Week 1: Protocol 1 - cellular responses to stress and toxic insults

1. Dystrophia parenchymatosa renis

In cases of extremely low blood pressure the body cuts down blood flow to the extremities,
including the kidneys, this can result in hypoxia. The cells of the renal tubule are particularly
vulnerable to low oxygen, and this apperas as cellular swelling as a result of low ATP, which
in turn impedes Na​+​/Cl​-​ pumps. ​Look for the kidney, then look for the puffy cells in the
renal tubules​.

2. Dystrophia adiposa hepatis

This is a kidney showing fatty deposits. These fatty deposits show as large vacuoles within
the hepatocytes. ​Look for the liver, then look for the large vacuoles within it​.

3. Atheromatosis aortae
When a patient has high levels of cholesterol in their blood stream, it builds up within the
walls of the vessels. This is an aorta with such a buildup. ​Look for aorta with an enlarged
intima layer.
 4. Anthracosis pulmonis
As people inhaled coal dust alveolar macrophages pick up the pigment and take it to
regional lymph nodes, where it remains. It is visible as a black substance. ​Look for lungs
and then black crap​.

5. Icterus renis
Tricky one. This is where there is excess bilirubin in the body and it it collects in the epithelial
cells of the proximal tubules. These bilirubin shows as an orange-yellow-brown mass. Note!
Do not mistake old erythrocytes for this substance, erythrocytes can turn orange after time,
the difference is that the bilirubin masses should be solid. ​Look for kidney, then orange
masses in tubules.
 6. Atrophia fusca hepatis
This is the liver that has collection of lipofuscin (an endogenous pigment formed from
peroxidize membrane lipids and phospholipids and proteins). This is the product of free
radical oxidation in the cell and is often described as the product of ‘wear and tear’.
Commonly found in elderly tissue and in hepatic tissue where the cells have had heavy
metabolic use (i.e. cancer patients who have been on anti cancer drugs). ​Look for liver,
and then look for a purple pigment surrounding the hepatic vein.

7. Naevus pigmentosus
This is the fancy term for a mole, it’s a collection of melanocytes sitting in the dermis of the
skin. It is exacerbated by direct sunlight. ​Look for dark pink melanocytes clustered in the
dermis​.
Week 2 - Mesenchymal degradations. Accumulations in cells and matrix

1. Corpus albicans ovarii

Example of hyalinosis (build up of hyaline, a substance made of proteins, cartilage and
lipids) within the ovaries. ​Look for ovarian strucure with pin circular bodies indicating
hyaline deposits.

2. Hyalinosis arteriolarum renis

This is a build up of hyalin in the capillaries of ​some ​of the glomerular capillaries. It is an
example of vascular type hyalinosis, is asymptomatic, and a result of arterial hypertension
and/or diabetes mellitus. Gross morphology sees a reduction in the size of the kidneys.
Look for kidney with only some of the glomeruli being degraded. Be aware, you may
have to look at a lot of glomeruli before you find one. ​(Note how on the image on the
right, many of the glomeruli are normal, the image on the left shows highlighted a damaged
glomeruli, this is two pictures of the same slide, you have to look hard for the bad glomeruli)
 3. Amyloidosis renis
Amyloidosis is also the build up of abnormal protein matter associated with different
pathologies. It is as a result of ​chronic inflammation​. When there is inflammation in the
body serum proteins are released by the liver. When there is chronic inflammation these
proteins build up in the body and need to be deposited. What we are seeing here is the
deposition of these proteins in the glomeruli for the kidneys. Morphologically the kidneys are
enlarged, and similarly, histologically ​we are looking for enlarged glomeruli within the
kidney​.
(Note how, under low magnification ® one could be forgiven for not noticing the glomeruli at
all, they are so deformed!)

4. Amyloidosis lienis
The mechanism of deposition is the same here as with the kidney (build up of serum
proteins as a result of chronic inflammation) however, here we are seeing the deposition of
these proteins in the spleen, rather than the kidney. ​Look for the homogenous seeming
tissue that is the spleen, and then identify the distinctive polished pink disks (not
dissimilar to what we saw in Ovarii)​.
There are two types, Sago spleen (deposition in white pulp) and Lardaceous spleen
(deposition in red pulp).

Week 3 - Necrosis
Necrosis Renis
Look for Kidney tubules with areas of solid pink. The nuclei have been destroyed and as
such there is no nuclei for purple staining, we are left with only the pink staining of HE on the
cytoplasm and membranes. This is an example of Coagulative necrosis. ​Look for Kidney
with lots of solid pink, not the normal purple.

Necrosis myocardii
Atherosclerosis of the cardiac arteries can lead to hypoxia of the myocardium, leads to
necrosis. This necrosis is visualised, similarly to the kidney, with large areas of pink without
the purple of the nuclei. This is an example of Coagulative Necrosis. ​Look for myocardium
with solid pink, and a lack of nuclei.
Necrosis Lymphonodi

This occurs in TB and is known as Caseous (dry) necrosis. The gross morphology looks
pale-yellow and crumbly, enough to put you off cheese! Around the outside you can see a
periphery of epithelioid cells, with numerous lymph. The necrosis is shown as again, a large
pink area without any nuclei. ​Look for Lymph Node with pink solid mass within it and
giant Langerhans ​(circled)​ lumps.

Necrosis cerebi
Example of liquefactive necrosis. ​Look for cerebral tissue with gaps! Can’t be anything
else from this box!​ Is a result of ischemia which leads to the formation of a pseudocyst (not
a true cyst which has epithelial lining)

Large ‘foam cells’ also visible (these are the big purple looking blobs).
Week 4 - Hemodynamic disorders.

Induratio fusca pulmonis

Etiological factor: Left sided ​chronic ​heart failure, resulting from MI.
This leads to increased blood pressure in alveolar capillaries, and causes increased
hydrostatic pressure. This then forces blood into the lung interstitial which can be seen as
the pigment hemosiderin, pigment then engulfed by macrophages, forming siderophages.

Gross - lungs smaller with firm consistency. Reddish brown.

Histology - siderophages with hemosiderin. Thick alveolar septa and small intra alveolar
hemorrhages

Oedema Pulmonis
Etiology: Acute left heart failure.

Similar to above, however here there is no fibrosis or blood leakage, only plasma leaks from
the capillaries into the lung interstitial as a result of suddenly raised hydrostatic pressure.

Gross - lungs are enlarged, heavy with pink foamy liquid

Histology - a homogenous pink fluid fills the alveoli

Cyanosis Hepatis
Etiology - acute right sided heart failure

This leads to a block up of the inferior vena cava, leading to increased blood stagnation in
the liver.

Gross - liver is enlarged and painful on palpation.

Histology - increased central vein diameter, atrophic cells around the central vein, and blood
remaining in the central veins.

Hepar Moschatum
Etiology - chronic right heart failure.

Results in persisting blood stagnation in the liver, leads to fatty deposits in the intermediate
hepatocytes. In the most advanced stages we see high levels of fibrosis and liver cirrhosis.

Gross - liver is reduced in size, cyanotic, when cut looks like ‘nutmeg liver’.

Histology - fatty deposits in the intermediate hepatocytes. In the most advanced stages we
see high levels of fibrosis and liver cirrhosis.
Hemorrhagia punctate cerebri
Etiology - this is bleeding on the brain, the result of trauma, Disseminated intravascular
Coagulation (DIC) syndrome, or increased permeability

Extravasation of blood, enters into brain tissue.

Histology - big circular ‘gaps’ with erythrocytes inside brain tissue.

Week 5- Thrombosis
Thrombus mixtus
This is a vessel which has a thrombus inside. Within the thrombus are different cell types,
this leads to different colours on the slide, hence ‘Mixtus’. When looking at this slide it should
be a circular vessel lumen with a big thrombus in the middle with different colours. Should be
obvious from macro.
Thrombus organisatus and recanalisatus
This is a thrombin where we can see the development of granulation tissue in the thrombus
with young mesenchymal cells and ​neovascularization​. It is these new vessels that we are
specifically looking for. They appear as circular structures within the Thrombus.

Infarctus haemorrhagicus pulmonis

This is an area of ischemic necrosis that has lead to a red haemorrhagic infarction, as a
result of occlusion of the artery or the venous drainage. This is caused by a ​pulmonary
embolism​. Look for the alveolar spaces being filled with erythrocytes, no nuclei in the
alveolar cells, and siderophages with brown induration in the surrounding tissue.
​Week 6: Exudative Inflammation
1. Pneumonia lobularis
Acute localised purulent inflammation ​of the terminal respiratory tree.

Gross: while yellowish foci of consolidation surrounded by normal parenchyma.

Micro: can see bronchi clearly with exudate within. The visible bronchi make it different from
other lung structures.

2. Pneumonia lobaris
Acute diffuse fibrinous inflammation​ of whole lobe of lung due to pneumococcal infection.

Gross: red to grey consolidation of lobes

Micro: all alveoli affected with bright magenta fibrin deposits within lung. Doesn’t look
particularly lung like. Be aware with this one.
 3. Pericarditis fibrinosa
Heart has myocardial muscle layer with pericardium outside. Pericardium has fat layer
underneath. In this ​fibrous​ ​acute i​ nflammation we see production of fibrinous exudate along
with ​neutrophils​ around the pericardial layer. Often caused by bacterial infection.

Gross: Dull white coating of the heart

Micro: look for additional cells (neutrophils) and bright pink substance (fibrin) on the outside
of the pericardium. (Here, just look for myocardium that looks normal!)

4. Leptomeningitis purulenta
Example of ​acute diffuse purulent inflammation ​of the arachnoid and pia matter of the
brain. Caused by microbial infection.

Gross: has purulent (pus filled) yellow exudate across top of brain (forms a ‘cap’).

Micro: Look for gaps in neural tissue and a dark purulent exudate, filled with neutrophils, on
the surface of the leptomeninges.
 5. Nephritis purulenta
Acute localised purulent inflammation of the cortex of the kidneys​. Caused by microbial
infection (either ascending via urine retention, leading to large abscess at one kidney pole.
Or caused by blood infection, leading to multiple abscesses throughout cortex ​THIS TYPE
IN SLIDE​).

Gross: multiple small round yellow abscesses

Histological: Look for kidney and then look for weird large purple structures that don’t look
like anything. They almost look like overly enlarged glomeruli, but they’re not, they’re just
newly formed abscesses.

6. Appendicitis phlegmonous
This is the only appendix in this box, look for the circular shape on the slide! It is an example
of ​phlegmonous acute inflammation​ (this kind of inflammation goes throughout the body!).
We can see neutrophils throughout the tissue.

Week 7 - Proliferative inflammation. Regeneration and repair

Granulatio
Non-tissue specific. This is granulation tissue that is formed from reapir of a soft tissue
wound, it is the transition stage between inflammation and a scar.
Gross - light pink/red, granular, soft

Micro - neovasculisation with inflammatory cells (neutrophils, eosinophils, lymphocytes,

plasma cells, macrophages) and fibroblasts.

Granuloma corporis alieni

Reaction to a foreign body

Histology - all of the characteristics of granulation tissue but this time we also have giant
foreign body cells which surround the foreign body.

Cicatrices myocardii
Scar tissue of the myocardium as a result of ischemic heart disease.

Gross - pale white, glossy and tough.

Micro - pale pink collagen waving throughout the myocardium. Aso has Van Gieson stain
version where collagen fibers are red and other tissue yellow.
Abscessus chronicus cerebri

Localised purulent inflammation that undergoes chronification if left. Chronification sees

formation of a ‘pyogenic membrane’ which isolates the inflammatory process from the rest of
the brain.

Gross - pus filled encapsulated lesion

Histology - look for interruption in normal brain tissue with necrotic cellular and tissue debris
with neutrophils.

Cirrhosis hepatis
Caused by alcoholism and other toxins generally.

Chronic liver damage leads to necrosis and inflammation which stimulates proliferation of
fibroblasts which is what we can see in the slide.

Gross - smaller, firm liver with nodular surface.

Micro - Fibrous bands and bridges through the liver. Van Gieson stain (R), collagen is red,
other tissue is yellow
Week 8 - Granulomatous inflammation
Tuberculosis miliaris pulmonis
Etiology = TB.

Gross = multiple yellow crumbly nodules in lung parenchyma

Micro - look for these granulomas throughout the lung parenchyma (pictured below). These
are nodules with caseous necrosis inside and inflammatory infiltrate composed of epithelioid
cells, giant langerhans cells and T-lymphocytes.

Leptomeningitis tuberculosa
Etiology - TB

Gross - inflammatory exudate around the base of the brain

Micro - look for thickened meningeal layer, thickened thanks to chronic inflammatory cells
such as lymphocytes and langerhans. NOTE the presence of langerhans giant cells is how
we distinguish this slide from Leptomeningitis purulenta, the other brain slide in the box.
Mesoaortitis luetica
Etiology - product of third stage syphilis (after 20 odd years)

Gross morphology - aorta harderns and looks a little like tree bark

Micro - look for thickening of the tunica media and intima. Media is filled with lymphocytes,
macrophages and plasma cells which damage the elasticity of the aorta. This can in turn
lead to aortic dilation.

The intima is fibrotic and thick as a result of the media's thickening.

Sarcoidosis

Actinomycosis
Etiology - opportunistic bacterium, anaerobic, gram positive. Part of the normal oral flora,
can cause infection in jaw, skin, pelvis and lung in exceptional circumstances.

Gross - forms a fairly gross abscess (see what I did there!!!).

Histology - granulomas with lymphocytes, giant cells and fibrous tissue. You can see these
little circles of dark pink which is actually the bacterial colony, known as ‘Sulphur granule’
(S.G on image below), to be honest, this slide couldn’t be anything else!
Week 10
Struma lymphomatosa
This slide is showing what we would know as Hashimoto's thyroiditis, it is an autoimmune
condition. Triggered by genetic susceptibility and environmental factors.

Gross - thyroid is enlarged and nodular, yellow tan colour

Micro - chronic inflammatory infiltrate of lymph, plasma cells and macrophages, with
formation of lymphoid follicles with germinal centers. Look out for:
- Heavy lymphocyte infiltrate
- Adaptive changes in follicles
- Eosinophilic
- Reduction of size (Hurthle cell metaplasia)
- Fibrous tissue in gland

Week 11 - Benign Epithelial Tumors

Non-cancerous growths, may be dysplasia (abnormal growth) or anaplasia (total lack of
differentiation, severe dysplasia).
 Benign Malignant
Capsule yes no
Growth expansive infiltrative
Recurrence no yes
Metastasize no yes
Cytological atypia no yes
Histological atypia yes yes

Fibroadenoma glandulae mammae

- Caused by hormonal imbalance, usually occurs at puberty, 30-40 y.o or menopause
- Gross appearance is firm, white, well circumscribed lobulated tumour
- Histology shows biphasic tumour with epithelial and mesenchymal components, there
are two types of tumor
- Pericanular - where ductal hyperplasia dominates
- Intracanalicular - where stromal hyperplasia dominates (luman of ducts gets
smaller)

Cystadenoma papilliferum ovarii

- Precancerous lesion, most common ovarian neoplasm, originates from surface of
ovary
- Gross shows as large, unilocular cyst sometimes consuming whole ovary. Has small
papillary projections
- Histology shows cyst and papillae lined with high columnar ciliated epithelium

Adenoma pleomorphe gl. Parotis (Tumor mixtus)

- Consists of ductal (epithelial) and myoepithelial (mesenchymal) cells.
- Gross shows a rounded demarcated mass which has a white and blue surface when
cut
- Histology shows ductal and myoepithelial cells from ducts, acini, tubules, strands or
sheets.
Adenoma vilosum recti
- Two types of lesions
- Exophytic - grows towards lumen, seen in benign cases
- Endophytic - growing towards wall/organ, seen in malignant cases
- These are adenomas (polyps) in the colon, gross shows as sessile polyps, with
raspberry like surfaces
- Histology shows dysplastic cylindrical epithelium over papillae

Papilloma planocellulare lingue

- Tumour growing on tongue and forming a papillae
- Stratified squamous epithelium cover the papillae, it is indistinguishable from normal
cells

Week 12 - Malignant Epithelial Tumours

Carcinoma Planocellulare Keratodes (aka Squamous cell carcinoma)
The second most common carcinoma, it is hard to identify, just looks like a big pink mess
frankly, but look for the increased dermal layer. Looks like a fat pink area, has visible
keratocytes​. The tumour cells grow in ​nests ​(see image on right), around the edges of the
nest we can see cells that resemble a normal basal layer, inside the cells grow. These
structures are known as ​keratin pearls​.

Carcinoma Basocellulare
The most common carcinoma, a malignancy of the skin originating from the basal layer. We
can see a normal line of epidermis and then the basal layer goes bat-shit crazy. Has a much
more bluish hue in comparison to the SCC. Once again nests are formed, but look here for
the distinctive ‘halo’ (a gap) around the nests, caused by the retraction of fibrous tissue
during slide preparation, along with the ‘palisade’ structure of the outer cells of the nest.

Adenocarcinoma ventriculi
This is a cancerous lesion of the glands of the stomach. Most commonly found on lesser
curvature of the antrum, originating from glandular epithelium. Caused by nitrates and
[Link].
Can originate from precancerous interstitial metaplasia lesion.

Cytologically, atypical glands lined with atypical cells (bigger nuclei, polymorphic,
hyperchromatic and atypical mitosis). Looks like a crazy maze!

Adenocarcinoma corpus uteri

Here, we have the exact same problem, cancer of glandular tissue, but this time in the
uterus. Caused by hormone (endocrine) imbalance. Precancerous lesion is the hyperplasia
of the endometrium. Look for the crazy maze (atypical glands with atypical cells) again, but
this time look for the myometrium, within which the cancer is embedded.

Carcinoma gelatinosum (mucinous carcinoma)

This type of carcinoma can occur in any tissue. The distinctive element is the big seemingly
empty ‘lakes’ in the tissue. These are actually filled with Mucin (a glycoprotein). Mucin is
produced by the cancerous cells, forming the Mucin lakes. These lakes stain very pale pink
with normal H&E staining, a lovely blue when stained with Alcian Blue.
Week 13 - Malignant epithelial tumors (carcinomas) part 2
Carcinoma renis (Renal cell carcinoma - RCC)

Carcinoma of the kidney arising from proximal convoluted tubules.

Gross - enlarged kidney with hemorrhage and yellow necrosis zones

Histology - look for ​clear cells​ caused by production of glycogen by the cancerous cells
which then look clear.

Risk of metastasis to contralateral kidney, adrenal glands, liver, lungs, bone and lymph. With
this, just look for kidney, its the only kidney tumour in the box.

Carcinoma hepatocellular (primary hepatic cancer)

Liver carcinomas can be primary or secondary. Hepatocellular cancer affects the

hepatocytes and is an example of primary liver carcinoma. Risk factors include cirrhosis,
Hep B and Hep C.

Gross - cancer can be a solitary node, multifocal (metastatic form) or diffuse, a cirrhosis
carcinomatosa.
Histology - we can see pseudoglandular structures, with multiple sinusoid-like structures and
clear cells visible. Pseudocapsule may be visible and cirrhosis may be present in
surrounding tissue.

Seminoma testis (example of germ cell tumour)

A Malignant tumor arising from seminiferous epithelium, common in young men of
childbearing age. Fount in testicles and anywhere along migration route of precursor germ
cells.

Etiology includes cryptorchidism and Klinefelter syndrome

Gross - white-tan, nodular mass, no haemorrhage or necrosis

Histology - look for big round nests of tumour cells with strips of CT separating nests and
inflammatory stromal reaction with formation of lymphoid follicles with germinal tumors. But
frankly, look for seminiferous tubules, it’s the only testis slide in the box.

Choriocarcinoma
Highly aggressive malignant tumor arising from trophoblast, occuring in a woman’s uterus.
Tumor starts in the tissue that would normally becomes .
Carcinoma papillare glandulae thyroideae

Week 14 - Malignant epithelial tumors (carcinomas) part 3

Carcinoma ductale invasivum mammae
- Most common non-skin malignancy. Can be in situ or invasive carcinoma
- Risk factors are gender, age, race, estrogen, obesity, BRCA1 and 2 mutations
- Gross shows solid, firm, white, chalky mass
- Histology shows cribriform structure, with nests of cells being formed. The invasive
tumors form tubules lined by cuboidal tumor cells. The nests and tubules mark this
cancer out from the next.

Carcinoma lobulare invasivum mammae

- Genetic factors (CDH1)
- Gross shows a white mass with irregular borders
- Histology shows no cribriform structure, and no basement membrane invasion. We
see discohesive tumor cells forming sheets or clusters, and monomorphic rounded
cells along with mucin-positive signet ring cells.
Adenocarcinoma glandulae prostatae
- Considered a precancerous lesion
- Gross shows a gritty, yellow/white mass on the posterior part of the prostate
- Histology shows back to back glands that lack branching, lined by single layer of
cuboidal cells with a loss of the basal membrane

Metastases carcinomatosae lymphonodi

- Special tumor disseminated poorly in different lung cancer. Tumour cells invade
lymphatic vessels and spread
- Histology shows a group of tumour cells surrounded by an empty-appearing halo (the
lymph vessel)

Week 15 - Benign Mesenchymal Tumours

These are soft tissue tumours. They can be connective tissue, muscle tissue, vessels, or
hematopoietic tumours. All of the following weeks are types of soft tissue tumours.

Dermatofibroma (fibroma cutis)

 - Benign proliferation of fibroblasts, normally effects elderly, bt also middle-aged
women. Develop in ovaries, not precancerous
- Gross shows as round, tan-brown mass, unencapsulated.
- Histology shows many spindle cells that resemble fibroblasts and fibrocytes. These
are pointy cells. Stroma has lots of vessels and collagen

Lipoma
- Most common soft tissue tumor in adults. Can develop anywhere there is adipose
tissue
- Gross shows nodular, capsulated yellow lumps
- Histology shows lipocytes with stroma and thick capsule.

Leiomyoma uteri (uterine fibroid)

- Neoplasm of smooth muscle, found in uterus, GI, vessels and skin
- Gross shows grayish-white or light pink nodes. Clinical shows as abnormal bleeding,
pain and lower abdomen pressure
- Histology shows the formation of spindle cells forming bundles, no collagen in stroma
but is encapsulated
Chondroma
- A benign cartilaginous tumors, often interphalangeal and joints of long bones
- Enchondroma (extraosseous), Enchondroma (intraosseous) and
chondromatosis (multiple condromas)
- Gross shows a round or spky mass
- Histology shows uniform chondrocytes with hyperchromatic nuclei. Lacunae exist
with multiple chondrocytes and different sizes.

Haemangioma cavernosum hepatis (sinusoidal hemangioma)

- Benign tumour of blood vessels. Often in liver and adrenals
- Gross is a blue-purple node, never capsulated
- Histology shows a thin-walled interconnected series of masses with channels lined by
endothelium and filled with blood. Forms intravascular thrombosis.

Week 16 - Malignant Mesenchymal Tumours

Three grades of malignancy (G1, 2 and 3)
Fibrosarcoma
- Malignancy arising from fibrous CT. Can be infantile or adult form. Found in long and
flat bones with local invasion. Risk factors are burns and radiation
- Gross is a gray-white formation that looks like fish meat
- Histology shows fibroblasts with spindle-shaped cells with elongated nuclei and
hypercellularity. Sparse stroma, with lots of collagen

Leiomyosarcoma
- Malignancy arising from smooth muscle. Commonly found in retroperitoneum, uterus,
skin of extremities and vessels. More common in women
- Gross is again a grayish white mass
- Histology shows cells with marked atypia, spindle shaped cells, hemorrhage and
necrosis common.

Sarcoma osteogenes (osteosarcoma)

- Malignancy arising from metaphysis of long bones. Common in young adult males in
knee, hip, joint, shoulder and temporomandibular joint
- Again, a grayish-white mass
- Histology shows pleomorphic cells with hyperchromatic nuclei. Formation of primitive
bone lamellae and stroma may have proliferating blood vessels. Atypical
malignancies also found in stroma.
- Commonly metastasizes to lung and liver
Liposarcoma
- Most common tissue sarcoma in adults, mostly found in retroperitoneum, never
superficial
- Gross shows a jelly-like yellowish nodular mass
- Histology gives us different subtypes based on differentiation
- Well differentiated adipocytes
- Myxoid and round cell liposarcoma
- Pleomorphic

Week 17 - Tumours of the Nervous system and Melanin production

Astrocytoma
- Most common CNS tumor, a sub type of glioma. Four grades
- Pilocytic
- Diffuse (our slide)
- Anaplastic
- Glioblastoma
- Gross shows an ill defined soft grey white mass. Looks pretty normal
- Histology shows star shaped cells that form a mesh. Microcytes, no mitosis and
infiltrative growth.
- Most commonly benign, but can be malignant.
Glioblastoma
- Fast growing glial tumour, highly malignant
- Gross shows soft infiltrative mass that appears similar to jelly like necrotic area
- Histology shows cell atypia, mitotic figures and bizarre cells (their actual name!)
- Benign

Meningioma
- Originate from meningo epithelial cells of the arachnoid
- Gross shows a firm nodule attached to dura
- Histology shows three types, meningothelial cell dominant, fibroblastic cell dominant
and transitional cell dominant (our slide).
- Commonly malignant

Neurinoma
- Arises from schwann cells, most common site is cerebellopontine angle
- Gross shows a solitary grey-white nodule
- Histology shows us two types
- Type A (our type) - fascicular pattern, elongated cells and verocay bodies
palisading the space between lines of tumour cells
 - Type B has a reticular pattern.
- Commonly malignant

Melanoma malignum
- Arises from skin, mucosa or iris. Common on back of men and leg of women. Has a
radial growth and vertical growth stages
- Gross shows a pigmented lesion with inflammation surrounding
- Asymmetry, Borders, Colour, Diameter, Evolution (ABCDE)
- Histology shows nests of atypical melanoma cells in dermis, no cellular maturation
and chromatin clumps at nuclear border. Often inflammatory stromal reaction, so
stroma have neutrophils

Week 18 - Tumours of Hematopoietic and Lymphoid systems

Leucosis myelogenous chronica (chronic myeloid leukemia)(myelosis hepatis)
- Originates from hematopoietic progenitor stem cell. Most common blood malignancy,
t(9;21)(philadelphia) - BCR-ABL fusion
- Bone marrow becomes reddish white instead of yellow. Hepatosplenomegaly
- Bone marrow becomes hypercellular with granulocytic precursors, megakaryocyte
and erythroid precursors
Leucosis lymphokines chronica (chronic lymphoid leukemia)(lymphadenosis hepatis)
- Originates from

Lymphoma Hodgkin (Hodgkin lymphoma)(lymphogranulomatosis lymphonodi)

Myeloma multiplex