September 2 &4:

ST Case 1A: Indigestion

ST Case 1B: Shortness of Breath

- Go to self-study Virtual Slides for Lab Study 1

MUSEUM TOUR:

• CV8: Note the transmural infarction (hyperemic area) in the cardiac wall. Define mural. What would you expect to see microscopically? Define atherosclerosis.
• CV11: The infarct is replaced by gray-white scar tissue. What is scar tissue?
• CV12: See the thrombus virtually occluding the coronary lumen.  This could result in a myocardial infarction. What does infarction mean?
• CV46: Note the lines of Zahn.  What composes these lines?
• P1A/A78-531 and A86-395: Note the fatty change (steatosis) in the liver and the pancreatic fat necrosis.  See the chalky necrosis within both of the pancreatic specimens.  Can you think of a common etiology for these conditions?
• L7A/49A: GSW to liver. What would you expect microscopically?
• S88-11638: Note the demarcation of the infarct.
• RSP 2A: See the large thromboembolus.  A patient would have a sudden onset of shortness of breath.  From where do most pulmonary thromboemboli originate? Name four other types of emboli.
• RSP3 and RSP4: See the wedge-shaped lung infarct. (Both specimens from the same patient). What would you expect microscopically?
• E20: Adrenal hemorrhage (in medulla) secondary to sepsis.  What is this syndrome? What is sepsis?
• L21: Cirrhosis: Note the regenerative nodules and surrounding fibrosis.  Why do we see nodules? Name a cause of this.
• RE8 A: Hyperemia/Congestion.  What would cause this in the spleen?
• RE 8: Note the wrinkled splenic capsule secondary to acute blood loss.

September 16 &18

ST Case 2A: Transplantation

ST Case 2B: Autoimmunity

ST Case 2C: Renal Failure

ST Case 2D: Shortness of Breath

- Go to self-study Virtual Slides for Lab Study 2

MUSEUM TOUR:

• S83-2408: Acute renal rejection.  Histologically, one may see edema, mononuclear inflammation, and vasculitis. Describe T-cell and antibody-mediated rejection.
• RSP 37B: Radiation pneumonitis secondary to radiation tx: Acutely, the lungs show atypia of the pneumocytes and diffuse alveolar damage.  Chronically, one may see fibrosis. Describe the molecular, cellular, and cytoplasmic changes of radiation.
• 145A: This is a child’s chest.  What causes the nodules?  Don’t these look like healing fractures?
• RSP 19: What is this black “stuff”?  Note the large air spaces.  Destruction of the alveolar walls results in poor air/gas exchange during respiration.
• L21: What is the most common cause of hepatic cirrhosis in the USA?
• L8: Amyloid.  What is a beta-pleated sheet?  What special histologic stain do we use for amyloid? Is amyloidosis a local or systemic disease?
• L4: PAN.  Which vessels are affected in PAN? Which organs are often affected?
• A79-826: What may this baby’s mother have taken/ingested while pregnant?
• CV 32: Microscopically you see numerous non-caseating granulomas.  What is the cause? What is granulomatous inflammation? Name six etiologies.
• FA95-09: Which vessels and which organs are usually affected by Wegener’s? Describe Wegener’s microscopically.
• FA89-80: Electrocution.

October 7 & 9

ST Case 3A:Hemoptysis

ST Case 3B: Skin Lesions

ST Case 3C: Shortness of Breath and Fever

ST Case 3D: Shortness of Breath

- Go to self-study Virtual Slides for Lab Study 3

MUSEUM TOUR:

• RSP 40: TB: See the massive destruction.  The patient will have bloody sputum. What do we see microscopically in a lung of a patient with TB? What special histologic stain can be used?
• RSP 42: See cavitary lesion in the apex.  Histologically, how do you stain the tissue to detect the mycobacterium tuberculosis? What is a Ghon focus? Ghon complex?
• 86-520 (122B): Note the two patterns of TB: Miliary and cavitary. What does caseating mean?
• RSP 44B: Note the “target” lesions.  This is characteristic of the Aspergillus fungus.  Is Aspergillus septate or nonseptate? Know the predilection for blood vessel walls.
• RSP 29: Note the well-demarcated abscess.  How does this differ from pneumonia? What is empyema? What is a septic embolus?
• Confluent lobar pneumonia secondary to aspiration: What type of individual is susceptible to aspiration pneumonia? Which side is more common, left or right?

October 21 & 23

ST Case 4A: Vaginal Bleeding

ST Case 4B: Abdominal Mass

ST Case 4C: Liver Mass

ST Case 4D: Weakness and Anorexia

ST Case 4E: Features of Malignancy

- Go to self-study Virtual Slides for Lab Study 4

MUSEUM TOUR

• L62: Malignant melanoma metastatic to the liver
• L64: Metastatic carcinoma. Define neoplasia, cancer, and oncology.
• U12: What does “leiomyo” mean?  Is this tumor primary in the uterus or metastatic to it? How does leiomyoma differ from leiomyosarcoma?
• RSP 68: single metastatic nodule. Understand seeding, lymphatic spread, and hematogenous spread.
• RSP 68B: How does this pattern of metastasis differ from the above RSP 68?  Can you visualize the X-ray appearance?
• S82-7940: Note the large tumor and the residual kidney pushed to the side.
• Hand: This is epidermoid carcinoma of the hand.  What does epidermoid mean? Define anaplasia, pleomorphism, and dysplasia.
• #173 (S69-2567): Squamous cell carcinoma of thumb. Define carcinoma.
• RE 8: Blood loss resulting in a shrunken spleen
• A78-519: What does “anthracotic” mean? See the cancer metastatic to the hilar lymph nodes. What does metastatic mean?

October 28 & 30

ST Case 5A: Prematurity

ST Case 5B: Failure to Thrive

ST Case 5C: Dysmorphic Features

- Go to self-study Virtual Slides for Lab Study 5

MUSEUM TOUR

• Siamese twins. Define malformation, deformation, disruption, and sequence.
• GI 21: See the mass of worms.
• L41: Why does cystic fibrosis affect the liver?  Can you name other organs commonly affected? Which chromosome is involved? What is meconium ileus? Biliary cirrhosis?
• RSP 80: Hypoplastic lung: Why would a diaphragmatic hernia result in a hypoplastic lung in a baby? Define hypoplasia. Define atrophy.
• RSP 8 and RSP 11: Bronchiectasis.  In a CF patient with bronchiectasis, what organism is known to “set-up” infection? What does duct ectasia mean?
• S83-887: Can you find the fetus? How would the mother present in the ER?  Can you think of another disease/medical condition that would present in the same fashion, i.e. that you would have to rule out?
• S74-06379: Six week GA fetus in uterus. Define fetus, neonate, and infant.
• Twelve week GA fetus in uterus

Cases 6 and 7 are for PATH602 only

November 18 and 25

ST Case 6A: Fatigue and Pallor

ST Case 6B: Glossitis

ST Case 6C: Abdominal and Joint Pain

ST Case 6D: Morphology: Abnnormal Peripheral Blood Cells

- Go to self-study Virtual Slides for Lab Study 6

MUSEUM TOUR

• RE 2: Sickle cell disease with splenic autoinfarction (note the adjacent normal spleen)

December 2 & 4

ST Case 7A: Leukocytosis

ST Case 7B: Abdominal Pain

ST Case 7C: Abnormal WBC Morphology

ST Case 7D: Epistaxis

ST Case 7E: Peripartum Bleeding

- Go to self-study Virtual Slides for Lab Study 7

MUSEUM TOUR

• RE 24: Spleen with lymphoma. What is a lymphoid neoplasm? Myeloid neoplasm?
• RE 19: Big spleen of acute leukemia. How does leukemia differ from lymphoma?
• RE 36: Hodgkin’s disease. The two broad groups of lymphomas are recognized as _____ and _____. What is a Reed-Sternberg cell?
• RE 21: Multiple myeloma - skull, vertebral column.  "Punched out", destructive skull lesions; destruction of vertebral bodies with ill-defined tumor nodules. (A73-466)
• RE 30: Malignant lymphoma of childhood - small bowel (S77-11592)