Renal pathology- QUIZ

Useful for Pathology residents preparing for, NEET-SS/ DM- Oncopathology/ DM Histopathogy, Nephropathology Fellowships, FRCPath- Histopathology, American Board of anatomic and clinical pathology.

 

QUIZ LINK

Posted in Histopathology, Nephropathology

Renal pathology quiz

Renal pathology quiz on 18/06/21

Useful for Pathology residents preparing for, NEET-SS/ DM- Oncopathology/ DM Histopathogy, Nephropathology Fellowships, FRCPath- Histopathology, American Board of anatomic and clinical pathology.

QUIZ will be live on 18/6/20

Meanwhile you may solve the quizzes below.

Posted in Female genital pathology, Histopathology

Difference between PSTT ( Placental site trophoblastic tumor) and Choriocarcinoma- Vascular invasion

Difference between PSTT ( Placental site trophoblastic tumor) and Choriocarcinoma- Vascular invasion

Difference between PSTT ( Placental site trophoblastic tumor) and Choriocarcinoma- Vascular invasion.
🎯📟PSTT – invasion is periphery to lumen.
🎯📟Choriocarcinoma- lumen to periphery.

Posted in Histopathology, Oncopathology

Tips to study for NEET-SS Oncopathology

NEET-SS Oncopathology is an entrance examination conducted once every year in AUGUST -SEPTEMBER

Anyone aspiring to become an Oncopathologist in India is supposed to clear the exam after completion of the primary degree(MD/DNB).

NEET-SS is an entrance examination conducted once every year in AUGUST -SEPTEMBER.  Anyone aspiring to become an Oncopathologist in India is supposed to clear the exam after completion of the primary degree(MD/DNB).   Every year thousands of aspirants attempt the examination. However, there are merely 13 seats for the said course. Hence the competition is high.  Proper planning and the right resources will definitely get you through.     Here is a step wise approach to study for NEET-SS Oncopathology.  Read Robbins pathologic basis of disease thoroughly- cover to cover. Read histotechniques, grossing and staining and revise them from your MD notes    Here are a few very important topics to cover. Choose either Rosai Ackerman or Sternberg to cover these topics based on your comfort. *Gastrointestinal pathology. *Male and female genital. *Salivary gland *Breast and *Thyroid. WHO updates and recent classifications as well as TNM staging. Revise and you are good to go.
NEET-SS Oncopathology study tips

Every year thousands of aspirants attempt the examination. However, there are merely 13 seats for the said course. The competition is high, ever increasing for NEET-SS Oncopathology.

Proper planning and the right resources will definitely get you through”

Here is a step wise approach to study for NEET-SS Oncopathology.

  1. Read Robbins pathologic basis of disease thoroughly- cover to cover.
  1. Read histotechniques, grossing and staining and revise them from your MD notes
  1. Here are a few very important topics to cover. Choose either Rosai Ackerman or Sternberg to cover these topics based on your comfort. *Gastrointestinal pathology. *Male and female genital. *Salivary gland *Breast and *Thyroid.
  1. WHO updates and recent classifications as well as TNM staging.
  1. Revise and you are good to go.

“So many things are possible, just as long as you don’t know they are impossible.”

–Norton Juster

You may join this telegram channel for daily topic wise Mcqs for DM oncopathology- Pathology mcqs

For weekly multiple choice questions based on the pattern of NEET-SS oncopathology. You my check this site- HOME – Pathology for all

Join the Facebook page for daily questions- Pathology mcq

Hope you found this useful.

Posted in Histopathology, Staining

VITAL, SUPRAVITAL AND INTRAVITAL STAINING

Vital, supravital and intravital staining are three different types of staining techniques. However, vital and supravital terms are often used interchangeably.

Let’s look at some of the major differences in staining between the three and why these terms shouldn’t be used interchangeably.

1. VITAL STAINING

1.Contrary to the name, vital stains are taken up by dead cells and not by living  cells.


2. Demonstration of  nuclear staining using a vital stain signifies cells death, because living cells are impermeable to the stain.


3. Example: Tryptan blue and propiodine iodine

VITAL STAINS ATE TOO BULKY OR TOO CHARGED THEY CANNOT ENTER LIVE CELLS- Hence only stain dead cells.

Vital, supravital and intravital staining are three different types of staining techniques. However, vital and supravital terms are often used interchangeably.  Let’s look at some of the major differences in staining between the three and why these terms shouldn’t be used interchangeably.  1. VITAL STAINING  1.Contrary to the name, vital stains are taken up by dead cells and not by living  cells.   2. Demonstration of  nuclear staining using a vital stain signifies cells death, because living cells are impermeable to the stain.   3. Example: Tryptan blue and propiodine iodine  VITAL STAINS ATE TOO BULKY OR TOO CHARGED THEY CANNOT ENTER LIVE CELLS- Hence only stain dead cells.   VITAL STAINS 2. SUPRAVITAL STAINS  1. Supravital staining is a method of staining used in microscopy to examine living cells that have been removed from an organism.  2. Those that enter and stain living cells are called supravital stains     3. Examples New Methylene Blue and Brilliant Cresyl Blue for reticulocyte staining.   Reticulocyte stained SUPRAVITAL stain 3. INTRAVITAL STAIN  1. Intravital staining of living cells is done by injecting the dye into any part of the animal body (either intravenous, intraperitoneal or subcutaneous), producing specific coloration of certain cells, particularly those of the reticulo-endothelial system.  2. Common dyes used are lithium, carmine and India ink.
Vital stains

2. SUPRAVITAL STAINS

1. Supravital staining is a method of staining used in microscopy to examine living cells that have been removed from an organism.

2. Those that enter and stain living cells are called supravital stains

3. Examples New Methylene Blue and Brilliant Cresyl Blue for reticulocyte staining.

Reticulocyte stained SUPRAVITAL stain

3. INTRAVITAL STAIN

1. Intravital staining of living cells is done by injecting the dye into any part of the animal body (either intravenous, intraperitoneal or subcutaneous), producing specific coloration of certain cells, particularly those of the reticulo-endothelial system.

2. Common dyes used are lithium, carmine and India ink.

There you go!! Hope the confusion is cleared.

For multiple choice questions on staining

Check below for a quick summary.

Posted in Histopathology, Microbiology

Some gastrointestinal pathogens and their differentiating features.

Gastrointestinal pathogens are very common in routine practice. It takes experience and keen observation to differentiate gastrointestinal pathogens from one another. In case of confusion, go with your ‘GUT’ feeling.

Lets look at a few differentiating features of Giardia lamblia, Cryptosporidium parvum and Isospora belli.

  1. GIARDIA LAMBLIA:

Pear shaped trophozoites with 2 ovoid nuclei, present in the luminal surface. They are 10-15 microns in length and 5-9 microns in width.

GIARDIA IS SEEN IN THE LUMINAL SURFACE

CRYPTOSPORIDIUM IS SEEN ATTACHED TO ENTEROCYTES LIKE SMALL BEADS.

2. CRYPTOSOPORIDIUM PARVUM

In tissue biopsies, 2 – 5 μm basophilic round bodies are seen protruding from the apex of enterocytes (“blue beads”) within the cell membrane. Parasites bulge out of apex of epithelial cells

ISOSPORA IS LARGEST AMONG THE THREE. IN CONTRAST TO GIARDIA AND CRYPTOSPORIDIUM – ISOSPORA DOES NOT HAVE AN APICAL LOCATION, INSTEAD LOCATED IN THE TIP OF VILLI.

3. ISOSPORA BELLI

Oocysts are generally ovoid to ellipsoid in shape, range from 10-40µm in length by 10-30µm in width. Cysts are present in PARASITO-
PHOROUS VACUOLE. Does not have an apical location.

Look below for a quick summary

Posted in Molecular pathology

Tumors showing TRK (tropomyosin receptor kinase) gene fusion

Recent molecular studies have revealed that,  several tumors harbor TRK fusion. However fusion frequencies vary. 

Several NTRK1/2/3 (neurotrophic tyrosine receptor kinase) fusions have been reported. It is important to identify them since they serve as potential targets for therapy

The NTRK1, 2, and 3 genes encode a family of tyrosine kinase receptors with an active role
in neural development.

They are encoded by three different NTRK genes:

1. NTRK1 located on chromosome 1q21-q22 – corresponding receptor TrkA binds to NGF (nerve growth factor)

2. NTRK2 on chromosome 9q22.1- corresponding receptor TrkB binds to BDNF (brain derived natriuretic factor)

3. NTRK3 on chromosome 15q25- corresponding receptor TrkC.

NTRK oncogenic fusions can be encountered in two main different scenarios:

  1. Consists of rare tumors in which NTRK fusions are found at very high frequencies, as dominant oncogenes.
  2. Comprises common tumors in which NTRK fusions are identified at low frequencies, including both solid and hematological malignancies.

Here are a few tumors with high frequency TRK gene fusion – [ETV6-NTRK3 fusion]  – t(12;15)

1.Mammary analogue secretory carcinoma (MASC)- >75%-  Some MASC harbour ETV6- RET fusion -t(10;12)- They have poor outcome since they are non-responsive to TRK fusion therapy.

2.Secretory carcinoma of breast- >75%

3. Cellular and mixed mesoblastic nephroma (>75%)

4. Infantile fibrosarcoma. >75%

Other tumors with NTRK fusion  partners is shown below.

NTRK gene fusions in cancers.  Partners of NTRK1, NTRK2, and NTRK3 are stratified according to the cancer
type where they are most frequent. Reference: doi:10.3390/ijms21100000

Reference: Federica Zito Marino et.al. NTRK Fusions, from the Diagnostic Algorithm to Innovative Treatment in the Era of Precision Medicine. Int. J. Mol. Sci. 2020, 21, 0.

Click below for summary and a mnemonic.

Posted in Breast pathology, Histopathology

6 KEY POINTS FOR BOARDS – MICROPAPILLARY BREAST CARCINOMA

Micropapillary breast carcinoma is a rare variant.

Micropapillary carcinoma of breast has a few unique clinical, microscopic and immunological features which aid in their differentiation from other subtypes of breast carcinoma.

Let’s look at them!!

1. Tufts of cells arranged in pseudopapillae ( lack fibrovascular cores). These pseudopapillae are surrounded by empty clear spaces formed by fibrocollagenous stroma.

Micropapillary breast carcinoma- microscopy

2. Aggressive tumor usually present with angiolymphatic invasion. They present with nodal invasion at the time of presentation.


3. Molecular and cytogenetics: BC-1514 (C21orf118) is commonly upregulated in the micropapillary area.

4. ER positive in 90% and PR positive in 50%

5. Micropapillary breast carcinomas show

‘INSIDE OUT’ staining pattern with EMA and CD15s.

INSIDE OUT staining pattern refers to – staining localized to the apical surface of tumor cells abutting the stroma but absent staining in the basolateral region.

Staining pattern of EMA ( Epithelial membrane antigen) and CD 15s in micropapillary breast carcinoma.

6. Another characteristic of micropapillary breast carcinoma is Incomplete basolateral or CUP SHAPED staining with apical sparing seen with E- cadherin,  Her-2-neu and p-120.

‘Cup shaped’ staining with EMA – stained basolateral surface and apical sparing.

Below is a picture which will help you remember all characteristics of micropapillary breast carcinoma.