoma


#The_blue_arrows
Normal thyroid

#The_black_arrows
Tumor tissue

#The_red_arrow
Calcification (Psammoma body)

#The_yellow_arrows
Tumor tissue
هنا عامله infiltrative

#The_features
- The tumor is usually solid
- grey white in color
- papillary projections
- sometimes it can be multifocal
- encapsulated or infiltrative
- calcification (appear white in color)
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#Gross

#Diagnosis 👉🏻  Papillary carcinoma


#The_blue_arrow
Colloid

#The_black_arrow
Normal thyroid

#The_white_arrow
papillary projections of the tumor

#The_white_star
Tumor tissue
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#Gross

#Diagnosis 👉🏻  Papillary carcinoma


#The_black_arrow
papillary projections of the tumor

#The_white_arrows
Tumor tissue

#The_blue_arrow
Calcification

#The_green_arrow
Normal thyroid
11👍5
#Microscopic

#Diagnosis 👉🏻  Papillary carcinoma


#The_white_arrow
Psammoma body

#The_green_arrows
Optical clear nuclei ( ground glass nuclei)

#The_blue_arrows
Papillae

#The_black_arrows
Papillae by transfert section

#The_features
Nuclear features
- Change of nuclear size and shape
• nuclear enlargement, elongation
Nuclear overlapping the nuclei are so crowded that they look like they are sitting on one another
Ground glass nuclei : it means the chromatin is finely dispersed and optically clear. This appearance is also known as “Orphan Annie Eye” 
groove nuclei are formed due to folding of  the unessential nuclear membrane
nuclear inclusions
Vascular Nuclei
- Nuclear membrane irregular

Other features
- randomly oriented papillae with fibrovascular cores
- Psammoma body in the fibrovascular cores
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#Microscopic

#Diagnosis 👉🏻  Papillary carcinoma


#The_blue_arrows
Overlapping nuclei

#The_black_arrows
Groove nuclei

#The_red_arrows
Optical clear nuclei ( ground glass nuclei)
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#Microscopic

#Diagnosis 👉🏻 Papillary carcinoma


#The_blue_arrows
Nucler inclusion

#The_black_arrows
Vascular nucleus
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#Microscopic

#Diagnosis 👉🏻 Medullary carcinoma


#The_blue_arrow
hyaline material
الذي تظهر باللون الوردي

#The_red_arrow
Amyloid

NOTES
• The medullary carcinoma is Neuroendocrine tumor derived from C cells (formerly called parafollicular cells) 
• Painless
• can be sporadic or familial. The familial kind are associated with multiple endocrine neoplasia syndrome.
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#Microscopic

#Diagnosis 👉🏻 Medullary carcinoma


#The_blue_star
Amyloid
الذي يظهر لونها reddish بواسطة صبغة Congo red
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#Gross

#Diagnosis 👉🏻  Normal adrenal gland


#The_black_arrow
Normal right adrenal gland

#The_white_arrow
Adipose tissue

#The_blue_arrow
Kidney
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#Microscopic

#Diagnosis 👉🏻  Normal adrenal gland


#The_red_star
Periadrenal fat

#The_black_star
Capsule

#The_blue_star
Zona glomerulosa
THE CELLS
- well defined cells
- Rounded
- acidophilic cytoplasm
- lipid droplets
- secretes mineralocorticoids

#The_yellow_star
Zona fasiculata
THE CELLS
- Broad band of large cells with distinct membranes arranged in cords
- Cytoplasm has numerous small lipid vacuoles
- secretes glucocorticoids

#The_green_star
Zona reticularis
THE CELLS
- Granular and eosinophilic cytoplasm with minimal lipid
- Richly vascularized, capsular blood vessels, nerves and lymphatics penetrate along connective tissue septae
- secretes androgens

#The_brown_star
Medulla
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#Gross


A
#Diagnosis 👉🏻  Atrophy adrenal gland
DUE TO Addison’s disease or Long term using of Corticosteroids and stop using it suddenly not gradually

B
#Diagnosis 👉🏻 Normal adrenal gland
• The cortex is yellow in color
• The medulla is red in color

C
#Diagnosis 👉🏻 adrenal hyperplasia
DUE TO Cushing's disease
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#Microscopic

#Diagnosis 👉🏻  Adrenal nodular hyperplasia


#The_black_arrows
Nodules

#The_blue_arrows
Lipid poor pink cells like reticulari

#The_red_arrows
Lipid-rich clear cells like fasciculata

NOTES
- The Nodules larger than 3mm ( macronodular )
- metaplasia or atrophic cortex between nodules
7
#Gross

#Diagnosis 👉🏻  Adrenocortical adenoma


#The_white_arrow
Adenoma

#The_features
- Circumscribed , Unilateral, solitary
- yellow tan in color
- Hemorrhage
- Functional adenoma may result in atrophy of contralateral adrenal cortex

NOTE
Cause hypertension and hypokalemia
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