CARCINOMA

BREAST(INVASIVE DUCTAL
CARCINOMA
MTI: Presence of tubular ducts lined by
cuboidal to columnar epithelial cells.
Two types of stroma:
•Dense eosinophilic interlobular stroma
•Loose intralobular stroma (just surrounding
the glands)
HPC:
1. Loss of normal architecture of glands and
stroma
2. Proliferation of glands and invasion of the
glands into the stroma(stromal invasion)
3. Multilayering of gland epithelium with loss
of polarity
4. Nucleus shows Hyperchromasia and
several mitosis with prominient nucleoli
5. Absence of Myoepithelial layer in the
glands
6. Presence of necrosis
SHWANNOMA
MTI: NERVE
It is a tumour in the nerve sheath,
develops in Schwann cells.
HPC:
a) Two areas:
i) Antony A- Hypercellular dense
areas, more spindle cells
ii) Antony B- hypocellular, pale,
less spindle cells
a) Verocay body: Pallisading rows
of nuclei with central anuclear
region
b) Found in Antony A area.
 
BHP
MTI: PROSTATE
Due to presence of Fibromuscular glandular
tissue, presence of glands and fibromuscular
stroma
HPC:
a) Presence of Corpora amylacea (presence
of Prostatic secretions) in concentric
lamellae.
b) Hyperplasia of epithelial lining of glands.
c) Fibromuscular stroma present in between
glands.
d) Cystically dilated glands lined with inner
columnar and outer cuboidal cells.
e)Chronic inflammatory cell infiltration.
 BLACK- BASAL CELL WHICH IS DENSER AND
HEAPPING OF EPITHELIAL CELL AND ELONGATED NUCLEUS PRESENT BELOW THE
PREOJECTING INSIDE THE LUMEN IN YELLOW EPITHELIUM BETWEEN EPITHELIAL CELL
AND BASEMENT MEMBRANE
CORPORA AMYLACEA- PROSTATTIC
SECRETIONS PRESENT IN CONCENTRIC
LAMELLI OFTEN CALCIFIED DURING COURSE HYPERPLASIA OF MUSCLE TISSUE IN BHP
OF TIME
HYADATIDIFORM MOLE
MTI: PLACENTA
Due to presence of chorionic villi and
trophoblastic cells.
HPC:
a) Presence of cisternae (vacuolated
spaces) in the central part of
chorionic villi.
b) Trophoblastic cell proliferation.
c) Absence of vasculature in stroma.
d) Enlarged edematous chorionic villi
with HYDROPIC DEGENERATION.
e)Scalopping (curving) of the border of
the chorionoc villi.
SCALOPING VILLI – MARGIN OF VILLI IS SPACE PRESENT IN VILLUS CALLED CISTERN(IN
UNDULATED (IRRGULAR)--FOUND IN COMPLETE MOLAR PREGNANCY
INCOMPLETE MOLAR PREGNANCY
LIVER CIRROHSIS
MTI: LIVER
Due to presence of hepatic lobules,
central veins and portal triads
HPC:
a) Loss of lobular architecture of liver.
b) Nodular appearance with
mononuclear cell proliferation.
c) Parenchyma divided into
Pseudolobules (with no central
vein).
d) Extensive fibrosis joining portal
triads with central vein.
e)Portosystemic collaterals and
vascular shunts.
NODULES AT HIGH POWER GREEN- LYMPHOCYTIC RED- HEPATIC ARTERY
INFILTRATION BLUE- PORTAL VEIN
BLUE- HEPATOCYTES GREEN- BILE DUCT
BLACK-BILOBED/BINUCLEAR BLACK-HEPATOCYTE WITH NO
HEPATOCYTES FATTY CHANGE
POC
MTI: PLACENTA
Due to presence of chorionic villi and
trophoblastic cells.
HPC:
a) Diluted congested sinusoidal vessels
b) Abundant fibrino-hemorhhagic material.
c) Chorionic villi with Inner Cytotrophoblast
and Outer Syncitiotrophoblast. (IC-OS)
d) Cytotropoblast: mononuclear cells with
centrally placed hypochromatic nuclei.
e) Vascular stroma with foetal blood.
f) Intravillous space with maternal blood.
 
EDEMATOUS APPEARANCE OF VILLI TROPHOBLASTIC LAYER OF VILLI
BLUE- SYNCYTIOTROPHOBLAST
GREEN- CYTOTROPHOBLAST
BRONCHIECTASIS
MTI: LUNGS
Due to presence of:
i. Alveoli, bronchi and bronchioles
ii. Presence of Hyaline cartilage
iii. Pseudo stratified ciliated columnar
epithelium
HPC:
a) Presence of Bronchial glands and Carbon
particles.
b) Dilated bronchi and bronchioles.
c) Shredding and ulceration of epithelium.
d) Dilated and congested blood vessels
e) Presence of both Acute (Neutrophils and
Macrophage) and Chronic inflammatory
cells (Lymphocyte, Histiocyte and Plasma
Cells).
BLUE- LINING EPITHELIUM(PSEUDO STRATIFIED CILIATED
RED- INFLAMMATORY CELLS
COLUMNAR EPI.)
BLUE- LINING EPITHELIUM
YELLOW-MUCOUS SECRETING GLANDS
YELLOW- ULCERATION OCCURS IN LINING
GREEN- CARTILAGE
PURPLE- SMOOTH MUSCLE LAYER EPITHELIUM
BLACK- CONGESTED BLOOD VESSELS
 BLUE- LINING EPITHELIUM
BLUE- LINING EPITHELIUM CARBON PARTICLE IN ALVEOLI
BLACK- ULCERATION PROCESS IS GOING ON
BLACK-FIBROSIS IN MUSCLE LAYER
BLACK- ONGOING ULCERATION PROCESS
YELLOW- MUCOUS SECRETING GLANDS
TB LYMPH NODE
MTI: LYMPH NODE
(due to presence of capsule,
pericapsular fat and subcapsular
sinus)
HPC:
a) Loss of lymph node architecture.
b) Epitheloid cell(modified
macrophages) granulation with
Caseous necrosis. (granuloma)
c) Langhan type of giant cells
present.
GRANULOMA IN TB LYMPH NODE CENTRAL CASSEOUS NECROSIS IN GRANULOMA
TB INTESTINE
MTI: INTESTINE
Due to presence of intestinal villi,
crypts, few remnants of Peyer’s
patches and the layers of GI tract
(Inner Circular and Outer
Longitudinal muscle layer).
HPC:
a) Granuloma in submucosa with
Caseous necrosis.
b) Ulceration of mucosa
c) Langhan type of giant cells,
epitheloid cells and lymphocytes
are present.
FATTY CHANGE IN LIVER
MTI: LIVER
(Due to the presence of hepatic lobules,
portal triads and central vein)
HPC:
a) Two types of fat accumulation: (i)
Microvesicular (ii) Macrovesicular
(nucleus pushed to periphery)
b) Lipid vacuoles coalesce to form
fatty cyst.
c) Polygonal shape of hepatocyte is
lost and rounding of cells occur.
d) Leakage of fat to stroma causes
lipogranuloma.
RED- MICROVASCULAR PATTERN OF RED-FAT CYST(HEPATOCYTIC FATTY RED-HEPATIC ARTERY
CHAIN FUSE TOGETHER TO FORM BLUE-PORTAL VEIN
FAT CELL
LARGE SPACES CONTAINING FAT GREEN-BILE DUCT LINED BY
GREEN- MICROVESICULAR PATTERN
FATTY CYST HAVE NO NUCLEII) CUBOIDAL EPITHELIUM
OF FAT CELL
OSTEOCHONDROM
A
MTI: BONE
Due to the presence of
osteoblast, osteoid and
osteoclast iin the field.
HPC:
a) Cap is of benign hyaline
cartilage with perichondrium.
b) The cartilage appears to be
disorganized growth plate
with endochondrial
ossification.
c) Ground glass appearance .
FIBROADENOMA OF BREAST
MTI: BREAST
Due to the presence of myxomatous stroma and
presence of ducts, lobules and glands lined by
columnar epithelium.
HPC:
a) Multiple lobules separated by collagenous
stroma.
b) Intralobular Myxoid stroma is present.
c) 2 types of proliferation:
i) Pericanalicular- Outside lumen, hence the
lumen is dilated
ii) Intracanalicuilar- Inside lumen, hence the
stroma compresses the ducts.
d) Interlobular stroma- dense, pink spindle
shaped cells.
e) 2 layers of epithelium present:
i) Cuboidal- secretory
ii) Myoepithelial- central nucleus, clear
cytoplasm
RED- LOBULES IN BREAST GREEN- CONSTRICTED GLANDS DUE TO
INTRALOBULAR STROMAL HYPERPLASIA
*COMPARE WITH RED*
 APOCRINE SNOUTS – APOCRINE
RED ARE INTERLOBULAR STROMA BLUE- DILATED DUCTS WITH
GREEN ARE INTRALOBULAR CHANGES IN THE EPITHELIAL
THEIR SECRETION
STROMA CELL CYTOPLASM IS RED- DILATED GLANDS WITH
PROJECTING OUTWARDS THEIR SECRETIONS
METASTATIC LYMPH
NODE
MTI: LYMPH NODE
Due to presence of Capsule and
Subcapsular Sinus.
HPC:
2 Types:
a) Adenocarcinoma: Cells in nest,
glandular form or papillary form
and Comedo necrosis (in
between glands).
b) Squamous Cell Carcinoma:
Polyhedral cell with abundant
cytoplast and keratin
production. Keratin Pearl may
be found.
ACUTE APPENDICITIS
MTI: APPENDIX
Due to the presence of all 4 layers of
GIT, and presence of simple columnar
epithelium with goblet cells and crypts,
but villi absent.
HPC:
a) Shredding of mucosa with fibropurulent
deposition in lumen.
b) Dilated and congested blood vessels in the
serosal layers.
c) Muscle fibres splitting due to edema,
causing infiltration of neutrophils into the
muscle layers.
GLANDULAR LYMPHOCYTES RED- LYMPHOCYTES
CELL IN LAMINA (ENLARGED) BLUE- MUSCULARIS
PROPRIA EXTERNA WITH
EDEMA AND
NEUTROPHILS
YELLOW- CONGESTED
BLOOD VESSELS
 INNER CIRCULAR AND OUTER LONGITUDNAL WITH
BLOOD CLUMPING IN LUMEN EDEMA AND NEUTROPHILS
RHINOSPORIDIOSIS
MTI- NASAL SEPTUM
Due to presence of pseudo-stratified ciliated
columnar epithelium and mucous glands
HPC:
a) Metaplasia of PSEUDO-STRATIFIED
COLUMNAR epithelium to STRATIFIED
SQUAMOUS epithelium.
b) Presence of sporangia at different stages of
development, with continuous Refractile
double layer chitinous wall.
c) Infiltration of sub-epithelial tissue with
numerous chronic inflammatory cells
(Leukocytes, Plasma Cells and Histiocytes).
d) Edematous sub-epithelial tissue.
e) Presence of dilated and congested blood
vessels.
A MATURE SPORANGIUM BLUE-LINING
RELEASING ITS CONTENT MATURE SPORANGIUM EPITHELIUM(PSEUDOSTRATIFIED)
HAVING THICK CHITINIOUS RED-ULCERATION IN LINING
WALLS EPITHELIUM
YELLOW-IMMATURE SPORANGIUM
BLACK-MATURE SPORANGIUM
GREEN-SPORANGIUM AFTER
RELEASING ITS CONTENT
 CHRONIC
CHOLECYSTITIS

MTI: GALL BLADDER

Due to the presence of folded mucosa
and tall columnar epithelium.
HPC:
a) In Mucosa: disrupted at times, also
marking the presence of
inflammatory cells.
b) Sub-mucosa: sub-mucosal fibrosis.
Exocrine proliferation of mucosa
leading to Rokitansky-Aschoff
Sinus.
c) Muscle Coat: edema occurs.
Presence of Chronic Inflammatory
cells.
d) Serous Coat: Dilated, congested
blood vessels with sub-serosal
fibrosis.
RED-BURIED CRYPTS IN LAMINA PROPRIA LINING EPITHELIUM- COLUMNAR
GREEN- CONGESTED DILATED BLOOD EPITHELIUM
VESSELS
BLUE- POLYPOID PROJECTION OF MUCOSA
BLUE- FIBROSIS IN SEROSA VARIOUS INFLAMMATORY CELLS IN MUSCEE LAYER
BLACK- THIN AND THICK WALLED BLOOD
VESSELS IN SEROSA
CAPILLARY HEMANGIOMA

MTI: SKIN
Due to the presence of dermal
appendages and stratified keratinized
squamous epithelium.
HPC:
a) Compact proliferation of capillary
sized blood vessels in the
underlying dermis.
b) Lobular appearance formed by
aggregation of capillaries.
c) Lobules separated by fibro-
connective stroma.
d) Areas of Ulceration present.
e) Capillary lined by Plump
Endothelial Cells.
 BLACK- CAPILLARY WITH
MOTHER TISSUE SKIN GREEN-LOBULAR PATTERN OF PLUMPED ENDOTHELIAL
RED- SEBACEOUS GLAND BLOOD VESSEL CELL
VIOLET-HAIR FOLLICLE BLACK- FIBROCOLLAGENOUS
BLUE-SWEAT GLAND STROMA/SEPTA
RENAL CELL CARCINOMA
MTI: KIDNEY
Due to the presence of glomeruli
and renal tubules.
HPC:
a) Large areas of ischaemic
necrosis and foci of
haemorrhagic discolouration.
b) Tumor cells arranged in cords
or trabeculae.
c) Large, round to polygonal cells
with pale abundant clear to
granular cytoplasm and
centrally placed small
vesicular nucleus.
d) High N:C ratio and mitosis.
e) Keratin Pearls present.
CAVERNOUS HEMANGIOMA
MTI: SKIN
Due to the presence of dermal appendages and
stratified keratinized squamous epithelium
HPC:
a) Large dilated/ Cavernous blood filled
spaces infiltrating into the subcutaneous
fat.
b) These blood filled spaces are lined by
flattened endothelial cells and filled with
RBCs.
c) Vascular spaces are separated by
edematous stroma.
d) Lumen: Thrombus appears homogenously
eosinophilic with entrapped WBCs.
e) Presence of Calcifiation and Chronic
inflammatory cells.
f) Adventitial fibrosis of blood vessels are
seen.
 YELLOW- FLATTENED
BLACK- LARGE VASCULAR THROMBOSED BLOOD VESSEL
ENDOTHELIAL CELL
SPACES GREEN- FIBROCOLLAGENEOUS
SEPTA/STROMA
PROLIFERATIVE
ENDOMENTRIUM
MTI: ENDOMETRIUM
Due to the presence of simple
columnar epithelium, endometrial
glands lined by simple columnar
epithelium and stroma.
HPC:
a) Endometrial glands present and
blood vessels present in stroma.
b) Round, regular, tubular, straight
endometrial glands lined by tall
columnar epithelium.
c) Telescopic arrangement of glands.
d) Compact Stroma composed of
Spindle shaped cells.
e) Increased mitotic activity, hence
aka FOLLICULAR PHASE
 REGULAR OVAL SHAPED GLANDS IN
GLANDS SHOWING COLUMNAR EPITHELIUM
PROLIFERATIVE ENDOMETRIUM
RED- SPIRAL ARTERIOLES
BLUE- DILATED AND TORTUOUS GLANDS RED- SPIRAL
BLUE - EOSINOPHILICSECRETIONS OF
ARTERIOLES
GLANDS
 SECRETORY
ENDOMETRIUM
MTI: Due to the presence of simple columnar epithelium,
endometrial glands lined by simple columnar epithelium and
stroma.
HPC:
EARLY SECRETORY PHASE
a) Tortuosity of blood vessels appear.
b) Stromal cells (present in between glands) become mildly
edematous.
c) Tortuous glands lined by columnar epithelium with
Subnuclear Vacuolation, giving rise to a serrated border
appearance.
 
LATE SECRETORY PHASE
a) Homogenous and eosinophilic secretions may be present.
b) Stroma:
i. Edematous
ii. Prominent spiral arteriole present.
iii. Predecidual changes: Hypertrophic Stromal cells with
eosinophilic cytoplasm
c) Infiltration of neutrophils and lymphocytes.
d)Secretions towards the lumen and nucleus comes down in the
cell.
 BLUE-LANGHANS CELL
GREEN- NECROSIS GREEN-FOREIGN BODY TYPE OF GIANT
YELLOW- EPITHELIOID CELL(SLIPPER LIKE)
CELL
SQUAMOUS PAPILLOMA
MTI: SKIN
Due to the presence of dermal appendages and
stratified keratinized squamous epithelium
HPC:
a) Proliferation of squamous epithelium upto
10 layers (normal: 3-5 layers)
b) Basement membrane is intact.
c) Acanthosis: Increased thickness of Stratum
corneum, diffuse epidermal hyperplasia.
d) Poikilocytic changes: Perinuclear clearing
e) Hyperkeratosis: Abnormal Keratinisation
with persistence of nuclei.
f) Papillomatous growth: Whole epidermis
thrown into papillary structures
SQUAMOUS CELL CARCINOMA
.
MTI: SKIN
Due to the presence of dermal
appendages and stratified keratinized
squamous epithelium
HPC:
a) Malignant features:
b) Lining epithelium is dysplastic.
c) Cellular and nuclear pleomorphism.
d) Nuclear hyperchromatia and
chromatin clumping.
e) Increased atypical mitosis.
f) Invasion into dermis by breaching into
basement membrane.
g) Presence of cell nests, sheets and
cords.
h) Presence of KERATIN PEARLS.
 PARAKERATOTIC PEARL
RED-MALIGNANT EPITHELIAL CELLS
BLUE-INFILTRATION OF INFLAMMATORY
CELL
 BASAL CELL
CARCINOMA
MTI: SKIN
Due to the presence of stratified squamous
epithelium and dermal appendages.
HPC:
a) Tumor cells following lobular pattern with
peripheral cells showing palisade appearance
in nuclei.
b) Tumor cells are present as solid masses, in
island, sheets and cord pattern.
c) Basaloid appearance of cells in periphery of
tumor cell nest.
d) Tumor cells are present with hyperchromatic
nucleus, moderate cytoplasm and
pleomorphism.
e) Retrartion Artefacts (clear area around cell
nests) separate the cell nests from the dermal
collagen
f) Edematous stroma.
TUMOUR NEST
 MALIGNANT
MELANOMA
MTI: SKIN
Due to the presence of dermal appendages and
stratified keratinized squamous epithelium
HP:
a) Malignant cells migrate downwards from
basal layers to below the epidermis.
b) Cells arranges in solid masses, sheets and
alveolar pattern.
c) Hyperchromatic nucleus with nuclear and
cytoplasmic pleomorphism.
d) 2 types of cells are seen: a) Spindle type-
Present in Fascicles b) Epitheloid Cells-
Present in nests
e) Scattered Giant Cells may be seen, along with
the increasd mitosis.
f) Extracellular and Intracellular melanin
deposition seen.
 
 COLLOID GOITRE
MTI: THYROID
Due to the presence of thyroid follicles
lined by simple cuboidal epithelium.
HPC:
i. Follicles of varying size filled with
eosinophilic homogenous material
are seen.
ii. 2 stages-
a.Hyperplastic: Tall columnar follicular
epithelium showing papillary infloding.
b.Colloid Involution: Large dilated follicles
distended with colloids and lined by
flattened follicular epithelium.
iii. Stoma appears to be congested
with areas of fibrosis
 GREEN- LOBULE IN
GREEN AND BLUE- MULTI NODULAR FIBBROUS BAND HYPERPLASTIC PHASE
GOITRE BLUE- LOBULE
RED- FIBROUS BAND INVOLUTION PHASE
 GREEN- INTACT BLOOD VESSEL
AREA OF HEMORRHAGE BLUE- BLOOD
YELLOW- PLASMA
PAPILLARY CARCINOMA OF
THYROID
MTI: THYROID
Due to the presence of thyroid follicles lined
by simple cuboidal epithelium.
HPC:
a) Varying sized follicles pushed to one side
and the other side is marked by presence
of finger-like projections or follicular
papillae in an arborosing pattern.
b) Complex branching papillae lined by
flattened/ cuboidal epithelium with
fibrovascular core.
c) Nuclei show ground glass/optically clear
appearance with overlapping and crowding
of nuclei.
d) ORPHAN ANNIE EYE APPEARANCE:
Open, fine and delicate chromatin with
nuclear clearing.
e) Presence of PSAMOMMA BODIES.
 PSAMOMA BODIES(DARK BLUE BLACK
FIBROVASCULAR CORE WITH GREEN-FIBROVASCULAR CORE IN COLOUR)(FOUND IN SEROUS
EMPTY LOOKING NUCLEUS RED- EMPTY LOOKING PAPILLARY CA.)(THESE ARE
APPEARANCE OF CONCENTRIC CALCIFIED WHORLS
NUCLEUS(ORPHAN ANNIE EYE FOUND IN CORE/
NUCLEUS) STROMA),DYSTROPHIC
CALCIFICATION
OSTEOCHONDROMA
MTI: SKIN
Due to the presence of dermal appendages and
stratified keratinized squamous epithelium
HP:
a) Malignant cells migrate downwards from
basal layers to below the epidermis.
b) Cells arranges in solid masses, sheets and
alveolar pattern.
c) Hyperchromatic nucleus with nuclear and
cytoplasmic pleomorphism.
d) 2 types of cells are seen: a) Spindle type-
Present in Fascicles b) Epitheloid Cells-
Present in nests
e) Scattered Giant Cells may be seen, along
with the increasd mitosis.
f) Extracellular and Intracellular melanin
deposition seen.
GREEN- CARTILAGINOUS CAP(MAJOR PART OF
TUMOUR PALE BLUISH IN COLOUR IDENTIFIED BY
CHONDROCYTES)
BLUE-BONY PART(EOSINOPHILIC AS Ca2+ IS
LOST )
OSTEOCYTES BLUE- BONY PART(OSTEOBLAST PRESENT AT PERIPHERY OF
BONE AND OSTEOCYTE REMAIN IN CENTRE)YELLOW- MARROW
SPACE(IDENTIFIED BY FAT CEL AND HEMATOPOETIC CEL LIKE
MEGAKARYOCYTE
OSTEOCLASTOMA
MTI: BONE
Due to the presence of trabeculae,
osteocytes, osteoids and bone marrow
vasculature.
HPC:
a) Presence of multinucleated osteoclast
type of giant cells
b) Uniform oval mononuclear cells.
c) Osteoclast type of giant cells, nuclei
resembling mononuclear cells.
d) Areas of hemorrhage is seen.
 BLUE- NUMEROUSLY UNIFORMLY ARRANGED
BLUE- HEMORRHAGIC LEHSION (NOT TO BE
OSTEOCLASTS LIKE GIANT CELLS
CONFUSED WITH CAVERNOUS HEMANGIOMA
RED- MONONUCLEARCELL/STROMAL CELL