Histopathological Patterns

Patterns and architectures in subject Histopathology are made easy to understand in this PPT

1. Patterns in Histopathology Dr. Sobia Khalid M.Phil. Histopathology

2. LEARNING OBJECTIVES By the end of this session you should be able to differentiate between most of the patterns in histopathology. HOPEFULLY !!!!

3. WHAT IS TRABECULAE ? A small supporting beam or bar. Any of the supporting strands of connective tissue projecting into an organ and constituting part of the framework of that organ. Any of the fine spicules forming a network in cancellous bone.

4. TRABECULAR PATTERN In cord-like arrays separated by fibrous septa in Long nests and cords of cell groups • Two cell-thick ( microtrabecular pattern) • Eight to Ten cell-thick ( macrotrabecular pattern) • Cells arranged perpendicular to the longest axis .

5. E XAMPLES

6. WHAT IS A SYNCYTIUM? A multinucleate mass of cytoplasm resulting from fusion of cells.

7. SYNCYTIAL PATTERN • Having cytoplasmic continuity between the constituent cells. • Looks like a collection of nuclei without recognizable borders.

8. Medullary CA Breast

9. Meningothelial Meningioma

10. WHAT IS ALVEOLUS? • A small cavity or pit • A socket in the jaw for a tooth • A small air-containing compartment of the lungs in which the bronchioles terminate and from which respiratory gases are exchanged with the pulmonary capillaries • An acinus of a compound gland • A cell of a honeycomb

11. ALVEOLAR PATTERN • Tumor cells grow in nests or clusters separated by fibrous septa • In little sacs or nests or nested structure

12. Invasive Lobular Carcinoma Breast

13. Alveolar Soft Part Sarcoma

14. Alveolar R habdomyosarcoma

15. WHAT IS HERRING? • Name given to a type of fish found in the shallow waters of north pacific and north atlantic .

16. HERRING BONE • The Herring Bone is nothing but the name given to the skeleton of the Herring fish • Arrangement in columns of short parallel lines with all the lines in one column sloping one way and lines in adjacent columns sloping the other way. • Shows bundles intersecting in a zig-zag array

17. Fibrosarcoma

18. Fibrosarcoma

19. WHAT IS STORIFORM? • Having an irregularly whorled pattern somewhat like that of a straw mat . • Having a cartwheel pattern, such as spindle cells having elongated nuclei radiating from a center .

20. STORIFORM PATTERN • Cartwheel pattern - spindle cells with elongated nuclei radiating from a center point • Cellular spindled lesion with whorls as opposed to parallel fascicles or right angle bundles.

21. Pinwheels

22. Malignant Fibrous Histiocytoma

23. Dermatofibrosarcoma protuberans

24. WHAT IS A FASCICLE? • A section of a book or set of books being published in installments as separate pamphlets or volumes.

25. FASICULAR PATTERN • A small bundle, tight cluster, or the like. • A close cluster, as of flowers or leaves. • A small bundle of nerve or muscle fibers. Bundles of elongated spindly cells streaming in polarized arrays

26. GLANDULAR PATTERN • Forming gland structures with lumens having polarized cells radiating around a lumen.

27. Glandular Pattern

28. WHAT IS CRIBRIFORM? • Sieve-like; containing many perforations. • Describing a structure with many perforations or punctures, as in the cribriform plate of the ethmoid bone. • Descriptive term referring to a sieve- like histologic pattern, in which sheets of epithelial cells are punctuated by gland-like spaces .

29. Cribriform Pattern

30. Adenoid Cystic Carcinoma

31. WHAT IS TUBULE? • A minute tube, especially as an anatomical structure.

32. TUBULAR PATTERN • Crowded small round tubules lined by single to multiple layers of cuboidal to low columnar cells

33. WHAT IS PAPPILAE? • Any small, nipple like process or projection. • One of certain small protuberances concerned with the senses of touch , taste , and smell: the papillae of the tongue. • A small vascular process at the root of a hair.

34. PAPILLARY PATTERN • Complex , branching, and randomly oriented, with a central fibrovascular core and a single or stratified lining .

35. Papillary Carcinoma Thyroid

36. Clear Cell Papillary Renal Cell Carcinoma

37. WHAT IS MICROPAPILLARY? • Papillary-shaped epithelial projections without true fibrovascular cores • Medusa-head appearance

38. Serous borderline tumor Ovary

39. WHAT IS INDIAN FILE? • A line of persons or things arranged one behind the other. • In a line: to walk single file INDIAN FILE PATTERN • Cells in a single line one after the other

40. ILC

41. WHAT IS HOBNAIL PATTERN? • Resembling a large headed nail used for shoes • Epithelial or endothelial cells round up and protrude into the lumen as little bumps.

42. C lear C ell C arcinomas of O vary

43. WHAT IS ROSSETTE? A n ornament usually made of material gathered or pleated so as to resemble a rose and worn as a badge of office, as evidence of having won a decoration (as the Medal of Honor), or as trimming A disk of foliage or a floral design usually in relief used as a decorative motif A cluster of leaves in crowded circles or spirals arising basally from a crown (as in the dandelion) or apically from an axis with greatly shortened internodes (as in many tropical palms) Rose windows found in gothic cathedrals

44. ROSSETTE IN PATHOLOGY A rosette is halo or "spoke-wheel" arrangement of cells around a central structure (which can be a lumen or cytoplasmic processes ) In pathology, rosette refers to aa  halo or “spoke-wheel” arrangement of cells around a central structure especially in neoplasms of neuroblastic or neuroectoderma origin. The central structure can be :

45. a . Empty lumen:  True ependymal rosette Well differentiated ependymomas (minority of cases) Ependymoblastoma (rare form of PNET) b. Meshwork of fibers ( Neuropil ):  Homer-Wright rosette Remember:  It is Neuropil and not neutrophil. Neuropil refers to primitive neuronal processes or neurites . Medulloblastoma Supratentorial PNETs Pineoblastoma Retinoblastoma

46. c. Cytoplasmic extensions of encircling tumor cells:  Flexner- Wintersteiner rosette Retinoblastoma Pineoblastoma Medulloepithelioma Fleurettes :  This refers to tumor cell’s attempt for photoreceptor differentiation. d. Blood vessel:  Perivascular pseudorosette This is pseudorosette because the central structure is not actually formed by the tumor itself, but instead represents an arrangement of cells around native, non-neoplastic element. Medulloblastoma PNETs Central neurocytoma Pilomyxoid astrocytoma Glomeruloid bodies are like pseudovascular rosette. They are seen in: Glioblastoma multiforme Schiller-Duval bodies of Endodermal sinus – Yolk sac tumor. e. Irregular large lumen with neuropil (similar to Homer-Wright rosette):   Neurocytic rosette

47. Carcinoid Tumor

48. Granulosa cell tumor

49. Neuroblastoma

50. MICROCYSTIC PATTERN • C onsisting of a loose network of cystic spaces lined by flattened epithelial cells Resembling a network or net-like array • Microcystic or honeycomb appearance

51. Yolk Sac Tumor : Microcystic Pattern

52. secretory carcinoma of the parotid

53. WHAT IS A FOLLICLE? A small bodily cavity or sac. A crypt or minute cul -de- sac or lacuna, such as the depression in the skin from which the hair emerges. An ovarian follicle. A spherical mass of cells usually containing a cavity. Botany A dry, single chambered fruit that splits along only one seam to release its seeds, as inlarkspur and milkweed .

54. FCT

55. STAGHORN PATTERN HEMAGIOPERICYTOMA Sheets of cell Starry sky BURKKITS LYMPHOMA

56. Hemangiopericytoma in the nasolabial fold

57. REFERENCES Rosai and Ackerman surgical pathology 10th edition www.pathologyoutlines.com www.pathpedia.com