ATHEROMATOUS PLAQUE IN CORONARY ARTERY

ACUTE MI

ACUTE RHEUMATIC ENDOCARDITIS

CHRONIC RHEUMATIC VALVULAR DISEASE

CHRONIC RHEUMATIC VALVULAR DISEASE mitral stenosis

INFECTIVE ENDOCARDITIS

COR PULMONALE

CHRONIC COR PULMONALE

HYPERTROPHIC CARDIOMYOPATHY

MICROCYTOSIS AND HYPOCHROMIA – IRON DEFICIENCY

MEGALOBLASTIC ANEMIA Oval macrocytosis indicates a problem with cell DNA replication. The developing red cell has difficulty in undergoing cell division but RNA continues to be translated and transcribed into protein leading to growth of the cytoplasm while the nucleus lags behind.

MEGALOBLASTIC ANEMIA

Hereditary spherocytosis Autosomal dominant inherited red cell membrane disorder caused by mutations in the genes that encode RBC membrane cytoskeleton proteins. Defective RBC's have problems with cellular proteins: spectrin and ankyrin. Spectrin deficiency leads to loss of erythrocyte surface area, which produces spherical RBCs. Spherocytes are cleared by the spleen more rapidly because their lack of deformability doesn’t let them squeeze through the spleen as easily.

MICROSPHEROCYTES

CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) WITH SMUDGE CELLS

CLL

REED-STERNBERG CELL - HODGKINS DISEASE

BURKITT’S LYMPHOMA The abdominal organs are the usual site for the American form of this tumor, although it frequently tends to affect the jaws and mouth in the African form. Burkitt lymphoma are associated with translocations of the c-myc gene on chromosome 8 to a site adjacent to the immunoglobulin heavy-chain locus on chromosome 14.

PERIAORTIC LYMPHADENOPATHY IN CLL

PUNCHED-OUT LESIONS IN MULTIPLE MYELOMA (X-RAY)

Agnogenic Myeloid Metaplasia Agnogenic myeloid metaplasia is characterized by splenomegaly, and progressive anemia with immature peripheral blood granulocytes and erythrocytes, and teardrop-shaped red cells. The bone marrow is often replaced by fibrous tissue and blood is made in organs such as the liver and the spleen (extramedullary hematopoiesis). Tear drop cells

AGNOGENIC MYELOID METAPLASIA (MYELOFIBROSIS WITH METAPLASIA) – TEARDROP CELL, NUCLEATED RED CELL, MYELOCYTE

Teardrop-shaped red cells

MICROANGIOPATHIC HEMOLYTIC ANEMIA

RBC Fragmentation Microangiopathic Anemias Schistocytes noted on the blood smear High shear stress leads to intravascular hemolysis –Microvascular disease DIC, TTP etc. –Heart valve –Trauma / implanted devices

Thrombotic Microangiopathies Group of disorders characterized morphologically by thrombosis in capillaries and arterioles throughout the body presenting clinically with microangiopathic hemolytic anemia, thrombocytopenia, and, sometimes, renal failure.

Fibrin stain showing platelet-fibrin thrombi (red) in glomerular capillaries characteristic of microangiopathic disorders.

Schwanoma compared to neurofibroma

Neurofibroma

Antoni A Antoni B Schwannoma Histologically characterized by dense (Antoni A) and loose (Antoni B) areas.

Acute Gout - Clinical toe

Gout, Tophus - Micro

polarized light use

Urate and pyrophosphate crystals

Diagnosis of gout Urate crystals in joint aspirate which are needle like, strongly negative birefringence under polarized light microscopy in inflammatory setting

Diagnosis of pseudogout CPPD crystals: blunted, rhomboid, weakly positive birefringence, light blue when parallel

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