Pathology set

OSPE

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Chronic suppurative otitis media

A long standing middle ear infection characterized by persistent hole in ear drum and discharge for at least 6 weeks.

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Jugular para-ganglioma of middle ear

M/P:

1.Classic nests called “zellballen”; the central cells are rounded with abundant eosinophilic granular cytoplasm.

2.Sustentacular cells are flat cells & present at the periphery of the nests.

3.Prominent fibrovascular stroma separates the nests.

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Retinoblastoma

M/P: The tumor is formed of undifferentiated retinal cells; that show characteristic rosettes which is of 2 types:

1.Flexner-Wintersteiner rosettes (around a lumen). in this picture.

2.Homer-Wright rosettes (around neuri-fibrillary structure).

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Keratitis

•Eye redness

•Excess tears or other discharge

•Difficulty opening eyelid because of pain or irritation

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Orbital rhabdomyosarcoma

N/E:

Rapidly progressive proptosis or rapidly enlarging orbital mass.

M/P:

The tumor cells have deeply esinophilic cytoplasm (sometimes with cytoplasmic striations), with hyperchromatic atypical nuclei and atypical mitosis.

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Cholesteatoma of middle ear

M/P:

Cyst filled with abundant keratin + cholesterol clefts + large number of histiocytes.

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Sebaceous carcinoma

N/E:

Localized or diffuse swelling of the tarsus.

M/P:

Tumor cells with sebaceous differentiation (cells with clear, foamy cytoplasm that resembles sebocytes).

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Conjunctivitis

•Eye redness

•A discharge that forms a crust during the night that may prevent eyes from opening in the morning.

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Cholesteatoma of middle ear

M/P:

Cyst filled with abundant keratin + cholesterol clefts + large number of histiocytes.

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Acoustic neuroma of inner ear

M/P: Typically show a biphasic appearance with: Antoni A and Antoni B areas. Antoni A Areas: hypercellular areas with the pathognomonic Verocay Bodies Antoni B Areas: hypocellular areas of loose meshwork of Schwann cells.

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Acute diffuse otitis externa

Most commonly due to bacterial or fungal infections after minor trauma to the ear

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Uveal malignant melanoma

N/E: Dom-shaped pigmented mass. M/P: The epithelioid variant  Larger irregular pleomorphic cells with larger nuclei and abundant acidophilic cytoplasm; that may contain melanin pigment.

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Orbital rhabdomyosarcoma

N/E:

Rapidly progressive proptosis or rapidly enlarging orbital mass.

M/P:

The tumor cells have deeply esinophilic cytoplasm (sometimes with cytoplasmic striations), with hyperchromatic atypical nuclei and atypical mitosis.

Identify?

Cerumen-gland adenocarcinoma

Atypical glands lined by several layers of atypical cells, show solid areas & invasive pattern.

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Sebaceous carcinoma

N/E:

Localized or diffuse swelling of the tarsus.

M/P:

Tumor cells with sebaceous differentiation (cells with clear, foamy cytoplasm that resembles sebocytes).

Identify?

Squamous cell carcinoma of the Conjunctiva and Cornea

N/E: Thickened well-demarcated leukoplakic lesion at the corneal limbus extending into the corneal center. M/P:

1.Replacement of the epithelium by atypical cells.

2.Mitoses are common.

3.Usually “insitu or intra-epithelial neoplasia”.

4.Occasionally invade deeper structures with central keratinization.

Identify?

Acoustic neuroma of inner ear

M/P: Typically show a biphasic appearance with: Antoni A and Antoni B areas. Antoni A Areas: hypercellular areas with the pathognomonic Verocay Bodies Antoni B Areas: hypocellular areas of loose meshwork of Schwann cells.

Identify?

Acute diffuse otitis externa

Most commonly due to bacterial or fungal infections after minor trauma to the ear

Identify?

Retinoblastoma

M/P: The tumor is formed of undifferentiated retinal cells; that show characteristic rosettes which is of 2 types:

1.Flexner-Wintersteiner rosettes (around a lumen).

2.Homer-Wright rosettes (around neuri-fibrillary structure). Shown n this picture

Identify?

Squamous cell carcinoma of the Conjunctiva and Cornea

N/E: Thickened well-demarcated leukoplakic lesion at the corneal limbus extending into the corneal center. M/P:

1.Replacement of the epithelium by atypical cells.

2.Mitoses are common.

3.Usually “insitu or intra-epithelial neoplasia”.

4.Occasionally invade deeper structures with central keratinization.

Identify?

Cerumen-gland adenoma

Composed of glands lined by 2 layers of cells;

-Inner luminal layer of cuboidal cells.

-Outer layer of myoepithelial cells.

Identify?

Jugular para-ganglioma of middle ear

M/P:

1.Classic nests called “zellballen”; the central cells are rounded with abundant eosinophilic granular cytoplasm.

2.Sustentacular cells are flat cells & present at the periphery of the nests.

3.Prominent fibrovascular stroma separates the nests.

Identify?

Uveal malignant melanoma
N/E: Dom-shaped pigmented mass. M/P: The epithelioid variant  Larger irregular pleomorphic cells with larger nuclei and abundant acidophilic cytoplasm; that may contain melanin pigment.