disorders of cell growth & neoplasia lab/tutorial...
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General Pathology
VPM 152
Disorders of Cell Growth
& Neoplasia
Lab/tutorial 1
Enrique Aburto Winter 2015
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MOCK LABORATORY EXAM GENERAL PATHOLOGY - VPM 152
Friday April 4, 2014 YOU NEED TO BRING: CLIP BOARD (TO WRITE ON) & PEN / PENCIL YOU NEED TO WEAR: LAB COAT + Gloves (optional, don’t “pick at” specimens) Schedule: Group A (Breau to Emmons) 10:30 to 10:50 Group B (Forcier to Korechy) 10:55 to 11:15 Group C (Lebang to Profit) 11:20 to 11:40 Group D (Quinlan to Wilson) 11:45 to 12:05 Exam in PM Demo room -- PLEASE BE ON TIME! REMINDERS: This is a MOCK EXAM - you will gain more information from this experience if you conduct the examination as if it was REAL! (note, an answer key will be provided to check your answers) There will be 6 stations with 18 minutes to complete the mock exam - so organize your time accordingly. Read the history carefully and answer the questions that are asked. [An answer key will be provided to check your answers] Do not panic! This is only a practice. This is a good time for you to evaluate yourself as to
what you do know and what you might need to learn or review for the final laboratory examination.
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LABORATORY PRACTICAL EXAM
GENERAL PATHOLOGY - VPM 152
Thursday April 17, 2014
YOU NEED TO BRING: Clip Board (To Write On), Pen / Pencil
WHAT TO WEAR: Lab Coat
Gloves (optional - since specimens can only be touched under supervision)
REMINDERS: Read the history carefully and answer the questions that are asked!
There will be 25 stations with 80 minutes to complete the exam - so organize your time accordingly (~ 3
minutes per station)
With 30 students and 25 stations there will be times when there are 2 people at one station
(but no more than 2 people at any one station at a time)
Do not touch the specimens without supervision - if you need to manipulate a
specimen to see a different angle or determine texture, please put your hand up so an instructor can assist
you.
Be warned that any observation of cheating will result in a grade of zero for this exam - -- - do not let your
eyes wander
SCHEDULE: Group A 9:30 to 10:50 Breau to Korecky
Group B 11:00 to 12:20 Labang to Wilson
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Gross Description:
A proper description must include:
•Distribution - spatial arrangement of the lesions (random, focal,
multifocal, coalescing, segmental, diffuse, symmetrical etc.)
•Contour/Shape (raised, depressed, round, square etc.)
•Colour
•Size (size of lesions, increases or decreases in organ size)
•Texture/consistency - what does the surface look like and how
does it feel (soft, firm, hard, friable, fluctuant, crepitus)
Morphologic diagnosis?
(includes the organ or tissue and the name of the main lesion)
What kind of growth does this lesion represent?
(anaplasia, hypoplasia, hyperplasia, dysplasia, neoplasia etc)
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Normal calf
Brain from a 3 day old calf (right side)
Hypoplasia = failure of an organ / tissue to reach its normal size
• Breach calf, pulled by producer
• Unable to rise or stand
• Hyperextension of head and neck
Morphologic
Diagnosis::
Cerebellar
hypoplasia
Etiology?
In-utero infection
with BVD virus
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Hip dysplasia, bilateral, dog.
Both femoral heads and
acetabula are flattened and
distorted by periosteal new bone
proliferation (arrows) .
Note - These changes are
secondary to the abnormal
organization/maturation
(dysplasia) of the tissues that
compose the coxofemoral joint.
Dysplasia of the hip causes
biomechanical abnormalities
and instability of the joint, which
predisposes it to repetitive
subluxation (loss of contact
between the joint surfaces)
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Single pale raised nodular mass (top left). Histo (top right): The mass is well-
defined, non-encapsulated and composed of mature pale (vacuolated)
hepatocytes, pushing the adjacent normal parenchyma (arrows).
Pathologic Basis of Veterinary Disease (2006), 4th ed., Mosby-Elsevier
Liver from a dog. Describe the lesion.
Morphologic diagnosis? Hepatic nodular hyperplasia, focal
Clinical significance? Usually an incidental finding; needs to be
differentiated from hepatocellular tumors (adenoma /
well-differentiated carcinoma); preneoplastic change?
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http://w3.vet.cornell.edu/nst/nst.asp
Hyerplastic nodules are white and
project above the surface (left , top).
Microscopically hyperplastic nodules
(N) are composed of numerous
small, well differentiated acini (a)
a a
Pathologic Basis of Veterinary Disease (2006), 4th ed., Mosby-Elsevier
Pancreas from an old dog.
Describe the lesion.
Morphologic diagnosis?
Pancreatic exocrine nodular
hyperplasia, multifocal
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Other examples of
pancreatic nodular hyperplasia
Clinical significance?
Usually an incidental finding;
preneoplastic change in cats?
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Nodular hyperplasia, spleen,
dogs. Multiple, red to pale, firm,
well-delineated and
nonencapsulated nodules are
present within the spleen. Nodules
are composed of mature
lymphocytes and hematopoietic
cells separated by congested red
pulp. These are a common age-
related change in dogs. Need to
differentiate these masses from
benign and malignant tumors.
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Multiple nodules in the abomasal mucosa of a sheep (inset: higher magnification).
These represent areas of mucous metaplasia and hyperplasia, the sequelae of an
infection by the nematode (parasite) Ostertagia circumcincta.
Abomasum from a sheep
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Section taken from an abomasal mucosal fold, at the level of a nodule of mucous metaplasia.
See the junction (curve line) between normal abomasal mucosal glands (N) and glands that have
undergone mucous metaplasia (M). A small number of lymphocytes are at the base of the
mucosa; likely remnants of the inflammation that was triggered by the parasitic infection.
N
M
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Skin biopsy from an old dog (cut in half). Describe the lesion.
Morphologic diagnosis? Cutaneous polyp (fibroepithelial polyp, acrochordon)
An approximately 3 cm in largest dimension, firm to rubbery, pedunculated mass
protruding from the skin. The external surface is black (hyperpigmented and corrugated
(cawliflower-like). Cut surface is smooth and white.
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Polyps may be hyperplastic /
inflammatory, hamartomatous or
neoplastic (benign). Intestinal
(colorectal) polyps (may lead to
carcinomas) Colonic adenomas. A, Pedunculated adenoma (endoscopic view). C, Pedunculated tubular adenoma supported by a stalk of fibrovascular connective tissue (s).
Schematic representation that shows the progression of intestinal adenomas (pedunculated and sessile polyps) into carcinomas
Robbins and Cotran Pathologic Basis of Disease (2010), 8th ed., Elsevier, Inc.
s
Clinical significance depends on
the nature or origin of the polyp
Polyps are any mucosal protrusion
usually supported by a stalk of
fibrovascular tissue (peduncle).
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The normal liver architecture is replaced by numerous,
coalescing, pale yellow nodules, ranging in size from
~0.2 to 2 cm in diameter. The surrounding parenchyma
is retracted and rubbery.
Describe the changes:
Liver from an 8 year old Labrador Retriever
• The mass-like lesions are
nodules of hyperplastic tissue
(regenerative change)
• The surrounding (retracted)
parenchyma has been replaced
by fibrous tissue (fibrosis)
Morphologic Diagnosis:
Liver: Nodular hyperplasia,
multifocal, disseminated;
diffuse fibrosis (cirrhosis,
“end-stage liver”)
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Compare cirrhosis with malignant hepatic neoplasia
Cirrhosis Malignant hepatic neoplasia
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Pathologic Basis of Veterinary Disease (2006), 4th ed., Mosby-Elsevier
Abdominal cavity from a dog
Dx: Unilateral cryptorchidism and testicular hypoplasia (testicle in the right side)
Comment: Besides hypoplasia, retained testicles are predisposed to develop
Sertoli cell tumors.
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Prostatic hyperplasia, dog, histo Prostate squamous metaplasia, dog
Prostate and urinary bladder
from a dog
There is marked symmetrical
enlargement of the prostate
Dx: Marked prostatic hyperplasia with multifocal squamous metaplasia
Comment: These changes are
commonly associated with estrogen-producing Sertoli cell tumors
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Horse, normal bronchial
pseudostratified ciliated
columnar epithelium.
Horse, bronchial epithelium that
has undergone squamous
metaplasia in response to chronic
irritation / allergy.
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Prostatic hyperplasia, dog
Prostate from a castrated dog
Morphologic diagnosis:
Prostatic atrophy, diffuse
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Skin tumor in a 10-year-old Rottweiler.
Considering the external appearance and color,
what would be the most likely diagnosis?
Dx: Malignant melanoma
Post mortem examination revealed the presence of
multiple well-defined, dark-brown to black masses in
different areas of the brain. Assuming that these lesions
are metastases from the cutaneous mass, which would
be the most likely pathway of dissemination?
Answer: Hematogenous
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Case #84
Clinical History:
• 5 yr-old, West Highland White terrier.
• skin mass from axillary region.
• has been present for the last 10 months with no apparent
change in size.
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Skin biopsy, dog. Note well delineated, diffuse red mass in skin /
subcutis.
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on low-power exam,
the mass is well
circumscribed and
extends from the
deep dermis of the
overlying skin into
the underlying
subcutis with at least
narrow zones of
normal tissue at the
peripheral margins.
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the mass is well circumscribed but non-encapsulated.
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at higher magnification, it consists of variable sized,
endothelial lined spaces / channels which are separated by
usually small amounts of fibrous stroma.
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the nuclei of the lining endothelial cells are elongate with dense
chromatin, usually inapparent nucleoli, mild anisokaryosis and
no apparent mitotic figures.
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Case #84
Description:
• on low-power exam, the mass is well circumscribed and extends from the deep
dermis of the overlying skin into the underlying subcutis with at least narrow zones of
normal tissue at the peripheral margins.
• at higher magnification, it consists of variable sized, endothelial lined spaces /
channels which are separated by usually small amounts of fibrous stroma.
• the nuclei of the lining endothelial cells are elongate with dense chromatin, usually
inapparent nucleoli, mild anisokaryosis and no apparent mitotic figures.
Morphologic diagnosis: Cutaneous hemangioma
Comment:
• a relatively common benign neoplasm of the dermis / subcutis of dogs
• usually solitary, but occasionally can occur at multiple sites.
• some cutaneous hemangiomas are associated with prolonged exposure to sunlight.