The following are a few of the High Yield cases collected from virtual slides on www.PathPresenter.net. If you haven't yet discovered this AWESOME, FREE resource, GO CHECK IT OUT! I love that allows you to examine entities you may not otherwise get to see during your daily practice or at your training program. Let's not forget to mention the educational value!
During my studies, I have taken screenshots of some classic findings from these slides and organized them here for rapid fire/quick review. These are great to flip through prior to covering a service you haven't been on in a while, or as a quick refresher when trying to formulate a differential diagnosis.
I highly recommend you open the virtual slide (link provided) and review the case on your own prior to viewing the answer. The final diagnosis and classic "high yield histology" can be found below the final histologic image. I do plan on going through and adding labels to each picture one day (when I find time)... sigh...
CASE 44: View Virtual Slide
SYNOVIAL SARCOMA, MONOPHASIC
Monophasic or biphasic pattern
Spindle cell or epithelial cell component
Fascicles of cells
Staghorn like vessels
Translocation: SYT:SSX (X;18)
CASE 54: View Virtual Slide
Well circumscribed, unencapsulated lesion with a pushing border
Organized small, tightly packed acini separated by acellular stroma
Somewhat primitive glands/tubular appearance with a few "intraductal papilloma"-like areas
CASE 55: View Virtual Slide
Two major components: epithelial-like cells and fibrous stroma
Tubular networks of slit-like tubules or cords
Flat, cuboidal, or low columnar tubular cells
Round to oval nuclei and abundant dense cytoplasm
Cytoplasm may contain intracytoplasmic vacuoles
Fibrous, hyalinized stroma
Peripheral lymphoid aggregates
CASE 56: View Virtual Slide
CLEAR CELL RENAL CELL CARCINOMA
Alveolar nests and sheets of clear cells
Delicate "chicken wire" vascular network
Graded based on nuclear atypia & ability to see a nucleolus at low/high power (see separate post on how to grade RCC).
CASE 58: View Virtual Slide
HIGH: In the image below, notice the sclerotic glomerulus (left) compared to an intact residual glomerulus (right). There is markedly increased fibrosis and inflammation in the interstitium with atrophic, cystically dilated tubules.
ADULT POLYCYSTIC KIDNEY DISEASE
Autosomal Dominant Method of inheritance
Enlarged kidneys (gross)
Single, flat to cuboidal lining of cysts
Cysts contain proteinaceous material (can look like thyroid gland hence the term "thyroidization of the kidney" in ESRD)
Intervening kidney with interstitial fibrosis, tubular atrophy
Few intact glomeruli with many globally sclerotic glomeruli
Small papillary projections may be seen