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Diseases of the Nervous System and Other Body Systems, Cheat Sheet of Laboratory Practices and Management

Ateneo de Manila University (ADMU)Laboratory Practices and Management

This comprehensive overview covers various diseases and lesions affecting the nervous system, head and neck, musculoskeletal system, and integumentary system. It details the morphological, histological, etiologic, clinical, and diagnostic characteristics of conditions like intracerebral hemorrhage, brain abscess, meningioma, squamous cell carcinoma, osteosarcoma, and malignant melanoma. This resource offers valuable insights into the pathogenesis, diagnosis, and management of these diverse medical conditions, serving as a valuable reference for healthcare professionals, medical students, and researchers.

Typology: Cheat Sheet

2023/2024

Uploaded on 05/22/2024

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Diseases of the Nervous System
Lesion Morphological/Histological Characteristics Notes
Intracerebral Hemorrhage
- Red cells in the subarachnoid
space
- Cuboidal to columnar cells lining
the ventricles
- Intracerebral hemorrhage caused
Blood confined to subarachnoid space
and ventricles
- Most likely a ruptured berry
aneurysm
Hemorrhage within the brain parenchyma
- No longer caused by JUST a
ruptured aneurysm
Middle meningeal vessel vessel
involvement: epidural
Bridging veins involvement: subdural
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Diseases of the Nervous System Lesion Morphological/Histological Characteristics Notes Intracerebral Hemorrhage

  • Red cells in the subarachnoid space
  • Cuboidal to columnar cells lining the ventricles
  • Intracerebral hemorrhage caused Blood confined to subarachnoid space and ventricles - Most likely a ruptured berry aneurysm Hemorrhage within the brain parenchyma - No longer caused by JUST a ruptured aneurysm Middle meningeal vessel vessel involvement: epidural Bridging veins involvement: subdural

by ruptured berry aneurysm Brain Abscess with Encephalitis

  • Localized purulent lesion within the subcapillary region - Ring enhancing lesion
  • What is seen on imagine is the granulation tissue along the wall of the tissue Most common etiologic agents: - Streptococcus - Staphylococcus

Psammoma Bodies Oligodendroglioma

  • Fried egg appearance
  • Chicken wire capillaries Adult type diffuse glioma of high grade: automatically WHO grade IV - Due to the presence of AMEN - A: Atypical cells - M: Mitosis - E: Endothelial proliferation - N: Necrosis IDH-1/IDH mutation - Production of 2-hydroxyglutarate instead of a-ketoglutarate Glioblastoma: IDH wild type WHO Grade IV diffuse astrocytoma: IDH mutant TERT promoter mutation Gain of whole-arm chromosome 7 Loss of whole-arm chromosome 10 EGFR mutation/amplification

Glioblastoma Multiforme Inset: immunostain for IDH-1 R132H

  • Positive for mutant protein, some of which surround the larger immunonegative cortical neurons (“perineuronal satellitosis”) AKA Grade IV astrocytoma Medulloblastoma Molecular Classifications: - WNT Mutated
  • Best prognosis - SHH Mutated
  • Desmoplastic/Nodular histology - Non-WNT/SHH
  • Large cell/Anaplastic histology
  • Intense inflammatory infiltrate with congestive vessels
  • Purulent exudates surrounding the cranial nerves Diseases of the HEENT Lesion Morphological/Histological Characteristics Notes

Chronic Tonsillitis

  • Can appear cerebriform on cut section
  • Similar to a lymph node (abundant in lymphocytes) microscopically
  • Germinal centers
  • Increased number of lymphoid Common VIRAL etiologic agents: - Rhinoviruses - Echoviruses - Adenoviruses Common BACTERIAL etiologic agents (secondary to viral): - Group A β-hemolytic streptococci - Staphylococcus aureus

**- Non-keratinizing SCC

  • HPV-associated**
  • Well-differentiated SCC showing keratin pearls

- Intercellular bridges Retinoblastoma

  • Nodular masses seen in the posterior retina Most common primary intraocular malignancy of children Germline mutation of one or both RB alleles
  • Well differentiated tumors: Flexner-Wintersteiner rosettes and Fleurettes
  • Undifferentiated tumor
    • Diffuse sheets
    • Trabecular and nesting formations
  • Hematoxyphilic deposits around blood vessels
  • Leukocoria or “Cat’s eye reflex” Pleomorphic Adenoma Most common benign tumor of the salivary gland PLAG1 overexpression

- Mesenchymal component - Loose myxoid tissue and hyaline tissue - Resembles cartilage without lacunae Warthin Tumor Parotid Males

  • 5th-7th decades of life Smokers
  • Double layer of oncocytic epithelial cells - Upper: palisading columnar - Lower: cuboidal - Germinal centers Diseases of the Musculoskeletal System
  • Pseudogout - Rhomboidal - Positively birefringent Intramuscular Hemangioma
  • Separation of muscle fibers
  • Intramuscular hemangioma with significant admixture of fat