Pathology Practical Slides

and Descriptions
Dr. Trisha Mandal
Assistant Professor, SRIMS
Acute appendicitis
• This is a section from appendix
• Epithelium is denuded (arrow), lumen
contains exudate
• Lining mucosa is ulcerated and broken
• All the layers (mucosa, submucosa and
muscularis propria) are infiltrated by
neutrophilic leukocytes

Dr. Trisha
• Pic A depicting appendiceal wall infiltrated by neutrophils and eosinophils (bleu arrow)
Pic B depicting distortion of crypt architecture (blue arrow) by lymphocytes (black
arrow)

Pic A Pic B

Dr. Trisha
• Mixed inflammatory infiltrate along
the perimuscular adipose tissue
(neutrophils, eosinophils and
lymphocytes)

Dr. Trisha
Chronic Cholecystitis
• Identify all the layers of
gallbladder: epithelium, lamina
propria, muscularis, and serosa
• Predominantly mononuclear
inflammatory infiltrate in lamina
propria

Dr. Trisha
• Variable amounts of predominantly mononuclear (lymphocytic) infiltrate in lamina propria,
extending into the musularis layer.
-Infiltrate consists of lymphocytes, plasma cells and few histiocytes.
- Accentuation of Rokitansky-Aschoff sinuses (pseudodiverticula)
cularis layer.

Dr. Trisha
Capillary & Cavernous Hemangioma
• Both are circumscribed lesion comprising of dilated congested thin
walled vessels
• The vascular channels are lined by single layer or flattened
endothelial cells

Dr. Trisha
Cavernous hemangioma:
Pic 1. Large vascular spaces of varying sizes, resembling a ‘cavern’
Pic 2. Vascular spaces are lined by thinned flat endothelium (arrow)

Dr. Trisha
Capillary hemangioma : Smaller vascular spaces (A) which are lined by single layer flat
endothelial cells (B). Supporting tissue is formed by few pericytes and fibroblasts

Picture from internet

Dr. Trisha
Tubercular lymphadenitis
• Section shows the structure of
lymph node (appreciate capsule,
cortex, follicles within the cortex
and medulla)

Dr. Trisha
Tubercular lymphadenitis
• Central area of necrosis,
• Surrounded by lymphocytes,
histiocytes, epithelioid cells and
Langhan giant cells
• Peripheral zone of fibrous tissue
consists of fibroblasts

Dr. Trisha
Left pic : Langhan giant cell
Right pic: Granuloma with central necrosis

Dr. Trisha
Tubercular pyelonephritis
• Section from Kidney ; appreciate
cortex by the presence of
glomeruli (black arrow) and
tubules (green arrow)
• See the presence of central
necrosis and multinucleated
giant cells surrounding it (blue
arrow)

Dr. Trisha
- Presence of multiple Langhan giant cells (left)
- Presence of central necrosis, giant cells , peripheral collar of lymphocytes

Dr. Trisha
- Glomerulus and tubules (left side)
- Confluent caseating type necrosis (arrow right pic)

Dr. Trisha
Lipoma
• Section shows network of
polyhedral clear cells of adipose
tissue which are separated by
irregular fibrous sepate

Dr. Trisha
- Blood vessels are within the fibrous sepate (left pic)
- Adipocytes are having polygonal shape, clear cytoplasm and peripherally placed nuclei
(right pic)

Dr. Trisha
Breast
• Terminal duct-lobular units
(TDLU) (black circles)
• Dense fibrous interlobar tissue
in between

Dr. Trisha
Breast
• Ducts are lined by double layers :
luminal epithelial cells and
abluminal myoepithelial cells

Dr. Trisha
Fibroadenoma Breast (pericanalicular type)
• Section from the breast shows
both epithelial and fibrous
component
• Patent ducts i.e., pericanalicular
type

Dr. Trisha
- Epithelial components have formed glandular structures lined by single or multiple layers
od cuboidal ductal epithelial cells with intact myoepithelial layer

- Stromal component is a loose cellular form of fibrous tissue

Dr. Trisha
Intracanalicular type Fibroadenoma Breast
• Biphasic tumor with epithelial
and stromal component
• Compressed ducts

Picture from internet

Dr. Trisha
Invasive Breast Carcinoma (Ductal)
• Transitional area between
normal (single arrow) and the
carcinoma (double arrow)

Dr. Trisha
Invasive Breast Carcinoma (Ductal)
• Invasive breast carcinoma is
defined by the absence of
peripheral layer of myoepithelial
cells
• Infiltrative tumor cells, few
arranged in tubules and few in
solid island

Dr. Trisha
Invasive Breast Carcinoma (Ductal)
• Few tubular architecture is
prominent (Circles)
• Cells having moderate
pleomorphism
• Few mitotic activities noted
(arrow)

Dr. Trisha
Leiomyoma Uterus
• Well circumscribed
• Bundles of bland spindle cells,
arranged in intersecting fascicles

Dr. Trisha
Leiomyoma Uterus
• “cigar” shaped nuclei with fine
chromatin

Smooth muscle fibers, “Cigar” (inset)

Smooth muscle fibers in cross sectional view
Dr. Trisha
Mature Cystic Teratoma (Teratoma)
• Often cystic tumors
• Composed of components from
2-3 different germ cell layers
• Common elements: skin (with
adnexal structure), cartilage, GI
mucosa, thyroid parenchyma,
cartilage, etc.
• Our slide shows cyst lined by
epidermis (arrow)

Dr. Trisha
Mature Cystic Teratoma (Teratoma)
• Another area shows skin and
skin appendages

Dr. Trisha
Mature Cystic Teratoma (Teratoma)
• Another area shows columnar
lining epithelium

Dr. Trisha
Seminoma Testis
• Sheets or lobular configuration
of tumor with fibrous septae

Dr. Trisha
Seminoma Testis
• Appreciate the sheet like tumor
arrangement and tumor cells are
closely packed
• Delicate fibrous stroma passing
through groups of tumor cells
are heavily infiltrated by
lymphocytes

Dr. Trisha
Seminoma Testis
• On higher power, the tumor cells
show large polygonal shape,
distinct cell borders, clear to
eosinophilic cytoplasm (because it
contains glycogen), vesicular
chromatin and prominent nucleoli
• Granulomas may present

*when to call vesicular chromatin? :

If you can see through it, then its
vesicular

Dr. Trisha
Adenocarcinoma Colon, Adenoma -->
Carcinoma Sequence
• Transitional area where an
adenoma (tubular adenoma) is
Adenoma arising in the colon
• Appreciate the normal colonic
mucosa by the presence f crypts
which are arranged in “test tube
rack appearance” (inset)
• Appreciate the adenoma where
Normal colonic mucosa there is abrupt transition from
normal to dysplastic epithelium

Dr. Trisha
Adenocarcinoma Colon, Adenoma -->
Carcinoma Sequence
• Transitional area between adenoma
and adenocarcinoma
• The dysplastic epithelium in the
adenomatous area shows elongated
pencillate nuclei (picket fence pattern)
having pseudostratification, but retain
basal orientation. No invasion beyond
Adenoma the lamina propria
• However, in adenocarcinoma area see
the invasion or infiltration of
Adenocarcinoma
dysplastic glands through the
muscularis propria

Dr. Trisha
Adenocarcinoma Colon, Adenoma -->
Carcinoma Sequence
• Dysplastic glands in adenoma
are limited within lamina
propria. No invasion beyond
lamina propria

Dr. Trisha
Adenocarcinoma Colon
• Infiltration of the dysplastic
glands through the muscularis
propria and reache upto
pericolic fat

Dr. Trisha
Adenocarcinoma Colon
• Dysplastic glands in
adenocarcinoma on high power

Dr. Trisha
Giant Cell tumor of Bone
• Woven bone formation (single
arrow) and proliferation of
numerous non neoplastic
osteoclasts (double arrow) along
with neoplastic mononuclear
cells
• Areas of hemorrhage and
deposition of hemosiderin
pigment

Dr. Trisha
Giant Cell tumor of Bone
• Mononuclear neoplastic cells
exhibit variety of morphological
appearances including round to
oval cells and spindled cells with
pale eosinophilic cytoplasm and
small nuclei
• Necrosis and mitosis may
present

Dr. Trisha
Giant Cell tumor of Bone
• Multiple osteoclast and round to
oval mononuclear neoplastic
cells can be seen here

Dr. Trisha
Colloid Goiter
• Mostly uncapsulated nodules
with pushing borders
• Mixture of large and small
follicles
• Follicles are lined by single layer
cuboidal epithelium
• Follicles contain abundant
colloid (eosinophilic
homogenous material)

Dr. Trisha
Colloid Goiter

Dr. Trisha
Squamous Cell Carcinoma
• Arises from epidermis and
invades the dermis
• Transition from normal stratified
squamous epithelium (single
arrow) to invasive carcinoma
(double arrow)

Dr. Trisha
Squamous Cell Carcinoma
• Cells have polygonal cells,with
dyskeratotic cytoplasm, and
pyknotic nuclei having jet ink
color
• Multiple squamous pearls
(arrow) are seen in keratinizing
type of SCC

Dr. Trisha
Squamous Cell Carcinoma
• Individual cell keratinization and
intercellular bridges are
prominent
• Frequent mitosis seen (arrow)

Dr. Trisha
Malignant Melanoma
• Identify the section of skin by
the presence of normal
epidermis at one end of the slide
(not shown here)
• Tumor is arising from the
epidermis and descending into
the dermis with asymmetrical,
poorly defined borders

Dr. Trisha
Malignant Melanoma
• Tumor cells show varied
morphological appearance,
epithelioid to spindled cells with
nuclear enlargement (>1.5x basal
keratinocytes)
• Nuclear hyperchromatia, coarse
irregular chromatin with peripheral
condensation (peppered moth
appearance)
• Prominent eosinophilic nucleoli
• Cytoplasm contains brownish dusty
pigment (melanin pigment)

Dr. Trisha
Malignant Melanoma
• Section shows nested
arrangement of tumor cells with
epithelioid tumor cells
containing melanin pigment
• Brisk mitosis may be seen
• Epidermis at places show
pagetoid melanocytes (single
scattered atypical melanocytes)

Dr. Trisha
Clear Cell Renal Cell Carcinoma
• Identify the structure of normal
kidney by the presence of
glomeruli in the cortex and the
tubules in the medulla
• Tumorous area show nested /
tubular / solid / alveolar
architecture with fine arborizing
vascularity (chicken wire
vasculature) that surround
essentially every nests tumor
cells

Dr. Trisha
Clear Cell Renal Cell Carcinoma
• Tumor cells show polygonal
shape with abundant clear to
granular eosinophilic cytoplasm
and pyknotic nuclei
• (the vacuolation in the
cytoplasm is because of the
cytoplasmic glycogen and lipid
accumulation)

Dr. Trisha