Anatomic and Clinical Pathology Flashcards

A 4-year-old child has a large abdominal mass with histology showing triphasic components: blastemal cells, stromal cells, and epithelial cells forming primitive tubules. What is the diagnosis?

Answer: Wilms tumor (nephroblastoma)

Wilms tumor is the most common pediatric renal malignancy and is defined by its triphasic histology of blastema, stroma, and epithelium.

A patient's cervical Pap smear shows cells with high nuclear-to-cytoplasmic ratio, nuclear hyperchromasia, and irregular chromatin in squamous cells. These findings are classified as HSIL. HSIL corresponds to which histologic diagnosis?

Answer: CIN 2 or CIN 3

HSIL (High-grade Squamous Intraepithelial Lesion) on Pap smear corresponds histologically to CIN 2 or CIN 3, indicating significant dysplasia.

A 60-year-old female has a lung biopsy showing pink, amorphous alveolar filling material that stains with PAS and is congophilic with apple-green birefringence under polarized light. What is the diagnosis?

Answer: Alveolar amyloidosis

Congo red staining with apple-green birefringence under polarized light is diagnostic of amyloid deposition; pulmonary amyloidosis can present as alveolar filling.

A 72-year-old man has a splenectomy specimen showing a diffuse infiltration of small lymphoid cells that also fill the splenic red pulp sinusoids and are positive for CD20, CD11c, DBA.44 with TRAP (tartrate-resistant acid phosphatase) staining. What is the diagnosis?

Answer: Hairy cell leukemia

Hairy cell leukemia is characterized by B-cells with hairy cytoplasmic projections, CD11c and DBA.44 positivity, TRAP positivity, and infiltration of splenic red pulp.

An autopsy on a 55-year-old male with a history of chronic hypertension shows concentric left ventricular wall thickening with a normal or reduced chamber size. What is this change called?

Answer: Concentric hypertrophy

Concentric hypertrophy results from pressure overload (as in hypertension), causing sarcomeres to add in parallel, increasing wall thickness while preserving or reducing chamber size.

A 48-year-old woman with rheumatoid arthritis develops new proteinuria. Kidney biopsy shows amorphous pink material in the mesangium and glomerular capillaries on H&E, Congo red positive with apple-green birefringence, and positive for SAA (serum amyloid A) by immunohistochemistry. What type of amyloid is this?

Answer: AA amyloid (secondary amyloidosis)

AA amyloidosis results from chronic inflammatory conditions (like RA) where sustained elevation of serum amyloid A protein leads to AA fibril deposition.

A 65-year-old male smoker has a centrally located lung tumor. Histology shows large polygonal cells with abundant pink cytoplasm, intercellular bridges, and keratin pearls. What is the diagnosis?

Answer: Squamous cell carcinoma

Squamous cell carcinoma of the lung is characterized by keratin pearl formation, intercellular bridges, and p40/p63 positivity, and typically arises centrally in smokers.