Fundamentals of Surgical Pathology Shameem Shariff
INDEX
Page numbers followed by f refer to figure and t refer to table.
A
Abscess 218, 263, 442
crypt 197
Acantholytic acanthoma 357
Acanthoma 364
epidermolytic 357
Acanthosis 19, 21
Acanthotic lesions, massive 168
Acellular structure 462
Achlorhydria 178
Acid-fast
bacilli 354
stain 87
Acinar cell
carcinoma 150f, 244f
cystadenocarcinoma 239
Acini, malignant 79
Acquired immunodeficiency syndrome 112, 190, 193, 199, 281, 304
Acral keratosis 339
Acrodermatitis enteropathica 193
Actin 475
Actinobacillus 435
Actinomadura madurae 355
Actinomycetem comitans 435
Actinomycosis 21, 256
organisms 32
Adamantinoma 391
Adenoacanthoma 35
Adenocarcinoma 26, 27f, 27t, 28, 28t, 55, 79, 147, 175, 183, 267, 273t, 275, 275t, 461, 465
endometrioid type of 63
high-grade serous 40
in situ 24, 269
incidence of 270
invasive 270
mucinous 271
large duct 80, 81
low-grade serous 40
lung, conventional 469
microglandular 243
microinvasive 27
minimally invasive 270
morphologic variants of 27
peripheral 80
polymorphous low grade 151
types of 28
Adenofibroma 33
Adenoid cystic carcinoma 25, 144, 150, 153, 175, 368
Adenolymphoma 147
Adenoma 89, 268, 342
apocrine 460
double 345
follicular 339, 341
hepatocellular 231, 232
high grade 184
hyalinizing trabecular 342
low grade 184
malignum 27, 27f, 28, 28f, 28t
pleomorphic 145, 146, 146f, 147, 460
traditional serrated 203
Adenomatosis polyposis
familial 202
serrated 204
Adenomyoma 33
Adenomyosis 17, 32
Adenosarcoma 33, 40
Adenosis, microglandular 315
Adnexae 62
Alagille syndrome 226
Allred's quick score 326
Alpha 1 antitrypsin deficiency 225
Alport's syndrome 111
Alveolar damage, diffuse 266
Alveolar pattern 122f
Alveolar ridge
lower 156, 158
upper 156, 159
Alzheimer's disease 455, 456
Ameloblastoma 168
malignant 169
American Academy of Pediatrics 122
Amino acid 466
metabolism, disorders of 227
Amiodarone 266
Amnion nodosum 11
Amniotic fluid, formation of 11
Amoebic meningoencephalitis, primary 446
Ampulla 5
Amyloid
deposits 115
goiter 343
precursor protein gene 456
Amyloidosis 95, 101, 115
Anal canal, classification of tumors of 206
Androblastomas 50
Angioleiomyoma 411
Angiolipoma 398, 401
Angiomatosis 412
bacillary 412
Angiomyofibroblastoma 15, 21, 405
Angiomyolipoma 99, 120, 122, 411
epithelioid 120
Angiomyxoma
aggressive 15, 21, 414
superficial 21, 414
Angiosarcoma 72, 120
Angiotensin-converting enzyme 264
Aniridia 423
Anitschkow cells 437
Ann Arbor staging system 307
Antibody
anti-melanoma 469
antimitochondrial 223
mediated rejection
Banff classification 129
chronic active 128
Antigen 465
antibodies, antineutrophil cytoplasmic 106
carcinoembryonic 22, 26, 465
epithilial membrance 26
stimulation occurs 285
Anti-inflammatory drug, nonsteroidal 111, 181
Antiphospholipid syndrome 110, 228
Antral gastritis, diffuse 181
Antrum, polyps in 178
Appendix 188190
classification of tumors of 205
Arias-Stella reaction 31
Armanni-Ebstein anomaly 115
Arnold-Chiari malformation 14
Arrhenoblastomas 50
Arrhythmias 437
cardiac 446
Arteries 117
Arterioles 117
Arteriolosclerosis 110
hyaline 115
Arteriosclerosis 110
Aryepiglottic fold 166, 249, 252
Arytenoid cartilages and ventricles 249
Asbestos bodies 267
Asbestosis 267
Askin tumor 390, 470
Aspergillus 435
fumigatus 445
spores 445
Astrocytoma
anaplastic 452
diffuse 452
fibrillary 452
gemistocytic 452
Atherosclerosis 447
Atresia
biliary 226
extrahepatic biliary 225
Atrial septal defect 14
Atrioventricular valves 433
Atrophic gastritis, multifocal 181
Atrophy 8
endometrial 36
Atropic glands 81
Attacks, recurrent 194
Atypia, greater degree of 44
Autosomal dominant 122, 123
adult polycystic kidney disease 122, 123
polycystic kidney disease 229
Autosomal recessive 122, 123
childhood polycystic kidney disease 124
disease 124
polycystic kidney disease 122
B
Bacillus Calmette-Guerin 77
Bacteria, pathogenicity 443
Bacterial overgrowth syndrome 190, 192
Balanitis 70
xerotica obliterans 72
Balanoposthitis 71
Balantidium coli 229
Balloon cell nevus 460
Banff classification 129
revised 129
Barrett's esophagus 173175
diagnosis of 174
Bartholin duct 142
Bartholin gland 18
cyst 18
Bartonella quintana 412
Basal cell
adenocarcinoma 148
adenoma 145, 147
carcinoma 357, 359, 461, 470, 470t
syndrome, nevoid 362
change 195
layer, irregular 167
proliferation 148
Basal keratinocyte necrosis 357, 360t
Basal lamina 462
epithelial 462
Basal low cuboidal cells 323f
Basaloid carcinoma 72, 469
Basaloid squamous cell carcinoma 23f, 25, 72, 168, 175
Basement membrane 114
destruction 357
Basophilia, cytoplasmic 191
Basophilic cytoplasm 291, 404
Battledore placenta 10
B-cell
hyperplasia, monocytoid 304
lymphocytosis, monoclonal 287
lymphoma 284, 306
fiffuse large 89, 290
intravascular large 291
red pulp small 282
splenic 282
neoplasm
mature 282, 307
precursor 306
Beckwith Wiedcmann syndrome 384, 417, 423, 424
Behçet's colitis 199
Bezoars 178
Bicuspid aortic valve 435
Bile duct
adenoma 232
atresia, extrahepatic 224
carcinoma 233t, 469
disease, vanishing 224
interlobular 224
intrahepatic 232
major 216, 216f
Bile-plug syndrome 226
Biliary cirrhosis, primary 223
Billroth procedures 192
Biopsy
colonoscopic 194
cystoscopic 132, 137
endoscopic 176, 185
excision 310f
needle core 215, 329
small 8, 73
specimens, small 70
transbronchial 261
transplant 126
types of 125, 215, 441
Bizzare leiomyoma 38
Black nodular mass 133
Bladder resection specimens 138
Blastomyces dermatitidis 445
Bleeding diathesis, severe 100
Blood vessels 403f
mesenteric 187
Bloodless glomeruli 116
Blue cell neoplasia, small 420
Blue nevus 460
common 367
Bluish multiple cysts 312
Blunt duct adenosis 315
Bone 376
arrangement 377
biopsy 377
cells 376
compact 377
cyst
aneurysmal 390, 391, 393
unicameral 392
destruction, cortical 389
extremities 378
formation 392
histology 376
infarction 383
lesions
grossing of 377
synoptic reporting 394
marrow needle biopsy 377
matrix 376
and collagen, disorders of 381
mineralization of 381
necrotic 380
normal anatomy 376
remodeling 377
resorption, cycle of 377
tumors 380
classification of 383
malignant 389
TNM staging of 394
Borderline malignancy
Brenner tumor 40
serous tumor of 89
Borderline serous ovarian tumors 42
Borderline tuberculoid 353
Borrelia burgdorferi 438
Botryoid rhabdomyosarcoma 28
Bouin's fluid 1
Bowen's disease 19, 70, 71, 352, 357, 363
Bowenoid actinic keratosis 363
Bowenoid papulosis 19, 71
Bowman's capsule 103, 118
Bowman's layer 462
Bowman's membrane 462
Bowman's space 100
Brain 441
abscess 443
areas of 446f
biopsy 441
eating amoeba 446
normal anatomy 442
parasitic infections of 445
parenchyma 443
pathology 442
tissue 423
tumors 448
Breast 309
benign lesions 313
biopsies, minimally invasive 328
cancer, early 324
carcinoma 328
invasive 319
molecular subtypes of 327
technique in 328
excision biopsy 309
fibrocystic disease of 313
gross pearls 312
histopathology synoptic report 331
incisional biopsy 309
like subtypes 328
mastectomy 309
microscopy pearls 313
mucinous carcinoma of 321f
normal histology 313
parenchyma, infiltration of 314f
secretory carcinoma 321
specimens received 309
tru-cut biopsy 309
tumors, WHO classification of 319
wide local excision 309
Brenner tumor 18, 40, 41, 44, 50, 89
benign 40
malignant 40, 44
proliferating 44
British Society of Gastroenterology 174
British Testicular Tumor Panel and Registry 89
Brodie's abscess 388
Bronchiectasis 267
Bronchioalveolar tumor, intravascular sclerosing 272
Bronchiolar alveolar carcinoma 471t
Brown bowel syndrome 189
Brown tumor 382, 393
Broyles ligament 250
Brucella 435
Buccal gingival gutter 167
Buccal glands 142, 143
Buccal mucosa 158
Budd-Chiari syndrome 218, 227, 230
Bulbar polio 444
Bulbospinal polio 444
Bullous impetigo 356
Bullous pemphigoid 361
Burkitt's lymphoma 293, 294, 301
Buschke-Lowenstein tumor 72
Byler's disease 226
Byler's syndrome 226
C
Cafe-au-lait spots 417
Call-Exner bodies 48
Calponin 466
Calretinin 467
Calyceal diverticulum 123
Calymmatobacterium granulomatis 19
Campylobacter jejuni 199
Campylobacter pylori 181
Canada-Conkhite syndrome 201
Canalicular adenoma 146, 148
Canaliculitis 461
Cancer genome atlas 37
Cancer syndrome, inherited 417
Candida 435
pseudohyphae 119f
Candidiasis 173
Capsular invasion 341
Carbohydrate metabolism, disorders of 227
Carbon monoxide 446
Carcinofibroma 33
Carcinoid 41, 47, 206
atypical 28
tumors 182, 271
Carcinoma 1618, 20, 28, 31, 70, 72, 81, 89, 324
adenosquamous 25, 35, 55, 72, 81, 168, 175, 183, 243, 268, 272
anaplastic 243
apocrine 368
breast 312, 318, 469
ciliated 36
colon 188f, 197, 467
cuniculatum 72
cytokeratins positivity in 466f
embryonal 46, 89
embryonic antigen 27
endometrial 32, 34t, 35, 37, 473
endometrium 6
epithelial-myoepithelial 144, 151, 153
esophagus 175
ex pleomorphic adenoma 147
extraovarian papillary serous 42
fibrolamellar hepatocellular 230
follicular 341
hepatocellular 231233, 233t, 423
hyalinizing trabecular 342
in situ 27, 71, 202, 239
ductal 318t
infantile pancreatic 244
intraductal 79
intraepithelial 35
intramucosal 175, 202
invasive 67, 240, 333
micropapillary 321, 321f
lung 471t
lymphoepithelioma-like 168, 272
midline 168
prostate 472t
small cell 23, 29, 29t, 32, 36, 51, 81, 244, 258, 472
stomach 183
superficial 7
unclassified 268
undifferentiated 18, 32, 175
Carcinosarcoma 33, 40, 312
Cardiac arrest 446
Cardiobacterium homini 435
Cardiomyopathy 439
dilated 439
histiocytoid 439
hypertrophic 439
primary 439
unclassified 439
Cardiovascular system 433
normal anatomy 433
Carney complex 417
Caroli's disease 229
Castleman's disease 281, 292, 301, 304
Caterpillar cells 437
Cauliflower like
appearance 133
mass 16
Celiac disease 192t
Cell 179, 317
adenocarcinoma, mixed 32
adipocytic 401f
carcinoma, mixed small 271
endothelial 467
hyperplasia, reserve 20
inflammatory 191, 444
membrane protein 468
morphology 292, 317
neoplasms, histiocytic 283
of origin 287, 288
peripheral palisading of 23f
resemble mature lymphocytes 287f
surface glycoprotein 465
variant, ciliated 32
Cellular
angiofibroma 21, 405
blue nevus 367, 460
components 465
crescents 110
inflammatory reactions 443
leiomyoma 38
schwannomas 373
variant 32
Cellularity, mixed 300
Central nervous system 116, 441, 445t
Centrilobular cholestasis 224
Centrocyte 286
Cerebral
blood flow, stagnant 446
hemispheres 453
hypoxia, causes of 446
Cerebrospinal fluid 443
Cervical
adenocarcinoma 473
in situ 23
adenofibroma 24
adenomyoma 24
endocervical type of 27
angiosarcoma 24
biopsy histopathology report 54
cancer 56
carcinoma 24
epithelium 20
fibroepithelial
polyp 23
neoplasia 1, 23, 24, 55
leiomyoma 24
leukemia 24
lymphoma 24
squamous cell carcinoma in situ 23
tumor, WHO classification of 23
Wilms’ tumor 24
Cervicitis
chronic herpetic 54
chronic papillary 54
nonspecific chronic 54
Cervix 1, 3, 4, 15, 20, 24, 27t, 32, 67
adenocarcinoma of 23
adenoid
basal carcinoma of 23
cystic carcinoma of 23
adenosarcoma of 24
adenosquamous carcinoma of 23
alveolar soft part sarcoma of 24
carcinoma of 6, 7, 17, 23f, 25, 25t
carcinosarcoma of 24
clear cell adenocarcinoma of 23
dermoid cyst of 24
early invasive adenocarcinoma of 23
glassy cell carcinoma variant of 23
large cell neuroendocrine carcinoma of 23
leiomyosarcoma of 24
malignant peripheral nerve sheath tumor 24
mature cystic teratoma of 24
mesonephric adenocarcinoma of 23
mucinous adenocarcinoma of 23
Müllerian papilloma 23
myxoid tumor like appearance of 15
removal of 3, 8
serous adenocarcinoma of 23
small cell carcinoma of 23
squamotransitional carcinoma 23
squamous
intraepithelial neoplasia 23
papilloma 23
undifferentiated carcinoma of 23
well-defined cysts in 15
yolk sac tumor of 24
Chalazion 460
Chemotherapeutic agents 266
Cherubism 384
Chlamydia trachomatis 20, 31
Chlamydial infections 32
Chocolate cyst 18
Cholangiocarcinoma, intrahepatic 469
Cholangitis lenta 225
Cholecystitis, chronic 218
Cholestasis 224, 226
familial intrahepatic 226
intrahepatic 226
Cholestatic disease 224
Cholesterosis 218
Cholesteryl ester storage disease 227
Chondroblastoma 385, 393
Chondroid
lipoma 398, 401
syringoma 368, 369
Chondroma 385
Chondromyxoid fibroma 386, 393
Chondrosarcoma 39, 385387
conventional 386
extraskeletal myxoid 415
primary central 386
secondary 387
Chorangioma 11
Chordoid sarcoma 415
Chordoma 391
Chorioadenoma destruens 53
Chorioamnion 51
Choriocarcinoma 17, 33, 46, 53, 86, 89, 90, 475
development of 52
Chorionic villi 9
Choroid plexus
carcinoma 454
papilloma 454
tumors 448
Chromatin 47
Chromogranin 467
Chromophil 121
Chromophobe renal cell carcinoma 120
Churg-Strauss syndrome 264
Ciliary body lesions 463
Circummarginate placenta 11f
Circumvallate placenta 11f
Cirrhosis 105, 222
biliary 217
cardiac 217
classification of 222
micronodular 217
Cistern formation 52
Clear cell
acanthoma 357, 365
adenocarcinoma 32, 40, 89
carcinoma 18, 28, 29, 36, 44, 151, 474
change 31, 195
chondrosarcoma 387
cribriform hyperplasia 81
follicular neoplasm 342
metaplasia 31
oncocytoma 148
papillary renal cell carcinoma 120
renal cell carcinoma 120, 121
sarcoma 72, 120, 123, 416
squamous carcinoma 72
tumor 40, 272
Clitoral hypertrophy 50
Clitoris 18, 20
Clostridium
difficile 197, 199
sordellini 197
Coccidial infections 193
Coccidioides immitis 445
Coccyx 422
Codman's triangle 388
Colitis
antibiotic-associated 197
collagenous 198
eosinophilic 198
indeterminate 196
ischemic 196
lymphocytic 198
Collagen vascular diseases 264, 439
Collecting duct
carcinoma 99, 120, 121
tumor of 89
Colon, tumor of 205
Colonic epithelium, cytokeratins positivity in 466f
Commissure tendon, anterior 250
Complete mole 52, 52t
Condyloma acuminatum 19, 21, 23, 26t, 72, 167, 352
Condylomata, anogenital 257
Cone biopsy 2
Congo red 434
Conjunctiva 462
Conjunctival papilloma 461
Conjunctivitis, inclusion 462
Connective tissue disorders 383
Cord 10
insertion of 10
Core biopsy 331
advantages of 329
limitations of 329
staining on 326
Cornea 462
Corneal endothelial cells 462
Corneal grafts 462
Corpus 1
luteal cyst, torsion in 18
luteum 17
cysts 39
Cortical nodule, small 99
Corticobasal degeneration 455
Corticomedullary junction 98, 98f
Cowden's polyp 182
Cowden's syndrome 201
Cranial nerve, tumor of 449
Craniopharyngioma 450
C-reactive protein 231
Crescent, formation of 103
Cribriform cystadenocarcinoma, low-grade 152
Cricoid cartilage 248
Cricopharyngeus muscle 171
Crohn's disease 167, 189, 195, 197t, 198, 199
Crown
heel length 14
rump 3
length 14
Cryptococcus 444
meningitis 297
neoformans 445
Cryptorchid testis 88
Cryptosporidium 190
Crystalloids, intraluminal 79
Cushing's syndrome 51, 245
Cutaneous myxoma 21
Cylindroma 368
Cyst 18, 19, 39, 98, 460
bilateral large 98
congenital 229
dermoid 89, 460
endometriotic 18
epidermal 460
epidermoid 89
follicular 18, 39
formation 423
gelatinous 445
glomerular 123
hemorrhagic 18
in cortex 17
in liver 218
in medulla 98
in wall 173
keratinous 143
lymphoepithelial 145
reniform mass of 98
simple 123, 229
with thick walls 99
with whitish thick laminated membrane 99
with yellow rim 18
Cystadenocarcinoma 149, 229
Cystadenofibroma 40
Cystadenoma 40, 146, 149
biliary 229
Cystectomy 133
Cystic cavities 47
Cystic conditions
benign 239
malignant 239
Cystic disease 124
acquired 120
renal 123
Cystic lesions, benign 460
Cystic teratoma
benign 18
mature 24, 47, 47f
Cysticercosis 445
Cystitis 86, 134
chronic tuberculous 134
common variants of 134
emphysematous 134
eosinophilic 134
interstitial 134
Cytogenetics 121
Cytokeratin 26, 408, 466
Cytomegalovirus 31, 173, 174
infection 444
Cytotrophoblasts 9
D
Dacryocystitis 461
Dandy-Walker malformation 14
Darier's disease 357, 360
Daughter cysts 228
De Quervain's thyroiditis 344
Dead bone 380
Decemet's membrane 462
Degenerative diseases 455t
Dementia, severe 456
Dendritic cell neoplasms 283
Denocarcinoma 81
Denys-Drash syndrome 423
Dermatitis herpetiformis 361
Dermatofibroma 371
Dermatofibrosarcoma protuberance 371, 372t, 406
pigmented 406
Dermatologic disorders 167
Dermatophytoses 354
Dermatoses 356
Descemet's membrane 462
Desmin 412, 468
Desmoplastic mesothelioma 467
Desmoplastic small round cell tumor 416
Diabetes mellitus 101, 220
Diabetic nephropathy 114
routine cases of 100
Diathermy loop excision 2
Diethylstilbestrol 36
Digestive systems 249
Digital fibromatosis 405f
Digital fibromyxoma 413
Digital papillary carcinoma 368
Distant metastases 84, 93, 131, 140, 278, 349, 374, 375, 419, 423, 432
Donovan bodies, demonstration of 19
Donovanosis 19
Dorsalis pedis vessel, dissection of 397
Down's syndrome 428, 456
Dubin-Johnson syndrome 217, 226
Duct papillomas 146, 149
Ductal adenocarcinoma 240, 242
Ductal carcinoma
in situ 316, 316f, 317, 317t
high grade 317t
low grade 317t
treatment of 317
variants of 317
variants of 243
Ductal hyperplasia, atypical 315317, 317t, 323, 329
Duodenal aspirates 193
Dysentery, bacillary 199
Dysgerminoma 18, 41, 45, 90, 474
Dysplasia 135, 175, 184
aplastic 123
argyrophilic cell 195
arteriohepatic 226
diffuse 123
diffuse cystic 99
exist, several distinct patterns of 123
fibro-osseous 392t
fibrous 389, 391, 392, 392t
glandular 23
severe 239
Dysplastic changes, severe 167
Dysplastic nevus
congenital 460
syndrome 367
Dysplastic nodules 231
E
Eccrine
acrospiroma 369, 460
cylindroma 369, 460
poromas 369
spiradenoma 370, 460
Echinococcosis 446
Echinococcus granulosus 228, 239
Echovirus 226
Ectocervical edge 55
Ectocervical mucosa 17
thickened 16
Ectocervix 1
Ectoderm 39
Ectopic origin, tumor of 268
Edema 197
inflammatory 443
Effusion lymphoma, primary 292
Egg basket appearance 300
Elastic tissue 316f
Elastofibroma 404
Elastosis, actinic 462
Electron microscopy 100, 102, 104, 108, 111, 117
Embryo 3
developmental changes of 14
Encephalitozoon intestinalis 194
Encephalomalacia 443
Enchondroma 383, 385
Enchondromatosis 384
Endobronchial lesion 263
Endocarditis 434
acute 435
infective 435, 438f
noninfective 436
subacute 435
Endocardium 437
Endocervical
adenocarcinoma, primary 27
canal
elongated 16
length of 4
columnar cell neoplasia 24
epithelium 55
glandular hyperplasia, lobular 22
invasion 61
polyp 22, 23
sarcoma, undifferentiated 24
Endocervix 1
Endoderm 39
Endolymphatic stromal myosis 37
Endometrial
adenocarcinoma, primary 27
biopsy histopathology report 58
cancer histopathology report 60
hyperplasia 7, 3133
new WHO classification of 33, 34t
intraepithelial
carcinoma 35
neoplasia 34
sarcoma, undifferentiated 32
stromal, mixed 33
Endometrioid 39
adenocarcinoma 23, 24, 27, 32, 35, 40
borderline tumor 40
tumor 40, 42, 44, 89
Endometriosis 22, 32
Endometritis
acute 31
chronic 31
Endometrium 3, 7, 27t, 29, 58, 59, 61, 469
carcinosarcoma of 17
hypersecretory 17
normal anatomy 3
secretory 17
thickened 17
Endomyocardial biopsy 434
complications 434
indications 434
techniques 434
Endosalpingiosis 42
Endothelial decompensation 462
Entamoeba histolytica 20, 229
Enterocytozoon bieneusi 194
Enteropathy, autoimmune 192
Enzyme histochemistry 232
Enzyme-linked immunosorbant assay 110
Eosinophils 191, 197
Ependymoma 453
Epidermis, atrophic 19
Epidermolysis bullosa
acquisita 361
simplex 357
Epididymitis
cause of 86
nonspecific 86
Epithelial and
mesenchymal tumor, mixed 24, 33
stromal tumor, mixed 120
Epithelial cells 281
pleomorphic 275f, 322f
surface 191
Epithelial membrane antigen 90, 168, 408, 468
Epithelial proliferation 316f
Epithelial proliferative lesions 315
Epithelial tumors
malignant surface 72, 64, 146, 257
surface 40, 41, 474
Epithelioid appearance 305
Epithelioid cell 264, 301, 463
nevus 460
tumor, perivascular 33
Epithelioid variant 32, 411
Epithelium cells, columnar 323f
Epitheloid sarcoma 72
Erdheim-Chester disease 450
Erythema
multiforme 357, 360
nodosum leprosum 354
toxicum neonatorum 358
Erythroleukoplakia 167
Erythroplasia 167
of Queyrat 71
Escherichia coli 118
Esophageal biopsy histopathology 208
Esophageal lumen 173
Esophageal resection 208
Esophageal tumors, WHO classification of 175
Esophagectomy specimens 171
Esophagitis, candidal 174
Esophagogastric junction 180f
Esophagus 171
endoscopic biopsy 171
lymphatic drainage of 171
normal anatomy 171
specimen handling 172
Esthesioneuroblastoma 255
Estrogen 475
receptor 27
European Grading System 317
Evan's tumor 409
Ewing sarcoma 120, 240, 384, 389, 415, 470, 472
Extracapillary proliferation 101
Extragonadal tumors, malignant 422
Eye 458, 458f
Eyelids 460
tumor of 460
F
Fabry disease 439
Facial
hemangioma 461
trichilemmomas 339
Fallopian tube 3, 5, 6, 17, 18, 32, 39, 63, 67
carcinoma 67
malignant tumor 18
tumor of 7
Familial intrahepatic cholestasis, progressive 226
Fatty liver disease, nonalcoholic 220
Faucial isthmus 161
Female genital tract 1, 474
lesions 473
normal anatomy 1
Femoral vessels, dissection of 397
Fenfluramine 439
Ferruginous bodies 267
Fetal surface 11
Fetus 3, 13
length of 15t
standard weights of 14
Fibrinoid necrosis 110
Fibroadenoma 314
juvenile 314
Fibroblastic tumor, malignant 408
Fibrocystic disease 314f
Fibrofolliculoma 369
Fibrohistiocytic tumors 384, 399, 409
benign 409
Fibroma 40, 50
congenital 408
irritation 166
non-ossifying 391
of long bones, ossifying 392t
Fibromatosis 404, 472
inclusion body 405
Fibropolcystic disorders 229
Fibrosarcoma
adult 408
infantile 408
inflammatory 407
Fibrosis
cystic 225
endocardial 439
generalized 88
hepatoportal sclerosis, noncirrhotic portal 228
interstitial 110, 128
staging 220
Fibrotic
hard gland 143
wall 218
Fibrous cortical defect 391
Fibrous histiocytoma
deep benign 410
malignant 416
Fibrous tissue, cellular masses of 392
Fibroxanthoma, atypical 371, 414
Fimbriae 5
Fine needle aspiration 328
biopsy 218
cytology 87, 328
First attack, acute stage of 194
Fixative-fatty liver 217
Flat lesion with
atypia 135
dysplasia 135
Flea bitten kidney 97
Follicles, cystic 39
Follicular
differentiation, tumor with 370
hyperplasia, reactive 293, 293t
infundibulum, tumor of 369
keratosis, Inverted 460
lymphomas, grading of 292
neoplasms, variants of 342
Formalin fixation 441
Fouchet's stain for bile pigment 219
Foveolar hyperplasia 181
Fracture 383
Frank carcinomas 337
Friable mass, solid 144
Friedreich ataxia 439
Frontotemporal lobar degeneration 455, 457
Fuch's dystrophy 462
Fuhrman nuclear grading system 131
Fundic gland polyps 178, 201
Fundus 1
Fungal infections 264, 301, 354, 445
G
Galactosemia 217, 225
Gallbladder 215, 217, 218, 469
small 218
thickened wall of 218
Gallstones, nature of 219t
Ganglion cell 425f
Ganglioneuroblastoma 425, 426
Ganglioneuroma 426
Ganglionic dysfunction 177
Gangrene 187
Gangrenous intestine 187f
Gardner's syndrome 178, 387
Gastrectomy 192
specimen 176, 177
Gastric
antral vascular ectasia 182
atrophy 181
carcinomas 183, 469
glands, mucus of 179
intraepithelial neoplasia 183
mucosal biopsies, endoscopic 179
stromal tumors 184
tumors, WHO classification of 183
Gastritis
autoimmune 180
chemical reaction 181
chronic 180, 181
eosinophilic 198
follicular 181
microscopic reporting of 182
Gastroenteritis 198
Gastroesophageal
junction 171
reflux disease 173
Gastrointestinal
autonomic nerve tumors 176
stromal tumor 183, 400, 472
tract 171, 206
Gaucher's disease 227, 383
Genes 324
Genetic disorders 226
Genital
abnormalities 423
rhabdomyoma 24
system, male 70
Germ cell 51, 88
aplasia 88
neoplasia
in situ 89, 91
noninvasive 89
tumors 18, 24, 33, 41, 45, 46, 88, 89, 120, 234, 422, 450, 474, 475
mixed 41, 89
nonseminomatous 89, 90
regressed 89
WHO classification of 89
Gerota's fascia 96
Gestational trophoblastic disease 33
Ghon's focus 263
Giant aneurysms 447
Giant cell 196, 390, 393
carcinoma 37
epulis 169, 393
fibroblastoma 371
fibroma 166
glioblastoma 453
granuloma, peripheral 169
hepatocellular 225
lesions 391, 393
multinucleate 19
osteoclast type of 409f
pleomorphic 243
reparative granuloma 393
response, multinucleated stromal 22
rich 391
tumors, osteoclastic 384
transformation 225
tumor 243, 390, 393, 409, 410
benign 390f
diffuse type 409
malignancy in 391
malignant 409
type of 313, 393f
Giant fibroadenoma 314
Giardiasis 193
Giemsa stain 19, 193, 219, 436
Gilbert syndrome 226
Gingiva
floor of 158
lymphatic drainage of 158
Glands 1
endometrial 32
enlarged 143
labial 142, 143
lacrimal 461
stratification of 27f
sublingual 142
Glandular epithelial cells 465
Glandular lesions
benign 23
non-neoplastic 22
Glandular neoplasm 76, 134
Glans penis 70
Glassy cell carcinoma 23, 25, 35
Gleason's grading 79, 80
Gleason's score 80
Gleason's system 79, 80
Glial fibrillary acidic protein 46, 452
Glial tumors 448
Glioblastoma 451, 452
variants of 453
Gliomas 448
Gliomatosis peritonei 422
Gliosarcoma 453
Glomerular diseases 101, 111
classification of 101
clinical patterns of 101
primary 101
Glomeruli 116, 127
Glomerulocystic disease, familial hypoplastic 123
Glomerulonephritis
acute postinfectious 101
anti-GBM 103
chronic 97
crescentic 101, 102
rapidly progressive 99, 102
Glomerulosclerosis
diffuse 114
focal segmental 101, 112
Glomus tumor 72, 183
Glossopalatine glands 142, 143
Glucagonoma syndrome 245
Glutaraldehyde fixation 441
Gluten sensitivity enteropathy 191
Glycogen storage 439
Goblet cells 31
Goiter, dyshormonogenetic 343
Gomori's methenamine 32
silver stain 21, 219
Gonadal stromal elements 89
Gonadoblastoma 51, 89
Gonorrhea 87
Gorlin's syndrome 362
Graafian follicle 17
Graft-versus-host disease 199
Gram stain 436
Granular cell
layer 364f
schwannoma 373
tumor 72, 183, 413f
Granulation tissue 166
Granuloma 196, 197
annulare 355
eosinophilic 266
inguinale 19
noninfectious 355
Granulomatosis, allergic 264
Granulosa cell tumor 40, 48, 48f, 50, 89, 475
adult 48, 89
juvenile 48, 49, 89
Graves disease 344, 461
Growth factor system, platelet-derived 452
Growth pattern variants 32
Guillain-Barré syndrome 444
Gynandroblastoma 41, 51, 120
H
Hacek organisms 435
Haemophilus 435
aphrophilus 435
influenzae 443
parainfluenzae 435
Hailey-Hailey disease 359
Hair
follicles, tumor of 460
presence of 18
Hairy cell leukemia 282, 294
Hairy polyp 169
Hamman-rich syndrome 266
Hard palate 159
Hashimoto's thyroiditis 343, 344
Haversian canal system 377f
H-caldesmon 466
Headache 454
Heart
disease
congenital 435
pre-existing structural 435
valves 433
Heck's disease 167
Helicobacter pylori 181
gastritis 184
infection 181
Hemangioma 72, 89, 120, 146
choroidal 463
epithelioid 391
Hemangiomapericytoma 407
Hematolymphoid neoplasms, classification of 282
Hematometra 32
Hematoxyphil bodies 107
Hematuria 99
glomerular 99
Hemicolectomy 186f
Hemiglossectomy 157, 251
specimen, grossing of 157
Hemimandibulectomy 158, 159f
Hemochromatosis 217, 227, 439
Hemolytic disease 226
Hemolytic uremic syndrome 115, 116
Hemophagocytic syndrome 303
Hemorrhage 17, 18, 30, 423
cysts 17
endomyometrium 17
subarachnoid 447
Hemosiderin laden macrophages 39
Henoch-Schönlein purpura 104
Hepatic
carcinomas 465
fibrosis, congenital 229
neoplastic cords 232f
parenchymal tumors 215
resections 215, 216
vein outflow obstruction 227
Hepatitis
acute 220
autoimmune 222
B surface antigen 221
C virus 301
chronic 221
Hepatoblastoma 232, 428
Hepatocellular carcinoma, primary 218t
Hepatorenal syndrome 100
Herpes gestationis 357, 360
Herpes simplex 19
encephalitis 443
infection 20
Herpes virus 301
Hibernoma 398, 401
Hidradenitis suppurativa 352
Hidradenocarcinoma 368
Hidradenoma 368
papilliferum 368
Hidrocystoma 368
Hilar mass 263
Hilar sinus 421
Hilus cells 51
Hirschsprung's disease 424
Histiocytoma
benign fibrous 72, 372t
fibrous 371
Histoplasma 435
capsulatum 445
Hobnail cell 28
change 31
metaplasia 31
Hodgkin's cells 300
Hodgkin's disease 299, 300
Hodgkin's lymphoma 146, 283, 299301, 302t, 303, 307, 468f
classical 283, 300
Homer-Wright rosettes 424
Honeycomb lung 265
Hormone 465
receptor
status 325
scoring systems for 326
syndromes, ectopic 245
Howship's lacunae 377
Human chorionic gonadotropin 13, 90
Human immunodeficiency virus 444
infection 105
Human leukocyte antigen 111, 281
Human papillomavirus 19, 71, 167
Hunner's cystitis 134
Huntingtons’ disease 455, 456
Hürthle cell
neoplasm 342
variant 340
Hyaline fibromatosis, juvenile 405
Hyaline thrombi 107
Hyaluronic acid 148
Hydatid cyst 99, 228
Hydatid disease 446
Hydatidiform mole 33, 52
Hydroa vacciniforme 299
Hydrocele 87
Hydrocystoma 460
Hydronephrosis 100
advanced 99
Hydropic abortus 52, 52t
Hydrosalpinx 18
Hyoid bone 249, 252
Hyperbilirubinemia
conjugated 226
hereditary 226
unconjugated 226
Hyperemia 197
Hypereosinophilic syndrome 198
Hyperestrinism 51
Hyperglycemia 220
Hyperkeratosis 16, 19, 167
epidermolytic 19
Hyperkeratosis, focal epithelial 167
Hyperlipidemia 401
Hyperparathyroidism 346, 382
familial idiopathic 346
secondary 347
tertiary 347
Hyperplasia 33, 34, 135
adenomatous 218
atypical adenomatous 269
atypical endometrial 33, 34, 34t
atypical lobular 318f
benign prostatic 77
crypt 191
diffuse 343
fibromuscular 182
flat 135
florid follicular 304
focal nodular 230, 232
inflammatory papillary 166
non-atypical 32
papillary 342
reactive 460
simple 33
atypical 7, 3234
Hyperplastic polyps 178, 200
microscopy of 200
Hypertension 220
malignant 100, 118
uncontrolled severe 100
Hypertriglyceridemia 220
Hypertrophy
cardiac 439
congenital 203
left ventricular 439
right ventricular 439
Hypocellular upper dermis 19
Hypochlorhydria 178
Hypogammaglobulinemia 193
Hypoglycemia 245
Hypopharyngeal wall lesions 164
Hypopharynx 161
Hypophosphatemia 382
Hypospermatogenesis 88
Hypotension, sudden 446
Hypoxia 446
Hysterectomy 3
radical 3
simple 3
total abdominal 3
I
Iliac nodes, common 56, 62
Immature teratoma 46
grading of 46
Immunofluorescence 102, 104, 108, 111, 117
microscopy 100
Immunoglobulin components 465
Immunohistochemistry 26, 175
In situ adenocarcinoma 27
In situ anaplasia 195
Infarction, hemorrhagic 144
Infection 173, 226, 301, 442
bacterial 352
modes of 118
sites of 442
Infectious disease 444
Infective endocarditis, ring abscesses in 436f
Inferior vena cava 421
Infertility 87
Inflammation 19, 197, 460
acute 442
interstitial 110
Inflammatory infiltrate, mild 167
Infundibulum 5
Inguinal lymph node 70
dissection 71
Insulinomas 245
International Federation of Gynecology and Obstetrics 35
staging for
carcinoma of cervix uteri 57
endometrial carcinoma 62
fallopian tube 68
ovarian malignancy 66
International Society of Gynecological Pathologist's Classification of Endometrial Epithelial Metaplasias 30
International Society of Nephrology 108t
International Society of Urologic Pathology 80
and World Health Organization 80
Interstitial fibrosis
diffuse 264
severe 265
Interstitial pneumonia 265
nonspecific 265, 266
Interstitium 127
Intestinal endoscopic biopsies, reporting of small 210
Intestinal mucosa, ulceration of large 190
Intestinal polypeptide, vasoactive 245
Intestine 472
large 185, 189
small 185, 189, 211
Intracystic papillary carcinoma 323
Intradermal nevus 460
Intraepidermal bullae 359t, 360t
Intraepithelial lesion, stratified mucin producing 24
Intraepithelial neoplasia 205
Intraluminal acid mucin 79
Intratubular germ cell 422
neoplasia 89
neoplasm 91
Intra-urothelial neoplasia
high-grade 135
low-grade 135
Invasion
depth of 61
maximum depth of 55
Invasive lobular carcinoma, classic 320
Invasive mole 53
Invasive squamous cell carcinoma, early 23
Iris 463
Iron deficiency anemia 182
Ischemic colitis, types of 196
Islet cell tumors 244
Isospora belli 193
Isthmus 1, 5
Ivor-Lewis procedure 171
J
Jaw, osteosarcoma of 389
Jiroveci pneumonia 297
Johnson's score 88
Jones Methenamine silver stain 115
Junctional nevus 366, 460
Juxtaglomerular apparatus 100
K
Kaposi's sarcoma 72, 168, 183, 301
Karyorrhexis 106, 110
Keratin 475
Keratinizing 23
Keratoacanthoma 364, 460
multiple 365
Keratoconus 462
Keratosis 8, 19, 167
actinic 357, 363
Keratotic lesions 461
Kidney
bilateral large 98
biopsy 125
clear cell sarcoma of 424
cystic disease of 122
cysts of 122
disease 123
sporadic glomerulocystic 123
dysplastic 14
grossing of 95
large 97
neoplasm 151
normal-sized contracted 98
polycystic disease of 100
rhabdoid tumor 424
small contracted 97, 98
tumors, classification of 423
WHO classification of tumors of 120t
Kikuchi's lymphadenitis 301
Kikuchi-Fujimoto disease 301
Kimmelsteil-Wilson nodules 115
Kimura's disease 303
Kingella species 435
Klinefelter's syndrome 88
Klippel-Trenaunay syndrome 412
Knodell's score 221
Koilocytosis 19, 21, 24
Kraurosis vulva 19
Krukenberg tumor 18, 50
Kupffer cell activation 225
Kuttner's tumor 143
L
Labia
majora 18, 20
minora 18, 20
Lamina propria 167, 181, 191
papillae of 174
Laminar endocervical glandular hyperplasia, diffuse 22
Langerhan's cell 303
histiocytosis 380, 385
Langhans giant cells 87, 264, 301
Large B-cell lymphoma 282, 291
Large cell
acanthoma 357
calcifying sertoli cell tumor 89
carcinoma 268, 271, 272
lymphoma 255
anaplastic 298
neuroendocrine carcinoma 23, 120, 272
variant 425
Laryngeal framework 249
Laryngeal surfaces 248
Laryngectomy specimen, total 253
Laryngoscopic biopsies 251
Larynx 248, 256
grossing of 251
infections 256
Legg-Perthes disease 383
Leiomyoblastoma 38
Leiomyoma 32, 38, 72, 120, 183, 398
epithelioid 38
hemorrhagic cellular 38
metastasizing 32, 33
mitotically active 38
schwannoma like 38
venign metastasizing 38
Leiomyomata 17
Leiomyomatosis
diffuse 32
hereditary 120
intravenous 32
Leiomyomatous submucosal polyp 17
Leiomyosarcoma 24, 32, 38, 39, 61, 120, 474
Lentigo simplex 357
Lepidic cell 440
Lepidic growth 269
Lepidic predominant invasive carcinoma 471t
Leprosy 352
lepromatous 353
reactions 354
Leptospirosis 226
Lesion
extracellular 456
exudative 115
intraocular 462
malignant 177, 240
multiplicity of 218
non-neoplastic 86, 186, 381, 393
patchy distribution of 191
pathologic 312f
precursor 257, 319
premalignant 175, 183, 233
purulent 443
red velvety 167
size of 8
Leukemia 33, 282, 461, 472
acute lymphoblastic 467
antigen, acute lymphoblastic 284, 467
chronic lymphocytic 287
derivation 284
Leukocyte
antigens 465
infiltration 110
Leukoplakia 19, 70, 167
homogenous 167
Lewy bodies 456
Leydig cell 48, 50, 51, 88, 89
hyperplasia 88
tumor 89
malignant 89
Lhermitte-Ducklos disease 448
Libman Sacks endocarditis 438f
Lichen planus 19, 356, 357
erythema multiforme 357
Lichen sclerosis 19
et atrophicus 19
Lichen scrofulosorum 352
Lichen simplex chronicus 19
Lichenoid keratosis 167
Li-Fraumeni syndrome 384, 448
Limb 402
lower 378
upper 378
Lingual glands 142
Lip 156
biopsies 156
bits 156, 157
drains, lower 156
excision 156
lymphatic drainage of 156
Lipid cell tumors 51, 475
Lipid metabolism, disorders of 227
Lipoadenoma 345, 398
Lipoid nephrosis 111
Lipoleiomyoma 38
variant 32
Lipoma 398, 401
like tumor 99
pleomorphic 398, 402
Lipomatosis 401
Lipoproteins 220
Liposarcoma 39, 402, 404
pleomorphic 402, 403, 403f
subtypes 402
Listeria monocytogenes 443
Liver 215, 217, 232
abscess, amebic 229
biopsy interpretation 218
microscopy 219
cysts of 228
disease, alcoholic 217, 219
hemosiderin lipofuscin, pigments in 228t
tumors 421
classification of 422t
Lobular carcinoma 151, 311, 320f
Lobular carcinoma in situ 317
Lobules, cancerization of 317
Loop electrosurgical excision procedure 2
Lucio reaction 354
Lugol's iodine 172
application of 172
Luminal ductal cells 146f
Luminal epithelium 324
Lung 261
adenocarcinoma of 471t
biopsy 276
carcinomas 470
cystic conditions of 267
disease, interstitial 265
parenchyma 263
primary adenocarcinoma of 270, 270t
resection for tumor 262
small cell carcinoma of 273t
tumors
classification of 267
TNM staging of 277
Lupus anticoagulant 110
Lupus nephritis 110
classification of 108t
clinically silent 100
diffuse 108
focal 108
modified WHO classification of 107
original WHO classification of 107
Lupus vulgaris 352
Lutein cells 51
Lyme disease 438
Lymph node 68, 172, 238, 254, 279, 303, 311, 391, 423
dissection 280
enlarged 281
largest 71
levels of 157f, 312f
normal anatomy 279
regional 84, 93, 140, 277, 280, 334, 349, 374, 375, 394, 419, 432
retroperitoneal 422
secondary in 304
single 279
spleen and thymus 281
Lymphadenitis, dermatopathic 303
Lymphadenoma 146
Lymphadenopathy 281
massive 303
Lymphangiectasia 190
intestinalis 193
Lymphangioma 72, 120, 240
Lymphatic circulation 250
Lymphedema 226
Lymphocyte 87, 191, 353, 437
depletion 300
intraepithelial 190, 191
rich 300, 305
Lymphocytic lymphoma, small 287
Lymphocytic thyroiditis, subacute 344
Lymphoepithelial lesion, benign 461
Lymphoepithelioma 23, 72
Lymphogranuloma venereum 19, 305
Lymphoid 24, 33
aggregates 197
cells 255
interstitial pneumonia 265, 266
tissue 161
mucosa-associated 289
tumors 135
Lymphoma 72, 175, 183, 205, 206, 240, 281, 282, 297, 301, 391, 449, 472
angioimmunoblastic 297
derivatives 285t
extranodal marginal zone 289
follicular 89, 292, 293t
lymphoblastic 296
lymphocytic 287f
lymphoplasmacytic 288
malignant 24, 33, 205, 320, 390, 461, 468
splenectomy for staging 281
Lymphoproliferative disorder 299
post-transplant 283
Lymphoreticular
invasion 61
system 279
M
Macchiavello's stains 436
Macronodular cirrhosis 217
Macroscopy 63, 64, 67
Madura foot 354
Madurella grisea 354
Madurella mycetomatis 355
Maffucci syndrome 384, 385, 412
Malakoplakia 87, 134, 343
Male breast, tumor of 320
Malformation, arteriovenous 447
Mallory's hyaline 220
Malt lymphoma 268, 282
Mammary dysplasia 312
Mandibulectomy
marginal 158
middle 158, 159f
partial 158
Mantle cell 285
lymphoma 288
development 289f
Masson's hemangioma 169
Masson's trichrome 434
Massons’ bodies 266
Mast cell neoplasm 307
Mastectomy 310f, 331
Mastitis 313
acute 314f
chronic 313
granulomatous 313
Maxillectomy 159
McCarty's H-scoring system, modified 326
McCune-Albright syndrome 384
Medullary carcinoma 99, 243, 320, 343
Medullary cystic disease 122
complex 122, 124
Medullary sponge kidney 123, 124
Medulloblastoma 449, 451, 454
Meibomian gland carcinomas 461
Meig's syndrome 50
Melanoacanthoma 357
Melanocytic lesions 72
Melanocytic nevi 366, 461
congenital 367
Melanocytic tumor 24, 134, 365, 449
Melanoma 20, 467
choroidal 463
malignant 17, 176, 365, 366, 416, 463
of soft parts, malignant 416
Melanosis, congenital oculodermal 461
Melanotic paraganglioma 33
Melanotic schwannoma 400
Melignant melanomas 463
Melkersson-Rosenthal syndrome 167
Membranoproliferative glomerulonephritis 101, 104
types of 105t
Membranous
glomerulonephritis 101, 113
lupus nephritis 108
Menetrier's disease 178, 182
Meninges 441
Meningioma 449, 451, 454
Meningitis, bacterial 442
Meningomyelocele 14
Menstrual cycle, normal 29
Mental retardation 423
Merkel cell carcinoma 373, 472
Mesangial cells 100
Mesangial hypercellularity 101
Mesangial lupus nephritis, minimal 108
Mesangial matrix 127
Mesangial proliferative lupus nephritis 108
Mesangial sclerosis, diffuse 113, 114
Mesangiocapillary glomerulonephritis 104
Mesenchymal chondrosarcoma 387
Mesenchymal neoplasms 414
Mesenchymal tumor 24, 32, 33, 72, 76, 120, 134, 175, 183, 205, 206, 234, 240, 268, 449, 461
benign 234
malignant 33, 72, 234
Mesoblastic nephroma 123, 424
Mesoderm 39
Mesodermal tumors, malignant mixed 35
Mesonephric duct rests 22
Mesothelioma 274, 275f, 275t
conventional peritoneal 42
malignant 274
Metabolic disorders 226, 227
Metabolic liver diseases 227
Metanephric adenofibroma 120
Metanephric adenoma 120
Metanephric stromal tumor 120
Metanephric tumors 120
Metaphyseal fibrous defect 391, 393
Metaplasias 20, 30, 182
apocrine 314f, 324
ciliated 31
endometrial 30
eosinophil 31
intestinal 31, 182, 182t
transitional 20
Metaplastic cells, eosinophilic 42
Metastasis 394
sites of 53
Metastatic cancer 41
Metastatic carcinoma 29, 218, 218t
Metastatic colorectal
adenocarcinoma 270t
carcinoma 270, 471t
Metastatic disease 422, 431, 463
Metastatic neoplasms 455
Metastatic neuroblastoma 389
Metastatic nodule 423
Metastatic tumors 72, 77, 120, 320, 450
Methenamine silver stain 436
Methyl green pyronin 434
Methysergide 439
Meyenburg's complexes 229
Michaelis Gutmann bodies 87
Microcystic adenoma 241
Microcystic adnexal carcinoma 368
Microcystic serous adenoma 239
Microglandular hyperplasia 22, 28
Microglial nodules 444
Microgranulomas 196
Microinvasive carcinoma 20, 26, 55
Microsporidium 190
Mikulicz's disease 461
Mikulicz's syndrome 461
Miliary tuberculosis 264
Miliary white nodules 189
Minimal change disease 101, 111, 112
typical of 112
Mitoses 81
Mitotic activity 440
Mitral stenosis, setting of 437
Mitral valve surface 436f
Molar pregnancy 33
Mole, partial 52, 52t, 53
Molecular classification 451
Molluscum bodies 352
Molluscum contagiosum 352
Mongolian spot 367
Monodermal teratoma 43, 89
Mons pubis 18
Mouth, floor of 158
Mucha-Habermann disease 167
Mucin cells 31
Mucinous
adenocarcinoma 23, 32, 36, 40, 81, 152, 243
borderline tumor 40
carcinoma 368
pure 321
cystadenocarcinoma 89, 241
cystadenoma 89, 241
ovary 43f
cystic neoplasms 241
metaplasia 30, 31
tumors 18, 40, 43, 474
Mucocele, extravasation 166
Mucoepidermoid carcinoma 149, 175
Mucosa, hemorrhagic 133
Mucosal atrophy 197
Mucosal deep fissures 189
Mucosal prolapse syndrome 200
Mucous membrane 159
Mucus nodules 1
Mullerian ducts 41
Müllerian epithelium 20
Müllerian origin 43
Müllerian papilloma 23
Müllerian system 41
Müllerian tumor 465
malignant mixed 17, 24, 39, 40, 61, 474
mixed 28
Multicentric carcinoma 324
Multicystic dysplasia 123
Multicystic dysplastic kidney 123
Multicystic kidney 123
Multicystic renal dysplasia 99
Multifocal carcinoma 324
Multifocal cystic change 123
Multilayered epithelium 24
Multilocular cyst 122, 123
Multinodular
goiter 336
mass 406
Multiple malformation syndrome 123
Multiple myeloma 294
Multiple neoplasia syndrome 417
Multiple nodules 263
Multiple osteochondromas 384
Multiple papillae 133
Multiple papillomas 322
Multiple pouches 190
Multiple schwannomas 417
Multiple superficial erosions 178
Multiple system atrophy 455
Multipotential cells, carcinoma of 20
Mumps 87, 144
Muscle tumor, smooth 32, 33, 399, 410
Muscular dystrophy 439
Muscularis mucosa 174
Mycetoma 354
Mycobacteria, atypical 305
Mycobacterium avium 190, 193
Mycoplasma 31
Mycoses
fungoides 299
superficial 354
Mycotic infections 445t
Myelodysplastic syndrome 228
Myeloid sarcoma 89
Myeloma 391
asymptomatic 294
staging system 307
Myocarditis 438
drug-related 439
hypersensitivity 439
lymphocytic 438
signs of 438
symptoms of 438
Myocardium 434, 437, 438
Myoepithelial
carcinoma 148
cells 151, 317, 467
Myoepithelioma 144, 145, 148
Myoepithelium 324
Myofibroblastic
sarcoma, low-grade 407
tumor 399, 404, 408
Myofibroma 411
Myofibromatosis 411
Myogenic tumors 384
Myogenin 412, 466
Myoglobin 412
Myointimoma 72
Myolipoma 401
Myometrial invasion 36, 53
Myometrium 17, 59, 62
Myositis ossificans 404
Myxofibrosarcoma 409
Myxoid 32
liposarcoma 403
variant 32
Myxoinflammatory fibroblastic
sarcoma 407
tumor, atypical 407
Myxoma 413
cardiac 439
cells 439
N
Nabothian cysts 55
Naegleria fowleri 446
Naegleriasis 446
NAME syndrome 417
Napkin ring stricture 190
Nasopharyngeal
angiofibroma 256
carcinomas 255
Nasopharynx 160
Nausea 454
Neck dissection
modified radical 254
standard radical 254
Necrobiosis lipoidica 355
Necrosis, severe 222
Needle biopsy 75, 85, 95
routine 125
Neisseria gonorrhoeae 31, 86
Neonatal cholestasis 225
Neonatal hepatitis 225, 226
syndrome 225
Neoplasia 97, 184
invasive 184
noninvasive 184
Neoplasm
benign 257
papillary 323f
cystic 7, 133
follicular 341
hematopoietic 384
invasive 135
thecoma fibroma group of 49f
Neoplastic
cells 150f, 244f
cysts 229
lesions 52, 188, 312, 393
polyps 202
Nephrectomy 95
partial 95, 96f
radical 96
simple 96
specimen 429
Nephritic syndrome 101
Nephritis, hereditary 111
Nephroblastoma 120, 423
cystic partially differentiated 120, 123
Nephrogenic rests 120
Nephroma
congenital mesoblastic 120
cystic 120, 122, 123
multilocular cystic 122
Nephronophthisis 124
juvenile 122
Nephrosclerosis 118
benign 97, 118
Nephrosis, congenital 123
Nephrotic syndrome 101
congenital 113
familial 123
idiopathic 99
Nephroureterectomy 96
Nerve sheath tumor 400, 412
malignant peripheral 24
Nerve tumors, peripheral 168
Nesidioblastosis 244
Neural tumors 371
Neurenteric cysts 173
Neuroblastic tumor 427f
stroma-poor 425
Neuroblastoma 423426, 472
grading of 426
peripheral 470
staging of 431
stroma-rich 425
Neurodegenerative diseases 455
Neuroectodermal tumor 33
Neuroendocarcinoma, small cell 271
Neuroendocrine
carcinoma 28, 258, 467
small cell 120, 255
cell hyperplasia, diffuse idiopathic 271
cervical carcinomas 28
neoplasms 175, 183, 204, 205, 240
tumor 23, 120, 134, 206, 257, 268, 271
well-differentiated 89, 120
Neuroepithelioma, peripheral 470
Neurofibroma 72, 372, 400
Neurofibromatosis 384, 417
Neutrophils 30, 31
Nevus
cells, type C 367
compound 366, 460
of Ito 367
of Ota 367, 460, 461
Niemann-Pick disease 225, 227
Night sweats 412
Nipple
depressed 312
eczema 312
tumor of 320
NK cell lymphoma 256
Nodes, number of 71
Nodular appearance 133
Nodular cystic hyperplasia 32
Nodular diabetic glomerulosclerosis 114
Nodular fasciitis 404
Nodular hyperplasia 75, 343
diffuse 230
Nodular pleura 263
Nodular regenerative hyperplasia 218, 230
Nodular sclerosis 300
Nodular ulcerating growth 71
Nodule 230, 282
endometrial stromal 32
regenerative 231
Nonchoriocarcinomatous trophoblastic tumors 89
Nonepithelial tumors 65, 205
Non-Hodgkin's lymphoma 204, 288, 288f, 292, 307
Noninvasive papillary urothelial carcinoma, high-grade 136
Non-lipogenic sarcoma 404
Nonmeningothelial tumors 449
Nonpolyposis colon cancer, hereditary 204
Nonseminomatous tumors 46
Non-squamous solid pattern 31
Notochordal tumors 384
Nottingham prognostic index 325
Nuclear
pleomorphism 145, 325
proliferation antigens 465
pseudoinclusions 340
raisins 19
Nuclei 324
Nut carcinoma 168, 256, 272
O
Oat cell carcinoma 258
Obliterative endarteritis 87
Obstruction, extrahepatic 226
Occasional cysts 98
Odontogenic tumors 168
Olfactory neuroblastoma 255
Oligoastrocytoma 453
Oligodendroglial tumors 453
Oligodendroglioma 453
anaplastic 453
variants of 453
Oligohydramnios 11
Olive tumor 177
Ollier's disease 384, 385
Oncocytic carcinoma 148, 244
Oncocytoma 120, 121, 144, 145, 148
Oncofetal antigen 465
Oncoproteins 465
Opportunistic infections 444
Oral cavity 156, 169
Oral intra-epithelial neoplasia 167
Oral mucosal papillomatosis 339
Oral squamous cell carcinomas 168
Orbit 458
Orcein stain 219
Orchidectomy specimen 85
Orchitis 86
autoimmune 87
granulomatous 87
Orepuce 70
Oropharyngeal wall 161
Oropharynx 156, 160, 161, 169
Osteiod osteoma 387
Osteoblastoma 388
aggressive 388
diagnosis of 390
Osteoblasts 376
Osteochondroma 385
Osteochondromyxoma 385
Osteoclast 377
rich osteosarcoma 393
stimulating factor 377
Osteoclastoma, grading of 391
Osteocytes 376
Osteogenesis imperfecta 14, 381
Osteogenic sarcoma 388, 391
small cell 390
Osteogenic tumors 384
Osteoid tumors 387
Osteoma 387
Osteomalacia 381
Osteoporosis 382
Osteosarcoma 39, 120, 388, 389, 423
diagnosis of 390
juxtacortical 389
small-cell 472
Ovarian carcinomas 465
Ovarian disease 40
Ovarian fimbria 5
Ovarian follicle 39
Ovarian tumors 7, 422
bilateral 18
cystic 18
solid 18
WHO classification of 40
Ovary 3, 4, 6, 8, 17, 32, 39, 6365, 67, 68, 423
cyst of 17
malignant tumor 18
normal anatomy 4
solid carcinoma of 49
Overgrowth syndrome 417
Overlap disease 223
Owl's-eye 444
Oxyphil 31
cell variant 340
Oxyphilic adenoma 144, 345
P
Page's criteria 316
Paget's disease 20, 72, 312, 368, 382, 389
extramammary 369
polyostotic 389
Pain abdomen 197
Palate, soft 161, 162
Palatine glands 142
Palatine tonsils 161
Pancellular dysplasia 195
Pancreas 237, 238, 469
annular 239
cysts of 239
edematous 239
endocrine tumors of 244
exocrine tumors of 241
giant cells tumor 243
Pancreatic biopsies 237
Pancreatic endocrine tumors 245
Pancreatic intraepithelial neoplasia 239, 240t
Pancreatic pseudocysts 239
Pancreatic tumors, WHO classification of 240
Pancreaticoblastoma 244
Pancreatitis 239
Pancytokeratin positive 148
Paneth cell metaplasia 194
Papillary
adenocarcinoma 243, 270
adenoma 99, 120
basaloid carcinoma 72
Papillary carcinoma 72, 324t, 339
hemithyroidectomy for 337f
invasive 323f
low-grade 136f
noninvasive 136
solid 323
thyroid 469
variants of 340
Papillary cystadenoma lymphomatosum 147
Papillary endothelial hyperplasia, intravascular 169
Papillary epithelial neoplasm 242
Papillary fronds 41
Papillary lesion 319, 322
single 133
Papillary mesothelial hyperplasia 42
Papillary neoplasm 135, 136f
Papillary proliferation 31
Papillary renal cell carcinoma 120, 131
Papillary serous carcinoma 27, 36
Papillary squamous cell carcinoma 72, 168, 257
Papillary syringadenoma 370, 460
Papillary tissue, confluent 133
Papillary urothelial
hyperplasia 136
neoplasm 136
Papilllary mesothelial hyperplasia 43
Papilloma 268, 323f
benign 324t
intraductal 149, 241, 323, 323f
solitary adult 257
Papillomatosis 21
Papulonecrotic tuberculid 352
Para-aortic nodes 57, 62
Paraganglioma 258
Paraglottic space 250
Parakeratosis 16, 19
Paralysis
glomerular 116
infantile 444
Paramyxoma virus 144
Paranasal sinuses 258
Paraspinal nerve, tumor of 449
Parathyroid
adenoma 345, 347t
variants of 345
carcinoma 346, 347t
gland 336, 338, 344
hyperplasia 345
Parenchymal tuberculomas 443
Parkes-Weber syndrome 412
Parkinson's disease 455, 456
Parosteal osteosarcoma 389
Parotid glands 142
Parotid salivary gland 142
Peau d'orange appearance 312
Pediatric cystic nephroma 120
Pediatric neoplasms 420
Peliosis hepatis 228
Pelvic
exenteration 7
lipomatosis 401
lymph nodes 8
nodes 56, 62
peritoneum 32
Pelvis 97
Pelviureteric junction 97
Pemphigus
familial benign 359
foliaceous 356, 358
vulgaris 360
Penectomy specimens 70
Penile carcinomas, TNM clinical staging for 74
Penile intraepithelial
neoplasia 72
Penis 70
plastic induration of 71
WHO classification of tumors of 72
Peptic ulcer 176, 180
chronic 179t
Pergolide mesylate 439
Periappendiceal mass 189
Pericardium 437
Pericytic tumors 399, 411
Perinephric abscess 100
Periodic acid silver methenamine 95
Periodic acid-Schiff 11, 20, 147, 280, 436
Periosteal chondroma 383, 385
Periosteal chondrosarcoma 387
Periosteal osteosarcoma 389
Periportal cholestasis 224
Peritoneal implants 42, 47
Peritoneal papillary serous carcinomas 42
Peritoneal reflection 213
Peritoneal surfaces 42
Perityphlitis, ligneous 189
Perivascular tumors 399
Perl's prussian blue stain 267, 434
Peutz-Jegher polyp 182, 201, 205
Peyronie's disease 71
Pharyngeal wall
lesions 164
posterior 162
Pharyngectomy specimens 165
Pharyngoepiglottic fold 161
Pharynx 160
grossing of 162
Phentermine 439
Pheochromocytoma 120, 439
Phimoses 71
Phosphaturic mesenchymal tumor 414
Phthisis bulbi 462
Phyllodes tumor 315
Piecemeal necrosis
mild 222
moderate 222
Pigment-Laden macrophages 440
Pilar sheath acanthoma 369
Pilocytic astrocytoma 448, 453
Pilomatrical carcinoma 368
Pilomatricoma 369, 370, 460
Pilomatrixoma 370f
Pineal gland, tumor of 448
Pinguecula 462
Pinpoint erosions 189
Pityriasis lichenoides acuta 167
Placenta 9, 51
examination of 10
extrachorialis 10
membranacea 10
normal anatomy 9
singleton type of 9
tissue 14
Placental site nodule 23, 33
Plaques, presence of 456
Plasma cell 87, 191, 286, 462
dyscrasias 257
granuloma 343, 407
occasional 437
type 304
Plasmablastic lymphoma 292
Plasmacytoid lymphocyte 286
Plasmacytoma 89, 294
Pleomorphic sarcoma, undifferentiated 416
Pleomorphism 440
Pleura 262
decorticated specimen of 262
tumor of 274
Plexiform fibromyxoma 183
Plexiform fibrous histiocytoma 410
Plexiform neurofibroma 412, 413f
Plump macrophages 437
Pneumoconiosis 266
Pneumonia
acute interstitial 266
cryptogenic organizing 265
desquamative interstitial 265
interstitial 264
Polio 444
virus 444
Poliomyelitis 443, 444
Poliovirus infection 444t
Polycystic appearance 48
Polycystic kidney 14
disease 229
Polycystic liver disease 229
Polycystic multiple follicular cysts 39
Polycystic ovarian disease 17, 40
Polycythemia vera 228
Polyembryoma 46
Polygonal cells, eosinophilic 122f
Polykaryocyte 303
Polyp 33
adenomatous 202
benign endometrial 17
cystic fundic 182
endometrial 17, 32
stromal 17
fibrovascular 173
hamartomatous 182, 200, 201, 204, 205
juvenile 182, 201
serrated 203
Polypectomy specimens 185
Polypoid 188
adenomyoma 33
endometrial carcinoma 17
mass 17
large 178
slender and small 16
small to large 16
variant, atypical 33
Polyposis
intestinal 387
lymphomatous 204
syndrome 178
Polyvesicular vitelline pattern 45
Porocarcinoma 368
Poroma 368
Portal hypertension 228
Portal vein thrombosis 230
Postcricoid carcinomas 165
Posthitis 71
Post-Turp granulomas 78
Pouch of Douglas 8
Pre-Epiglottic space 250
Pregnancy, toxemia of 51
Pressure, intracranial 454
Progerioid syndrome 417
Proliferative fasciitis 404
Proliferative phase, mid 29
Proliferative verrucous keratosis 167
Prominent nucleoli 33
Prostate 75, 467
adenocarcinoma 470
size of 78
specific antigen 75, 78
transurethral resection of 83
WHO classification of tumors of 76
Prostatectomy, radical 76
Prostatic adenocarcinoma, Gleason's microscopic grading 79
Prostatic basal cells 466
Prostatic carcinoma 78, 83
TNM staging for 84
Prostatic glands 79
Prostatic intraepithelial neoplasia 75, 78
high-grade 79
Prostatic needle biopsies 82
Prostatitis 86
acute bacterial 77
allergic granulomatous 78
chronic bacterial 77
granulomatous 77
Prosthetic heart valves 435
Prosthetic valve 435
Protein 376
accumulated and location 455t
C deficiency 228
myogenic regulatory 466
S deficiency 228
Proteinuria 99
non-nephrotic range 99
Proteus mirabilis 118
Protoplasmic astrocytoma 452
Protozoal-giardiasis 193
Psammoma bodies 36
Pseudallescheria boydii 354
Pseudocyst 239
pancreas 239
Pseudoepitheliomatous hyperplasia 368, 460
Pseudoglandular carcinoma 72
Pseudohyperplastic carcinoma 72
Pseudomembranous colitis 197
Pseudomonas 86
Pseudopapillary tumor, solid 242
Pseudotumor 143
inflammatory 407
Psoriasis 19, 356
Psuedomultiple papillomas 322
Pterygium 462
Pulmonary carcinomas 467
Pulmonary chondromas 185
Punch biopsy 1, 132, 162
Putative tumor 452
Pyelonephritis 100, 118
active 100
acute 97, 118
chronic 98, 118
Pyloric metaplasia 182
Pyloric stenosis, hypertrophic 177
Pyogenic granulomas 166
disseminated 412
Pyometra 32
Pyriform sinus 161
cancers 165
Pyrrolizidine alkaloid 228
R
Radial scar, center of 316f
Radical neck dissection, extended 254
Rat placenta, endodermal sinus of 46
Rectal tumors 213
Rectovaginal septum 32
Rectum 8
tumor of 205
Red blood cells 280
Red hyperemic mucosa 133
Reed Sternberg cell 299
Reflux esophagitis 174
Reidel's thyroiditis 344
Renal agenesis, bilateral 14
Renal allograft biopsy 128
interpretation 126
Renal artery aneurysm 100
Renal biopsy 95, 99, 100
Renal carcinomas, TNM staging of 131
Renal cell
carcinoma 99, 119, 120, 123, 467, 470
multilocular cystic 123
tumors 120, 121t
Renal cystic dysplasia 123
Renal disease 115
congenital 123
end-stage 119
Renal failure
acute 99
chronic 100
Renal hematopoietic neoplasms 120
Renal medulla, cystic disease of 124
Renal medullary carcinoma 120
Renal neoplasm 119, 424
multilocular cystic 120
Renal parenchyma 119f, 421
Renal Pathology Society 108t
Renal pelvis, cystic hamartoma of 123
Renal tumor
ossifying 120
resection, adult 130
Renomedullary interstitial cell tumor 120
Resorption lacunae 377
Respiratory
bronchiolitis 265
distress syndrome, acute 265
epithelium 254
system 248, 249
tract
lower 261
upper 248
Restrictive cardiomyopathy 439
Retention cyst 460
Retention mucocele 166
Reticulin around individual cells 50
Reticulin stain 37, 50
Retinal capillary hemangioma 463
Retinal cavernous hemangioma 463
Retinal epithelium 203
Retinal tumors 463
Retinitis 444
Retinoblastoma 417, 423, 427, 463
gross 427
syndrome 384
Retromolar trigone 156, 158, 161
tumor of 163
Retroperitoneum 402
Retrovirus 444
Reye's syndrome 227
Rhabdoid tumor 120, 424
Rhabdomyoblasts 428, 429
Rhabdomyomas 168
Rhabdomyosarcoma 39, 120, 168, 411, 428, 466
alveolar 412, 428, 429
embryonal 411, 423, 428, 429
pleomorphic 412
round cell 472
Rheumatic endocarditis 436
Rheumatic heart disease 438f
Rheumatic vegetations 437
Rheumatoid
arthritis 356, 383
nodules 356
Rhodanine 219
Rickets 381
Riga-Fede disease 167
Rochalimaea henselae 412
Rokitansky's protuberance 18, 47
Rosai-Dorfman disease 89, 281, 303, 450
Rothmund-Thomson syndrome 384
Rotor syndrome 226
Round-cell tumors 472, 473t
Rubeanic acid 219
S
Salivary duct carcinoma 144
Salivary gland 124, 469
classification of tumors of 145
cysts of 145, 145f
major 142
minor 142145
neoplasm, malignant 149
normal anatomy 142
sublingual 142
tumors 257, 268
high grade 152
low grade 152
minor 144
types of 142, 142f
Salmonella typhimurium 199
Salpingo-oophorectomy, bilateral 3
Salpingo-oophoritis, chronic 18, 39
Sampling sinus 421
Sarcoidosis 264, 301, 355
Sarcoma 362
alveolar soft part 416
botryoides 15, 24
endometrial stromal 32, 61, 474
epitheliod 415, 472
high-grade undifferentiated 61
histiocytic 283
pleomorphic 384
unclassified 401, 416
undifferentiated 401, 416
Sarcomatoid carcinoma 29, 72, 243, 268, 272
Scalded skin syndrome, staphylococcal 356
Scanty lymphocytes 264
Scar
radial 315
U-shaped 97
Scarff-Bloom-Richardson grading system 325
Schaumann bodies 264, 355
Scheuer's staging 222
Scheurer system 222
Schiller-Duval bodies 45, 46
Schistosomiasis 446
Schmincke type 255
Schneiderian papillomas 254
Schneiderian respiratory membrane 254
Schwannoma 38, 72, 120, 372, 400
with cystic change 239
Sclerocystic ovaries multiple follicular cysts 39
Sclerosing adenosis 315
Sclerosing cholangitis, primary 223
Sclerosing epitheliod fibrosarcoma 409
Sclerosing lupus nephritis, advanced 108
Sclerosis
amyotrophic lateral 455, 456
glomerular 110
Sclerotic cortex 17
Scrotal skin 70
Sebaceoma 369
Sebaceous
adenoma 146, 149, 369
carcinoma 149, 369, 371
differentiation, tumor with 371
gland
adenoma 460, 461
carcinoma 371
hyperplasia 460
lymphadenoma 149
Seborrheic keratosis 357, 365, 460
Secondary diseases 101
Secretory
carcinoma 35
phase, mid 30
Segmental mandibulectomy 158
Selective neck dissection 254
Sellar region, tumor of 450
Semilunar valves 434
Seminal vesical glands 81
Seminoma 89, 90
classic 90
Sentinel lymph node 312
Septa, fibrous 230
Serous
adenocarcinoma 23, 32
borderline tumor 40
carcinomas 42
cystadenocarcinoma 89
cystadenoma 41f, 89, 241
microcystic adenoma 241
oligocystic adenoma 241
papillary cystadenoma 18
papilloma, surface 18
tumor 18, 40, 41
Serpigenous longitudinal deep ulcers 189
Sertoli cell 48, 50, 88, 89
only syndrome 88
tumor 89
malignant 89
Sertoli-Leydig cell 51
tumors 18, 41,50, 475
Serum antinuclear antibodies 265
Sessile serrated adenomas 203
Sex cord
stromal tumors 40, 48, 51, 89, 475
tumor 33, 41, 51
Sezary syndrome 299
Shigella organisms 199
Shikata orcein stain 219
Shrunken kidneys 100
Sialadenitis 144
acute 144
autoimmune 145
chronic 144
granulomatous 145
Sialadenoma papilleferum 149
Sialoblastoma 152
Sialometaplasia, necrotizing 145, 167
Sigmoidoscopy 197
Signet ring cell adenoma 81, 342
Silicosis 267
Sinus
histiocytosis 303
hyperplasia 303
Sinusoidal ectasia 231
Sjögren's disease 265
Sjögren's syndrome 105, 145, 223, 461
Skeletal muscle tumors 400, 411
Skin 70, 350
common bullous lesions of 356
excision biopsy 350
grossing techniques 350
melanoma 373
microscopy pearls 352
mixed tumor of 369
nonmelanocytic tumors of 374
Peau d'orange appearance 312
punch biopsy 350
shave biopsy 350
Small cell carcinoma, extrapulmonary 28
Sneddon-Wilkinson disease 358
Soft tissue 396
giant cell tumor of 410
leiomyoma of 410
leiomyosarcoma of 411
masses 396
sarcomas, grading of 416
tumors 146, 258, 371, 387, 396
syndrome-associated 417t
TNM staging of 419
WHO classification of 399
Solar keratosis 363
Solitary bone cyst 392, 393
Solitary fibrous tumor 120, 276, 407, 467, 472
Solitary intraductal papilloma 322
Solitary kidney 100
Solitary neurofibroma 398
Solitary nodule in thyroid 344
Solitary polypoid lesion 133
Spermatic cord 86, 402
Spermatocytic
arrest 88
seminomas 90
tumor 89
Spermatogenesis 88
Spherical mass 189
Spinal polio 444
Spindle cell 175, 305, 398, 402
carcinoma 72, 120, 168
eosinophilic 410
nevus 460
pigmented 368
nodule, postoperative 24
Spinocerebellar ataxias 455
Spiradenocarcinoma 368
Spiradenoma 368
Spitz nevus 368, 460
Spleen 280, 282
normal anatomy 280
splenectomy 280
Spongiotic dermatosis 359
Spongy bone, cancellous 377
Squamotransitional carcinoma 23
Squamous cell 273t
carcinoma 20, 23, 24, 26t, 32, 36, 55, 71, 72, 81, 167, 168, 175, 258, 268, 269, 357, 362, 364, 469, 470, 470t, 471t
histological variants of 72
in lung 269f
invasive 352
microinvasive 23
mixed 72
section of 362f
variants of 168
dysplasia 268
islands of 23f
lesions, benign 23
neoplasm 134
papilloma 173, 460
Squamous epithelial cells 362f
Squamous epithelium 363f
nonkeratinized 174
stratified 47f
Squamous hyperplasia 19
Squamous intraepithelial
lesion 19, 24
high-grade 24
neoplasia 23
Squamous metaplasia 11, 20, 30, 31, 55
Squamous papilloma 19, 23, 24, 257
Squamous tumor 23
Staphylococcus aureus 144
Steatohepatitis 227
nonalcoholic 217, 220
primary nonalcoholic 220
Stein-Leventhal syndrome 17
Stellate abscesses 304
Stem cells, hematopoietic 467
Stereotactic core biopsy 330f
Sternocleidomastoid muscle 254
Steroid cell tumors 41
Stomach 176
biopsy histopathology 209
carcinoma resection histopathology 210
normal anatomy 176
polyposis syndrome 178
polyps of 182
Stone, types of 219
Strawberry gallbladder 218
Streptococcus
faecalis 118
pneumoniae 442
Streptomyces somaliensis 355
Stroke 447
hypertensive 447
Stroma 32
endometrial 39
inflammation of 21
Stromal hyperplasia 40
Stromal hyperthecosis 40
Stromal mast cells 405
Stromal reactions, non-neoplastic 22
Stromal sarcoma 28
Stromal tumors 176
common 472
Stromatosis 22
Struma ovarii 41, 47
Strumal carcinoid 47
Subcorneal bullae 358t
Subcorneal pustular dermatosis 358
Subcutaneous 356
Subendothelial hyaline deposits 110
Subependymoma 454
Subepidermal bullae 357, 361t
Subepithelial tissue 461
Submandibular
gland 142, 143
lymph nodes 156
salivary gland 142
Submucosal glands 250
Subtotal hysterectomy 3
Subungual keratoacanthoma 365
Succinate dehydrogenase 467
Sun-burst appearance 388
Suprabasal bullae 357
Supraglottic laryngectomy specimen 252
Supraglottic larynx 248
Supranuclear palsy, progressive 455
Suprapubic prostatectomy 75
Surgery, types of 3, 143
Sweat gland tumors, benign 460, 461
Swollen pancreas 239
Symplastic leiomyoma 38
Symptomatic myeloma 294
Syncytial knots 9
Syncytiotrophoblastic cells 89
Syncytiotrophoblasts 9
Synovial sarcoma 120, 415, 472
Synovioma, benign 409
Syphilis 87
Syringocystadenoma papilleferum 149, 368
Syringofibroadenoma 368
Syringoma 368, 369, 460
Systemic lupus erythematosus 101, 106, 145
T
T cells 437
Tall cell variant 340
Tamoxifen related lesion 32
Tan tumor, solid 144
T-cell
development and maturation 294
leukemia, adult 297
lymphoma 192, 294
enteropathy 298
extranodal 298
generic 297
hepatosplenic 299
lymphoepithelial 297
peripheral 297
mediated rejection 128
acute 128
chronic active 128
Telangiectasia 231
Tenal cysts tuberous sclerosis 123
Tendinous cords 433
Tendon sheath 409
giant cell tumor of 409
Tennis racket 303
Tent’ sign 370
Teratoma 41, 88, 89, 123
cystic 47
malignant 46
mature 86, 90
solid 48
mixed 89
Testicular biopsy 91
Testicular cancer 91, 93
Testis 70, 85, 422
germ cell neoplasia in situ of 91
miscellaneous tumors of 89
WHO classification of tumors of 89
Testosterone 475
Tetralogy of Fallot 14
Thecoma 18, 40, 49, 475
tumor of 89
Thoracotomy 171
right 171
Thrombocytopenia
moderate 100
severe 100
Thrombotic endocarditis, non-bacterial 438f
Thrombotic thrombocytopenic purpura 116
Thymectomy specimen 281
bits 281
Thymic carcinoma 306
Thymoma 305
classification of 305
clinical staging for 306
mixed 305
type
A 305
AB 305
C 305, 306
Thymus 281
needle biopsy 281
normal anatomy 281
Thyroglossal cysts 344
Thyroid 469
adenomas 339
biopsy 347
cancer 339
carcinomas 339
cartilage 250, 251, 252
follicles 290f
gland 336
maltoma of 290f
specimens, types of 336
tumors 339
TNM staging of 349
Thyroidectomy, total 336
Thyroiditis 223, 343, 344
subacute 344
Tissue
components 465
core 219
biopsy 403f
handling 434
surrounding 324
Tongue 157
adenocarcinoma of 152
base of 161
biopsy of 157
geographic 167
hamartomas of 169
lymphatic drainage of 157
ulceration with eosinophilia 167
Tonsillectomy specimen 163
Touch preparations 442
Touton giant cells 410
Toxic
goiter 344
myocarditis 439
Toxoplasmosis 226, 444
Trabecular adenoma 342f
Trabeculated myometrium 17
Transformation zone, large loop excision of 2
Transitional cell
carcinoma 32, 40, 44, 81, 135, 470, 472t
gross features of 137
tumors 40
Transthoracic trucut 261
Trichilemmal cyst 460
Trichilemmoma 370, 460, 461
Trichoblastoma 369
Trichodiscoma 369
Trichoepithelioma 370, 460
Trichofolliculoma 369, 460
Tricholemmal tumor, proliferating 368
Tricholemmoma 369
Tricuspid valve orifice 433
Tropheryma whipplei 193
Trophoblastic
lesions, non-neoplastic non-molar 33
neoplasms 33
tumor 89
placental site 17, 33, 53, 89
Tropical sprue 190, 192
Trypanosoma cruzi 438
Trypsinemia, hereditary 217
Tubal gestation, ectopic 18
Tubal metaplasia 20, 31
Tubal type ciliated columnar epithelium 41f
Tubectomy 5
Tuberculid 352
leprosy 352
Tuberculoma 264, 443
meningeal 443
Tuberculosis 87, 256, 263, 301, 352, 443
endometrial 32
fibrocaseous 264
hyperplastic 199
Tuberculous
abscess formation 443
bronchopneumonia 264
epididymo-orchitis 87
granulomatous inflammation 77
meningitis 443, 443f
ulcer 199
Tuberous sclerosis 417
Tubes 8
Tubo-ovarian mass 18
Tubular adenomas 202
Tubular adenosis 315
Tubular androblastoma 50
Tubular atrophy 110, 128
Tubular carcinoma 368
breast 322
invasive 322f
Tubular diverticulum 189
Tubular necrosis, acute 99
Tubular papillary adenoma 368
Tubules 117, 126
annular 41, 51
Tubulocystic renal cell carcinoma 120
Tubulovillous adenomas 202
Tularemia 305
Tumor 17, 55, 70, 89, 99, 138, 139, 169, 209, 216
adenomatoid 33
adipocytic 399, 401
adnexal 461
anaplasia 423
appendageal 368
astrocytic 448, 451, 453
benign 72, 147, 368, 369, 413
epithelial 145
fibrohistiocytic 372
mesenchymal 33
bilateral 144
borderline 40, 42, 43
bulky polypoid 133
cardiac 439
cartilage 258, 384
cells, pleomorphic 72
chondrogenic 383
clinically indolent 362
cut surface of 7
cystic 18, 120, 143
sebaceous 369
trophoblastic 89
dermoid 203
diameter, maximum 213
differentiation 418
diffuse
astrocytic 448
oligodendroglial 448
dimension 421
embryonal 448
endodermal
sinus 41, 45
stromal 37, 467
ependymal 448, 453
epithelial 23, 32, 76, 175, 183, 205, 206, 232, 240, 267, 319, 384, 460, 474
myoepithelial 319
epitheliod trophoblastic 53, 89
extraprostatic 81
fibroblastic 399, 404
fibroepithelial 320, 362
fibrogenic 384
functional 245
gelatinous 440
glandular 23
gross description of 60
hematolymphoid 76, 89, 146, 258
hematopoietic 33
hemosiderotic fibrolipomatous 414
histiocytic 450
hyalinizing trabecular 339
induced osteomalacia 414
inflammatory myofibroblastic 407
intraocular 463
intraosseous 158
invades serosa 61
involvement 213
jaw resection for 158
juxtaglomerular cell 120
keratinocytic 357
lesions, non-neoplastic 256
like conditions 24
lipogenic 384
lymphohistiocytic 268
malignant 18, 368, 415
mixed 368
masses, white worm-like 17
medullary location of 99
metastasizing benign 147
miscellaneous 24, 51
mixed 368
osseous 378
painful 385
perforation, presence of 213
predisposition syndrome 417
primary 84, 93, 131, 140, 169, 277, 349, 374, 394, 419, 432
secondary 24, 146, 175, 183
solid 7, 18
circumscribed 144
stages, pathological 132
syndromes 384
inherited 373
thecoma fibroma group of 49
type 121
volume 81
Tumoral conditions 96, 97f
Tunnel clusters 22
Turcot's syndrome 203
Twin type placentas 12
Twinning, conjoined 14
U
Ulcer
decubitus 16
flask shaped 190
malignant 179t
region of 196
small superficial 15
transverse 189, 197
types of 196
Ulceration 8, 55
diffuse 190
Ulcerative colitis 194, 195, 197t, 199
chronic active 194
longstanding 194
Umbilical cord, swelling of 17f
Unilocular cyst 229
Urachial carcinoma 134
Ureter 97, 124
long segment of 97
Urethra 70, 137
Urethral
atresia 14
opening 71
Urethritis 86
Urinary bladder 132, 134, 137, 470, 472t
location in 137
TNM classification of 140
Urinary system 95
Urinary tract, classification of tumors of 134
Urothelial neoplasm, noninvasive 134
Urothelial tract 135
Urothelial transitional cell neoplasms 135
Urothelial tumors 134
invasive 134
Uterine cavity 17
length of 4
Uterine segment, lower 1
Uterine smooth muscle tumors 472
Uterus 3, 17, 29, 67
corpus of 32
removal of 3, 8
WHO classification of tumors of 32
Uvula 162
V
Vacuolated cells 401f
Vacuum-assisted biopsy 331
Vagina 8, 32
Varioliform gastritis 181
Vascular disorders 446
Vascular immune deposits 110
Vascular tumors 384, 400, 412, 463
Vasculitis 101
Veno-occlusive disease 227, 228
Ventricular septal defect 14
Verhoeff's stain 316f, 434
Verner-Morrison syndrome 245
Verotoxin-producing escherichia coli 116
Verruca 363, 437
plana 357, 363
plantaris 357, 363
vulgaris 167, 257, 357, 363, 364f
Verruciform xanthoma 169
Verrucous carcinoma 20, 26t, 72, 168, 175, 257, 362, 469
Verrucous keratosis 167
Vessels 127
Vienna classification 175, 183
Villi, measurement of 3
Villoglandular papillary adenocarcinoma 28
Villoglandular variant 32, 35
Villonodular synovitis, pigmented 409
Villous adenomas 202
Villous blunting 191
Vimentin 474, 475
Viral encephalitis 444f
Viral endometritis 32
Viral esophagitis 174
Viral hepatitis 217
Viral infections 167, 352, 444f
acute 443
Virus 19
Visual disturbances 463
Vocal cord polyp with fibrin 257
Voice, deepening of 50
Vomiting 454
von Brunn's cell nests 134, 137
von Hansemann cells 87
von Hippel-Lindau disease 123
von Meyenburg's complexes 229
V-shaped scars 97
Vulva 8, 18, 32
myxoid lesions of 21t
Vulval intraepithelial neoplasia 19
Vulvar dystrophy, chronic 19
Vulvar ulcers 19
Vulvectomy
radical 8, 9
simple 8
types of 8
W
Wagner-Meissner’ corpuscles 372
WAGR syndrome 423
Waldenstrom's macroglobulinemia 288
Waldeyer's ring 288, 307
Wart virus infection 55
Warthin's tumor 143145, 147
Warthin-Starry
silver impregnation technique 19
stain 19
Warty basaloid carcinoma 72
Warty carcinoma 72
Warty dyskeratoma 357, 364
Warty excrescences 71
Water clear variant 345
Watermelon stomach 182
Wedge biopsy 2, 85, 215
Wegener's granulomatosis 167, 264
Weigh placenta 9
Weight loss 412
Werner syndrome 384
Wharton's duct 142, 143
Whipple's disease 190, 191, 193
Whipple's procedure 237
Wilms’ tumor 99, 122, 123, 420, 423, 424, 429
study system 423
Wilson's disease 217, 227
Wireloops 107
Wolman's disease 227
World Health Organization 454
X
Xanthelasma 460, 461
Xanthoastrocytoma, pleomorphic 453
Xanthogranuloma, juvenile 72, 89
Xanthogranulomatous endometritis, diffuse endometrial 32
Xanthoma 178
Xanthomatous degeneration 455
Xerostomia 145
Y
Yolk sac
elements 45, 90
tumor 18, 24, 41, 45, 89, 91, 422, 474
Z
Zeil-Neelsen stain 264
Zellballen pattern 258
Zellweger's syndrome 226
Zinc deficiency 191
Zollinger-Ellison syndrome 182, 183, 245
×
Chapter Notes

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Fundamentals of SURGICAL PATHOLOGY
Fundamentals of SURGICAL PATHOLOGY
Second Edition
Shameem Shariff MBBS MD (Pathology) PhD (Pathology) Formerly Professor and Head Department of Pathology St John's Medical College and Hospital and MVJ Medical College and Research Hospital Bengaluru, Karnataka, India Foreword Harsh Mohan
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Fundamentals of Surgical Pathology
First Edition: 2010
Second Edition: 2019
9789388958967
Printed at
My Parents
Husband, Dr MH Shariff
and my Children, Raheel and Mariam Zeba.
Foreword
I am pleased and honored to have been asked by Professor Shameem Shariff, the author of Fundamentals of Surgical Pathology, to write Foreword for the second edition of her book.
While we are all aware of a few well-known and voluminous reference books in Surgical Pathology which trainees and pathologists consult frequently during sign-outs in surgical pathology, here is a pleasing book on basics of surgical pathology assimilating sufficient ‘must know’ material which may be best summed up as ‘Mini-Surgical Pathology’.
As you open the preliminary pages of the book, you will come across five subheadings under which the author has addressed major aspects of surgical pathology of each system/topic: Grossing Techniques, Gross Pearls, Microscopy and Aids in Diagnosis, Immunochemistry, and Synoptic Reporting and Minimum Datasets. Each of these aspects has been covered adequately, and in a user-friendly manner. Presentation of the text is in simple language, having short sentences or phrases, with bulleted or numerical points and various levels of headings and subheadings, making it easy-to-read and understand quickly, and also helps the user for a rapid review later. The text is beautifully supported by numerous nicely drawn and well-annotated line diagrams, especially on gross anatomical pathology, and photomicrographs of important and common lesions. Wherever required, tables for classification and comparative listing of closely-related conditions have been efficiently used by the author and added recent WHO classification schemes in the revised edition. The format of description of grossing, first detailed, and then short of it (‘Grossing Pearls’), is to let the reader understand the basic concepts first, followed by ‘cherry-picking’ when you concentrate only on the most important facts in each topic. She has accomplished a herculean task of picking-up ‘pearls’ from the ocean of microscopic pathology, listing important microscopic features of the lesions, in a highly user-friendly manner, and supported the same with photomicrographs. These features make the book as a complete and excellent mini-Surgical Pathology. We know that contemporary practice of surgical pathology requires a comprehensive and clinically relevant report, but not necessarily detailed narration; she has achieved this objective by including an edited version of synoptic reports or minimum datasets by checklist format of most of the tumors as recommended by the Royal College of Pathologists or the Directors of Pathology, USA. I feel this is just appropriate for the needs of users in the developing countries and will sensitize young trainees in pathology as well as practitioners in surgical pathology to adopt the abridged checklist format of surgical pathology reports in their sign-outs.
Overall, the content of the book and the style of writing by Shameem Shariff reflect her deep knowledge of the subject, which enabled her to present the matter in such a concise, yet adequate manner. Her writing also shows her clarity of thinking and quality as an exceptionally talented and committed teacher in Pathology; I compliment her on achieving this excellent outcome.
I am sure, users of this book will enjoy reading, learning and practicing basics of surgical pathology and adapted synoptic reporting, as much as I did when I went through it before sitting down to write this foreword.
Harsh Mohan
MD FAMS FICPath FUICC
Former Professor and Head
Department of Pathology
Former Medical Superintendent
Former Professor In-Charge, Academics
Government Medical College and Hospital, Chandigarh, India
President, IAPM, 2008
Editor-in-Chief, IJPM, 2003-2007
Preface to the Second Edition
The second edition of Fundamentals of Surgical Pathology is a fruition of the last few years of untiring effort. I hope this update of first edition, serves to enhance the knowledge of the surgical pathologists, in the current classifications, recent advances and better understanding of the concepts of surgical pathology reporting.
The style of the book has been retained, with sections on how best to deal with specimens while grossing, appearances on gross pathology, microscopic pearls and synoptic reporting with minimum data sets. I have tried to weave a pleasing pattern of inter-relationship between normal anatomy, gross pathology, microscopy, immunohistochemistry and genetic profile of pathologic lesions.
Additional chapters have been added and the result I hope will stimulate all surgical pathologists towards better clarity while dealing surgical specimens and a better reporting format in fulfilling their duty towards patients and clinicians.
The section on microscopy gives features of all surgical lesions commonly encountered in a tertiary care hospital. It gives salient points of differentiation between two entities with similar microscopic morphology, outlined crisply in tabular forms. Data in its entirety is out of scope of this book and is in no way complete, but offers useful hints based on the author's experience in countering problems in routine practice. Photomicrographs of several lesions have been added in this edition and give a lucid picture of the disease entities.
A complete chapter on Immunohistochemistry has been introduced considering its usage in modern practices. This gives details on all antigens with regard to their origin, use on tissues, their positivity in various tumors and the differentiating features of their staining patterns. Immunohistochemistry is a double-edged sword and can do more harm than good if taken out of context of the clinical and morphological setting. The importance of this fact has been outlined.
I shall conclude by saying that investment in knowledge pays the best dividends and hope this small contribution helps surgical pathologists to walk the bridge of uncertainty towards a better knowledge and greater achievements.
Shameem Shariff
Preface to the First Edition
Surgical Pathology is a vital aspect of pathology, which determines patient treatment and well-being. The pathologist's contribution to patient welfare cannot be more aptly emphasized than by the responsibility of giving accurate, precise and comprehensive reports. By comprehensive is not meant voluminous reports but reports, which contain precise data which aid patient management. We are presently in an era of molecular pathology with giant strides being made towards genomic typing of tumors; yet treatment in most hospitals, including tertiary care hospitals is decided on the conventional histopathology reporting and this will I believe prevail for the next couple of decades.
It becomes mandatory that specimen handling, grossing, and microscopic reporting of slides be as standardized as possible in order to send out precise and accurate reports from any histopathology laboratory.
The section on grossing outlines step-by-step how a specimen is to be handled in the laboratory. With several diagrams, it helps the pathologist to systematically examine, cut through the specimen along the optimal planes and take representative bits for section.
Gross Pathology and descriptions are mainly to aid the pathologist in correlating the naked eye appearances of specimens with varied pathological appearances as against their normal morphology. Gross Pearls will be of immense help to the postgraduates.
Microscopy: What the mind does not know the eyes cannot see holds very true for histologic reporting. A thorough knowledge of the microscopic findings in various pathologic lesions goes a long way in the correct interpretation of disease. A pathologist should aim at identifying each and every normal and abnormal cellular detail in every case; and when the report is made, it should appear as a completely solved jigsaw puzzle with clinical features, gross and microscopic blending one with the other to form a complete wholesome. This can be only achieved when one gets acquainted with all cells in the human body—both friends (normal cells) and foes (abnormal and neoplastic cells) alike! Therefore, it is important to keep in touch on a daily basis!
Microscopy: Aids in Diagnosis gives the salient features and points of differentiation between lesions with similar microscopic morphology. It is in no way complete, but offers useful hints based on the authors’ experience with the common lesions encountered routinely in day-to-day practice.
Delivering goods: The ultimate beneficiary of all our efforts is the patient and to convey meaningful histopathology reports, it becomes mandatory to lay down criteria in histopathologic reporting. Core information for proper treatment and management should be conveyed to the treating physician. A uniformity of reporting pattern goes a long way in maintaining standards in histopathology reports. A complete checklist of information to be given should be at hand. This is more meaningful and helps much more than giving descriptive reports in flowery language! The last section Synoptic Histopathology Reporting and Minimum Data Sets outlines the responsibilities of a reporting pathologist in conveying to the clinician all relevant data for patient management. In this regard minimum data sets have been provided for the reporting of all organ systems based on the Royal College of Pathologists criteria as well as The Directors of Anatomic Pathology, America with minor modifications.
Last but not the least, all cannot be excellent pathologists but, what we can strive to achieve is to give correct and sensible information towards health care and avoid grave mistakes which would jeopardize patient welfare.
I hope that this small endeavor helps surgical pathologists, both seniors and juniors in their task of reporting.
Shameem Shariff
Acknowledgments
I would like to thank the faculty members of the Department of Pathology at MVJ Medical College, for their help and support in updating certain sections of this edition—Dr Raja Parthiban, Professor and Head; Dr Shruthi NS, Dr Purvi Mathur, Dr Indrani K, Dr Rashmi, Assistant Professors, and my trainees, Dr Pritha Aggarwal, Dr Hasrath Mohamadi, Dr Sneha Burela, Dr Shobhitha, Dr Hema Priya, Dr Roma Jawane, Dr Najmunnisa, and Dr Sumayya.
I thank Dr Harsh Mohan, formerly Professor and Head, Department of Pathology and Professor In-Charge, Academics; Government Medical College and Hospital, Chandigarh, India, President IAPM 2008, and Editor-in-Chief, IJPM (2003-2007), for having written the Foreword for this edition of the book.
I wish to acknowledge the encouragement, guidance and support of my husband, Dr MH Shariff. His immense patience in bearing with my long hours spent in the writing of this book, and his contribution to oncologic pathology dealt with in the book is deeply appreciated.
I wish to record that the Institutions where I have worked—St John's Medical College and Hospital, Bengaluru, Karnataka, India; Salmaniya Medical Complex and Arabian Gulf University, Bahrain; Royal Hospital (Ministry of Health), Muscat, Oman; MVJ Medical College and Research Hospital, Bengaluru, have been the portals of entry to the vast experience in the field; the knowledge gained has enabled me to fulfill this venture for the benefit of others.
Lastly, I would like to thank Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Ms Chetna Malhotra Vohra (Associate Director—Content Strategy), Mr Ashwani Kumar (Proofreader), Mohd Iqbal (Typesetter), Mr Manoj Pahuja (Graphic Designer) and all the staff of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for their untiring support during these two years.
Introduction
Surgical Pathology is a dynamic and challenging science. The art of being a complete surgical pathologist lies in the realization of a chain of events-receipt of specimen, grossing, microscopic study of the gross bits taken, analysis of clinical data in combination with gross and microscopic findings and the “final diagnosis” which is to be signed out in black and white by the reporting pathologist. Ancillary techniques have always helped but the pressure of adhering to the turn around time to match the clinician's curiosity and patient anxiety have a toll on the surgical pathologist. A meticulous methodology carries a long way in achieving the desired accuracy in diagnosis and the following chapters of this book unfold means of doing the same.
 
GROSSING
Grossing of specimens is a vital area in pathology. It is as important as microscopic interpretation and representative sampling is extremely essential. Surgical pathologists examine specimens routinely and decide what representative areas are to be taken for study under the microscope.
Grossing is an art and the importance of it should be ingrained into a postgraduate student from ‘day one’ of his training course. A knowledge of what needs to be grossed is crucial to the final diagnosis. Tissue appearances both normal and abnormal need to form a mental picture in the pathologist's mind enabling him to read the specimen. Specimens should be easily accessible, and should be examined and re-examined in problematic cases.
 
Prerequisites for ‘Grossing’
 
Methods of Studying Surgical Margins
In case of esophagus, stomach and intestine sections may be taken in two ways:
  1. Enface, with the long axis of the bit running parallel to the cut margin or
  2. Longitudinally, i.e. perpendicular to the margin.
    1. If sections are taken horizontally or enface, microscopic viewing can be done in two ways:
      1. The embedding outer surface is marked with eosin and not India ink, in which case this will not be visualized on the slide. Study the cut surface which has been marked with eosin and embedded, for presence of tumor. Since some of the tissues would have been shaved off while trimming the block, this in truth may not be the actual surgical margin, but may be read as such for practical purposes.
      2. An alternative method is to eosin and embed the cut margin which is apposition to the intestine and study the surface sequentially. If tumor is detected on the first section, further sectioning will ensure whether the tumor is extending up to the actual surgical margin.
        The above method may also be used to study the cut margins of the vaginal cuff in hysterectomy specimens.
    2. If vertical (longitudinal) sections are taken mark the surgical margin with India ink for viewing on the slide.
 
MICROSCOPY
An in-depth knowledge with regard to normal organ histology and its variation is essential in order to appreciate the abnormal. The reporting surgical pathologist should be clear with regard to the gross-naked eye appearance of the representative section under study. In case of any doubt he should call for the specimen and re-examine it in the light of microscopic findings.
All sections should be arranged in serial order of bits taken. Each section should be first examined in low power as this gives a good hint towards the diagnosis, e.g. cystic hyperplasia endometrium, polyps, etc. Only after this, should a detailed high power examination be done. Spend enough time examining each section. Problem sections should be re-examined first thing in the morning when eye fatigue has not set in.
 
HISTOCHEMISTRY AND IMMUNOHISTOCHEMISTRY
Histochemistry and immunohistochemistry (IHC) should be resorted to wherever facility is available and certain reports (as in lymphomas and breast carcinomas) are never complete unless accompanied by IHC results. Every laboratory should have a panel of markers outlined—the first set and the subsequent one if the first set does not help in arriving at a diagnosis. This entails an economical approach, e.g. in a small round cell tumor the first panel could be just an CLA (leukocyte common antigen) and CK (cytokeratin) markers. If this does not yield results then 2nd set could consist of CD99, myogenin/myoD1, chromogranin, etc. IHC should always be interpreted in combination with morphology and never by itself. The importance of histochemistry will only be realized with practise and usage and those who jump the line and resort only to IHC will fail to know what they miss!
 
SYNOPTIC REPORTING
A synoptic report and checklist ensures that the clinician has been communicated on all aspects of a lesion or neoplasm that enables him to give the best possible treatment. The end of every chapter of this book gives a complete checklist and synoptic reporting format for most lesions. Turn around time as per international norms should be adhered to. Copies of reports should always be archived for future retrieval. Digital archiving should always be supplemented by back up. Policies with regard to this and time of maintaining records should be decided by individual institutions and departments.